Is There a Link Between Birth Control and Emotions?

Women have complained about mood-related changes like depression and anxiety ever since the pill came out in 1960. The newest generation of pills have lower doses of hormones. Even so, a sizeable number of women still quit the pill because of side effects.

During a typical 28-day menstrual cycle, estrogen levels reach their peak around day 14. That’s when many women feel best emotionally and physically. Most hormonal contraceptives smooth this mountain-shaped hormonal cycle into an even line for the first 21 days. Then the levels of estrogen and progestin plunge during the final 7 days.

Limited research suggests that compared with women who don’t use hormonal birth control, those who do are more likely report feeling depressed, anxious, and angry. But those symptoms don’t make the list of common side effects. Other studies have turned up no significant link between hormone combinations or concentrations and differences in mood. Still more research has found that women on the pill and those taking dummy pills report similar symptoms, suggesting that any effects they noticed were unrelated to the actual pills.

Popping the pill: Severe mental health side effects of contraceptive pill revealed in new BBC documentary

The contraceptive pill has been sparking controversies since it became available in the UK in 1961.

Despite research linking it to everything from breast cancer and blood clots to low libido and weight gain, it remains the most popular form of contraception for women today and is taken by more than 100 million women worldwide.

But countless studies have identified strong links between taking the pill and poor mental health, and a new BBC Two documentary sheds light on the severity of the problem, revealing how it’s left some women suffering from depression and experiencing suicidal thoughts.

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The hormone in the pill that has been linked to prompting psychiatric complications is called progesterone, which is found in both the combined pill and the mini pill.

Studies have linked the hormone to depression, anxiety and low mood, but researchers have yet to find an ethical way to prove cause and effect because this would involve distributing placebo pills to study subjects, which could lead to unwanted pregnancies, the moral complexities of which are obvious.

A survey conducted by the team behind the documentary, titled The Contraceptive Pill: How Safe Is It?, found that one in four women taking the pill said it had negatively affected their mental health.

Danielle, 31, is one of these women. Speaking in the Horizon episode, she recalls how her side effects were “completely debilitating and terrifying”, adding that she’d never experienced poor mental health prior to taking the pill.

“I went from being fine to having suicidal thoughts within six months,” she adds.

Riverdale star Lili Reinhart delivers powerful body image speech at Glamour’s 2018 Women of the Year Summit

Grazia’s editor-in-large Vicky Spratt had a similar experience, recalling how her mental health deteriorated soon after she began taking the pill aged 14, leaving her suffering from depression and regular panic attacks.

“I remember thinking ‘if this is what the rest of my life is going to be like, I don’t want to live it’,” Spratt, 30, says in the documentary.

At the time, Spratt was prescribed antidepressants and cognitive behavioural therapy, but she claims that not a single doctor thought to make the connection between her deteriorating mental health and her contraceptive pill.

After some extensive Googling, she came across research online that linked the pill to depression and decided to stop taking it to see if it would make a difference; she felt better “within weeks”.

In the documentary, we see Spratt interview the Copenhagen-based professor Øjvind Lidegaard, who has access to a unique database of medical records because in Denmark, every single person’s data is logged in a central system.

This enabled him to look at the records of more than one million Danish women aged between 15 and 34 over a sixteen-year period, producing two studies on the topic of mental health and hormonal contraception.

One found that women taking the pill – either the combined pill or the progestogen-only pill – were more likely to be prescribed an antidepressant than those not on hormonal contraception. The difference was particularly noticeable for young women aged between 15 and 19 on the combined pill. Another found a link between hormonal contraception, suicide attempts and suicide.

Lidegaard’s findings were confirmed by a separate Swedish study of more than 800,000 women that had been published in March.

Despite the number of women experiencing poor mental health as a result of the pill, Spratt says little is being done to combat this in the UK due to a lack of data and an apparent reluctance from the NHS to take measures to rectify this.

She has been investigating the links between the contraceptive pill and mental illness for nearly two years and, after conducting a series of freedom of information requests, found that this was not something the NHS had any data on.

This means that the NHS is not monitoring women who are currently taking hormonal contraception and being treated for mental health issues, at least not in the same way that Danish medical officers are.

