Spend a few minutes reading the leaflet that comes with birth control pills like Yaz, Estrostep or Ortho Tri-Cyclen and there’s a chance you’ll come away with the impression that hormonal birth control is, to put it lightly, a little dangerous.
First, there are the common side effects, which can range from nausea to weight gain, spotting and breast tenderness. Then there are the less common side effects, which can range from high blood pressure and sleep issues to serious, life-threatening medical events like blood clots.
The reality of birth control is that while side effects can and sometimes do happen, birth control pills are very safe for most women. Serious side effects from the pill are rare, and the majority of women will only experience minor side effects, if any at all.
Below, we’ve looked at how common side effects are from hormonal birth control pills. Our list covers everything from minor side effects such as spotting and weight gain to far less common, more serious side effects such as blood clots, hypertension and stroke.
- The Most Common Birth Control Side Effects
- Less Common Birth Control Side Effects
- Rare, Serious Side Effects of Birth Control
- Learn More About Birth Control
- Does the birth control pill stop you from recognizing emotions?
- Women on the pill 10 percent less accurate
- Signs Hormonal Birth Control Is Messing With Your Mental Health
- Your Mood Swings Are Extreme & Feel Out Of Control
- You’re Fighting With Your Partner Way More Than Usual When You PMS
- You Feel Depressed When You PMS
- You’re Experiencing Inexplicable Hostility
- The Bottom Line
- Mood Swings, Hormones, and Birth Control: What to Know
- How to Use Birth Control to Regulate Hormones and Diminish Mood Swings
- How do hormones affect someone’s mood?
- What are the causes of PMDD and severe hormonal mood swings?
- Who is at risk of experiencing severe PMDD mood swings?
- What is the difference between normal mood swings and PMDD?
- How can birth control alleviate mood swings?
- How does the pill change hormone cycles?
- Can the pill make mood swings worse?
- Can Birth Control Cause Depression?
- Birth Control Basics
- What Is Depression?
- Is There a Link Between Birth Control Pills and Depression?
- What You Should Do If You’re Depressed
- The Takeaway
- You Asked: Do Oral Contraceptives Cause Mood Swings or Depression?
- Can Hormonal Birth Control Affect Your Ability to Pick up on Social Cues?
- Birth control pills may affect whom you are attracted to, experts say
- Three Reasons “the Pill” may Be Hurting Your Relationship
- We Know Surprisingly Little About How Birth Control Affects Our Brains
The Most Common Birth Control Side Effects
Not all birth control pills use the same formula, meaning there’s no one-size-fits-all formula that applies to side effects for every type of hormonal birth control.
Most birth control pills contain a mix of an estrogen (typically ethinyl estradiol) and a progestin hormone. These hormones work together to stop ovulation, preventing you from releasing eggs and reducing your risk of becoming pregnant.
There are also progestin-only birth control pills, or “mini pills.” These pills only use a progestin hormone and don’t contain any ethinyl estradiol.
Because of these different formulas, your risk of experiencing side effects from birth control can vary depending on which pill you use. Despite this, there are several side effects that can occur with all birth control pills, from combined pills to progestin-only mini pills.
Intermenstrual spotting, or bleeding between periods, is one of the most common side effects of the birth control pill. It usually occurs within the first three months of using birth control and tends to resolve on its own.
Spotting is a normal side effect of using birth control. It’s usually not worth worrying about. If you have taken birth control for longer than one week, it will still be effective at preventing pregnancy while you’re experiencing spotting.
Most of the time, spotting resolves itself within two to three days. If your bleeding feels unusually heavy and continues for three or more days, or is mild but continues for more than five days, it’s best to contact your doctor.
Spotting is a common side effect of birth control. In one study, 24% of women given a combined birth control pill containing lynestrenol and ethinyl estradiol experienced spotting during the first three months of use. This rate decreased to four percent over the course of the study.
If you’re experiencing spotting from birth control, it’s best not to panic. Most of the time, spotting goes away on its own, just like in the study linked above. If it doesn’t, contact your doctor. They can help you switch to a form of birth control that doesn’t cause this side effect.
Breast tenderness is another common side effect of birth control pills. The hormones used in both combined and progestin-only birth control pills can stimulate your breast tissue, causing everything from minor discomfort to enlargement of your breasts.
Like spotting, your risk of experiencing your breast tenderness is highest during the first few months of using birth control. During this period, your body is still adjusting to the hormones used in your birth control pills and tends to be the most sensitive to potential side effects.
Breast tenderness normally resolves on its own. However, some women experience ongoing discomfort in their breasts. If your breasts still hurt after more than a few weeks, contact your doctor so that you can discuss the issue.
In some cases, birth control can also cause lumps to form in your breasts. These are usually benign (almost 80% of all breast lumps are non-cancerous). If you feel a lump in your breast after you start using birth control, the best thing to do is to contact your doctor.
Finally, it’s important to point out that birth control is not linked to a significant increase in your risk of developing breast cancer. Studies have consistently shown that your risk of developing cancer from modern birth control pills is extremely low, so much so that it’s best not to worry.
Ever panicked when you stepped onto the scale after starting birth control? The hormones used in birth control pills can cause a mild increase in your weight, especially during the first weeks of using hormonal birth control.
This doesn’t affect everyone who uses birth control. In fact, detailed analysis of studies of birth control side effects shows that most women who use birth control don’t see any change in their weight or body composition.
Usually, any weight gain from birth control pills is caused by your body retaining more fluid than it normally would. Estrogens and progestins, which are used in combined birth control pills, can cause your body to retain more fluid, particularly in your breast tissue and around your hips.
This weight gain can happen fairly quickly, often within a few weeks of you starting to use birth control pills.
If you’ve noticed your weight creeping upward after you started using birth control, it’s best not to panic. Assuming you haven’t increased your calorie intake, the weight gain is most likely just a result of your body retaining more water than it normally would.
Studies show that the average amount of weight gained from birth control is around 4.4 pounds after six to 12 months of use.
This weight gain is often temporary, meaning you’ll retain more water as your body gets used to the hormones used in your birth control pills. Small changes to your diet, like avoiding salty food, can often be enough to reduce the amount of fluid your body retains.
All in all, it’s best not to worry about this one. With the exception of Depo-Provera (the hormonal birth control injection), birth control usually isn’t linked to any increase in body fat, meaning any weight you gain without increasing your calorie intake is probably just extra water.
Light or Missed Periods
Missed your period after starting birth control? You’re not alone. Many women occasionally miss a period after they start using hormonal birth control, a side effect that’s typically caused by how extra progestins and estrogen affect your menstrual cycle.
Because hormonal birth control stops your ovaries from releasing eggs, your uterus no longer needs to produce a protective lining. This gives you a lighter, often very mild period that might not even come at all.
