It’s important to know all the facts prior to trying hormonal contraceptives, and the truth is that many do women report feeling moody from birth control. But what actual causes this? Here’s what you should know
How hormonal contraceptives work
Birth control prevents pregnancy by using a specific set of hormones to suppress ovulation, which prevents the sperm from joining with an egg. “The ones with estrogen and progesterone work by blocking ovulation (the egg from popping out), thinning the endometrium (the lining of the uterus), and by creating a cervical mucus plug (the cervical mucus is like concrete and does not allow sperm to pass into the uterus),” says Dr. Sophia Yen, MD, MPH, and co-founder and CEO of Pandia Health. However, there are some birth control options that only thin the uterus lining. This creates a cervical mucus plug. “The ones with only progesterone work by thinning the endometrium (the lining of the uterus), and by creating a cervical mucus plug (the cervical mucus is like concrete and does not allow sperm to pass into the uterus),” Dr. Yen explains.
Is there a link between birth control and emotions?
Whether or not birth control makes you moody varies from person to person. “Each individual has a different response to hormones in birth control, including impact on emotions or mood. Hormonal birth control can be associated with positive impacts, negative impacts or no impacts on mood,” says Kelly Culwell, “Dr. Lady Doctor,” Board Certified OBGYN and nationally-renowned women’s health expert. Estrogen and progestin affect everyone differently. “Each person with a uterus responds differently to the different hormones: estrogen and progestin (synthetic progesterone),” Dr. Yen states. “Estrogen increases levels of the neurotransmitter serotonin, which generally causes positive mood and emotional well-being. However, too much serotonin can cause increased anxiety.” In terms of what happens in the body, hormones in birth control impact the cycle of hormones from the brain and ovaries. If you have mood issues before taking birth control, it may make matters worse. “The exact mechanism of how hormonal birth control might impact mood is unknown,” says Dr. Culwell. “Hormones in birth control alter the natural cycling of hormones from the brain and ovaries which for some women with hormonally sensitive mood conditions (like premenstrual dysphoric disorder or PMDD) can help with symptoms but for others might negatively impact mood.” The good news is that if your body doesn’t respond well to one type of birth control, there are many other options.“Because there are eight different progestins and two to three different levels of estrogen/progestins, there are 40 different pills. Know that if one doesn’t work for you, there are many others you can try,” says Dr. Yen. As it turns out, being on birth control can actually help stabilize emotions. “Most women benefit from having a stable level of hormone on hormonal birth control (compared to the ups and downs of not being on hormonal birth control),” Dr. Yen explains. “When you are not on hormonal birth control, then your hormones cycle up and down. When you are on monophasic birth control, then your hormones are maintained at a steady, smooth level, and if you skip the optional bleeding week, it’s even smoother.”
The science behind birth control and emotions
One study showed women on birth control experienced fewer symptoms of depression compared to women using low-efficacy contraception or no contraception at all. In another study, scientists compared a combination oral contraceptive pill, vaginal ring, the shot and IUD. They found TLDR (the shot) posed the highest risk for depression, whereas the combination pill posed the lowest. “Each woman is different. That’s why you want expert care by expert doctors,” Dr. Yen states. “I’ve personally written 2,000 birth control prescriptions in 2 years and studied the progestins to minimize side effects.”
When should you see a doctor about birth control side effects?
Side effects tend to be worst when you first start your birth control and tend to improve as time passes. “If symptoms have not improved in two to three months, they probably will not improve much with longer use,” Dr. Culwell states. “If the mood symptoms are severe, for example, severe depression or thoughts of suicide, you should seek medical care immediately and not wait to see if the symptoms improve with time.” You also probably shouldn’t wait longer than one to two months if you’re depressed. “If you notice that you are feeling more depressed/anxious on your new medication, give it two months tops,” Dr. Yen explains. “But if it is unbearable or you feel suicidal, call 911.” Next, read about Phexxi, the new hormone-free birth control gel.
Sources
Sophia Yen, MD, MPH, the co-founder and CEO of Pandia HealthKelly Culwell, “Dr. Lady Doctor,” Board Certified OBGYN and nationally-renowned women’s health expertPandia Health: “The Science Behind Why It’s Safe to Skip Your Period”American Journal of Epidemiology: “Association of Hormonal Contraceptive Use With Reduced Levels of Depressive Symptoms: A National Study of Sexually Active Women in the United States”