It also means that women may not be fully informed about these possible side effects prior to taking the pill, with no mention of depression or anxiety on leaflets distributed to women in sexual health clinics. Instead, they list “mood changes” as a possible side effect.

“What does that even mean? It could refer to anything,” Spratt tells The Independent.

“I think the NHS is sticking with ‘mood changes’ because they’re nervous about women being deterred from taking the pill and unwanted pregnancies rising as a result.

“It surprises me that despite known links between progesterone and depression, the NHS aren’t looking into it and, as a result, we don’t know how many women are affected by this in the UK.”

Spratt describes the seeming reluctance as “odd”, adding that this is why she decided to take part in the BBC documentary.

“We just need to do the research and collect the data so doctors are able to properly inform women about the potential risks of taking the contraceptive pill.”

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Dr Zoe Williams, who presents the documentary, explains that all medicines have potential side effects, but the pill is different to most because it is taken by women who are well, rather than to prevent or treat illness or disease.

“Therefore side effects that significantly impact on quality of life, in a negative way, are not acceptable,” she tells The Independent.

“Especially when there are so many types of pill and alternatives methods for contraception available.”

Horizon’s The Contraceptive Pill: How Safe Is It? airs on BBC Two on Wednesday at 9pm

We’ve all heard the jokes about how women tend to be “moody” and “hormonal,” especially when it comes to PMS. Often any sign of emotion is quickly explained away by hormone fluctuations. However, while hormones do affect our mood, mental-health diagnoses such as depression and anxiety are more than just moodiness or hormone fluctuations. And with depression affecting women at a rate almost two times greater than men (5.5 percent vs. 3.2 percent), it is an issue that deserves our attention.

Depression is characterized by a depressed mood, feelings of hopelessness, loss of interest, changes in appetite, changes in sleep patterns, changes in energy, difficulty concentrating, and thoughts of death, suicide, or suicide attempts. And there are many factors that contribute to someone developing depression or worsening depression. Genetics, stress, and environmental changes are generally known as risk factors. Oral contraceptives might not be something you’d think to include on that list, but the birth-control Pill has been identified as one of several medications that may cause depression.

Even though depression is listed as an “uncommon” but serious side effect of oral contraceptives, it is often dismissed as a real possibility when it comes to taking the Pill. But with 62 percent of women in the United States taking some form of birth control, according to the Centers for Disease Control and Prevention (CDC), and with the Pill (oral contraceptives) being the most common form of birth control used, should we take it more seriously?

A 2017 study published in The American Journal of Psychiatry that took place in Denmark found that the use of hormonal contraception (such as oral contraceptives) was associated with an increased risk for depression and suicide attempts compared to those women who were not taking hormonal contraception. Additionally, women who were taking oral contraceptives were 23–34 percent more likely to be diagnosed with depression. Use of IUDs, the study found, was associated with depression across all age groups. While this doesn’t mean that every woman who takes hormonal birth control will develop depression, it does mean that doing so may put some women at risk for developing depression.

Some doctors say that the benefits of oral contraceptives outweigh the risks or negative side effects of taking them, arguing that the percentage of women likely to be affected is so small that most women won’t be affected. However, the risk of depression, among the other possible“serious” side effects of oral contraceptives, is not something to take lightly. If you are a woman who is at risk for developing depression, the small chance of developing this serious side effect matters. And even if depression is not a known pre-existing risk, we know that, according to Harvard Medical School, women, in general, are at a greater risk for developing depression than men.

Listening to Your Body

It’s important to underscore here the importance of monitoring your mental health and knowing how different medications and lifestyle changes can impact your mental health. For example, in an article for The Guardian, Alice Roberts writes how she experienced an increase in mood swings and depressive symptoms when she took a certain type of oral contraceptive. In an interview with the lifestyle website, GOOP, Dr. Maggie Ney, says that it’s important to know your body. If you recognize any changes in mood, don’t dismiss them. Bring them up to your doctor who can help you figure out what might be affecting your mood.

You know your body best. Don’t be afraid to bring up your concerns to your doctor or therapist. When my psychotherapy clients report a significant change in mood, I always ask my female clients if they have started any new medication or experienced any significant lifestyle changes. Don’t be afraid to speak up.

