Could Your Birth Control Be Causing Depression?

Hormonal birth control is a widely used method for preventing pregnancy, but its effects on mental health, particularly depression, have sparked ongoing debate. While some studies suggest a potential link between hormonal contraceptives and mood disorders, the risk remains low for most women. Understanding these risks and consulting with a healthcare provider can help individuals make informed decisions about their contraceptive options.

Does Birth Control Cause Depression?

Birth control may cause depression in some women. A high-quality Danish study of over 1 million women between the ages of 15 and 34 suggests that all forms of hormonal contraception are associated with an increased risk of mood disorders, like depression, across age groups. The risk is especially high with non-oral forms of hormonal birth control (patch, ring, and intrauterine device or IUD). 

But while there is an increased risk of depression with hormonal birth control, the number of women affected is small. The study showed that 2.2% of women reported being depressed on hormonal contraceptives. In comparison, 1.7% of women in the control group reported depression (those who were not taking oral contraceptive pills or other types of hormonal contraception). 

Because only a small number of women report feeling depressed on hormonal contraception, experts do not recommend avoiding the use of this form of birth control to lower the risk of mood symptoms or depressive disorders in sexually active women of childbearing age. 

Learn about 8 Hormone-Free Birth Control Options.

The Link Between Hormonal Contraception and Depression

Researchers in women’s health have studied potential links between the use of hormonal contraceptives and negative mood changes. The results are mixed, with some studies showing that hormonal contraception increases the incidence of depression and others showing no effect or improvement in depression symptoms. Future research in women’s mental health is needed to find out if women taking hormonal contraception develop depression and the brain regions implicated in birth control and moodiness.

What Types of Birth Control Are Hormonal?

There are various types of hormonal contraceptives, including:

• Traditional combined hormonal contraception (pills containing two hormones - estrogen and progestin), for example, Alesse, Ortho Tri-Cyclen, Nordette, and Velivet.

• Newer oral contraceptive pills with lower estrogen content, for example, Lo Loestrin Fe, Ortho Novum, Lo Ovral, Yasmin, Yaz.

• Extended cycle or continuous dose pills, for example, Lybrel, Seasonale, and Seasonique.

• Progestogen-only contraception (mini-pill), for example, Jolivette, Heather, Errin.

• Depot medroxyprogesterone acetate (DMPA) contraceptive injection (progestin-only birth control method), brand name Depo-Provera. 

• Transdermal contraceptive patch, for example, Xulane, and Twirla.

• Contraceptive vaginal ring, for example, NuvaRing, EluRyng, and Annovera.

• Intrauterine device (IUD), for example, Mirena, Kyleena, Skyla, and Liletta.

How Does Hormonal Birth Control Work?

Hormonal birth control helps to prevent pregnancy through various effects on the reproductive organs, including:

• Preventing ovulation (stopping the egg from being released from the ovaries each month).

• Thickening the lining of the cervix (the neck of the uterus), making it harder for sperm to come through.

• Making the lining of the uterus thinner and decreasing the chances of implantation of a fertilized egg.

Findings of Scientific Studies

The following studies examine the potential link between hormonal contraceptives and depression, offering varying perspectives on the topic. These studies include a comprehensive review of past research, a large cohort study from Denmark, and a population-based study from the UK Biobank.

Study #1

A comprehensive MEDLINE review of studies over the last 30 years did not find that the use of combined oral contraceptives increases depression risk. However, due to inconsistent research methods and the absence of a uniform assessment, the authors highlighted the need for more prospective data to understand the relationship between specific types of combined hormonal contraception and negative mood effects.   

Note: Prospective studies involve following participants over time to gather data about specific outcomes (such as depression and other negative mood effects while being on birth control). This means that data collection begins in the present and continues into the future.

Study #2

One nationwide prospective cohort study in Denmark that looked at more than 1 million women of reproductive age found that hormonal contraceptives are linked to developing depression and using antidepressants. However, the number of women affected was small. When looking at the first use of antidepressants, the rate was 2.2% for women using hormonal contraception compared to 1.7% for those not using it. 

Besides the initial use of antidepressants, the other outcome measured in this study was the first diagnosis of depression at a psychiatric hospital. The incidence rate was found to be 0.3% for users of hormonal contraceptives, compared to 0.28% for nonusers. 

As mentioned, while the use of hormonal birth control was associated with subsequent antidepressant use and first depression diagnosis at a psychiatric hospital, the incidence rates were relatively low. 

Interestingly, this study also showed that adolescents (aged 15 to 19) were at a higher risk for these adverse outcomes than women aged 20 to 34.  

Study #3

A population-based cohort study of more than 264,000 women from the UK Biobank showed that there was a greater propensity for depression and mood disorders in the first 2 years of oral contraceptive pills use compared to never users.

Women who have discontinued the use of birth control pills may still be at risk for depression, especially if they had used these pills during their adolescent years. This suggests that taking oral birth control during adolescence could potentially increase the risk of developing depression later in life.

The study findings highlight the necessity of assessing the risks and benefits of oral birth control on an individual basis.

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Risk Factors For Depression

Anyone can experience depression, regardless of age, gender, ethnicity, or socioeconomic background. But people with a family history of depression, those who have gone through significant life stressors, people with certain personality traits like low self-esteem, and women are considered more susceptible to developing depression. 

What Are Typical Depressive Symptoms?

