- Researchers say a study involving rats indicates that hormonal contraceptives can produce mood changes, especially in adolescents.
- They also note that these birth control pills provide many benefits, in particular helping to prevent unwanted pregnancies and treat medical conditions.
- They say that a person taking contraception who experiences mood changes should consult a medical professional.
They’re used to prevent pregnancy as well as to treat a variety of health conditions, such as acne, polycystic ovary syndrome (PCOS), and premenstrual dysphoric disorder (PMDD).
Like any medication, hormonal contraceptives not only provide potential benefits but also carry the risk of side effects. Among other potential side effects, some people who take hormonal contraceptives develop symptoms of depression or other mood changes.
A new study presented at the annual meeting of the Society of Neuroscience this week may help shed light on how synthetic hormones in birth control affect brain development and the risk of mood changes— specifically in adolescence.
These findings, which haven’t been published yet in a peer-reviewed journal, may help scientists and other community members better understand the risks of hormonal contraceptives.
However, experts who spoke with Healthline also emphasized the potential benefits of hormonal contraceptives for many adolescents and other people who take them.
“Users should have information about the potential positive impacts and negative side effects of any medication, including hormonal contraceptives,” Adriene Beltz, Ph.D., an associate professor of psychology at the University of Michigan in Ann Arbor who was not involved in the study, told Healthline.
“The complex calculus involved in weighing those potential positives and negatives can only be done by an individual in the context of why they need or want to use that medication — and having more scientifically sound information concerning reproductive and women’s health is a really important part of that calculus,” she said.
Forms of hormonal contraceptives include birth control pills, injections, implants, and certain intrauterine devices (IUDs) that contain synthetic progesterone, estrogen, or both.
To study the potential effects of synthetic progesterone and estrogen on adolescent brain development, the authors of the new study administered forms of both hormones to young female rats.
After about three weeks, they found changes in how brain cells in the rats’ prefrontal cortex communicated with one another. Changes in the prefrontal cortex can alter mood and behavior.
Rats that received the synthetic hormones also produced higher levels of the stress hormone corticosterone, the main stress hormone in rodents.
Beltz said that more research is needed to investigate the potential effects of different hormone formulations and routes of administration.
“Studies like this that report on experiments in animals can reveal things about potential mechanisms that underlie hormonal contraceptives and how they might influence behaviors in ways that we can’t typically study in humans,” she said. “This study begins to showcase what can be done, but there’s so much more work to do to begin to figure out which aspects of hormonal contraceptives matter for which behaviors. Not all hormonal contraceptives are created equal. They contain different hormone formulations and are administered in different ways.”
Studying hormonal contraceptives in rats or other animal models allows scientists to control for certain variables that are more difficult to hold steady in humans.
However, greater variability in humans and differences in our biological and environmental risk factors for certain health conditions can limit the clinical relevance of animal study findings.
“We must keep in mind that humans are not rats,” said Dr. Natalie L. Rasgon, a professor of psychiatry and obstetrics and gynecology and the director of the Stanford Center for Neuroscience in Women’s Health at Stanford University in California.
“So while I think this study in animals is an interesting foray into the clinical neuroscience effects of contraceptives, it is just a first step. We need translational studies that take the premise of an animal study and examine it in young women,” she told Healthline.
Among humans, research suggests that hormonal contraceptives affect different individuals in different ways. While some people develop mood challenges when taking hormonal contraceptives, others notice improvements or no changes in their mood.
“In general, on a population level, associations between hormonal contraceptive use and psychiatric outcomes are weak, inconsistent, and unlikely to be causal,” said Dr. Thalia K. Robakis, an associate professor of psychiatry in the Women’s Mental Health Program at the Icahn School of Medicine at Mount Sinai in New York.
“On an individual level, certain women are susceptible to mood disruption from particular hormonal contraceptives, while others find them beneficial,” she told Healthline.
In particular, people with pre-existing mood disorders such as PMDD often have improvements in their mood when they take hormonal contraceptives. These contraceptives help limit fluctuations in hormones that can worsen symptoms of mood disorders such as PMDD.
All of the experts who spoke with Healthline emphasized the importance of considering not only the potential risks but also the potential benefits of hormonal contraceptives for preventing unplanned pregnancies and treating certain health conditions in adolescents and other people who take these medications.
“Even as we discover more and more about mood, contraception, and the effects of estrogen and progesterone, we can’t overlook what these medications have done for young women,” Dr. Shawna Newman, a child and adolescent psychiatry specialist at Lenox Hill Hospital in New York City, told Healthline.
“[Many] pregnancies in adolescents are unplanned and can cause life-changing and often devastating effects, especially in our changing political environment. These are vital medications that allow young women to have safety and autonomy, and compared to the 1950s, they are so much more safe than ever before,” she added.
To learn more about the potential benefits and risks of hormonal contraceptives, Newman encourages young people to speak with a gynecologist or other qualified health professional.
“I really encourage people not to reject this [family planning or treatment] option out of hand because something might happen. You have to weigh the risk and benefit in your overall picture,” she said.
If an adolescent develops symptoms of depression or other mood challenges after they start taking a hormonal contraceptive, Newman encourages them to speak with the clinician who prescribed the medication.
If they’re taking the hormonal contraceptive to prevent pregnancy, their healthcare provider may recommend a different form of hormonal contraceptive or another type of birth control.
If they’re taking the hormonal contraceptive to treat PMDD or another health condition, their healthcare provider may recommend a different treatment or strategy to manage the mood changes.
Some adolescents may decide to continue taking hormonal contraceptives even if they develop unwelcome mood changes. Some stop taking hormonal contraceptives but continue to experience mood disruptions, which can be caused by a variety of factors beyond hormonal contraceptives.
“There are genetic, genomic, biological, and environmental effects that go into having mood disorders, and the most common time for these disorders to start is adolescence,” said Newman.
“If a mood problem persists with or without hormonal contraceptives, it’s not unreasonable to go to a child and adolescent psychiatrist or back to your pediatrician and consider whether or not psychotherapy and/or a medication to address the mood problem is indicated,” she said.