Hormonal birth control involves everything from the pill and patch to the implant, IUD, and shot.

There are two main types: One contains a type of synthetic progesterone called progestin, and the other is a combined form that includes both progestin and estrogen.

“These two hormones naturally flood the body during ovulation and create a lot of PMS symptoms,” explains Dr. Shirin Lakhani, an intimate health specialist and cosmetic doctor at Elite Aesthetics.

The synthetic hormones in birth control have also been linked to a range of side effects. If you’re wondering whether anxiety is one of them, read on.

Hormonal contraception can cause feelings of anxiety in some people. But other users may find their birth control relieves anxiety symptoms.

It all depends on the individual person.

When it comes to adverse effects, the pill is often the first contraceptive method that springs to mind.

But there’s a link between anxiety and all forms of hormonal contraception, says Dr. Enam Abood from London’s Harley Street Health Centre.

A 2004 review found hormonal contraceptive users had higher rates of anxiety than nonusers.

And a 2018 study noted that users of IUDs containing the hormone levonorgestrel also had higher anxiety rates.

But the pill seems to have been the focus of more research than other methods.

“Combination oral contraceptives and progesterone-only minipills are usually associated with depression and anxiety more than other options of birth control,” Lakhani says.

Between 4 and 10 percent of users report mood problems while on the combined pill. Most people, however, say they’re satisfied with it.

In fact, a review of studies published in the past 30 years found most combined hormonal contraceptive users — those using the combined pill, hormonal patch, or combined vaginal ring — had either no effect or a positive effect on their mood.

However, the review did conclude that non-oral combined hormonal contraceptive methods may result in fewer mood changes.

There are a few simple reasons.

First, there isn’t enough research into the mental and emotional effects of hormonal birth control.

Second, the research that does exist has produced conflicting results. (Again, this is likely because hormonal contraception’s effects differ from person to person.)

And third: All of the above, plus varying research methods, has meant it’s impossible to prove cause and effect.

In other words, researchers are currently uncertain. It’s likely to remain that way until more studies are carried out.

If you have a personal history of anxiety or mood disorders, you may be more prone to the emotional effects of birth control.

This hasn’t been fully proven, but it is a theory put forward in several studies.

Unfortunately, it’s pretty difficult to determine what effect your contraceptive will have.

If your anxiety is related to the physical taking of a pill, for example, it’s safe to say an oral contraceptive is likely to worsen those feelings.

If you have a history of anxiety, hormonal birth control may mean you’re more likely to experience anxiety. Preexisting feelings may also intensify.

But if your anxiety is a result of PMS, some combined hormonal contraceptives — especially ones containing drospirenone — may help relieve symptoms.

It’s an altogether different story if you’re concerned about your birth control causing general anxiety.

Often, that spells a case of trial and error. Choose a method and stick with it for a few months before seeing how you feel.

Certain forms of birth control can cause anxiety simply because people worry they won’t use it properly.

A big example of this is, of course, the pill. Users may stress that they’ve forgotten to take it, or that they won’t take it at the same time each day.

The other cause of anxiety is thought to be the effect synthetic hormones can have on the body.

Most of the research into this has focused on the pill, which can contain forms of estrogen and progesterone, or the latter on its own.

“Both progesterone and estrogen are hormones that impact mood,” Lakhani explains.

And the hormone fluctuations that result from the pill — especially the estrogen — have been linked to anxiety, she says.

“Hormone contraceptive pills are believed to affect different regions of the brain,” Lakhani continues.

Indeed, a 2015 study found a link between oral contraceptive use and significant thinning in two brain areas.

As Abood explains, they were “the posterior cingulate cortex, [which is] linked to emotional stimuli based on our internal state of mind, or what is referred to as the view of self.”

The second was the side orbitofrontal cortex. This is “linked to emotion and behavior in relation to external stimuli,” Abood says.

Further research is needed to confirm whether the pill is causing brain thickness changes.

But, Abood says, these changes “suggest that hormonal contraceptives not only affect how [users] view external circumstances, but may also affect their view of themselves.”

Hormonal birth control has also been linked to an increased risk of depression.

A 2016 study of more than 1 million Danish women found hormonal contraception was associated with first antidepressant use and first diagnosis of depression. The risk was especially present in adolescents.

But a 2013 study of women in the U.S. found the opposite: Hormonal contraception may reduce depression levels in young women.

Neither study proves that hormonal birth control causes or prevents depression — just that there may be a relationship between the two.

However, it’s worth noting some contraceptive methods — like the pill and ring — list mood changes as a potential side effect.

Some users have also reported experiencing panic attacks, though there’s very little research into this.

“There are a number of ways to manage anxiety,” Lakhani says, “from cognitive behavioral therapy (CBT) sessions and counseling to simple things that can be done at home, such as yoga and meditation.”

Lifestyle changes, like eating nutritious food and exercising regularly, can also help, Abood says.

Of course, you can consider changing your birth control method too.

If you already have an anxiety disorder or are worried about a specific type of contraception, speak to your doctor.

Be as open and honest as you can. Remember, their job is to help you decide which birth control method is right for you.

If you’re concerned that your current contraceptive is affecting your mood, track your symptoms in a diary and show it to your doctor.

“The earlier they can address those symptoms, the better,” Abood says.

Your doctor can then recommend self-help strategies, refer you to a mental health specialist for therapy, or prescribe medication, like an antidepressant.

Changing birth control may alleviate feelings of anxiety. But there’s a chance it could make little difference.

If you begin to experience anxiety or other mood changes, you can consider switching to a nonhormonal form of contraception. The list includes:

Long-acting reversible contraception (known as LARC) is also a possibility for people who are worried they’ll forget to take a pill or apply a patch.

Your doctor can guide you down the best path.

If you want to stop taking hormonal contraception, it’s entirely your choice.

But Lakhani advises never coming off your birth control without consulting with your doctor first.

Ask them the following:

  • Can I get pregnant straight away?
  • What side effects might I experience?
  • What should I use for contraception now?

Some methods, like the pill and patch, can be stopped immediately. Others, like the implant, will need to be removed by a healthcare provider.

Something to consider: It’s good practice to not stop the pill or patch in the middle of your pack. Doing so can cause irregular bleeding.

The hormones from birth control should exit your body within a few days. (The shot, however, is designed to last for 3 months, so you may have to wait a little longer.)

Stopping any kind of hormonal birth control can have an impact on both your body and mind.

You may find that your menstrual cycle becomes irregular, or that your mood changes.

You may also experience symptoms your contraception was helping to manage, like painful periods and acne.

None of the side effects should be too severe. Many will right themselves as your body gets back to its usual hormone production.

But if your menstrual cycle is still irregular 3 months after stopping your birth control, or the effects are becoming difficult to manage, visit your doctor again.

It’s also important to know that you may get pregnant rather quickly. Use an alternative form of contraception if you don’t want to conceive.

Whether hormonal birth control will help or hinder anxiety is difficult to say.

Just because someone else has a bad experience doesn’t mean you will.

But before deciding on a contraceptive, weigh the potential effects.

And if you’re worried, speak to a doctor. They’ll work with you to find a method that suits your needs.

Lauren Sharkey is a journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.