Contraception and mental health: Why’s the link so… confusing? 

Google ‘can contraception affect your mental health?’ and no doubt you’ll be confronted by varying accounts. In fact, the more you research, the more downright confusing it can get. 

The thing is, it’s an extremely important question (as in, ya know, the sort of thing that affects millions of people around the world), so why are there still so many conflicting points of view? Why isn’t there a simple ‘yes’ or ‘no’ answer? And is this simplicity even possible? 

Read on for 11 reasons why the link between mental health and contraception still isn’t exactly clear-cut. 

1. Research has been under par for years (So… MAYBE there’s a link)

To be blunt, research surrounding our hormones and their relationship with contraceptives has, so far, left much to be desired (*cough cough* that’s one reason we’re here). For those of us with cycles, our hormones haven’t been given anywhere near as much attention as those without. 

2. And the analysis of studies also leaves much to be desired

Time and time again, we’ve seen studies that look into our hormones focus too much on the ‘average’ result rather than drilling down into the data.

For example, a study in Denmark(2) that looked into the association of hormonal contraception with depression concluded the following: “Use of hormonal contraception, especially among adolescents, was associated with subsequent use of antidepressants and a first diagnosis of depression, suggesting depression as a potential adverse effect of hormonal contraceptive use.” (In other words, yes, using hormonal contraception increases the risk of depression diagnosis). 

BUT, this oversimplifies the results, and when looking more closely at the study:

• The result was different for different hormonal contraceptive types. 

• The result was different for different age groups, i.e. those taking progestogen-only contraceptive pills (POPs) aged 15-19 were more likely to use antidepressants for the first time than 15-35s. 

• For younger women, contraceptive choice may have a more significant impact on their mental health and wellbeing because of hormonal changes during adolescence. 

• The unique hormone profile of each individual is key when it comes to the risk of depression. (At Tuune, we consider all the factors important to you before we help you optimize your hormonal health.)

Then again, look to a US study of 6,654 sexually active women aged 25-35, which aimed to understand women’s perceptions of contraception and treatment patterns. This concluded that hormonal contraception actually protects against depressive symptoms and reduces the risk of suicide attempts.

This study also has its flaws: 

• It only takes into account 25-34-year-olds—it doesn’t consider younger people with cycles who experience greater fluctuations in their hormones. 

• It only included sexually active women. Sexually active people will have differences in their hormonal profile than those who aren’t.

3. Some people do report side effects (So… YES there’s a link)

Although the data is lacking, we do know that a study found that nearly half of US women (49%) reported being concerned about side effects before starting their first prescription. 

These side effects, which include anxiety and depression as well as other health conditions including weight gain, may be alleviated if birth control is prescribed based on each person’s unique needs and desires. (*Waves vigorously* That’s why we’re here folx). 

4. And the guesswork is disconcerting  (So… MAYBE there’s a link)

The U.S. Centers for Disease Control and Prevention Study(2), using data collected from 2015-2017, found that numbers of women using birth control pills were dropping—partly due to concerns about how it may affect their mental health. The data came during a time when people started sharing the hashtag #mypillstory on their social media channels to tell their own, very diverse, contraceptive experiences.

However those of us with cycles want to talk about our experiences, it’s so important for these diverse stories to (finally) be listened to. By listening, we can learn and ensure progress is made so those of us with cycles no longer have to face the side effects that we’ve kind of just ‘had’ to accept. Sharing stories can often be one step, and systematic change is the next.

5. Everyone is different (So… MAYBE there’s a link)

A common story for many is they visit their doctor when they reach reproductive age and are prescribed a hormonal contraceptive—limited questions are then asked about their mental health, wellbeing, and other factors that are important to the person. Any side effects, like depression and anxiety, are often discovered later. 

The problem with that approach is our genetics, our wants, and our hormonal baselines are all unique, so a contraceptive that works for one person may not be suitable for the next. (That’s why with us, you start with an hour-long Tuune 360 where you fill us in on your contraceptive and medical history, as well as your health goals).

Holistic care that looks at the whole person (i.e. physical as well as psychological wellbeing) is key to ensuring everyone feels their best.

6. And different contraceptive methods affect everyone, well… differently (So… MAYBE there’s a link)

One person’s experience on the birth control pill, or the IUD, or the implant, will be completely different to another’s. What’s gone wrong in the past is we’ve all been treated the same. By personalizing your contraception, we can help to find the right contraception for you so you can feel your best and improve your mental and physical wellbeing.

7. Hormonal contraception can be beneficial for mental health (So… YES there’s a link)

It gets tricky as although some people experience side effects when their contraception isn’t right for them, some women(3) find their mental health, sense of wellbeing, and overall mood improves when taking hormonal contraception. 