While great strides have been made in studying mental-health issues unique to women, there is still a great deal of work that needs to be done. Further studies are needed to help women be informed of the risks and benefits of their options when making decisions related to their physical and mental health. Women deserve to have all of the resources they need readily available and not buried in research papers and professional jargon. Knowing your risk factors for depression and other mental-health diagnoses, and how your mental health may be impacted by the medications you take is a crucial part of taking control of your mental and physical health. Empower yourself by working with your healthcare professional to identify your risk factors and by making decisions that increase your physical and mental wellbeing.

Depression on birth control: Everything you need to know

Share on PinterestA person using birth control may experience mood changes.

Birth control that uses synthetic hormones could influence a person’s mood, potentially triggering depression or other mental health symptoms.

Hormones are the body’s chemical messengers. They affect many processes in the body, including mood, health, and how a person thinks.

Message boards, blogs, and popular articles commonly feature stories of people who developed depression after taking birth control. However, depression is common, affecting 7.1% of all adults in the United States, including 8.7% of females.

A person who develops depression during or after using birth control may experience symptoms for reasons other than their birth control.

However, there is plenty of anecdotal evidence from people who say their depression went away after they stopped using birth control. While many individuals may be tempted to interpret this as birth control being responsible for depression, researchers studying the topic have achieved mixed results.

The analysis appearing in 2016 provides some of the strongest evidence of birth control linking with depression. The study included data on more than 1 million females resident in Denmark. Those who used hormonal birth control, especially as teenagers, were more likely to take antidepressants later.

Major depressive disorder with peripartum onset, which doctors previously called postpartum depression (PPD), can occur during pregnancy or after childbirth. A 2018 retrospective study that gathered data from patient databases suggests a potential link between certain types of birth control and this form of depression occurring after delivery.

Researchers found that those individuals who used birth control containing progesterone — including IUDs, implants, and birth control pills — in the postpartum period were more likely to develop PPD later.

A 2018 systematic review suggests the link between progesterone-based contraceptives and depression is less clear. The analysis included 26 studies of progesterone-based contraception methods. While one study did show an increased risk of depression with birth control, that study had a risk of bias.

Based on their analysis, the researchers conclude there is little evidence to support a claim that progesterone-based birth control causes depression.

A 2012 study outlines some of the problems researchers face with untangling a potential link between contraceptives and depression.

The authors of that study emphasize that definitions of depression vary and that there are many different types of hormonal birth control, each using different synthetic hormones. These factors make it difficult to establish clear correlations.

For now, the research suggests that depression is a relatively uncommon birth control side effect, though some studies have documented it as a very real phenomenon.

Can Birth Control Cause Anxiety?

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Around 264 million people worldwide suffer from an anxiety disorder. For women, they are nearly 5 times as likely to be diagnosed with an anxiety disorder than men. Anxiety can cause many significant problems in daily functioning, and severely impact a person’s quality of life. For women, can taking hormonal birth control cause or alleviate the symptoms of anxiety? The following article will explore what an anxiety disorder is and if birth control has any impact on anxiety.

Can hormonal birth control alleviate symptoms of anxiety?

TLDR: Yes hormonal birth control can alleviate symptoms of anxiety. Hormones are complicated things, and the impact of hormonal birth control on each woman can vary significantly.

Some women’s anxiety about getting pregnant is very strong. Birth control would decrease that type of anxiety.

However, some women experience “pill anxiety” the fear of running out of birth control, the stress of having to run to the pharmacy each month to get their birth control. Pandia Health takes care of this by providing FREE delivery and automatic refills and reminders.

Those with uteruses who choose the birth control pill, patch, or ring may also be anxious from having to remember to take the medication every day, every week, every month, respectively.

Estrogen increases levels of the neurotransmitter serotonin, which generally causes positive mood and emotional well-being.

However, too much serotonin can cause increased anxiety.

Should women who have a history of depression or anxiety steer clear of hormonal birth control?

TLDR: No. Most women benefit from having a stable level of hormone on hormonal birth control vs. the ups and downs of NOT being on hormonal birth control. When you are not on hormonal birth control, then your hormones cycle up and down. When you are on monophasic birth control, then your hormones are maintained at a steady, smooth level. And if you skip the optional bleeding week, even smoother.

The research is still not clear as to whether hormonal birth control pills make symptoms worse in women who are prone to anxiety and depression.

