The Emotional Side of Birth Control: What We Know (and Don’t)

Hormonal birth control is an important option for many people, providing reliable contraception and other health benefits. Yet, one topic that often goes under-discussed is how hormonal birth control can affect mood and emotions. For some, it’s not an issue at all. For others, however, starting hormonal contraception can feel like an emotional shift they weren’t expecting. And truthfully, science is still working to fully understand why.

Physical and Mental Health Effects

Research shows that mood changes such as increased anxiety, irritability, or symptoms of depression can occur after beginning hormonal birth control. A large 2016 Danish study, which included over a million women, found that users of hormonal contraception—including the pill, patch, and hormonal IUD—were more likely to be diagnosed with depression or start antidepressant treatment. This association was especially pronounced among adolescents. This suggests that for some individuals, hormonal birth control may influence emotional well-being in a significant way.

However, the effects are not universal. Many people experience improved mood stability and reduced premenstrual symptoms while on hormonal contraception. For individuals with conditions like premenstrual dysphoric disorder (PMDD), certain contraceptives can even be therapeutic. The emotional response to hormonal birth control depends on a complex mix of factors, including individual brain chemistry, hormone sensitivity, genetics, and the specific type of birth control used.

Physically, hormonal birth control can also cause a variety of side effects. Common symptoms include headaches, breast tenderness, nausea, changes in libido, and alterations in menstrual bleeding patterns such as lighter periods, breakthrough bleeding, or missed periods. Some users may notice weight changes or bloating. Many of these physical effects improve after a few months as the body adjusts, but persistent or severe symptoms should be discussed with a healthcare provider to consider alternative methods.

What we are still learning about:

Despite growing research, there remain significant gaps in our understanding. For example, why does birth control affect some people’s mood positively while causing distress for others? Hormones like estrogen and progestin interact with brain chemicals such as serotonin and GABA, which regulate mood, but the exact mechanisms remain unclear.

Additionally, few studies directly compare emotional side effects across different birth control methods, making it difficult to predict which option may be best for an individual.

Long-term emotional effects are another area with limited research. While short-term mood changes have been documented, we know little about the impact of hormonal contraception on mental health over years or decades—a relevant consideration given that many begin use in adolescence and continue for many years.

If you’ve recently started hormonal birth control and notice changes in your mood—whether increased anxiety, feelings of depression, emotional numbness, or irritability—it’s important not to dismiss these symptoms. Tracking your experiences and discussing them openly with both your healthcare provider and therapist can help you make informed decisions. You are not being overly sensitive; your emotional well-being matters, and hormonal changes can significantly impact it.

Ultimately, birth control should empower you to feel more in control of your body and your life—not less. If you find your mental health is suffering while on hormonal contraception, know that support, alternatives, and answers are available. While research continues to evolve, your lived experience is valid and deserves to be heard.

References:

• Skovlund, C. W. et al. (2016). Association of Hormonal Contraception With Depression. JAMA Psychiatry.

• Zethraeus, N. et al. (2017). The impact of hormonal contraception on mood: a randomized clinical trial. Fertility and Sterility.

• Planned Parenthood. Birth Control and Mood Changes.