Some research suggests hormonal birth control can affect mood, stress, and overall mental health. The potential impact varies by method and from person to person.
All hormonal birth control methods contain a synthetic version of progesterone called progestin and a synthetic version of estrogen, such as ethinyl estradiol.
These synthetic hormones can impact different areas of the brain, says Bassam Zeina, MD, PhD. The hypothalamus-pituitary-gonadal axis, for example, regulates reproductive function and can be disrupted by hormonal birth control.
This disruption can lead to changes in neural signaling within the limbic system, affecting mood regulation and potentially leading to symptoms of depression or anxiety.
Hormonal birth control may also affect cognitive abilities, such as memory and attention, due to alterations in neurotransmitter levels.
“These effects are not uniform across all individuals and may vary based on factors such as age, previous history of mental health issues, or use of other medications that could interact with hormonal contraceptives,” explains Zeina.
“Differing hormonal birth control techniques can have different side effects on the brain, some of which may be more severe or distinctive than others,” says Hilda Wong, MD.
Combination birth control pills, for example, tend to cause more severe mood changes than progestin-only pills, says Michael Green, MD, OB-GYN, chief medical officer at Winona, a telehealth company specializing in menopause care.
Hormonal intrauterine devices (IUDs) may have less of an impact than other hormonal contraceptives due to their location. Hormonal IUDs release progestin directly into the uterus rather than systematically through ingestion.
In a 2020 review of neuroimaging studies, researchers identified changes in affective and cognitive processing areas, including the amygdala, hippocampus, prefrontal cortex, and cingulate gyrus.
In a
More specifically, researchers found that participants who used oral contraceptives experienced more anger, fear, and disgust than those who did not.
“While the findings of [that study] are interesting, they do not show a definitive causal and effect relationship between birth control and emotions,” says Green.
After all, people taking the pill could also be engaging in other behaviors that increase the experience of those emotions.
Older studies have also shown a link between hormonal birth control use,
While small, both studies suggest that the potential for birth control medication to worsen mood is worth paying attention to, particularly if you have preexisting mental health conditions.
One of the biggest limitations is the vast nature of hormonal contraception. Although there are seven different types of hormonal birth control, each has multiple variations across generic and brand-name formulations.
The available research is also limited. Many studies involve a small number of human participants — if any. One of the most widely cited
While animal studies can reveal general patterns that are worth further investigation, they don’t give direct information to scientists, doctors, or patients about how something — in this case, hormonal birth control — affects humans.
On a similar note, animal studies allow scientists to control for variables that would be unethical to control in humans.
As a result, certain environmental, genetic, and sociological influences are not measured at all in animal studies.
When weighing the benefits and risks of hormonal birth control, the main thing to consider is why you want to take hormonal birth control in the first place.
Is it to prevent pregnancy? Is it to help manage premenstrual symptoms? Is it as part of an endometriosis treatment plan? A combination?
Wong says the answer to this question will give you insights into whether alternatives could work similarly.
If pregnancy prevention is one of the reasons you’re considering hormonal birth control, you should consider which method — hormonal or not — you’re most likely to use consistently, suggests Wong.
For example, can you trust yourself to take the pill at the same time every single day? How about getting a shot every 3 months? What about using a condom every time you have penis-in-vagina sex?
The most effective method is generally the one you know you’ll use without interruption.
If you’re noticing mood changes, make an appointment with your birth control prescriber as soon as possible. You might also consider making an appointment with a mental health professional if you currently have one.
“It’s important for healthcare providers to be informed about patients’ neurological side effects so that they can work with the patient to determine if that prescription hormonal birth control option is the best contraceptive option for them,” says Zeina.
Depending on the severity of your symptoms, your clinician may suggest switching to a different contraceptive.
They may also recommend adopting certain lifestyle changes, such as more regular movement, increased sleep, and meditation practices, says Wong.
Some research suggests that hormonal birth control can impact the brain. While this potential side effect is worth noting, it doesn’t mean that all forms of hormonal birth control impact all users the same.
Consult with a healthcare professional to learn more about your options and discuss any side effects that you may be experiencing.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.