The 2017 Medical Eligibility Criteria for Contraceptive Use report by the Centers for Disease Control and Prevention (CDC) concluded that depression is not a contraindication to hormonal contraception for women with depression, citing a lack of evidence supporting a causal relationship.

One study indicated that women who take combination oral contraceptives or progesterone-only minipills were more likely to be prescribed an antidepressant than women who did not take these types of contraceptives. However, this could be due to other factors such as women on birth control are more likely to be in a relationship and at risk of pregnancy, both of which can cause depression and anxiety.

What is an anxiety disorder?

Feeling anxious, or having anxiety is a typical response to a stressful situation, and it can sometimes be beneficial. Anxiety alerts someone to danger and compels them to be aware of their situation and take action to keep themselves out of harm’s way. But an anxiety disorder is a different matter entirely.

An anxiety disorder is when someone feels intense fear or stress about a future concern, and anxiety disorders are usually characterized by avoidant behaviors and physical symptoms that interfere with a person’s daily functioning. An anxiety disorder can cause someone to avoid normal situations, and the symptoms can significantly interfere with a person’s work, school, and personal relationships.

For a person to be diagnosed with an anxiety disorder, their fears must be considered out-of-proportion to the situation, not age appropriate, and also impair the person’s ability to function normally. There are different types of anxiety disorders:

  • Generalized anxiety disorder (GAD)
  • Panic disorders
  • Phobias
  • Social anxiety disorder
  • Separation anxiety disorder
  • Agoraphobia

Anxiety disorders are incredibly common and will affect up to 30% of all U.S. adults at some point in their lives. Anxiety disorders, although they are common and the symptoms debilitating, are highly treatable. A combination of medications and talk therapy can treat most cases of anxiety. Medications commonly used to treat depression, such as SSRIs and SNRIs, are also used for anxiety disorders.

However, it’s crucial that anxiety sufferers know and understand what triggers their symptoms and how to cope with stressful situations to prevent anxiety from getting out-of-hand.

The causes of anxiety are not completely understood, but genetic factors, temperament, and unique, biochemical characteristics can increase a person’s risk of experiencing anxiety symptoms. Mental health conditions like anxiety cannot be cured, but they can be effectively managed, and people can live symptom-free for life.

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Can birth control impact or alleviate anxiety?

First, it’s important to understand how hormonal birth control works to appreciate its effects on emotions and moods fully.

During the menstrual cycle, the hormones progesterone, estrogen, and testosterone are continuously rising and falling. The rise and fall of each of these hormones trigger different biological responses, including ovulation and menstruation.

When a woman starts taking hormonal birth control, hormones are prevented from rising and falling continuously, and in some cases, the hormones should be pretty stable. The body is exposed to a continuous level of hormones to trick the body into thinking it is already pregnant, thus preventing ovulation from occurring. If a woman takes monthly hormonal birth control pills, she will get a withdrawal bleed, which mimics a period, at the end of each month. For those on regular birth control pills, women can choose to skip the monthly bleed by skipping the last week of pills of a 4 week pack and going straight into the next pack.

Hormonal birth control can cause some side effects, such as decreased libido, spotting, and nausea. Also, there are mental health side effects that can occur, including mood swings, depression, and increased feelings of nervousness or anxiety. However, TLDR: most people do not experience changes in mood or any adverse side effects while taking hormonal birth control, but it is a risk.

Both progesterone and estrogen are known to affect mood, and the hormonal birth control pill contains synthetic versions of these hormones. Research has found that women with a history of depression are at increased risk of experiencing mood swings and anxiety when taking hormonal birth control.

What types of contraceptives can women who are prone to anxiety use?

TLDR: Women who have anxiety and depression can use all forms of contraception. Each woman is different and responds differently to hormones.

It’s common for women to try several different types of birth control before settling on an option that fits with both her lifestyle and specific biochemistry. For the birth control pill, there are 8 different types of progestins with 2 different levels each (or more) that women can take and see which one will work for her. But it’s important to talk to your provider about any history of depression or anxiety before trying a new hormonal contraceptive method.

Currently, there is no known risk of depression or anxiety when using a non-hormonal method of birth control such as the copper IUD and/or condoms. However, some women with the copper IUD have reported copper toxicity with symptoms of “brain fog and fatigue” and 2-5 months post insertion with decreased energy and increasing depression and irritability which resolved with copper IUD removal.

