Can birth control cause depression?

Millions of people worldwide use hormonal birth control. According to the Centers for Disease Control and Prevention (CDC), 65.3% of women ages 15 to 49 in the United States use birth control. The most common forms include hormonal pills (14%) and IUDs or implants (10.4%).

Although research is conflicting, certain types of birth control — including hormonal intrauterine devices (IUDs), oral pills, vaginal rings, and patches — may be associated with a higher risk of depression and other mental health issues.

Language matters

Sex and gender exist on a spectrum. We use “women”, “men,” or both in this article to reflect the terms assigned at birth. However, gender is solely about how you identify yourself, independent of your physical body.

Birth control and depression: What does the research say?

The CDC notes that 4.8% of people in the United States experience regular feelings of depression, while 11.7% experience regular feelings of worry, anxiety, or nervousness. It makes sense that many people worry about the safety of using birth control while managing their mental health.

This concern may not be unwarranted, with some research indicating that people using hormonal birth control may be at a higher risk of developing depression.

For instance, a large, high quality study from 2016 looked at 14 years’ worth of data for over a million women in Denmark. It concluded that all hormonal contraception increases the risk of antidepressant use and depression diagnosis.

In particular, the following birth control types had an association with a higher risk of depression:

• Combined oral birth control pill: These contain both estrogen and progestin. Brand names include Yaz, Sprintec, and Junel FE 1/20.
• Progestin-only pills: Also called the “minipill,” these contain progestin but no estrogen. There are different forms of progestin, including levonorgestrel (Quartette) and norethindrone (Aygestin).
• Transdermal patches: These skin patches can contain a progestin called norelgestromin.
• Vaginal ring: Vaginal rings are hormonal birth control that you insert into your vagina to prevent pregnancy. Etonogestrel (Nuvaring) is one option.
• Hormonal IUDs: This device is inserted into the cervix to prevent pregnancy. Hormonal IUDs often contain levonorgestrel.

Similarly, a 2022 review concluded that women who use hormonal contraception are more likely to experience anxiety and depression compared with those who use nonhormonal forms.

However, not all research agrees that birth control causes depression.

For instance, a 2022 review that included 26 studies found no link between progestin-only pills and depression.

In addition, a 2018 study of over 4,000 adolescents also found no correlation between oral contraceptive use and depression.

It’s important to note that depression is a complex mental health condition that can be associated with factors like genetics, life stressors, and other medical conditions. Although using hormonal birth control may increase the risk of depression in some people, research hasn’t proven that it directly causes mental health issues.

Ultimately, more research is necessary to understand the exact mechanisms behind this relationship.

Best birth control options for people with depression or anxiety

According to an older 2014 review and a newer 2020 review, women with depression or anxiety can use whatever type of contraception they prefer. However, you may want to talk with a doctor before taking hormonal birth control in the following situations:

• you have heart risk factors, like smoking or high blood pressure
• you’re using St John’s Wort
• you take certain epilepsy drugs
• you use psychiatric drugs that contain tricyclic antidepressants (TCAs) or monoamine oxidase inhibitors (MAOIs)

According to these same reviews, good alternatives to birth control pills may include:

• copper IUDs
• levonorgestrel-releasing IUD
• subdermal implants
• the depot medroxyprogesterone acetate injectable (DMPA)
• the vaginal ring

It’s best to discuss which option best suits you and your health with a doctor. For instance, different birth control can vary significantly in how long they work, their cost, side effects, and ease of use.

If you need help covering the cost of medications, Optum Perks free Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Alternatives to hormonal birth control

If you are concerned about a possible link between hormonal birth control and depression, other effective options are available.

Nonhormonal birth control methods do not alter the levels of hormones in your body and are, therefore, less likely to affect your mental health, including depression.

Some options are single-use, while others are long lasting. They include:

• condoms
• diaphragms
• cervical caps
• spermicide
• copper IUDs
• female or male sterilization

Condoms also protect against some sexually transmitted infections.

Many studies highlight how the risk of depression from contraception may be greater in adolescents and in women with ongoing or previous mental disorders.

If you’re an adolescent or have a history of depression or anxiety, it’s especially important to discuss your options with a doctor. They can help you weigh the risks and benefits of different birth control options and suggest suitable alternatives to hormonal types if necessary.

Summary

Some studies have found that hormonal birth control options could be associated with an increased risk of depression in some people. However, research is conflicting, and it is still too early to conclude with certainty if there is a direct link.

Regardless, if you’re an adolescent, have a history of depression or anxiety, or have any concerns regarding your choice of birth control, it’s best to discuss your options with your doctor.

For instance, you can opt for nonhormonal alternatives like copper IUDs, condoms, or sterilization.