Many people who use birth control experience unpleasant side effects like nausea, breast tenderness, and changes in sex drive. But not all side effects are physical — doctors say birth control can also affect your mood, noting that studies have found a correlation between hormonal contraception and depression. So, could your birth control be to blame for your symptoms? Experts say that, while there's a link, it's a bit more complicated than that — and other factors certainly play a role.
Kim Langdon, MD, a board-certified ob-gyn in Ohio, told POPSUGAR that the hormones in birth control could worsen a mood disorder or unmask a latent depression or anxiety disorder. However, Dr. Langdon explained that it's unlikely birth control is the sole cause of depression or anxiety because these conditions are caused by low neurotransmitters in the brain which are influenced by many factors, including genetics.
"There's a complex interaction and balance of serotonin, dopamine, GABA, and norepinephrine, or the 'happy hormones' in the brain," Dr. Langdon said. Low estrogen and testosterone play a role in depression and, as Dr. Langdon explained, even though birth control pills contain hormones, "[many] actually lower the overall production of hormones from the ovaries by stopping ovulation." She added that, conversely, too little progesterone is linked to anxiety because progesterone has a sedating or calming effect.
Carla Marie Manly, PsyD, a licenced clinical psychologist and author, told POPSUGAR that any form of hormonal birth control — such as birth control pills, patches, and certain IUDs — can certainly affect a person's mood. "In fact, the use of hormonal contraception was associated with a later use of antidepressants," said Dr. Manly, citing a 2016 study published in JAMA Psychiatry, which found that people who used hormonal contraception were 23 percent more likely to be prescribed an antidepressant later on than those who didn't. "Although the study falls short of stating that hormonal birth control causes depression, the correlation is clear," Dr. Manly said.
She also cited a 2019 study published in the Journal of Child Psychology and Psychiatry, which found that teens who used oral contraceptives were up to three times more likely to suffer from depression in adulthood. However, she acknowledged that there's some controversy surrounding the research on the connection between birth control and depression because correlation doesn't equal causation. "Although studies may not be able to show definitive causality between the use of hormonal birth control and depression, many do show definitive associations between the use of hormonal contraception and depression," Dr. Manly explained.
Both experts told POPSUGAR that certain people are more susceptible than others to these specific side effects. "Any underlying psychiatric diagnosis can be aggravated by a change in hormone status," Dr. Langdon explained. Similarly, Dr. Manly said that individuals who have a preexisting mental illness are often more likely to have birth control affect their mood.
Although there isn't conclusive evidence that birth control causes depression, it's worth discussing with your doctor when you're making a decision about what type of contraception to use — especially if you have a history of depression, anxiety, or any other mental health conditions.