How Does Hormonal Birth Control Affect Mood and Mental Health?
Many people get mixed information about hormonal birth control and mood. Some people claim they felt depressed while taking hormonal birth control. Others say they started taking hormonal birth control to manage symptoms of PMS-related depression.
Hormonal birth control and depression have a complex relationship. In some cases, people taking hormonal birth control have developed depression – but that doesn’t necessarily mean you should stop taking it.
Read on for more information about how hormonal birth control can affect your mood and what your options are.
What is hormonal birth control?
Birth control is any method or treatment that prevents pregnancy. For example, condoms are one of the most common types of birth control.
When we talk about hormonal birth control, we refer to any type of birth control method that prevents pregnancy by affecting female hormones.
Some examples of hormonal birth control include[1]:
- Birth control pills (Oral contraceptives)
- Birth control patch
- Birth control injection (Depo-Provera)
- Birth control implant (Nexplanon)
- Vaginal ring (NuvaRing)
- Intrauterine device (IUD)
- Hormonal intrauterine system (IUS) (e.g., Mirena, Skyla, Liletta)
- Combination hormonal contraceptive sponge
Hormonal birth control works by releasing synthetic hormones, typically estrogen and progestin, into the body. These hormones affect the natural hormonal fluctuations that drive the menstrual cycle, which prevents ovulation and alters the cervical mucus to create a less hospitable environment for sperm.
Avoiding pregnancy isn’t the only reason why someone may take hormonal birth control.
Other reasons include:
- Regulating menstrual cycles
- Reducing menstrual cramps and pain
- Managing heavy or irregular periods
- Treating endometriosis and polycystic ovary syndrome (PCOS)
- Clearing acne and improving skin
- Easing premenstrual syndrome (PMS) symptoms
- Providing relief from menstrual migraines
- Lowering the risk of certain cancers
- Controlling hormonal imbalances
How hormones affect mental health
You might have heard someone complain they’re feeling “hormonal.” They likely stated this when they were pregnant or on their period and used the phrase to describe feeling moody. Although this is a cliche, it does have scientific truth to it.
Hormones are the body’s chemical messengers. We have many types of hormones, many of which are critical to mental health and mood regulation[2].
These molecules, produced by various glands in the endocrine system, circulate in our bloodstream and influence how we feel and behave.
One of the main hormones associated with mood is serotonin, often called the “feel-good” neurotransmitter. Serotonin plays a vital role in managing feelings of happiness and well-being.
Another essential hormone related to mood is cortisol, often termed the “stress hormone.” Cortisol is released in response to stress and helps the body cope with overwhelming situations. However, people who have chronically high cortisol levels can develop depression and anxiety.
Estrogen and progesterone, primarily known for their menstrual cycle and reproduction roles, can also impact your mood. Fluctuations in these hormones during the menstrual cycle can cause mood swings, irritability, and, in some cases, worsen pre-existing mood disorders.
Maintaining a healthy hormonal balance is essential for stable mood and emotional health. When this balance is disrupted, it can lead to mood swings, depressive symptoms, or even mental health conditions.
The link between hormonal birth control and depression
Studies on the link between hormonal birth control and depression have had mixed results. However, there is some evidence suggesting that taking hormonal birth control may heighten the risk of depression for some people.
One of the most significant studies conducted was a Denmark-based study; because Denmark has access to all citizens’ health records, the researchers were able to measure the effects of hormonal birth control on all healthy, non-depressed women between the ages of 15 and 34.
They found, when looking at these women’s health records 14 years later, that the women taking hormonal birth control were up to 50% more likely to have developed depression than the women who didn’t take hormonal birth control[3].
However, other researchers aren’t so sure about the link.
Some experts point out that the effect shown in this study was significant but small. On average, 2.2 women who took hormonal birth control had developed depression, compared to 1.7 women who did not take hormonal birth control[4].
Although this is statistically significant, it means relatively few people will experience this side effect of hormonal birth control.
Other studies have found the link between hormonal birth control and depression is more complicated than it may look on the surface. For example, one review of 7 small randomized controlled trials concluded the mood-related side effects of hormonal birth control were due to psychological responses to taking birth control, not the birth control itself[5].
Overall, we need more research to be able to say for sure whether hormonal birth control can lead to depression in a small percentage of women. Overall, hormonal birth control is considered a safe and effective pregnancy control method.
Will going on birth control make my depression worse?
If you already live with depression, you may worry hormonal birth control will make your symptoms worse.
There’s good news: No evidence has been shown so far that hormonal birth control makes pre-existing depression worse. The World Health Organization has no restrictions on taking hormonal birth control for people with depression[6].
It’s still important to talk to your medical provider about any symptoms of depression you’re having so they can give you the best treatment options.
Can birth control make your mental health better?
Conversely, some people report hormonal birth control has improved their mental health. For example, premenstrual dysphoric disorder (PMDD) causes people to have significant depression symptoms before or during their period. Hormonal birth control is often used to help people find relief from PMDD symptoms. Even for people without PMDD, the hormonal changes that come with taking birth control can sometimes help with depression.
There are also indirect effects to consider. For example, most people take hormonal birth control for its intended purpose – to avoid pregnancy. Going off birth control and having an unwanted pregnancy is likely to increase your risk of developing depression, including postpartum depression. Research shows mothers with unplanned pregnancies are more likely to have postpartum depression.
Hormonal birth control may also be helping you manage the symptoms of another health condition, like acne or endometriosis. If you stop birth control and these symptoms come back, you could feel more depressed.