Birth control pills can also speed up or delay your period. Some women get theirs a little early after starting birth control (the normal range is 21 to 35 days), while others experience a period that’s shorter or longer than normal.
While it’s quite normal to have an extremely light period on birth control (sometimes you might not experience any flow at all), it’s still worth taking a pregnancy test before you start your next cycle if you don’t notice any bleeding at all.
Like many other birth control side effects, this one is most common during the first few months of using hormonal birth control. After three to six months, you’ll normally have a consistent and predictable period that starts at the same time every cycle.
It’s also worth noting that other factors can affect your period, not just birth control. If you’ve felt stressed, made changes to your diet or started using any other prescription medications, these factors could all have an effect on your period.
Have you noticed an upset stomach after you started birth control? The hormones used in birth control pills—in particular, ethinyl estradiol—can contribute to feelings of nausea, giving you an urge to vomit or use the toilet once you start taking birth control pills.
These feelings can occur temporarily after you take each pill or persist throughout the day as a general side effect.
Like other birth control side effects, nausea is usually temporary. It’s most common during the first two to three months of using birth control pills and usually subsides on its own. It tends to be more severe with emergency contraceptives such as Plan B than with regular birth control.
There are several ways to make nausea from birth control pills easier to tolerate. The first is to only ever take your birth control with food. This means your body will have something to digest at same time as it’s metabolising the hormones inside the birth control pill.
The second is to take your birth control pill at night. Many women notice that taking the pill at nighttime makes nausea easier to deal with, especially since you’re less likely to be awake as the symptoms peak.
If you opt to take your birth control pills before going to bed, it’s important to stick to a consistent daily schedule. Most birth control pills are only 99% effective if you take them within three hours of the same time every day.
Less Common Birth Control Side Effects
Birth control pills can also cause several less common side effects. These include a decrease in your sex drive, mood changes and even migraine headaches. For a small percentage of people, birth control pills can even have an effect on your eyes.
We’ve listed these less common side effects below, along with the available scientific data on why each side effect happens and how common it is.
Headaches and Migraines
Although it’s uncommon, the estrogen and progestin hormones in birth control pills can trigger headaches and migraines in some people.
This side effect was more common in the past than it is now, as older-generation birth control pills used higher doses of estrogens and progestins. Today’s combined birth control pills use a relatively low dose of each hormone, reducing your risk of experiencing side effects.
Still, it’s possible to experience the occasional headache after you start using birth control. Like many other birth control side effects, headaches are caused by fluctuations in your body’s level of progestin and estrogen hormones, both of which are used in combined birth control pills.
This is also why many women experience headaches during their period. On your period, your body’s estrogen levels can fluctuate, giving you a higher risk of experiencing a hormone-induced headache.
If you’ve noticed occasional non-migraine headaches after starting birth control, the best way to reduce their severity is to take your birth control pill at the same time every day. This can help to even out your hormone levels and prevent the sudden fluctuations that can cause headaches.
It’s also important to take general headache prevention precautions. Make sure you sleep well, avoid sources of stress, limit your alcohol consumption and stay hydrated, especially after you start using birth control.
If you get migraine headaches after starting birth control, it’s important that you let your doctor know as soon as possible. Migraines can indicate that you may have a higher stroke risk from hormonal birth control, making it important to talk to your doctor about safer alternatives.
Your doctor might recommend switching to a safer, alternative form of hormonal birth control, or using a non-hormonal method of contraception.
The progestin and estrogen hormones used in birth control pills can affect you mood, causing you to experience mood swings. Like other uncommon birth control side effects, this tends to only affect a small percentage of women who use birth control.
Your body’s levels of estrogen and progestins fluctuate on their own, usually over the course of your menstrual cycle. When you start using birth control, the higher levels of these hormones in your body can make it easier to become annoyed, sad or angry.
This is because hormones like estrogen have a real, noticeable effect on your mood. In a 2012 study, scientists found that women given high doses of estrogen were more likely to experience fear and anxiety than their peers.
Other studies show that progestin hormones can induce irritability, depressed mood and anxiety when given to women as part of a hormone replacement therapy (HRT) treatment.
In short, the hormones in birth control probably won’t affect you, but if they do, they could make you feel more easily annoyed, depressed, anxious or angry than normal.
Of course, these are completely normal emotions that you’ll experience regardless of whether or not you use hormonal birth control. But if you notice yourself feeling sad, angry or annoyed after you start taking the pill without any obvious reason, it could be the result of your hormones.
According to studies, mood changes affect four to 10 percent of women who take hormonal birth control pills. Just like headaches, this is another uncommon but potentially serious side effect of that’s worth looking out for.
As always, if you experience mood changes after you start using birth control, it’s best to talk to your doctor. These side effects can often be minimized or avoided by switching to a different pill, or by using a non-hormonal form of contraception.
Reduced Sex Drive
Birth control can have mixed effects on your libido. Some women notice an increase in sexual desire after they start taking birth control. However, it’s more common to experience a reduced level of interest in sex.
Like the other side effects in this section, a reduced sex drive from birth control isn’t a common problem. Most women who use birth control don’t notice any difference in their level of sexual interest, be it an increase or a reduction.
The key reason birth control can affect your sex drive is its impact on androgens. Birth control pills work by reducing your body’s production of androgenic hormones like testosterone, which plays an important role in regulating your sex drive.
Testosterone is also one of the main hormones that can cause acne, which is why some birth control pills are approved by the FDA as acne treatments.
For some women, this can cause a noticeable reduction in your interest in sex, as well as your level of desire for sexual activity.
On the whole, a reduced sex drive from birth control pills is fairly rare. According to Lee Sharma, MD, of Auburn, AL, about one in 100 women notice a reduced sex drive. Studies also show that it’s rare for birth control to affect libido, with the exception of the Depo-Provera injection.
If you’ve noticed a lower sex drive after you started using birth control, the best option is to talk to your doctor. Switching to a different type of birth control pill (such as a progestin-only pill) or using a non-hormonal form of contraception can often help to reverse this side effect.
Although it’s very rare, it’s possible for birth control pills to cause some minor changes to your eyes.
While there’s no evidence linking birth control pills to eye disease, the hormones used in birth control pills can lead your cornea (the clear layer at the front of your eye) to thicken. If you use contact lenses, this means that they might not fit after several months of using birth control.
If you notice your contact lenses becoming uncomfortable or failing to properly fit, make sure you let your ophthalmologist know that you’ve started taking hormonal birth control. They’ll be able to switch your contact lenses to larger ones that provide a more comfortable fit.
The hormones in birth control pills can also slightly increase your risk of experiencing dry eye syndrome (DES). This can cause your eyes to feel itchy and uncomfortable. It can also cause your vision to become blurred and less defined than normal.
