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By Dr Dulcy Rakumakoe

Chief Executive Officer


How contraceptives affect your mental health

Birth control pills can bring negative side-effects, so beware.


The many synthetic hormones found in most birth control methods can cause problems with your moods.

All hormonal options contain some amount of a lab-formulated version of oestrogen and progesterone, the two hormones that, along with testosterone, control your cycles.

Occasionally, traditional hormonal birth control can exacerbate depression and anxiety because of the effect hormones have on the intricate balance of serotonin, dopamine, Gaba, and norepinephrine – all “feel-good” neurotransmitters in the brain.

Oestrogen in particular plays a role in depression, with too little causing a dip in serotonin – and once this happens, the ovaries produce less oestrogen, starting a vicious cycle of feeling bad.

On the other hand, too little progesterone is associated with anxiety since the hormone has a calming effect.

Contraceptives, oral or inserted or injected, are the most popular methods used for controlling fertility and they contain hormones. These hormones change how your reproductive organs work in order to prevent pregnancy.

Combination pills contain man-made versions of the female hormones oestrogen and progesterone. These hormones prevent the release of an egg from the ovary (ovulation).

They also thicken your cervical mucus, which makes it hard for sperm to travel to your uterus and fertilise an egg.

Picture: iStock

The side effects of birth control

Low-dose progesterone birth control pills also change cervical mucus. They also take prevention one step further by thinning the lining of the uterus. This makes it difficult for implantation to occur. The side effects of birth control are generally mild. These may include:

  • spotting or irregular bleeding;
  • sore breasts;
  • nausea;
  • a headache;
  • changes in libido; and
  • Many women also report weight gain and depression or mood swings.

The implant (Norplant) has been linked to major depression and panic disorder because of its high progesterone content. It is very important to know how different contraceptives can affect not only your overall physical health but also your mental health before you start taking them.

Researchers at Harvard Medical School conducted a study to determine if oral contraceptives impact mood, and found that 16.3% out of the overall sample of 658 participants, experienced a worsening of their moods.

Literature over the last 40 years has shown how numerous side-effects negatively impact many users and even society at large.

Three large studies were the first to demonstrate, on a grand scale, certain emotional and behavioural associations with contraceptive use.

The studies showed that contraceptive use was associated with an increased rate of depression, divorce, tranquiliser use, sexual dysfunction, suicide and other violent and accidental deaths.

Depression has been shown to be one of the most common reasons women stop taking birth control pills. Despite this, the studies conducted could not clearly explain the connection.

Any woman who has a history of depression, anxiety, panic disorders, mood swings or seasonal affective disorder should consider how well she manages her mental health prior to beginning a hormone-containing contraceptive, because for a subset of women, taking this type of contraceptive can worsen an underlying mental health issue.

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Contraceptives come in many forms, such as the birth control pill and intrauterine device (IUD), so each type could potentially have varying side effects depending on the individual.

For women who experience negative side effects from birth control pills that contain hormones, there are other contraceptive alternatives, such as the IUD, which can be found with or without hormones, other options include diaphragms, condoms and tubal ligation.  

Picture: iStock

For women who do decide on contraceptives with hormones, there are ways to eliminate potential negative side effects.

The mechanism is complicated and involves the woman’s innate state of health, her overall toxic burden, and the way her liver processes and her gut excretes the hormones she has taken.

Additionally, oral contraceptives inhibit ovulation, which can blunt a woman’s sexual drive. This can be distressing for many women and their partners.

For women who are already experiencing mental health problems before taking contraceptives, it can be a gamble. There are however also benefits that women experience due to contraceptives, apart from the obvious birth control.

Some women have PMS-related anxiety/depression/irritability just prior to the menstrual period.

Hormonal contraceptives, particularly when taken continuously, can reduce the severity of the symptoms.

Additionally, more control over their own bodies is always beneficial for women. The accessibility of contraception in itself would have a positive impact on mental health.

NOW READ: Male contraceptive pill found 99% effective in mice

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