Is it my mental health or is it my contraception?
Your health expert: Dr Naveen Puri, Medical Director, Bupa UK Insurance
Publish date 12/08/2024.
Next review 12/08/2025.
Dr Naveen Puri explores the potential positive and negative ways hormonal contraception may affect mental health, what your other options are, and what to do if you’re struggling.
What do the search engines say?
Google search volume data from April 2022 to March 2024 uncovers the UK’s growing concern about the possible connection between hormonal contraception and mental health.
In particular, searches involving the pill. The data shows:
Can the pill make you depressed?
Searches have tripled.
Can birth control pills make you depressed?
Searches have tripled.
Does the mini pill cause depression?
Searches have doubled.
Dr Naveen Puri says,
“Research shows hormonal contraception taken orally can cause mood changes for around half that use it. This is because the hormones they contain – oestrogen, progesterone or both - can affect the way your brain functions. For some, these hormones can actually help improve poor mood, if it’s caused by premenstrual syndrome (PMS) or pre-menstrual dysphoric disorder (PMDD). Everyone is different.
“Whilst one person might start hormonal contraception and find their mood improves, another may experience the complete opposite. Noticing a negative shift in your mood can feel worrying, especially if you can’t pinpoint an exact reason why.
“Mood changes can have many causes, including hormones, lack of sleep, and mental health conditions like depression. If you think your contraception could be affecting your mental health, always talk this through with a health professional.
“If one method of hormonal contraception doesn’t feel right for you, it’s possible to explore other options. I’d always recommend doing this with the support of a health professional, so you’re aware of all options and facts to make a decision that’s right for you.”
What is hormonal contraception?
A hormonal contraceptive is one of the three main types of contraception available to help prevent pregnancy. It can also be used to manage symptoms associated with your periods.
Hormonal contraception uses either oestrogen, progesterone, or a combination of both to prevent pregnancy. Hormonal contraception comes in different forms, including:
The combined pill or mini pill
Intrauterine system (IUS)
Injection
Implant
Patch
Vaginal ring
The dosage of hormones found within each contraceptive type varies. Pills have a higher dose of hormone in them, compared to implants or intrauterine systems.
Some forms of hormonal contraception, such as pills, patches and rings rely on you remembering to use or take them.
Others, including injections, implants and intrauterine devices are administered once by a health professional and give more long-lasting protection.
Can the pill help with mood swings?
If you struggle with mood swings before or during your period, speak to a GP.
They’ll ask you about your medical and family history. If they think it’s suitable for you, you’ll be prescribed hormonal contraception.
Studies show that this can be an effective way to help manage your mood if it fluctuates during your menstrual cycle, but it’s not the same for everyone. Some people prescribed hormonal contraception don’t notice any improvement to their mood.
Hormonal contraception and mental health: What's the link?
The contraceptive pill is the most common form of birth control in the UK and like most medications there can be side effects from using it.
Recently, there’s been lots of speculation around hormonal contraception affecting mood. This may have prompted you to think: should I come off the pill?’
Taking hormonal contraception in pill form is sometimes linked with mood effects. Contraceptive pills contain a higher dose of hormone, compared to other forms, like implants or intrauterine systems.
Pill contraception can be linked to mood changes as hormones taken orally can act on the whole body including your brain as well as working as a method of contraception.
It’s thought that around two in every 100 people who use hormonal contraception develop depression. Research shows that mood changes are one of the most common reasons that people choose to stop taking it.
Some studies say hormonal contraception can worsen mood and sex drive. Other studies found people aged 16 to 31 are just as likely to be prescribed antidepressants, regardless of whether they use hormonal contraception
How to tell if hormonal contraception is triggering depression
Our research hints those using some forms of hormonal contraception are struggling with mood swings and depression. But is the cause of this from their birth control pills or intrauterine devices?
If you’ve been searching for answers, it’s difficult to say whether your symptoms are directly linked to your contraception. It very much depends on your individual circumstances.
The type of hormonal contraception you use may make you more likely to feel its side effects. Particularly when you compare them to intrauterine systems, pills contain a relatively higher dose of hormone.
However, you know your body better than anyone else. If mood struggles never affected you before starting hormonal contraception pill or otherwise - always speak to a health professional.
If one type of hormonal contraception doesn’t feel right for you, it doesn’t necessarily mean other hormonal contraception types will be the same.
It’s especially important to talk to a health professional if your symptoms have lasted longer than three months or if you have a family history of poor mental health
Signs hormonal contraception may be affecting your mood
Feeling more anxious than usual
Constantly feeling down or tearful
Feeling disconnected from friends and family
Lost interest in the things you usually enjoy
Having trouble sleeping, or having no energy
Feeling restless or agitated
Feeling hopeless about the future
Non-hormonal birth control option
Our research shows searches such as least hormonal contraception is a common query. If you’re looking for a choice of contraception with the least or no hormone within them, there are multiple options available. These include
The copper coil
These are T-shaped devices that are placed inside your womb by a health professional.
The device is made out of copper, which is toxic to sperm and eggs, reducing the chance of conception. They also reduce the chance of a fertilised egg implanting in your womb.
You can have a copper coil for between five and 10 years, depending on the type and brand.
Condoms
Condoms are placed on the penis to create a barrier each time you have sex. They can also help to protect you against sexually transmitted infections (STIs).
Always check the expiration date on condoms before using them, and use a new one every time you have sex.
Caps or diaphragms
Caps and diaphragms hold a sperm-killing gel against your cervix.
You can insert them inside your vagina up to three hours before having sex, and you should leave it there for at least six hours afterwards.
As caps and diaphragms come in different sizes, a health professional should fit you for your first one to make sure it provides a cover over your cervix.
Like hormonal contraception, non-hormonal options also come with possible risks and potential side effects. The IUD may cause discomfort after having it fitted, and it may make your period more painful or heavier.
Barrier contraception, like condoms, caps and diaphragms may cause irritation or even an allergic response in some people. You can discuss the pros and cons with appropriate healthcare professionals before deciding which method is best for you.
A final word from Dr Naveen Puri
“Whatever the cause, struggling with your mood isn’t something anyone should go through alone. Poor mood shouldn’t be expected or accepted as a side effect of contraception. Please speak to a health professional to hear about other options available to you.
“Talking to a health professional also helps monitor the possible cause of your poor mood, and offer extra support if the cause isn’t as clear cut as your contraception.”