As always, the best way to deal with dry eye syndrome is to talk to your doctor. Let them know you’ve started using birth control and explain your symptoms. Your doctor might be able to give you an alternative form of contraception that doesn’t cause this side effect.
Like mood changes, headaches and a reduced sex drive, dry eyes or corneal changes are all rare side effects of birth control. In one study, researchers stated that the risk of vision-related side effects from birth control is as low as one in 230,000.
In short, unless you’ve noticed symptoms of dry eye syndrome or struggled to comfortably fit your contact lenses, you probably don’t need to worry about this potential side effect.
Rare, Serious Side Effects of Birth Control
Overall, birth control pills are extremely safe. Tens of millions of women use them without any significant issues in the US alone, with hundreds of millions of safe, healthy birth control users worldwide.
Despite this, it is possible for birth control pills to cause potentially serious side effects. These side effects are mostly cardiovascular in nature and occur rarely, usually in people with certain lifestyle or genetic risk factors.
Below, we’ve listed the most serious potential side effects of hormonal birth control, as well as any relevant scientific data on how these side effects occur, how frequently they occur and the key factors that can contribute to them.
Blood Clots and Deep Vein Thrombosis (DVT)
Blood clots from birth control pills are rare, affecting about 12 in every 10,000 women who use oral contraceptives. Deep vein thrombosis, a blood clot that affects veins deep inside the body, is also rare, affecting three to nine out of every 10,000 women on birth control annually.
Despite this, blood clots can and sometimes do happen to women who use birth control. Your risk of experiencing a blood clot from using birth control is higher if you smoke, with smokers aged 35 or older the highest risk group.
The possibility of a blood clot from birth control tends to increase the more you smoke, meaning every additional cigarette increases your risk. Our guide to smoking and birth control covers this topic in more detail, as well as other smoking-related health risks for birth control users.
Because of this, your doctor will usually recommend an alternative form of contraception if you smoke, particularly if you’re 35 or older.
Although birth control pills don’t cause strokes directly, they can potentially increase your risk of suffering a stroke in certain situations.
Overall, the risk of experiencing a stroke as a result of using birth control is extremely low. More than 100 million women safely use birth control worldwide, with only a tiny fraction of active birth control users suffering from strokes and other serious health issues.
According to current research, using birth control increases your risk of risk of having a stroke to approximately 1.9 times the standard level.
On average, approximately 4.4 women out of every 100,000 women of childbearing age suffer ischemic strokes every year. Women who use birth control pills have a slightly higher risk, with approximately 8.5 strokes every year per 100,000 women of childbearing age.
While this figure might look alarming, it’s important to put it into context. Your risk of suffering a stroke as a result of using birth control is very small. About 10.6 people per 100,000 die in auto accidents every year, while 115.8 people in every 100,000 die from coronary artery disease.
In short, while a 90% increase in stroke risk can seem like a serious cause for concern, the tiny percentage of childbearing age women who experience strokes in the first place means this isn’t a reason to avoid birth control.
With this said, there are several factors that can contribute to a higher stroke risk. If you’re aged 35 and up and regularly smoke cigarettes, you should not use birth control. People in this group have the highest risk of experiencing stroke and other cardiovascular issues from birth control.
If you’re concerned about the stroke risk from birth control, the best option is to discuss it with your doctor. They’ll be able to put birth control’s cardiovascular health risks in context so that you’re more informed and capable of deciding whether birth control pills are right for you.
Learn More About Birth Control
Overall, birth control is a safe, effective way to prevent pregnancy. Most birth controls are 99% effective when used correctly, with side effects—aside from common issues such as spotting and nausea—fairly uncommon.
Our guides to Yaz, Estrostep and Ortho Tri-Cyclen explain how three of the most widely used combined birth control pills work. You can also learn about progestin-only pills in our guide to the differences between combined birth control and “mini pills.”
Interested in using birth control to treat hormonal acne? Our guide to birth control pills and acne explains how combined birth control pills like Yaz, Estrostep and Ortho Tri-Cyclen can help you prevent acne outbreaks and improve your skin.
Does the birth control pill stop you from recognizing emotions?
New research that features in the journal Frontiers in Neuroscience suggests that women who use oral contraceptives are less able to recognize facial expressions of complex emotions.
Share on PinterestResearchers are uncovering new psychological side effects of oral contraceptives.
Over 60 percent of women aged 15–44 years are currently using a form of contraception, according to the most recent estimates from the Centers for Disease Control and Prevention (CDC).
Approximately 28 percent, or 10.6 million, of these women are using the birth control pill. Worldwide, the number of women using oral contraceptives is at least 100 million.
In addition to their contraceptive benefits, birth control pills have several therapeutic uses, such as controlling endometriosis, acne, painful or heavy periods, polycystic ovary syndrome, and uterine fibroids.
However, oral contraceptives can also have a range of side effects, depending on the type of pill and the hormones that it contains. Such side effects include nausea, breast tenderness, headaches, and bloating.
What are the psychological effects of using the pill though? Some studies have suggested that there is an association between taking the birth control pill and having mood swings and an increased risk of depression.
New research adds another potentially adverse psychological effect to the list: impaired social judgment. According to the new study, women who take the pill are less likely to identify “complex emotional expressions,” such as pride or contempt, accurately.
Alexander Lischke, a researcher in the Department of Physiological and Clinical Psychology/Psychotherapy at the University of Greifswald in Germany, is the senior author of the new paper.
Women on the pill 10 percent less accurate
Lischke explains the motivation for the study, saying, “More than 100 million women worldwide use oral contraceptives, but remarkably little is known about their effects on emotion, cognition, and behavior.”
“However,” he adds, “coincidental findings suggest that oral contraceptives impair the ability to recognize emotional expressions of others, which could affect the way users initiate and maintain intimate relationships.”
To determine some of these effects, Lischke and colleagues asked two groups of women to engage in an emotion-recognition task. The first group consisted of 42 healthy women who were taking oral contraceptives, while 53 healthy women who were not on the pill formed the second group.
The study’s senior author explains how the researchers designed the task. “If oral contraceptives caused dramatic impairments in women’s emotion recognition ,” says Lischke, “we would have probably noticed this in our everyday interactions with our partners.”
“We assumed that these impairments would be very subtle, indicating that we had to test women’s emotion recognition with a task that was sensitive enough to detect such impairments. We, thus, used a very challenging emotion recognition task that required the recognition of complex emotional expressions from the eye region of faces.”
Such emotional expressions included contempt and pride, which are more complex than the expressions of simpler emotions, such as fear or happiness.
“Whereas the groups were equally good at recognizing easy expressions, the users were less likely to correctly identify difficult expressions,” reports Lischke.
