Birth Control & Anxiety: What's the Connection?

Kristin Hall

Reviewed by Kristin Hall, FNP

Written by Geoffrey Whittaker

Updated 11/08/2022

When mental health disorders, 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 fair. So, let’s talk about birth control and anxiety.

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

There are some things you need to know about anxiety and birth control before we can answer that question, so let’s start with the basics.

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

A person with an anxiety disorder feels a lot of these negative emotions, but the most powerful of them is fear — fear about the hypothetical or perceived risks of danger in the future. 

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

A person with an anxiety disorder might feel so worried about crime where they live that they avoid making plans after dark altogether, rather than put themselves in a position to be even a hypothetical victim. 

In other words: anxiety disorders make you envision the worst outcome for future events, and you make choices to avoid those risks — sometimes, at great personal cost.

So, what does all of this have to do with birth control? Well, because birth control affects your hormones, it’s hypothesized by some experts that long-term use of birth control can affect your mood and possibly even make your anxiety worse.

A 2011 review of 50 years of birth control studies, for instance, found that as many as four in 10 contraceptive pill users may suffer some form of mood disorder symptoms or emotional adverse effects during their use of the pill, including symptoms of anxiety

Some women say they can feel their depression and anxiety levels increase (and the resulting stress increase) while taking birth control

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However, there have also been numerous studies in the last few decades that have found that hormonal contraception doesn’t affect your mood. 

Adverse effect incidents are fairly uncommon in these studies, and four in 10 isn’t a majority, even if we give the data the benefit of the doubt.

And the data in question is admittedly not terribly reliable. That 2011 review acknowledges that many studies haven’t used placebos. 

And the symptoms they did record often happen during the pill-free interval of the treatment cycle, suggesting the lack of medication may affect mood more than the medication itself. 

It may even be that some reported symptoms are not related to the pill at all.

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 mood was measured differently in many studies  and that there were few studies that actually separated types of hormonal birth control for accurate results. 

The result is a lot of data that sort of has to be converted and approximated if you want to paint a complete picture.

We’ve mostly discussed oral contraceptives, but what about intrauterine devices  (IUDs) — can IUDs have negative effects of your anxiety? 

Evidence suggests that it’s certainly possible. 

A case study from 2020 found that one woman suffered escalated symptoms of depression and panic attacks after having her Levonorgestrel® intrauterine device replaced. 

The patient in question saw that those effects — which included suicidal thoughts — occurred within weeks of implantation, and a couple of weeks after it was removed, saw marked improvements in her mood health and mental health generally.

This wasn’t the first time an IUD containing Levonorgestrel was documented for these effects. 

A 2018 comparative study found that Levonorgestrel IUDs have a “statistically significant association” with anxiety and sleep problems. 

It concluded that additional studies were warranted, but stopped short of blanket recommendations for altering treatments.

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.

At the end of the day, it’s not entirely clear that hormonal birth control and the birth control itself is at fault, regardless of whether the contraceptive is a pill or IUD. 

Some studies have posited that it’s the psychological effects of taking birth control, the life situations in which birth control like oral contraceptive pills are needed and other environmental psychological factors that can lead to increased anxiety in contraceptive users. 

Unfortunately for the people who experience anxiety due to birth control, preventing or curing those adverse effects on your mental health isn’t really possible. 

Preventing anxiety in the first place is generally difficult because little is known about the underlying biological mechanisms that could potentially cause anxiety from hormonal birth control.

You can, however, reduce certain risk factors that may trigger anxiety disorders like stress. With genetics and the side effects of birth control, you really just have to treat and manage those adverse effects as they come. 

Monitoring for signs of anxiety and reporting them to a healthcare provider is a great way to get tailored treatment when anxiety does happen. 

As for the birth control issues with anxiety, a healthcare provider can help with that too, if need be. Switching forms of birth control might be an option—that’s part of a bigger conversation about your quality of life.

Treatment could also be quite simple. It may just be a question of making certain lifestyle changes, like getting better sleep, limiting caffeine intake and eating a balanced diet. 

Treatment may also come in the form of medication like antidepressants, or therapeutic techniques like cognitive behavioral therapy — you won’t know until you talk to a professional.

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

Each birth control method does come with some common side effects, and this is something that most women accept as part of the package.

However, that doesn’t mean there’s nothing you can do to help alleviate your symptoms of anxiety if you’re experiencing them.

You deserve support for your mental health, whether it be for anxiety, major depression, sex drive issues, bipolar disorder, dysphoric disorder or any others. 

Depressive symptoms and anxiety symptoms aren’t something you have to live with, and certainly not as side effects of methods of birth control.

Luckily, that’s something we can help with. 

Hers’ online therapy platform is a great first step to take if you’re trying to connect with healthcare professionals and find the right person to support your anxiety management — including your concerns about the right to access necessary healthcare products. 

If your medication is contributing to existing anxiety issues, our mental health resources can help you navigate your options.

Getting the help you need and deserve isn’t always easy. If we can make just one part of it a little less difficult, we’re here to help.

6 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Slattery J, Morales D, Pinheiro L, Kurz X. Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice. Drug Saf. 2018 Oct;41(10):951-958. doi: 10.1007/s40264-018-0683-x. PMID: 29785475.
  2. Robinson SA, Dowell M, Pedulla D, McCauley L. Do the emotional side-effects of hormonal contraceptives come from pharmacologic or psychological mechanisms? Med Hypotheses. 2004;63(2):268-73. doi: 10.1016/j.mehy.2004.02.013. PMID: 15236788.
  3. Zeiss R, Schönfeldt-Lecuona C, Gahr M, Graf H. Depressive Disorder With Panic Attacks After Replacement of an Intrauterine Device Containing Levonorgestrel: A Case Report. Front Psychiatry. 2020 Aug 28;11:561685. doi: 10.3389/fpsyt.2020.561685. PMID: 33005164; PMCID: PMC7485277.
  4. Schaffir J, Worly BL, Gur TL. Combined hormonal contraception and its effects on mood: a critical review. Eur J Contracept Reprod Health Care. 2016 Oct;21(5):347-55. doi: 10.1080/13625187.2016.1217327. Epub 2016 Aug 15. PMID: 27636867.
  5. Poromaa IS, Segebladh B. Adverse mood symptoms with oral contraceptives. Acta Obstet Gynecol Scand 2012;91: DOI:10.1111/j.1600-0412.2011.01333.
  6. Chand SP, Marwaha R. Anxiety. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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