More than half of women in the United States are using some form of birth control, but many are worried that birth control could cause depression. Is this true?

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Some people have reported mood changes and depression when using hormonal birth control. Many have chosen to stop taking or avoid hormonal methods entirely due to fear of unwanted mood-related side effects.

So far, studies looking at the link between hormonal contraception and depression have yielded mixed results.

Some large-scale studies suggest that there’s indeed an association between birth control and depression, but other studies suggest the opposite, finding that hormonal birth control could even reduce mood problems in some women.

The link between hormonal birth control and depression remains inconclusive.

Many women have reported that their hormonal birth control has altered their mood or caused them to feel depressed. But studies are divided on whether there’s a definitive association between birth control and depression.

One of the most significant studies linking depression with hormonal contraception is a 2016 study of more than a million women aged 15 to 34 years living in Denmark. The researchers used data collected over a 14-year period.

The researchers concluded that all forms of hormonal contraception — including combined and progestin-only pills, patches, implants, and IUDs — were associated with an increased risk for depression (measured as taking antidepressants or having a first diagnosis of depression). The risk was higher in adolescents.

A 2018 study of more than 800,000 Swedish women ages 12 to 30 years found that use of hormonal birth control was associated with later use of antidepressant or anti-anxiety drugs. This link was found among young adolescents, but not in adults.

A 2019 review study summarizes recent research, concluding that, “Based on the evidence currently available, it is likely that [hormonal contraceptive]-intake can lead to mood-related side effects, particularly in women with a history of previous depressive episodes.”

However, other studies find no association between birth control and depression.

One 2019 study of over 4,000 adolescent females in the United States reported that oral contraceptive pills did not appear to increase the risk of depression.

A 2018 review of the use of progestin-only hormonal contraceptives did not find an association with depression. The researchers reviewed 26 research studies examining the mental health impact of using contraceptives, including pills, injections, and implants. They concluded that there’s not enough evidence to prove a link between hormonal birth control and depression.

There are many types of birth control. These include IUDs, implants, injections, combined oral contraceptives (also called “the pill”), progestin-only pills, patches, and the hormonal vaginal contraceptive ring.

Each form of birth control may have a different impact on mood or risk of depression. Only hormonal forms of birth control can impact mood.

IUD

The IUD is a T-shaped device that a doctor inserts into the uterus. It’s a progestin-only form of contraception that releases small amounts of progestin every day. Depending on the type of IUD used, it may stay in the body for 3 to 10 years.

The Danish and Swedish studies discussed above both suggested that the IUD may be associated with depression. This is a potentially important finding because, historically, doctors were taught that the IUD is only locally acting and doesn’t have any effect on the rest of the body.

Implant

The implant is a progestin-only form of contraception. It’s a thin rod that a doctor inserts under the skin in the upper arm. It releases progestin into the body over a 3-year period.

Shot

The shot or injection is a progestin-only form of contraception. A doctor injects the hormone progestin into the arm or buttocks every three months.

Combined oral contraceptives

Combined oral contraceptives, also called “the pill,” contain both estrogen and progestin. You take the pill daily at the same time. Brands include Yaz, Yasmine, and Levora, among others.

A 2017 study found that the oral contraceptive pill was associated with mood changes throughout the menstrual cycle. The study found women on the oral contraceptive pill experienced mood-related side effects in the intermenstrual phase, but positive mood effects were also found in the premenstrual phase.

Progestin-only pill

Also called the “mini pill,” the progestin-only pill contains only progestin and is taken the same way as the combined oral contraceptive pill. Brands include Heather and Camilla, among others.

Patch

The patch is worn on the skin on the buttocks, upper body, or lower abdomen. The patch releases the hormones progestin and estrogen. The patch is replaced once a week for three weeks and is removed on the fourth week, triggering a period.

Ring

The ring is a hormonal contraceptive containing both estrogen and progestin. It is placed inside the vagina and works for 3 weeks. In the fourth week, it is removed and triggers a period.

It’s unclear why some women experience mood changes and depression on hormonal contraceptives and others do not.

Some studies suggest that the negative effects of hormonal contraceptives on mood are most common in women who have a history of depression.

Importantly, association with depression is not the same as causation. Although some forms of hormonal birth control may be associated with depression, this does not necessarily mean birth control has been the cause of depression or mood changes.

Generally, women are already at an increased risk of depression compared to men. Women are twice as likely to experience depression. In the United States, depression is common, with 1 in 10 women reporting depressive symptoms in the past year.

Generally, there are a number of factors that can increase the risk of depression in women. These include:

  • low levels of social support
  • sexism and a lack of gender equity in society
  • a family history of depression
  • stressful life events
  • being a mother
  • preterm labor and delivery
  • birth complications

Birth control affects every woman differently. Some women may notice significant changes when coming off birth control, while others will notice no changes at all.

No studies so far prove that coming off birth control can cause depression. However, some women may experience changes to their mood if they cease their hormonal contraception.

One study found that in some women, being on hormonal contraception can stabilize symptoms related to mood and may reduce mood-related symptoms in women with psychiatric disorders. Women with psychiatric disorders who experience improvements in mood related to taking hormonal birth control may notice a worsening of symptoms when they cease use.

Due to the changes in hormones, some women may feel more irritable or experience mood shifts when they come off hormonal birth control. Other women may not notice this at all.

Deciding whether to start or stop birth control is a personal decision. Women may be concerned about possible side effects of taking hormonal forms of birth control like the pill, patch, IUD, or ring.

Some studies suggest that hormonal birth control is associated with depression, but it’s important to remember that association is not the same as causation. Just because you’re on hormonal birth control doesn’t necessarily mean you’ll experience depression or mood changes.

If you’re on hormonal birth control and experience unwanted side effects, including mood changes or depression, you can talk with your doctor about trying a different form of birth control.

Only hormonal forms of birth control can impact mood, and there are nonhormonal forms of birth control available. These include barrier methods like condoms, the diaphragm, and spermicides.

Your healthcare professional will be able to work with you to find the best form of birth control for you, if that’s what you’re seeking. You can learn more about the different kinds of birth control options available at the American College of Obstetricians and Gynecologists and the U.S. Centers for Disease Control and Prevention.