More specifically, women who took the pill were 10 percent less accurate in their emotion recognition than women who did not take the pill.
The findings did not depend on the menstrual cycle phase of the women or on whether the facial expressions were positive or negative.
Lischke comments on the potential mechanism that may explain the findings, saying, “Cyclic variations of estrogen and progesterone levels are known to affect women’s emotion recognition and influence activity and connections in associated brain regions.”
“Since oral contraceptives work by suppressing estrogen and progesterone levels, it makes sense that oral contraceptives also affect women’s emotion recognition. However, the exact mechanism underlying oral contraceptive-induced changes in women’s emotion recognition remains to be elucidated.”
The authors note that their findings “should be taken into account when informing women about the side-effects of .”
Signs Hormonal Birth Control Is Messing With Your Mental Health
There are so many things to consider when you’re choosing which birth control to jump into bed with. You have to think about the convenience, the cost, what the side effects will be, and so much more. But have you considered how hormonal birth control might affect your mental health?
Even though there are numerous options out there to choose from, the Pill still takes the top spot for most-used contraception in the U.S. Almost 26 percent of women on birth control are using the Pill, according to a report from the Guttmacher Institute. However, recent research released from Denmark has shown that the Pill may have negative effects on mental health. JAMA Psychiatry published a study surveying 14 years of data for more than 1 million women, finding that women who took progestin-only pills were 34 percent more likely to be diagnosed with depression, and those taking the combined oral contraceptives (estrogen and progestin) were 23 percent more likely to become depressed. The rates were even higher for teens on the Pill. The combined contraceptive made teenagers 80 percent more likely to suffer from depression.
Although they don’t tell the whole story, these are frightening numbers that force us all to take a long, hard look at how contraception is truly affecting our mental health. Julie Holland, MD, psychiatrist specializing in psychopharmacology and author of Moody Bitches, tells Bustle that it’s common to see women mentally affected by their birth control. “Many of my patients find that they cannot tolerate how emotional the Pill makes them,” Dr. Holland says, “and after trying several different brands over the years, they abandon the idea of using oral contraception for birth control.”
If this sounds familiar, read on for the signs your birth control is messing with your mental health, and see if it’s time to have a conversation with your OBGYN about making a contraception change.
Your Mood Swings Are Extreme & Feel Out Of Control
Out of all the PMS side effects, mood swings are probably one of the most common (and most dreaded). You feel irritable and short-tempered, and it doesn’t take much to set you off. Dr. Holland says your birth control has the possibility of making your mood swings much, much worse — to the point where you’re crying for no reason, you feel terrible about yourself, or you’re unable to enjoy life.
“Synthetic progestin is horrible for your mood, and about 10 percent of women really can’t tolerate it at all,” Dr. Holland tells Bustle. “For these patients, the Pill is destabilizing.” She’s heard many patients say these exact words: “The Pill made me crazy.” As soon as you cross over into territory where you feel like you’re totally out of whack emotionally, that’s when your mental health has been compromised.
You’re Fighting With Your Partner Way More Than Usual When You PMS
The Pill contains both estrogen and progesterone, which tricks the pituitary gland into thinking it’s already ovulating so the follicle won’t release an egg. It’s the estrogen that could have an impact on your mental health. “Estrogen and serotonin regulate each other in a complicated dance,” Dr. Holland says. “Anything that affects estrogen is going to have an impact on serotonin.”
The inability of serotonin to reach its receptor sites has been linked with depression, but it’s also been connected to excess anger, which can manifest itself in various personal relationships. If you and your SO simply can’t get along when you’re PMSing, and the level of bickering has reached an Olympic degree, it could be a sign that your mind isn’t functioning at its healthiest state.
You Feel Depressed When You PMS
The hormonal shifts you experience in the days before your period will naturally leave you feeling emotionally sensitive, less confident about yourself, and downright moody. This is all pretty normal. You should be concerned, though, when these side effects turn from uncomfortable feelings to depressive symptoms — like being unable to get out of bed, feeling severely unhappy about your life, and significant changes in appetite.
Dr. Holland says many of her patients “are coming to me for complaints of depression, not just PMS.” She tells Bustle about another study in which women who had a history of depression overwhelmingly reported worsening depressive symptoms when they were PMSing after they had started using the Pill. If you have a history with depression and you sense a significant shift in how you feel in the days leading up to your period — and especially if you have any suicidal thoughts whatsoever — speak with your doctor about whether there are any alternatives that will help you get your mental health back on track.
You’re Experiencing Inexplicable Hostility
Chemical imbalances in your brain can have a strong impact on your everyday life. Dr. Holland says the changes in your brain from birth control can make you feel “a bit bonkers.” That might mean you get uncharacteristically angry for no apparent reason or feel like clobbering the person who cut you off in traffic.
“Estrogen causes the manufacture of a serotonin receptor called 5HT2A,” Dr. Holland explains. “This is the receptor that mediates the effects of hallucinogens like LSD and is the target of some antipsychotic medications.” Nearly a third of women have variations on this receptor, which can present problems when your estrogen levels are high — in other words, when you PMS.
Being bewilderingly angry isn’t something you should have to simply put up with. It’s likely a sign that your birth control doesn’t gel very well with how your brain naturally functions, and it’s just time for you to take a different route when it comes to preventing pregnancy.
The Bottom Line
Just because some studies have found links between birth control and mental health issues, doesn’t mean depression will be the fate of everyone on the Pill. However, there is some real evidence here there that can’t be ignored. Particularly if you have struggled with mental illness in the past, keep a close eye on how you’re feeling, and if something just isn’t right in your gut, don’t hesitate to bring it up.
“Talk to your gynecologist or your psychiatrist,” Dr. Holland recommends. “You can try another Pill.” You may also want to opt in for non-hormonal forms of contraception, such as the copper IUD, because Dr. Holland says these “won’t affect your mental functioning.” There are many different options to choose from. Don’t feel like you have to stick with the first birth control option you landed on.
Mood Swings, Hormones, and Birth Control: What to Know
How to Use Birth Control to Regulate Hormones and Diminish Mood Swings
About 16% of U.S. women of reproductive age use hormonal birth control pills to prevent pregnancy. But, 7% of those women use hormonal birth control pills strictly for health reasons. Although the pill is highly effective at preventing unintended pregnancy, it offers numerous other health benefits, too. Taking birth control pills can help to regulate hormonal swings and imbalances that can cause an array of different symptoms that interfere with day-to-day functioning. The following article will discuss how hormones cause mood swings, and in which situations the pill can be used to prevent them from happening.
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How do hormones affect someone’s mood?
From the onset of puberty and through menopause, women will experience cycles of hormonal fluctuations that affect mood, reproductive processes, and brain chemistry. It’s possible that these constant hormonal fluctuations that are a natural part of being female may explain why women are at higher risk of experience mood disorders such as depression and anxiety.
