Can birth control cause anxiety? What the research says, and what to do

You started a new pill, or had an implant fitted, and since then you’ve felt more on edge. Is it the contraception, or just life? It’s a reasonable question, and one that many people ask.

Here’s what the research shows, why some people are affected and others aren’t, and how to make a change safely.

Don’t stop your contraception suddenly unless a doctor tells you to, and use another method, like condoms, if you do. Stopping without protection could lead to an unplanned pregnancy, which is a big source of anxiety in itself.

Can birth control cause anxiety?

For some people, yes. Hormonal contraception contains synthetic versions of oestrogen and/or progesterone (called progestogens or progestins), which can affect mood. The NHS lists mood changes among the side effects some people report on the combined pill.

But most people don’t notice any mood changes, and some feel better, especially people whose anxiety or low mood is worst before their period. That’s because some methods smooth out the monthly rise and fall of hormones.

What the research shows

The largest study followed more than a million women aged 15 to 34 in Denmark for several years. Compared with women not using hormonal contraception, those who did were somewhat more likely to start antidepressants or be diagnosed with depression:

• The combined pill was linked to about a 23% higher relative risk of starting an antidepressant.
• Progestogen-only pills, the patch, the vaginal ring and the hormonal IUD were also linked to higher relative risks.
• The link was strongest in teenagers aged 15 to 19, and got weaker with age.

Some important context:

• This study looked at depression, not anxiety specifically. Research on anxiety is more limited and mixed.
• It showed a link, not proof that the contraception caused the depression.
• Relative risks can sound large, but most people in the study didn’t develop depression.

Who might be more likely to notice mood changes

• teenagers and young adults
• people with a history of depression or anxiety
• people who have had mood changes on a hormonal method before
• people sensitive to premenstrual mood changes, though some of them feel better on contraception

What contraception-related anxiety can feel like

• feeling more on edge, worried or irritable than usual
• low mood or tearfulness
• trouble sleeping
• feeling “not like yourself”
• changes that started within a few weeks or months of a new method

Track it before you change it

Because life changes all the time, it helps to see the pattern clearly:

1. Keep a daily mood note for 2 to 3 months: anxiety and mood from 1 to 10, sleep, and where you are in your cycle.
2. Note when you started or changed your contraception.
3. Look for other causes too, like stress, sleep, caffeine, alcohol or life events.

The NHS says side effects of the combined pill often settle, and advises speaking to a pharmacist or doctor if they last longer than 3 months and are a problem. If mood changes are severe, don’t wait. Talk to a doctor straight away.

How to switch safely

There are lots of options, so you don’t have to choose between your mental health and reliable contraception. A doctor or sexual health clinic can talk you through:

• a different pill, with a different progestogen or a different dose of oestrogen
• a different type of method, like moving from a pill to an IUD, or the other way round
• non-hormonal options, like the copper IUD, which contains no hormones, or condoms

While you switch, ask exactly when the new method starts protecting you, and use condoms until then.

Warning signs that need urgent help

Combined methods (those containing oestrogen, like most pills, the patch and the ring) slightly raise the risk of blood clots. The NHS says this affects up to 1 in 1,000 people using them. Get urgent medical help (call 911) if you have:

• pain, swelling, warmth or redness in one leg
• sudden breathlessness or sharp chest pain
• coughing up blood
• a sudden, severe headache, changes in your vision, weakness on one side, a drooping face or slurred speech

Also get help right away if you have thoughts of harming yourself. Call or text 988 (US), or 911 in an emergency.

When to see a doctor

• your anxiety or mood has noticeably changed since starting or changing contraception
• you’ve had depression or anxiety before and you’re thinking about a hormonal method
• side effects have lasted longer than 3 months
• you’re not sure whether it’s the contraception or something else

Frequently asked questions

Which birth control is least likely to cause anxiety?

There isn’t one answer that fits everyone. The copper IUD and condoms contain no hormones. Among hormonal methods, people respond differently, so it can take some trial and error. A doctor can help you choose based on your history.

How long does anxiety from birth control last?

Side effects often settle within the first few months. If anxiety is still a problem after 3 months, or it’s severe, talk to a doctor about switching. Many people find their mood improves after switching to a different method.

Can stopping birth control cause anxiety?

Some people notice mood changes when they stop, as their natural cycle and any premenstrual symptoms return. Worry about pregnancy can also cause anxiety, which is why it’s important to have another method in place.

Can birth control help anxiety?

For some people, yes, particularly if anxiety is linked to their cycle. Some pills that stop ovulation can help premenstrual symptoms. Our post on anxiety before and during your period explains more.

How Breatheasy can help

Breatheasy makes it easy to track your mood while you work out what’s going on. Ten-second check-ins and a journal build a day-by-day record you can share with your doctor when deciding whether to switch. When anxiety spikes, tap “I’m feeling anxious” and Luma walks you through slow breathing and grounding. Breatheasy is coming soon to iPhone and Android.

Sources

• Association of hormonal contraception with depression, Skovlund and others, JAMA Psychiatry, 2016
• Combined pill: side effects and risks, NHS
• Your contraception guide, NHS
• Blood clots, NHS
• Premenstrual syndrome (PMS), American College of Obstetricians and Gynecologists