"as far as birth control goes, well i&#039;m not pregnant yet (and i don&#039;t use alternate protection) so i&#039;d say it works well in that aspect so i gave it a 6. however, i have had severe nausea, headaches (on the verge of migraines), and slight bloating. i have also been seriously tired all the time, i fall asleep all the time, anywhere, anytime, without control. i never had a problem staying awake for even a couple days without sleep until i started taking apri. "