Ultimately, whether you experience better mental health is not down to chance—it’s down to your individual profile, including hormones, family history, genetics, pre-existing mental health conditions, etc. Basically, what works for your mate, won’t necessarily work for you. That’s why we ask you all the questions you’ve probably never been asked before about your health and wellbeing before we start to consider the best contraception method for you.

You can also check out a recent success story from a Tuune community member called Jo, who knows first hand the complicated relationship between birth control and mental health.

8. But some studies have found a link between hormonal birth control pills and depression in young adults (So… YES there’s a link)

A University of British Columbia(4) study found that the risk of a depression diagnosis in adults increased 1.7-3 times in people who used hormonal birth control pills during adolescence, versus those that started taking them as adults (or those that never used them). The study, which analyzed 1,236 women in the US, shows the importance of taking age into account when considering contraceptive choices.

9. And contraception can improve hormone-related conditions (So… YES there’s a link)

Around 10% of women of reproductive age suffer from endometriosis(5). Women with the condition often report high levels of anxiety and depression(5)—both common mental health symptoms associated with endometriosis. Some people find this condition improves when they take oral contraceptive pills. 

It’s also common that when an individual is prescribed hormonal contraception to treat heavy and/or painful menstrual bleeding (menorrhagia), their mental health improves as they’re less uncomfortable and in less pain(5). The same is true for conditions like headaches and nausea around their period—people that take hormonal contraception can experience improvements in their mental health(6).

Again, there’s no ‘one sits fits all’ approach here—some people with these conditions experience great improvements to their conditions by taking hormonal birth control, others may not. It’s why we’re all about getting to know YOU so we can work out what’s best for you.

10. Tailoring contraception regimen may improve mental health-related symptoms (So… YES there’s a link)

The way you take your contraception has also been proven to positively impact mental health for some people. Oral contraceptive pills, for example, can be used to treat people with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). By taking the contraception to either delay or stop withdrawal bleeds, some people with cycles also report an improvement to their mental health.

For example, following an extended regimen(7) has been shown to have a satisfactory influence on PMS symptoms such as dysmenorrhea (severe menstruation cramps) and bloating. A standard regimen with a shortened HFI can also treat dysmenorrhea and premenstrual dysphoric disorder (PMDD) symptoms(8).

Check out our article on different contraception regimens you can follow when using hormonal contraception to learn about how regimens can improve mental health and wellbeing.

11. But some suggest it’s actually impossible to certify a link between contraception and mental health  (So… MAYBE there’s a link)

There’s another train of thought(9) that suggests it’s near impossible to certify a link between hormonal contraception and increased risk of depression, anxiety, and low mood. Ultimately, it’s because this would call on double-blind placebo trials, where one group of people would be given birth control pills and the other given placebo pills. Of course, this is unethical as it would lead to unwanted pregnancies.

So (drum-roll please), can contraception affect your mental health?

Ultimately, yes it can. But the way it does so can vary hugely based on the person and the contraceptive method they’re using. What we’ve learned is that blanket statements simply can’t be made when it comes to hormones as we all have completely unique profiles. It’s time to get comfortable with complexity and relish the fact that our hormones—and our bodies—all work brilliantly differently. After all, who wants to be the same as everyone else?  

But it’s not just this difference that makes the issue so complex, it’s also the lack of research (and dare we say the lack of interest too). The world’s understanding of female hormones has barely scratched the surface. It’s something we’re determined and passionate about fixing, and every single one of you that joins the Tuune journey is helping to drive the future of female healthcare forever. 

We’re here to help you find the right contraceptive method for you (hormonal or otherwise). It’s time to take the guesswork out of contraception and finally make informed, intelligent choices about what will work best for you and your mental health.

What do you think?

We’d love to hear your experiences! Share your stories with us over on Twitter or Instagram

Written by

Hermione Wright (she/her)

An NCTJ-qualified journalist, Hermione writes for national and local publications in addition to creating thought leadership for brands with a purpose. Passionate about telling the stories that matter, she helps our community make their own clued-up choices about their healthcare.

Medically reviewed by

Dr. Alejandra Elder Ontiveros, MD, PHD (she/her)

Ale is a PhysicianScientist with a doctoral degree in Development Biology and Embryology and is currently a Postdoctoral Scholar at UCSF. Ale believes that the union of academia and business can lead to transformative discoveries for women’s health.

Scientifically researched by

Hannah Durrant (she/her)

Hannah is a Biomedical Content Writer at Tuune, with a BSc in Biomedical Sciences from University College London. She is passionate about bringing together the scientific community and the general public by disseminating modern science via digestible, engaging and thought-provoking content.