Birth Control and Mental Health

Mental health is an important aspect of a person’s overall health. About 20% of American adults are currently experiencing mental health issues, which is around 50 million people.

What is the connection between medication and mood?

Hormones are chemical messengers that send signals to different parts of your body. Medications containing hormones also function by sending messages throughout the body. Any imbalances can result in negative mood symptoms, and in some cases lead to depression or anxiety. Fluctuating hormones in your body during your menstrual cycle can cause mood changes that may cause you to feel sad, angry, or irritable prior to your period. This is also known as premenstrual mood symptoms (PMS). 

Does birth control impact mental health positively or negatively? (It can be both!)

People who take birth control can experience a variety of side effects. Many side effects are physical (changes to your skin, periods, weight, etc.), but some people may experience changes in mood as well. More research is needed to look into the impact of birth control methods on people’s mental wellbeing; there are differing opinions in the scientific community about birth control’s relationship with mental health and the mechanisms through which they affect any change are less well understood. 

Currently, while the majority of available data recognizes a relationship between mood and use of hormonal birth control, the use of hormones in people with mood disorders is safe and does not seem to be associated with an increase in the likelihood that someone will develop negative mood symptoms. There are few studies that have suggested an increase in negative mood symptoms, but the risk is low overall. The Centers for Disease Control and Prevention (CDC), US Medical Eligibility Criteria (MEC) for contraception does not restrict hormonal contraception in people with an underlying mood disorder. 

Positive impacts have been observed in the Harvard Study of Moods and Cycles, where the majority of people who had a history of depression experienced either no change in their mood when taking hormonal birth control (61%) or even a mood improvement (14%). Hormonal birth control can sometimes help to alleviate the depressive symptoms that are associated with premenstrual symptoms (PMS) and premenstrual dysphoric disorder (PMDD). For many people, being on a form of birth control also contributes positively to mental health and wellbeing because of its protection against an unwanted pregnancy.

If you’re speaking with a doctor about starting birth control, is it important to disclose mental health conditions?

It’s important to speak with your doctor about any health conditions you have and any medications you are taking, to make sure they have your full medical history when deciding which type of birth control is appropriate for you. It’s not always possible to predict what symptoms you will have when you start a method of birth control, and you should feel comfortable following up with your doctor if you do experience any side effects. This way, the doctor can work with you to find another birth control brand or method that might be more suitable. 

What should you do if you have concerns about mental health?

Generally, hormonal birth control is safe, regardless of someone’s history of mood disorders. If negative mood changes develop, it’s important to speak with your doctor and they may screen for an undiagnosed mood disorder. In some cases, they may refer you to a psychiatrist, change your hormonal birth control method, and/or start an antidepressant if that’s necessary. Your doctor may start with a lower dose of estrogen, try different progestins, or select birth control formulations with evidence to help address different mood disorders. 

If you’re in crisis, call your mental health provider, 9-1-1, or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). You can also use their online chat feature to talk to a skilled, trained counselor at a crisis center in your area.

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