The research is mixed on progestin only methods such as the IUD with hormone, implant, and progestin only pills.

In 2016 in a study of 1 million Dutch women, women on hormonal birth control (the pill, patch, ring, IUD with hormone, implant) had a 2.2% chance of being prescribed antidepressants vs 1.7% of those not on hormonal birth control. So, that’s a 0.5% greater chance. A flaw in the study is that you can have depression and not be prescribed medications e.g. refuse medications or prefer therapy to medications, so perhaps those not on hormonal, are also anti-medication and refused the anti-depressant prescription.

A 2018 review of 26 studies concluded there was no increase in depression with progestin only contraceptives.

IUDs and implants are long-acting, reversible birth control methods that can be removed whenever a woman wishes to become pregnant. IUDs and implants are also relatively easy to remove in case a woman has an adverse reaction to the hormonal cocktail present in the implant and hormonal IUD. The copper IUD does not use hormones and is effective for up to 10 years.

For women with a history of anxiety, there are many different and effective birth control methods she can try until finding one that’s right for her. But it’s critical that women thoroughly communicate with their medical provider about their concerns and needs. Sign up with Pandia Health today to find out which birth control method would be right for you.

The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.

Updated 8.13.19 sy

Birth Control and Depression: The Pill and its Reported Effects on Mental Health

  • Birth Control + Abortion
  • March 26th, 2019
  • by Sara Shah

The birth control pill comes with a slew of benefits, including better skin, reduced rates of ovarian cancer, and decreased possibility of pregnancy—which remains its primary purpose. In 1960 the first oral contraceptive was approved by the FDA, a result of women’s activist Margaret Sanger persuading Dr. Gregory Pincus to create a contraceptive pill for women. In fact, Sanger is responsible for coining the phrase “birth control.”

The pill and where it came from

At first, the pill was only prescribed to women with severe menstrual issues, and it was not until 1969 that it became legal to prescribe the pill for contraception—that was only 50 years ago!

Reported side effects of the first pill included headaches, nausea, dizziness, and blood clots. But most importantly, side effects of the pill also included a lack of full disclosure and a large lack of relevant research on the psychological effects of the pill.

Since the 1960s, the information available on birth control options has grown, as have birth control options available to women, but knowledge gaps and misinformation surrounding birth control remains prevalent. With the new options available an even wider array of birth control side effects exist. Hopefully, these risks are being more readily researched and openly discussed. The sad truth is, research on the pill was often written in a way that dismissed its effects on women’s mental health; the misinformation persists today.

So, let’s dig into the underreported emotional side effects of hormonal birth control in the form of the contraceptive pill. Just as a note, other forms of hormonal birth control apart from the pill include, the NuvaRing, the Patch, Nexplanon (an arm insert in the form of a small rod), and hormonal IUDs (such as Skyla or Mirena). Though the side effects of all these birth control options vary, hormonal birth control is often associated with an increased risk of depression and anxiety.

How Birth Control Works: The Combo Pill vs. the Mini Pill

Today the pill comes in two categories: the combination, or “combo,” birth control pill and the mini-pill. The combo birth control pill is called a combo because it contains ethinyl estradiol, a form of estrogen, and a type of progestin, a form of progesterone. These two hormones naturally flood the body when women ovulate, and create many of the symptoms women experience during PMS.

In contrast, the mini-pill contains only progestin, but no estrogen. As a result of the decreased hormones in the mini pill, or progestin-only birth control option, it’s often labeled as a “safer” alternative to the combo pill for women. Which is why it is prescribed to women who are breastfeeding due to overall decreased levels of common birth control side effects—but this does not mean there are NO side effects.

Both progesterone and estrogen are hormones that impact our moods. Most women who have experienced PMS know how intense these impacts can be, so when you add more of these chemicals to the body via hormonal birth control, exercise caution. Data reveals fluctuations in progesterone may induce depression in women, while certain estrogens have been linked to causing anxiety and depression.

A short note on hormonal birth control

Hormonal birth control has been linked to reports of increased depression and anxiety among patients. In a study of 90 women, with 44 of the women taking birth control pills, researchers found the pill affected mental states by altering the brain. Two parts of the brain revealed changes in particular; the posterior cingulate cortex (linked to emotional stimuli based on internal states of mind or the view of the “self”) and the lateral orbitofrontal cortex (linked to emotion and behavior in relation to external stimuli) appeared thinner in women on the pill. Thinning of these regions reveals heightened risks of abnormal emotional functioning.

