Birth Control Can Cause Mood Swings — Here’s What You Should Know

Dr. Tania Adib, a consultant gynecologist at Callaly, highlights both the combined oral contraceptive pill and the minipill.

A small 2013 study reported that 4 to 10 percent of combined oral contraceptive users noted adverse mood effects.

Emotional side effects have been found to be one of the best predictors of discontinuing an oral contraceptive or switching to another method.

However, a 2019 review stated that pills provided the strongest conclusions, because they have been the focus of the majority of research.

So, can other hormonal methods lead to mood swings? Potentially, but there’s less research into them.

Implant users have reported experiencing mood swings, for example.

Conversely, a 2008 study found that those who got the birth control shot were less likely to have mood swings than those who didn’t use hormonal birth control.

The vaginal ring has also been linked to a lower likelihood of mood swings compared with oral contraception. Again, the effects can differ from person to person.

It’s hard to say.

Researchers have found differing results. Plus, it’s difficult to conclude if a particular method of birth control causes mood swings or if other factors play a part.

For example, a 2016 Danish study found that depression could be an adverse effect of any hormonal contraceptive.

But a 2013 U.S. study found that hormonal contraception may “reduce levels of depressive symptoms among young women.” (Mood swings are a symptom of depression.)

Much of the conversation has revolved around the pill. But, while the pill has been linked to adverse mood effects, the hormones in it can actually help to regulate some people’s mood. So, currently, there’s little agreement on whether one method is more likely than another to cause mood swings.

This is even the case if you’re taking other hormonal medication, such as testosterone. After all, both high and low testosterone levels have links to mood changes.

There’s no clear-cut answer.

Some people “with a history of depression are more susceptible to a worsening of their depression while taking the pill,” Adib says.

For example, a 2019 review concluded that hormonal contraception can “lead to mood-related side effects, particularly in women with a history of previous depressive episodes.”

But, Adib adds, many “don’t feel worse — even if they’ve been depressed before.”

Right now, the Centers for Disease Control and Prevention (CDC) says there aren’t restrictions on contraceptive methods for people with existing depressive disorders.

It’s very difficult to tell.

As Adib explains, “it isn’t possible to predict how you’ll feel taking a certain contraceptive, and it’s often a case of trying different ones until you find the one that suits you best.”

There’s some research that suggests a greater chance of negative mood effects from the pill if you’re 19 or younger or taking a progestin-only pill.

It also stated that taking a combined oral contraceptive pill could be protective against mood disorders.

But these effects can differ from person to person.

The best thing to do is connect with a healthcare professional about your concerns, detailing your lifestyle and any history of mental health conditions.

They can then use the available research to figure out which method might work best.

For example, Adib says, “one combined oral contraceptive containing the progestogen drospirenone has been found to improve symptoms of premenstrual syndrome (PMS) in women. So it’s the best one to use if you [experience] PMS or low mood.”

As no cause and effect has been proven between birth control and mood swings, there isn’t a definitive checklist to tick off.

But, when you start taking hormonal contraception, it’s always a good idea to keep a note of how you’re feeling.

You can use daily diary entries to track changes in your mood and ask a close relative or friend to let you know if they notice changes in your behavior.

If you’re experiencing more down days than happy ones, that’s a sign to connect with a doctor or other healthcare professional.

The potential mood effects of hormonal birth control are still a mystery in some ways, requiring more research.

But much of the research that has been carried out focuses on the pill. So, how can the pill cause changes to your mood?

Well, it “contains synthetic hormones, which can affect neurotransmitters,” Adib explains. These are “chemical messengers that the brain uses to communicate with itself and the different organs in the body.”

GABA is an inhibitory neurotransmitter that slows down that communication for a calmer effect. It’s released when its receptors are stimulated by the likes of alcohol and a type of natural steroid produced in the body when progesterone breaks down.

That’s important, because a synthetic version of progesterone is found in all forms of hormonal contraception.

