Q: Does hormonal birth control have consequences for mental health?

Mental Health Reproductive Health

A: It’s possible but unlikely for most people.

Hormonal forms of birth control, such as the pill, patch, ring, shot, and some types of IUD, can occasionally cause mood side effects. This makes sense, as there are receptors for these hormones in brain cells. It appears that for most people, any mood symptoms that occur are short-lived and mild, but in rare cases people do report significant changes.

There are two things to keep in mind here: 1) this question is hard to study, and 2) your risk may depend on who you are and what form of birth control you use. This is a difficult question to study because it is difficult to find a suitable control group, and people would have to be followed for at least 6 months to a year.

There’s another added twist here: unintended pregnancies and planned pregnancies both can trigger bouts of depression, and postpartum depression is also a major mental health concern. There’s a real mental health benefit to effective family planning.

For those who are affected, it looks like feeling depressed or emotionally unwell on hormonal birth control may be more common among teenagers and with the ring, patch, and IUD as opposed to pills. A 2018 Swedish study found increased use of psychiatric drugs among teenagers on hormonal contraception but not among adult women. It is difficult to assign causality based on this study, since it could also be that teenagers who take psychiatric medications are more likely to seek prescriptions for birth control. Another study of 1 million women in Denmark found a similar age differential. It’s still unclear whether age matters, but scientists think it may have some effect. Those who already have a well-managed psychiatric diagnosis don’t appear to have more mood symptoms with hormonal contraception than those without a pre-existing diagnosis.

All this being said, studies do find reports of mood side effects from both IUDs and oral contraceptives. Even though a very low number of people report these effects, it is essential for doctors to be aware of this and not dismiss patients who report these feelings.

In addition, the highest rates of mental illness are in people in their prime reproductive years (18-25), many of whom are likely to use various forms of birth control. Psychiatrists need to have a strong understanding of how birth control interacts with these mental health issues.

At the end of the day, people should pay attention to how they feel. If you have concerns, let your doctor know immediately. Even if the scientific evidence doesn’t clearly suggest this emotional effect for large numbers of people, if you’re not feeling well, never keep it to yourself.

Resources for further learning:

Can hormonal birth control trigger depression?

How Hormonal Birth Control Can Affect Your Mood

No, your birth control won’t cause depression

Why Birth Control Side Effects Have Eluded Science

Do Birth Control Pills Affect Your Mood? Scientists Can’t Agree

Association of Hormonal Contraception With Depression

Does Some Birth Control Raise Depression Risk? That’s Complicated

Intrauterine contraception in nulliparous women: a prospective survey

Hormonal contraception increases the risk of psychotropic drug use in adolescent girls but not in adults: A pharmacoepidemiological study on 800 000 Swedish women

Contraception for Women With Psychiatric Disorders

Association of Hormonal Contraception With Depression

Link to Original FB Post