Women are also subject to experience PMS in the week leading up to menstruation, and in more severe cases, a condition called premenstrual dysphoric disorder (PMDD). Unlike PMS, PMDD is a debilitating condition that can severely impact a woman’s mood and put her at higher risk of suicide attempts. Research on PMDD shows that roughly half of all women’s suicide attempts are made with the first four days before or after menstruation.
PMDD symptoms can include any of the following factors, and each woman with PMDD will experience different clusters of symptoms that can vary in intensity for each menstrual cycle:
- Extreme fatigue
- Problems sleeping
- Neurologic and vascular issues
Women with allergies and skin disorders are also prone to flare-ups around the time of menstruation if they have PMDD. PMDD is known to affect between 3% and 8% of all women of reproductive age. Symptoms usually start in a woman’s twenties, and symptoms can worsen during perimenopause.
What are the causes of PMDD and severe hormonal mood swings?
There is no exact known cause of PMDD. But current research suggests that a serotonin deficiency may cause PMDD and hormonal mood swings around the time of menstruation. Serotonin is a naturally occurring neurotransmitter found in the brain. It is used to regulate feelings of mood and well-being. A lack of serotonin can also be seen in people who suffer from depression.
Who is at risk of experiencing severe PMDD mood swings?
Women with a history of severe PMS symptoms, and who also have a personal history or family history of depression or postpartum depression may be at higher risk for experiencing PMDD symptoms.
What is the difference between normal mood swings and PMDD?
Around 90% of all women of reproductive age experience some form of PMS, including mood swings. For most women, these symptoms are mild and do not interrupt their day-to-day functioning. But for women with severe moodiness and other PMS symptoms, this can be a sign of PMDD. PMDD is diagnosed if symptoms are problematic enough to disrupt daily functioning. A doctor will need to establish a pattern of symptoms to determine if hormonal swings associated with PMDD causes them, and also rule out other physical or psychiatric symptoms that can mimic PMDD symptoms.
How can birth control alleviate mood swings?
When mood swings and severe PMDD symptoms are a direct result of hormone fluctuations, oral contraceptives can help decrease the severity of mood swings. Birth control pills help to regulate hormones so that women are not subjected to wild, sudden and severe fluctuations that can cause painful and uncomfortable symptoms.
When a woman is not taking the pill, her body will naturally produce estrogen within the first half of the menstrual cycle. During this time, estrogen tells the uterus to create the endometrial or uterine lining. The endometrium is where a fertilized egg will implant and form the placenta. When estrogen hits peak levels, one of the ovaries will release an egg. Once an egg is released, the body will produce progesterone hormones, which signals to the uterus to stop growing the endometrium.
If the egg is not fertilized, then both progesterone and estrogen fall. Once those levels bottom out, it signals to the uterus to shed the endometrium, thus resulting in a period. Unfortunately, some women are more sensitive to these changes in hormones and will experience PMS and PMDD symptoms. But taking oral contraceptives can diminish these hormone swings.
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How does the pill change hormone cycles?
A majority of birth control pills contain both synthetic estrogen and progesterone, and the pills are formulated to stop ovulation. The pill starts by releasing steady doses of estrogen with no peak levels, so the ovary isn’t signaled to release an egg. The pill then starts to deliver a regular dose of progesterone, so the uterus doesn’t grow the endometrium. With the pill, not only is an egg not released, but the uterus remains inhospitable to implantation.
Finally, the pill is given as a placebo for the final week of the cycle, inducing a period. This is referred to as withdrawal bleeding because it is the body’s reaction to a loss of hormones. With a steady dose of hormones via the pill, women won’t experience intense hormone fluctuations.
Can the pill make mood swings worse?
Every woman is different, so it’s important to try different hormonal contraceptive methods until a woman finds one that works for her specific biochemistry. Some studies show that women with a history of depression have a slight chance of experiencing worse moods when taking an oral contraceptive. It’s crucial that women let their doctors know if they have a history of depression before trying the pill or switching contraceptives. In most cases though, low-dose combination birth control pills will not cause mood swings.
It’s now simple, fast, and affordable to access birth control pills from the comfort of your own home. Contact Pandia Health today to see what birth control options you can use to alleviate mood swings and PMS discomfort.
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.
Can Birth Control Cause Depression?
Depression is one of the most common reasons women stop taking birth control pills. Despite this, research can’t explain the connection. If you experience depression while you’re on birth control pills, should you stop taking the pills? Here’s more on this controversial topic.
Birth Control Basics
Birth control pills contain hormones. These hormones change how your reproductive organs work in order to prevent pregnancy. Combination pills contain man-made versions of the female hormones estrogen and progesterone. These hormones prevent the release of an egg from the ovary, or ovulation. They also thicken your cervical mucus, which makes it hard for sperm to travel to your uterus and fertilize an egg.
Low-dose progesterone birth control pills, known as minipills, also change cervical mucus. Minipills take prevention one step further by thinning the lining of the uterus. This makes it difficult for implantation to occur.
The side effects of birth control are generally mild. These may include:
- spotting or irregular bleeding
- sore breasts
- a headache
- changes in libido
Many women also report weight gain and depression or mood swings.
Which Birth Control Is Right for You?
What Is Depression?
Depression is more than a temporary case of the blues. It’s a mood disorder characterized by long-term feelings of sadness and disinterest. Depression can interfere with daily life. The symptoms range in severity and may include:
- persistent sadness
- persistent anxiety
- feelings of hopelessness or pessimism
- decreased energy
- difficulty concentrating
- a loss of interest in hobbies
- reduced libido
- increased or decreased appetite
- suicidal thoughts
- suicide attempts
- digestive problems
It’s difficult to know why depression happens. The following are often thought to be causes:
- the environment
In some cases, depression can be linked to a traumatic event. In many cases, there’s no obvious cause.
Is There a Link Between Birth Control Pills and Depression?
Depression and mood swings are commonly reported side effects of birth control pills. Researchers have been unable to prove or disprove a link. The research is often conflicting.
A pilot study showed that depression is the most common reason women stop using birth control pills. It also found women using combination birth control pills were “significantly more depressed” than a similar group of women not taking the pills.
By contrast, a more recent study published in the Archives of Gynecology and Obstetrics (AGO) concluded that depression isn’t a common side effect of birth control pills. This study maintained that the link between the two is unclear.
Signs of Depression
Despite the lack of a definite link, many women report feeling depressed while taking birth control pills. According to the AGO study, this may be due to “the inconsistent use of the word depression.” This could also be due to variance in pill formulations
The perceived connection may also be due to a large number of women with depression. Approximately 12 million women in the United States experience clinical depression each year. Although exact numbers can’t be confirmed, it’s likely that many of those women take birth control pills. In some cases, the timing of depression may be a coincidence.