But, unlike natural progesterone, the artificial version doesn’t seem to have the same effect on GABA receptors. And GABA under-stimulation has been linked to depression and PMS.

Other neurotransmitters, such as levels of the feel-good dopamine and serotonin, may also be affected by the hormones in birth control.

This could be due to progesterone’s ability to make rewarding things feel less rewarding. This dampened reward response has been noted in hormonal contraceptive users, but needs more investigation.

Some changes to your lifestyle can help regulate your mood, although it’s always best to see a healthcare professional for personalized advice.

You can try to exercise more regularly to release those feel-good hormones and work toward a sleep routine of around 8 hours every night.

You can also alter your diet to include less of the foods and drinks that can cause natural highs and lows and more whole foods. Think: less caffeine, sugar, and alcohol, and more fruits, vegetables, nuts, and fish.

Relaxation techniques, like meditation, can also help if stress levels are impacting your mood.

Yes. “Other mood-related symptoms include anxiety, depression, and irritability,” Adib says.

Plus, she adds, “physical side effects of breast tenderness, weight gain, and bloating can also affect your psychological health.”

The same lifestyle changes — eating a balanced diet, being physically active, and following a sleep routine — can help.

If you have an underlying condition, like anxiety or depression, you may find medication or other clinical treatment methods beneficial.

If you’re concerned about your current contraception and emotional state, or if you’re considering a new form of birth control, a doctor or other healthcare professional is the best person to speak to.

Being open with how you feel will help them find the best option for you, whether that’s a different contraceptive or referral to a mental health specialist.

This is where a diary comes in handy. The more information your doctor has, the easier it’ll be for them to assist.

“Changing [your] contraceptive method to the copper coil, which contains no hormones, is certainly an option,” Adib says. (FYI: Contraceptive coils are also known as intrauterine devices, or IUDs.)

But there’s always a chance that a swap will have no effect on your mood.

If you experience PMS, a hormonal method may help balance your hormones. But this doesn’t necessarily mean sticking with the method you’re currently on.

As Adib points out, IUDs containing a synthetic progestin “can improve mood as most of the hormone stays locally in the womb and very little is absorbed into the body, reducing the chance of mood-related changes.”

“Lower dose hormone coils are available,” she adds, “so there are many options.”

Regardless of whether you’re experiencing detrimental side effects, coming off of hormonal birth control is always an option.

Before taking any steps, it’s always a good idea to visit a doctor or sexual health clinic for advice on how to stop the method you’re taking and how to prevent pregnancy, should you wish to do so.

Generally, pills and patches can be stopped at any time, and you’ll need to use another form of contraception immediately if you want to prevent pregnancy.

(But planning when you stop — like waiting until the end of the pill pack — can help you predict the timing of your next period.)

Implants and IUDs need to be removed by a healthcare professional. You’ll need to use an alternative contraceptive, such as condoms, straight away to prevent pregnancy.

With the birth control shot, things are slightly different. As you get the shot every few months, you can simply stop booking repeat appointments.

But its contraceptive effects can last for a while — up to 18 months in some cases. So talk with a doctor or other healthcare professional to find out when you may need to use another form of contraception.

Stopping hormonal birth control can cause a few changes as your body’s hormone levels return to their natural state.

Everyone is different, but periods can be irregular for a couple of months or come with lighter or heavier bleeding. You may also notice spotting in between periods.

If you’re still experiencing menstrual irregularities 3 months after stopping, have a doctor check that there’s nothing else going on.

If you started hormonal birth control to help conditions, such as acne and PMS, you may also notice previous symptoms returning. Similarly, any effects caused by your birth control, like headaches or weight gain, can disappear once the hormones leave your body.

Right now, there’s no way to predict whether birth control will have a positive or negative effect on your mood. There’s a possibility of either — or no change at all.

As always, bring up any concerns to a doctor or other healthcare professional.

And remember that there are lots of hormonal and non-hormonal contraceptive options out there. So if one doesn’t work for you, that doesn’t mean you need to steer clear of the rest.

Lauren Sharkey is a U.K.-based 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.