Psychological signs and symptoms of depression include:

• Persistent low mood 

• Feelings of sadness, hopelessness, worthlessness, or helplessness

• Low self-esteem

• Feelings of guilt

• Mood changes, including anger, irritability, or frustration

• Lack of interest or motivation in things

• Difficulty remembering things, concentrating, and making decisions

• Suicidal thoughts or attempts

Physical symptoms of depression include:

• Changes in appetite or weight

• Tiredness

• Lack of energy

• Sleep disturbances

• Unexplained aches and pains

• Low sex drive

Behavioral symptoms of depression include:

• Social withdrawal (avoiding social contact with friends and family members) 

• Lack of interest in hobbies

Other Common Hormonal Birth Control Side Effects

Commonly reported side effects of hormonal contraception include headaches, mood swings, weight gain, breast tenderness, and acne. More serious risks include an increased risk of blood clots and breast cancer. Find out: What Are The Best Birth Control Pills For Acne?

Selecting The Right Contraceptive Method

Managing Mood Changes and Side Effects

Most side effects of hormonal contraception get better once your body adjusts to them. Many women find that oral contraceptives reduce the symptoms of premenstrual syndrome and premenstrual dysphoric disorder (emotional and cognitive processing symptoms that occur before menstruation). Therefore, if you experience negative mood changes on hormonal contraception, give your body some time to adjust. If the mood swings or depression continue, talk to your doctor about alternative methods of birth control.

Which Birth Control Is Most Likely To Cause Depression?

Current research suggests that older oral contraceptive pills, which contain ethinylestradiol, were linked to more severe mood problems. In contrast, newer oral contraceptive pills that contain physiological forms of oestrogen are better tolerated with a lower incidence of mood changes.

The type of hormonal contraception can also make a difference. Some studies have suggested that non-oral forms, especially intrauterine devices (IUDs), are the most likely to cause depressive symptoms. Find out more IUD side effects.

What Is The Best Contraceptive Pill For Anxiety and Depression?

The link between birth control and depression is not well understood. Some women find that combined oral contraceptive pills ease anxiety and depression. Others say they developed depression after starting the use of hormonal contraception.

If you want to try a contraceptive pill for anxiety and depression, talk to your healthcare provider for treatment options. The U.S. Food and Drug Administration (FDA) has approved a low-dose oral contraceptive pill called Yaz for the treatment of premenstrual dysphoric disorder (PMDD). Yaz has been found to improve mood, daily functioning, and overall quality of life in people with PMDD, a condition that causes depressed mood, anxiety, and mood swings before menstruation.

When To Talk To Your Doctor

If you develop persistent mood changes after starting hormonal contraceptives, talk to your healthcare provider. Switching to a different type of contraception may provide relief. For example, some studies suggest that IUDs are linked to depression more than other forms of hormonal contraception. So, for example, if you develop severe depression with an IUD, switching to a contraceptive shot or continuous dose oral contraceptives may work better. Remember, each person is different, and your experience may not be the same as someone you know.

Severe Depression Symptoms

If you have thoughts of suicide or self-harm, seek immediate care by calling the 988 Suicide and Crisis Lifeline in the US.

Expert and Anecdotal Reports

Insights From Healthcare Professionals

Based on current research findings, healthcare professionals do not recommend stopping or avoiding the use of hormonal birth control due to a potential increased risk of depression. However, it is important to discuss these potential side effects with the prescribing provider. This way, you can be vigilant for any changes in your mood and seek timely care if you develop depression. 

Learn about Over-the-Counter Birth Control Pill Now Backed by FDA.

Personal Experiences and Testimonials

Here are some anecdotal reports about depression on hormonal contraception:

Jenny, 28: “After giving birth to my daughter, I was off birth control for 12 weeks and was doing fine. When I got back on the pill (I had previously been on it for 10 years, from age 16 to 26), I developed depression within a couple of months. I had to get back on antidepressants. My PCP and I both thought it was postpartum depression. But then my OB/GYN suggested I switch from the pill to an IUD. I immediately felt so much better. While there are still days when I’m not mentally 100%, my depression is manageable, and I’m not spiraling as often. I can’t believe I spent a decade of my life on the pill, suffering from depression, not knowing the cause.” 

Martha, 35: “I started taking oral contraceptives in my early 20s, and this coincided with the time I went into a depression. Almost a decade later, my doctor recommended getting off contraceptives for a different medical reason. What do you know? My depression goes away! It’s been two years now off the pill, and I feel so much like myself again. I thought oral contraceptives were a blessing, but now I realize we need better women’s health and counseling.”

FAQ on Hormonal Contraception and Depression

Can Birth Control Make You Depressed?

Hormonal birth control can make some women depressed. However, a systematic review of studies shows mixed results. Women who are at risk of mood disorders should discuss the pros and cons of hormonal contraception with their clinician. Depression can affect every aspect of daily life, so it’s important to seek timely care for a proper diagnosis and treatment. Find out what medications can cause depression.

Can Birth Control Make You Lose Feelings For Someone?

According to research, using hormonal birth control, particularly when initially choosing a partner, can potentially lead to feeling less attracted to them and being less sexually satisfied in the relationship. This is believed to be due to changes in natural hormone levels which influence attraction and relationship satisfaction. However, this isn't a universal experience and depends on individual factors and the type of birth control used. 

Is It Healthier To Be Off Birth Control?

Whether it's “healthier to be off birth control” depends on your specific health situation. For most people, there's no inherent medical reason to stop using birth control if it's working well for them. However, some people may feel healthier off birth control due to a return to their natural menstrual cycle or relief from side effects. Always consult a doctor before making any changes to your birth control method. 

Does Birth Control Make You Emotional?

There is evidence to suggest that both estrogen and progesterone (hormones found in birth control pills) can influence brain function. Therefore, it is possible that hormonal contraceptive use can make you emotional or result in other negative mood changes and depression. You should discuss these potential risks with the prescribing clinician if mental health issues are a concern for you.

Can Birth Control Cause Mood Swings?

Yes, mood swings are a commonly reported side effect of hormonal birth control.