One study showed birth control pills may improve mood swings. The study used data from 6,654 non-pregnant, sexually active women ages 25 to 34 taking hormonal contraception. These women had fewer symptoms of depression and were less likely to report a suicide attempt than women using less effective contraception or no contraception.
Even though the evidence is contradictory, many drug manufacturers list depression on birth control package inserts as a possible side effect. For example, the physician’s insert for the combination pills Ortho Tri-Cyclen and Ortho-Cyclen lists mental depression as a side effect likely to be caused by the drug.
What You Should Do If You’re Depressed
Depression is serious and shouldn’t be taken lightly. If you’re experiencing the symptoms of depression, ask your doctor for a referral to a mental health professional. Your symptoms may be relieved through therapy or antidepressant medications.
If you’re in a depressive crisis or feeling suicidal, call 911, go to your local emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
To date, research hasn’t proven an undeniable link between birth control pills and depression. Still, the anecdotal evidence is strong. You know your body better than anyone. If you’re on birth control pills and experience depression symptoms for the first time, call your doctor. You should also call your doctor if previous depression symptoms worsen. Your doctor can help you decide if you should stay on your current pills, try another formulation, or use another form of contraception that doesn’t contain hormones.
You Asked: Do Oral Contraceptives Cause Mood Swings or Depression?
Many women have concerns about the side effects of oral contraceptives (birth control pills). Potential side effects include bloating, breast tenderness, and weight gain. In addition, some women may experience depression or mood swings, side effects that may influence a woman’s decision to start taking an oral contraceptive (OC), particularly if she has a history of depression. Despite the prevalence of OC usage, few studies have explored the association between hormonal contraceptive use and mood disturbance.
Clinically we find that some women report depression or mood swings with oral contraceptive. In our group, we refer to this as “OC dysphoria”. Women with OC dysphoria typically develop moderate to severe depressive symptoms shortly after starting oral contraceptives, and they usually stop taking it before finishing the first pack. While this is what we observe clinically, it is not a common side effect but is severe enough to lead to discontinuation. The few research studies we do have show that oral contraceptives are well-tolerated by most women.
The Harvard Study of Moods and Cycles examined the effect of oral contraceptives on mood. In this study, data from 658 women were analyzed to determine the proportion of women whose mood either improved or worsened while taking an oral contraceptive. In the overall sample, 107 women (16.3%) noted worsening of their mood on oral contraceptive, 81 (12.3%) experienced mood improvement, and 470 (71.4%) had no change in their mood. They noted that women with a history of depression were more likely to experience mood worsening on the pill than those with no history of depression. However, most women with a history of depression experienced either no change in their mood (61%) or mood improvement (14%); only a small number (25%) experienced mood worsening on the pill.
One of the largest studies included 6,654 sexually active non-pregnant women participating in the National Longitudinal Study of Adolescent Health. In a cohort of women aged 25–34 years, the researchers compared contraceptive users with other sexually active women who were using either non-hormonal contraception or no contraception. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale.
What they found was that users of hormonal contraceptives had lower mean levels of depressive symptoms and were less likely to have attempted suicide in the previous year (odds ratio = 0.37, 95% confidence interval: 0.14, 0.95) than women using other forms of contraception or no contraception.
While this study may provide some reassurance to women concerned about the impact of oral contraceptives on their mood, many questions remain. This was a cross-sectional study, where women were evaluated at a single time point. One might hypothesize that women who developed mood symptoms after treatment with an oral contraceptive most likely stopped taking OCs, so that in this study the hormonal contraceptive users as a group consisted primarily of women who tolerated OCs whereas the non-user group contained a higher number of women who were unable to tolerate OCs.
Of particular concern is the impact of hormonal contraceptives on mood in women with histories of depression. In the Harvard Study of Moods and Cycles, it was found that women with histories of depression were more likely to experience premenstrual mood worsening on OCs than women with no history of depression. However, most women with a history of depression experienced either no change in their mood (61%) or mood improvement (14%); only a small number (25%) experienced premenstrual mood worsening on the pill.
Before starting a birth control pill, women should talk to their clinicians about their history of depression. Those with a history of depression should be attentive to potential mood changes after starting an oral contraceptive; however, these studies taken together indicate that oral contraceptives may be a viable option for contraception for all women, including those with a history of depression.
Ruta Nonacs, MD PHD
Keys KM, Cheslack-Postava K, Westhoff C, et al. Association of Hormonal Contraceptive Use With Reduced Levels of Depressive Symptoms: A National Study of Sexually Active Women in the United States. Am J Eidemiol 2013.
Joffe H, Cohen LS, Harlow BL. Impact of oral contraceptive pill use on premenstrual mood: Predictors of improvement and deterioration. Am J Obstet Gynecol 2003;189:1523-30.
Can Hormonal Birth Control Affect Your Ability to Pick up on Social Cues?
Hormones are very powerful and can significantly influence our moods, behaviors, and how our brains function.
For example. high levels of estrogen have been associated with mood swings and anxiety, while low levels of progesterone have been linked to anxiety and depression.
However, when it comes to the external hormones used in prescription birth control, and how they impact people’s emotional functioning, there have been mixed theories.
“There have been previous research on mood changes and OCPs, however, the results are not consistent. Some studies suggest that OCPs are associated with depressed mood or anxiety, while some show the opposite,” Dr. Candice Fraser, an obstetrician-gynecologist and founder of Trinity Medical Care in New York, said.
Here’s how the medication works: There are estrogen receptors in areas of the brain — like the hippocampus — that are involved in memory and attention. When these receptors come in contact with estrogen, which is naturally produced by the body, they bind to the hormone and carry out various cognitive functions related to memory and learning.
It’s possible that, when exposed to the man-made hormones used in OCPs, those areas of the brain do not function as well, Monk suspects.
“When you’re on oral contraceptions, you are having this external, exogenous source of estrogen, so there is a question of how is the receptor dealing with that in the brain in terms of what’s typically available,” Monk explained.
In addition, previous studies using brain imaging have identified reduced activation of specific brain regions that are responsible for emotional salience in women taking hormonal contraceptives, compared to those who are not.
So, while it isn’t at all surprising that hormonal contraceptives could affect cognitive function, health experts agree that more research is needed to fully understand how, exactly, they affect emotion regulation and detection.
All things considered, it’s crucial for women to have complete autonomy over their reproductive abilities, says Monk. It’s important to have access to a lot of different tools — OCPs, IUDs, barrier methods — so each woman can choose the contraceptive that’s right for her.
Birth control pills may affect whom you are attracted to, experts say
The pill can dictate whom you fall in love with and significantly lower your sex drive, according to experts.
