Birth Control & Anxiety: What's the Connection?

When mental health disorders like mood disorders and anxiety disorders interact with hormone-affecting medications like birth control, some women can feel like everything just gets worse.

 And those feelings are completely valid. So, let’s talk about birth control and anxiety.

Does birth control cause anxiety? How strong is the link? Is there anything you can do to help lessen the severity of your anxiety symptoms while on birth control? 

First, we start with the basics. Then, we dive into the potential connection between birth control and anxiety and what you can do if you’re feeling more anxious while taking hormonal contraceptives.

 Anxiety disorders are, by definition, not single-day events. They involve a chronic or repeating pattern of negative feelings that affect your quality of life. 

A person with an anxiety disorder feels a lot of negative emotions, but the most powerful of them is fear — fear around hypothetical or potential danger.

And these fears can be so powerful they make life a little worse. 

If you have an anxiety disorder, you might worry so much about potential dangers that you shift your life around to accommodate your fears – sometimes at great personal cost. 

So, what does all of this have to do with birth control? 

When we talk about birth control, we’re referring to hormonal contraceptives like:

• Birth control pills 

• Birth control patches

• Birth control shots

• Implants 

• Intrauterine devices (IUDs)

• Vaginal rings 

Combined oral contraceptive pills contain synthetic forms of the hormones estrogen — ethinylestradiol — and progesterone —progestin. Another form of oral contraceptive is the mini-pill and it contains only progestin.

These hormones prevent ovulation (AKA when the ovaries release an egg). And because there’s no egg ready to be fertilized, you can’t get pregnant. 

Hormones and Your Mood

Because birth control affects your hormones, some experts theorize that using oral contraceptives could affect your mood.

And the research backs this up. Your brain has estrogen and progesterone receptors. And both hormones can influence mood-related neurotransmitters like

• Serotonin

• Dopamine

• GABA

While estrogen mostly has anti-anxiety effects, there’s a link between higher levels of progesterone and increased anxiety. Progesterone levels might also have something to do withpremenstrual syndrome (PMS) and its more severe counterpart, premenstrual dysphoric disorder (PMDD).

Hormones and Stress

Some research suggests that hormonal birth control may impact the body’s stress response, potentially affecting your mood. 

A 2024 study found that women using hormonal contraception had a stronger reaction to stress with increases in inflammation markers compared to non-users.

Anxiety and Birth Control Prevalence

So, how common is it to experience anxiety on birth control?

A 2011 review by Swedish researchers analyzed 50 years of birth control studies and found that four to ten percent of contraceptive pill users reported mood changes or emotional side effects, including anxiety. However, researchers note that many of the included studies weren’t placebo-controlled.

Some women report feeling more anxious or depressed while taking birth control. 

A 2023 survey study found nearly 40 percent of women with a history of mental health issues noticed their symptoms worsened while on birth control. 

The effects on hormones on the brain are complex — and poorly understood. But some women find that taking hormonal birth control reduces anxiety.

The Pill and Lower Anxiety Levels

One 2014 study found that women on oral birth control had a lower prevalence of panic disorder symptoms in the past year. The same study also hinted at a possible link between the pill and a reduced risk of generalized anxiety disorder (GAD) — though researchers point out that the connection wasn’t statistically significant.

Symptoms During Pill-Free Week

In some studies, symptoms often crop up during the pill-free interval of the treatment cycle. This suggests that a lack of medication may affect mood more than the pill itself. 

A 2023 study found that 12.67 percent of women on combined birth control pills felt more negative emotions during the pill-free break, while 7.42 percent reported increased anxiety. This happened no matter which pill formulation they took. 

One caveat: The researchers noted that these emotional side effects were similar to natural mood changes that happen throughout the menstrual cycle. 

Poor Study Data

There’s also a lack of standardization in the results we do have. 

A 2016 review of birth control mood studies since the 1980s found that many studies measured mood symptoms differently. And few separated types of hormonal birth control for accurate results. 

Mood-related symptoms could also stem from the psychological effects of taking birth control, like circumstances that lead to using contraception. Environmental stressors might also play a role. 

What about hormonal intrauterine devices (IUDs)? Can IUDs have negative effects on your mood?

Evidence suggests it’s possible. 

A 2020 case study outlines one woman’s experience with a levonorgestrel intrauterine device. After getting the IUD, she experienced symptoms of depression, panic attacks, suicidal thinking — all occuring within weeks of implantation. 

After removal, she saw major improvement in her mood and mental health. 

And this wasn’t the first report of side effects with an IUD containing levonorgestrel 

A 2018 study found a link between levonorgestrel IUDs and anxiety and sleep problems. Though researchers concluded that more research was needed. 

A couple of limited studies are far from scientific certainty, but it’s enough data to suggest that if you’ve experienced anxiety with an IUD, you’re not alone. 

There’s no surefire way to prevent the mental health side effects of birth control. That's partly because we don’t fully understand the biological reasons behind anxiety in general. 

What you can do is focus on reducing triggers like stress, while managing the effects of factors you can’t control, such as genetics or hormonal changes.

Keep an eye out for signs of anxiety, and share them with your healthcare provider. They can help you find the right treatment plan. 

If birth control seems to be a factor, ask your provider about switching to a different form or brand. Different brands contain different levels and proportions of hormones. With a little patience, you might find one that doesn’t cause side effects.

And sometimes, small lifestyle tweaks, like getting better sleep, limiting caffeine intake, and eating a balanced diet can make a big difference. 

Other times, treatment might include antidepressants or therapeutic techniques like cognitive behavioral therapy (CBT).

Birth control pills, oral contraceptives, IUDs — all of these products are designed to help, not cause more problems. 

But side effects can happen.

Let’s recap what we know about birth control and anxiety:

• The research is mixed. Some studies suggest there’s a link between mood changes and birth control use. Others not so much.

• Other factors could be at play. Hormones can influence your mood but they’re just one potential contributing factor. Plus, hormone shifts naturally happen throughout your menstrual cycle, too. 

• Talk to a doctor about your symptoms. Whether you’re feeling moody or noticing other worrisome changes after starting birth control, it’s always a good idea to bring it up with your provider. 

And if you do experience mental health concerns while taking birth control? Help is available for whatever you’re dealing with. Be it anxiety, major depression, sex drive issues, or bipolar disorder.

Reaching out to a healthcare provider is a great first step.