The marked changes in these two regions alone suggest that the pill not only affects how women view external circumstances, but may also affect their view of themselves. With emotional stimuli affected on both the external and internal levels, it makes sense that we may react differently than we typically would—and perhaps even be more prone to depression and anxiety as a result of the abnormal functioning the pill may create in these regions.

Even though we know sex hormones play a large role in our brain and decision making, the research suggests that as a result of the hormone-altering nature of the pill, it may have profound impacts on our emotions and these changes in our brains could lead to increased levels of mental health risks among women. A recent Danish study supported this evidence by finding women on either the combo or mini pill experienced a greater likelihood of depression and were prescribed antidepressants more often than women taking non-hormonal forms of birth control.

Birth control side effects via the pill may lead to an onset of depression and anxiety in women who have not experienced depressive symptoms before. But it should also be noted that hormonal birth control pills are more likely to lead to depression and anxiety in women who are already prone to depressive symptoms. So if you suffer from depression and anxiety already, you should take into account you are at greater risk of hormonal forms of birth control potentially altering your emotions.

Mood swings and hormonal birth control

When beginning the pill, mood swings can be a common indicator of an onset of emotional changes. The mood swings can be characterized by anger, sudden onset of tears, feelings of lack of joy, etc. If you notice these symptoms do not waste any time and set up a time to see your doctor. The earlier you can address the symptoms the better. From personal experience, sometimes doctors will advise you to stay on the pill, promising these feelings will level out. Worse, one doctor shared that she knows of other colleagues who will tell patients the feelings “are all in their heads.”

If it feels like a doctor is brushing aside the very real emotional symptoms you are experiencing, try getting a second opinion. Your emotions and mental health matter and you should not have to suffer from depression and anxiety in exchange for contraception. When you visit a doctor, discuss potential alternative contraceptive options if the symptoms feel unbearable (or even if they just feel uncomfortable). And if you have a history of anxiety or depression be sure to share that with your doctor too.

The problem with the research on hormonal birth control

A peculiar puzzle has emerged. Many prior studies in the U.S. were released over the years when birth control was still relatively new (keep in mind, it’s still only 50 years old). For years the studies stated that hormonal birth control had no impact on women’s emotions. Despite these studies, many women continued to self-report that the pill led to negative emotions, mood swings, depression, and anxiety.

So what gives?

The sad truth is women’s health is often under-addressed in many circumstances. Women’s health care in the U.S. is often ranked last out of the major developed countries. This could explain those sneaky claims from earlier studies reporting no link between hormonal birth control and depression occurred despite women self-reporting negative mental health symptoms while taking birth control.

With the times changing, those research claims are changing too; today many studies are showing that there is indeed a link between hormonal birth control and increased risks of depression and anxiety. As noted earlier, the large majority of these studies reveal a correlation to depression and anxiety at the onset of taking the pill, which is particularly worsened if the patient is already prone to these mood symptoms.

Why confusion surrounding birth control and mental health continues

The confusion appears to be a result of the longstanding fact that men have dominated the healthcare space, and as a result, have determined women’s health care outcomes and treatment options. Perhaps that’s the reason we have years of research claiming hormonal birth control did not impact women’s emotions, despite many women sharing first hand that they were feeling sad, anxious, and depressed after starting the pill.

At the end of the day, understanding that the women’s health care space (and health care in general) has been largely dominated by male scientists is important. That dynamic is changing, as are people’s views—women’s voices are being heard and the impact is resounding. Voicing our views and symptoms from the effects we feel from birth control is important.

Women tend to underreport or choose not to self-report symptoms of depression or anxiety because of the societal stigma that remains. But by women reporting how certain health care solutions make them feel, we allow other women to do the same, paving the pathway to change and improved healthcare solutions for a variety of women’s health care issues.

So if you’re feeling adverse emotional symptoms from birth control, or any medical solution, reporting these adverse symptoms is powerful. By doing so, you’re playing your part in improving women’s health care for women everywhere.

Featured image by Jana Sabeth Schultz

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