A top psychologist found that the contraceptive pill can significantly affect a woman’s brain and change her personality, she claims.
Dr. Sarah Hill revealed that it affects “sex, attraction, stress, hunger, eating patterns, emotion regulation, friendships, aggression, mood, learning, and so many other things.”
In particular, she said, women on the pill are attracted to less masculine men and are less interested in sex.
That’s because the hormone progesterone, which sends a message to the body that ovulation is not required, is dominant throughout your cycle.
“When you’re on the pill, progesterone dominates the entire cycle. And rather than experiencing an increased preference for sexy men at high fertility like naturally cycling women do, pill-taking women exhibit an unwavering preference for men with less masculine faces and voices,” Hill told the Daily Mail.
“This is the sort preferred by naturally cycling women during the second half of their cycles, when progesterone is high.”
Several studies have supported this — with one led by Craig Roberts at the University of Stirling revealing that those not taking the pill when they met their partners generally found their other halves sexier.
On the other hand, those who had met their partner while they were on the pill didn’t have as good sex lives.
Despite this, women who chose their partners when they were on the pill were more satisfied with their partners’ financial providing and intelligence than the women who chose their partners when they were off it.
And women who chose partners when they were on the pill were significantly less likely to divorce than women who chose their partners when off it.
“It seems a natural cycle makes a woman more attuned to sexiness thanks to estrogen levels, but progesterone dominance in pill-taking women emphasizes qualities that would have helped to keep them safe and secure when preparing for pregnancy,” Hill added.
On top of this, the pill makes your brain “less interested in sex” and can “dial down your sexual motivation.”
This may have an impact on how attractive a woman may look.
Hill revealed that women not on the pill are more open to “new experiences” and put more effort into their appearance as they’re at a high fertility.
“When women are coming into their fertile period, hormones do their utmost to make them attractive to a mate,” she said.
“Women at high fertility also wear more makeup, wear sexier clothes, and wear more red, a color known to make women appear particularly attractive and desirable to men.”
One unconventional study, made by the University of New Mexico, even revealed that dancers at a strip club earned more money when they were not on the pill in comparison to those who were.
Dancers not on the pill earned an average of $69 per hour, whereas those on the pill averaged around $37 per hour.
A recent study found that the pill “numbs a woman’s emotions” and “harms relationships.”
It revealed that while women on the pill can tell if someone else is happy or scared, they’re 10 percent less likely to pick up on pride or contempt.
Alexander Lischke, from the University of Greifswald in Germany, said: “More than 100 million women worldwide use oral contraceptives but remarkably little is known about their effects on emotion, cognition and behavior.
“Findings suggest oral contraceptives impair the ability to recognize emotional expressions of others, which could affect the way users initiate and maintain intimate relationships.”
Earlier this year, experts warned that 1 million women could be taking the wrong contraceptive pill — and could be suffering nasty side effects in silence.
Common side effects of the contraceptive pill include:
- Headaches and migraine
- Weight gain
- Mood changes
- Loss of libido
- Missed periods
- Vaginal discharge
- Breast tenderness
- Spotting between periods
Doctors estimate 3 million women are plagued by nasty side effects of their contraception, yet a third have never raised the issue with their doctor, meaning they are likely suffering in silence, unaware there could be a solution.
Earlier this month, a nurse claimed that the pill triggered two strokes in one week.
Hannah McGrath, 23, revealed she felt a sudden burst of pain explode in the back of her head while in the kitchen and the room started spinning.
Three Reasons “the Pill” may Be Hurting Your Relationship
To 80 percent of the females reading this article, this is a painfully familiar routine. As if setting those alarms on your cell phone to remind you of your daily appointment with synthetic hormonal overload isn’t embarassing enough. Or, as if crying to hallmark greeting card commercials isn’t annoying enough to everyone sane around you. (Or, as if the possible downstream environmental consequences of turning female frogs into male frogs isn’t, kind of, absolutely, terrifying enough.) As if these reasons weren’t enough to convince you of the disruptive power of the Pill, there’s even more to the story. And it’s not looking good for us (or our boyfriends, for that matter).
These days, you don’t even need to be sexually active for a prescription—doctors are putting women on the Pill to clear up acne, to regulate the menstrual cycle, and to alleviate heavy periods. Currently, more than 100 million women worldwide take this tiny pill on a daily basis. For many women, it’s a quick, easy fix, and after all, it is 99.7% effective at preventing unwanted pregnancy. But as with fast food, and everything else that’s gloriously easy and convenient, we have to wonder, ‘at what cost?’ Since the Pill’s arrival on the birth control scene in the 60’s, study after study has been published arguing for or against the health risks associated with long-term usage of the Pill. But what threat could it pose to the health of our relationships?
1) Immunocompatability and Attraction: The Pill could be drawing you towards a genetically incompatible mate
Scent is one of the most powerful communicators in the mating game. According to a 2008 study at the University of Liverpool, hormones contained in the Pill may alter a woman’s ability to sniff out the best mate.
Encoded in a man’s scent are clues to his genome. In specific, researchers have found that a man’s scent is strongly related to the genes found in a section of DNA called the major histocompatability complex (MHC). This is the most gene-dense section of the human genome, and is responsible for producing molecules that help the immune system combat foreign invaders. The more variable your genetic code in this region, the better prepared your immune system is to defend itself from illness. Increased heterozygosity in this section of the genome is achieved in the offspring of two individuals with very different MHC profiles. Because offspring with the most variable MHC are more likely to survive, women may be evolutionarily programmed to be more attracted to men with a very different set of MHC genes.
Previous research has supported this notion, finding that ovulating women preferred the scents of men with MHC profiles that contrasted from their own. In the 2008 study, female subjects not on the Pill indicated a preference for the scent of T-shirts worn by MHC-dissimilar men. When they were placed on the Pill however, their hormone changes were linked with a shift in scent preference. The subjects were now more likely to rate the scents of T-shirts worn by MHC-similar men as pleasant and desirable.
Some evolutionary psychologists attribute this strange change in behavior to the pressures our female ancestors faced during pregnancy. In the era of adaptation, pregnant women who sought the comfort and care of family were more likely to survive, and so were their offspring. Since families share a huge chunk of genetic code, and therefore MHC genes, preference for the scent of MHC-similarity during pregnancy may have been adaptive. The pill works to bring ovulation to a halt by circulating hormones that trick the body into thinking that it’s pregnant. As a result, researchers believe, women on the Pill may instinctively crave MHC-similar men to help nurture their “pregnancy.”
So maybe lower-genetic-quality offspring doesn’t really concern you (though…I think it should). But if the point of the Pill is for two people to be able to enjoy sex without worrying about kids just yet, then it could be defeating its purpose altogether. A study published in 2007 found that women who are paired with MHC-similar men are less sexually satisfied, and more likely to cheat on their partners than women paired with MHC-dissimilar men.
