Birth Control and Depression: What You Need to Know

    Birth Control and Depression: What You Need to Know
    Kristin Hall, FNP
    Medically reviewed by Kristin Hall, FNP Written by Our Editorial Team Last updated 9/21/2020

    Mood changes are are a side effect that may be experienced by women who use hormonal methods of birth control such as the birth control pill. 

    Despite this, research on the topic of birth control and depression hasn’t been able to produce much in the way of detailed findings on why many women feel depressed after starting hormonal contraception.

    If you feel depressed after you start using the pill, patch or other hormonal forms of birth control, you’re not alone. Below, we’ve looked at the possible link between birth control and depression to find out why it may happen, as well as what you can do if you feel depressed.

    How Hormonal Birth Control Works: An Overview

    Before we get into the specifics of birth control and depression, it’s important to explain how the birth control pill and other forms of hormonal birth control work.

    Hormonal contraceptives like the pill, patch, ring or shot contain hormones that prevent you from becoming pregnant by either stopping you from ovulating (releasing eggs from your ovaries), by thickening your cervical mucus, or by doing both of these things at once.

    This makes it significantly less likely that your partner’s sperm will come into contact with your egg , resulting in pregnancy.

    Some forms of hormonal birth control, such as the progestin-only mini-pill, also affect the lining of your uterus, making it harder for a fertilized egg to implant and develop into a pregnancy. 

    Used the right way, most methods of hormonal birth control are highly effective. According to the CDC, the pill, patch, ring and shot -- four of the most common methods of hormonal birth control -- are between 91 and 94 percent effective at preventing pregnancy.

    Like other hormonal medications, hormonal methods of birth control can cause a range of side effects. These can vary from one medication to another. For the birth control pill, common side effects include spotting, breast tenderness, nausea, weight gain and lighter periods.

    We’ve explained these side effects and others in more detail in our guide to the side effects of the birth control pill

    Birth Control and Depression

    Another side effect of hormonal birth control is the potential for mood changes. Some studies of hormonal birth control have found that women who use contraceptives like the pill may be likely to experience certain emotions and mood changes.

    For example, one study noted that between four and 10 percent of women who use combined oral contraceptives (COCs) report adverse effects on their mood.

    In this study, women with previous experience of mood deterioration while using hormonal birth control were split into two groups. One group received a levonorgestrel contraceptive, while the other was given a non-therapeutic placebo.

    During the last week of the study, the women who received the levonorgestrel reported higher scores for mood swings, fatigue and depressed mood than the group of women who received the placebo. 

    The study authors concluded that use of combined oral contraceptives was accompanied by a change in emotional brain reactivity, and that the contraceptives resulted in mood deterioration for the women that took part in the study.

    The findings from this study are interesting, but with only 34 women taking part, it’s hardly the large, diverse sample that’s typically needed to draw any firm conclusions. 

    A much larger study from 2016, which featured data from more than one million Danish women aged 15 to 34, also found a link between birth control and depression.

    In the study, researchers found that women who use hormonal birth control, particularly during adolescence, had an elevated risk of subsequently being diagnosed with depression and using antidepressants.

    The data revealed that all forms of hormonal birth control were associated with a higher risk of developing depression. However, the risk was highest with the hormonal birth control patch, a form of birth control that’s highly effective at preventing pregnancy.

    Adolescent women aged 15 to 19 also had a high risk, especially those who used the IUD, ring or patch as their form of birth control.

    While this data might sound alarming, it’s important to keep in mind that the overall increase in risk for depression revealed in the study was small. 

    The researchers found that approximately 1.7 out of every 100 women who did not use a form of hormonal birth control later developed depression, versus 2.2 out of every 100 women who did use hormonal birth control.

    In short, although there is some link between birth control and depression, research indicates that it only affects a relatively small percentage of women who use hormonal contraceptives.

    Benefits of Hormonal Birth Control

    Although the potential side effects of birth control can seem scary, it’s important to remember that there are also numerous benefits of hormonal birth control beyond reducing your risk of pregnancy. These include:

    We’ve explained these benefits in more detail in our full guide to the non-pregnancy benefits of using birth control

    What to Do if You Feel Depressed

    Depression is a common condition. In fact, according to the Centers for Disease Control (CDC) women are about twice as likely to develop major depressive disorder (MDD) than men, as well as other, related conditions such as seasonal affective disorder (SAD).

    If you’ve recently started using birth control and feel depressed, the best thing to do is to talk to a doctor. 

    We offer the ability to talk to a mental health practitioner for an online evaluation. If appropriate, you may be prescribed evidence-based medication to help improve your mood and treat your depression. 

    Depression is a treatable condition. If your doctor thinks that your depression is related to your use of hormonal birth control, they may recommend that you switch to a different contraceptive to see if your symptoms improve. 

    Your doctor may also prescribe medication to lift your mood, treat your symptoms and help you recover from depression. This may include:

    • Selective serotonin reuptake inhibitors (SSRIs)
    • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
    • Tricyclic antidepressants (TCAs)
    • Monoamine oxidase inhibitors (MAOIs)
    • Atypical antidepressants
    • Antipsychotics, mood stabilizers and other medications

    Many of these medications are scientifically proven to improve the symptoms of depression over the long term. Most people begin to notice improvements after using antidepressants for a period of time. 

    Your doctor may also recommend other forms of treatment, such as therapy. Research shows that psychotherapy in combination with antidepressants may be more effective for people with depression than the use of medication alone or psychotherapy alone.

    In Conclusion

    Research shows that using hormonal forms of birth control such as the pill, patch, ring, shot and IUD may increase your risk of developing mood symptoms or depression. 

    However, the increase in your risk of developing depression is relatively small, with women who use hormonal birth control only minimally more likely to develop mood symptoms or become depressed than those who don’t. 

    Hormonal forms of birth control such as the pill, patch, ring, shot and IUD offer a wide range of benefits beyond protecting you from pregnancy. Serious side effects are not common and most women are able to safely use the pill or other forms of birth control without any significant issues. 

    If you’ve recently started to use hormonal birth control and feel depressed, talk to a doctor. Your doctor will work with you to find a suitable treatment to improve your mood and help you recover from your depression.

    Learn More About Birth Control

    Interested in using birth control? From the pill to the patch, ring, shot, IUD and more, there are numerous different options available that can reduce your risk of becoming pregnant, all while offering other advantages. 

    Our guide to your birth control options goes into greater detail on the forms of birth control that are available, covering everything from convenience to effectiveness, protection from sexually transmitted diseases (STDs), side effects and more. 

    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.