2) The Pill may be killing your sex-drive
Studies have yielded mixed results about whether the Pill actually lowers libido in women. However, a recent, large study in Germany found a correlation between hormonal contraceptive use and incidence of sexual dysfunction. Women on the Pill reported higher rates of problems with orgasm, desire, satisfaction, lubrication, pain, and arousal, compared with women who were using no contraception or non-hormonal contraception.
Testosterone is an important hormone in both males and females, and helps fuel libido. Hormonal contraceptives disrupt the surge of testosterone (and estrogen) that occurs mid-cycle for females. It is at this time that women are most likely to conceive, and therefore, most primed for romance. So, when the Pill interrupts fertility, it takes desire down with it.
3.) If you’re a stripper, the Pill could make your clients tip less (Or, men may be less attracted to women on the Pill)
A notorious study by Geoffrey Miller and his colleagues in 2007 revealed that strippers make significantly more money during the days of peak-fertility in their cycle. Moreover, lap-dancers who are on the Pill (and therefore, infertile) made an average of $37 an hour less than those not on the pill. Researchers attribute the economic fluctuation to slight changes in body odor, waist-to-hip ratio, facial features, and even language.
So, when is that male birth-control pill thing happening?
We Know Surprisingly Little About How Birth Control Affects Our Brains
Since the first birth control pill was approved in 1960, tens of millions of people have used oral contraceptives to prevent pregnancy and regulate their periods. Many have been on the pill for decades. And yet, scientists know basically nothing about how birth control affects our brains.
We know plenty about the ways oral contraceptives can affect our physical health. Common side effects include headaches and dizziness, nausea, decreased libido, and breast tenderness. Many of these side effects are temporary and will go away as you continue to take the pill. Hormonal contraceptives can also sometimes (but rarely) cause more serious side effects like blood clots, heart attack, and stroke and are therefore generally not recommended for anyone who has a heart condition.
Even though mood swings are one of the most commonly reported side effects of hormonal birth control, there’s hardly any research into how the pill interacts with our brains. “There’s really very little research I’m aware of on this topic, despite the fact that the pill has been around for more than half a century,” Justin Lehmiller, PhD, a research fellow at the Kinsey Institute and author of Tell Me What You Want, tells Health. “The studies that do exist tend to have quite small samples and aren’t well suited to determining cause and effect.” There’s so little research that Lehmiller doesn’t feel confident saying anything about birth control and the brain—except that we need more research.
RELATED: 6 Birth Control Mistakes You Didn’t Realize You Were Making
Ob-gyn Felice Gersh, MD, author of PCOS SOS: A Gynecologist’s Lifeline To Naturally Restore Your Rhythms, Hormones and Happiness, however, feels quite confident that birth control affects our brains. “To think won’t affect the brain would actually be ludicrous,” she says. That’s because birth control was designed as an endocrine disruptor. While we often call certain types of birth control—such as the pill, IUDs, vaginal rings, and skin patches—“hormonal” birth control, there aren’t any “real” hormones in them. Instead, there are chemicals meant to mimic the hormones progesterone and estrogen.
These pretend-hormones, as Dr. Gersh calls them, have some similarities with real hormones but can have different effects. And by essentially “replacing” your body’s real progesterone and estrogen with the synthetic versions, the pill may tinker with your brain, she says. “We do know that hormones are hugely important to brain health and brain function,” she says.
For starters, estrogen is involved in maintaining your circadian rhythm, or your internal body clock. Research indicates that when that time-keeping gets thrown off—which can affect the sleep-wake cycle, hormone release, eating habits, digestion, and body temperature, among other 24-hour cycles—we’re at higher risk for psychiatric illnesses like depression and anxiety.
RELATED: How to Know If Your Bad Mood Is Actually Depression
Birth control may also alter our gut microbiomes, the community of bacteria that live in our stomachs and intestines, Dr. Gersh says, “and we know that the gut microbiome is related to brain function.” If taking birth control changes the population of bacteria in your gut, and the bacteria in your gut affect your brain, then it stands to reason that taking birth control will also alter your brain. Will it change your brain in good ways or bad? That we still don’t know, because there is so little research—especially research with large-enough sample sizes to say anything conclusive.
There are certain things we can guess at, thanks to the past 50 years of people taking birth control. We know that many people on oral contraceptives report anxiety and/or depression as a side effect. Up to 9% of women who take combined hormonal pills report changes in mood, according to Kelley T. Saunders, MD, an ob-gyn with Banner University Medicine Women’s Institute.
Some studies that have looked into this phenomenon suggest that people who are already at risk for mood disorders, because they have a family history, are most likely to be triggered by birth control. Other studies claim that women who are on the pill are no more likely to experience symptoms of depression than women who aren’t on the pill. “There’s a lot of conflicting data, and no consistent evidence,” Dr. Saunders says.
Yet she’s seen birth control actually help some patients with mood disorders such as PMS or PMDD (premenstrual dysphoric disorder). Many of us have likely blamed a crabby mood or two on PMS, but PMDD is more severe. It’s a condition that causes extreme irritability, depression, or anxiety in the weeks leading up to menstruation.
Birth control is one of the common treatment options for PMDD, Dr. Saunders says. “The fluctuations of natural hormone levels may be contributing to these mood disorders,” she says. “And we’ve seen women with pre-existing PMS and PMDD do better on continuous-use hormonal contraceptives.” For some, it seems that a steady level of “fake hormones” is better than up-and-down levels of real ones.
RELATED: Is It Really OK to Skip a Period Using Birth Control?
It’s important to remember, though, that all of this is still theory. Does taking birth control change your gut bacteria and therefore your brain? Does it throw off your circadian rhythm and put you at risk for psychiatric disorders? Does it cure pre-menstruating people of their irritability and depression? Maybe. But science hasn’t conclusively told us any of that yet.
And it’s hard to question nearly 60 years of reproductive freedom based only on theory. Hormonal birth control has without a doubt changed lives simply by making it possible to choose when to start a family. “Overall, oral contraceptives have a number of benefits,” says ob-gyn Kecia Gaither, MD, who’s also board-certified in maternal fetal medicine. Those benefits include pregnancy prevention, of course, but also clearing acne, treating severe cramping and heavy bleeding, decreasing symptoms of endometriosis, preventing ovarian cysts, treating symptoms of PCOS, and decreasing risk of ovarian and endometrial cancer.
So the first step isn’t to drop your birth control. The benefits still seem to outweigh the costs for many. Instead, we need more research about what birth control is really doing to our brains. As Dr. Gersh points out, “If we aren’t aware of what we’re doing, we’ll never get quality alternatives.”
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