The Pill’s Hormones And The Brain
Ob-GYN Felice Gersh, MD, author of PCOS SOS: A Gynecologist’s Lifeline To Naturally Restore Your Rhythms, Hormones, and Happiness, said she felt confident that birth control affects the brain. “To think won’t affect the brain would actually be ludicrous,” said Dr. Gersh. That’s because birth control was designed as an endocrine disruptor.
In fact, according to Medline Plus, birth control pills contain man-made forms of 2 hormones: estrogen and progestin. These hormones are made naturally in a woman’s ovaries.
These synthetic hormones, said Dr. Gersh, have some similarities with real hormones but can have different effects. And by essentially “replacing” your body’s real progesterone and estrogen with the synthetic versions, the pill may tinker with your brain, said Dr. Gersh. “We do know that hormones are hugely important to brain health and brain function,” she said.
Can Birth Control Cause Depression Or Anxiety
For most people, hormonal birth control does not cause or worsen mood disorders like anxiety or depression. In studies, most people don’t report changes in mood after starting hormonal birth control.
Tell your provider if you have a history of mood disorders, or if you’re concerned about mood changes.
Negative mood changes are most often reported with progestin-only birth control like:
- Long-acting reversible contraception
If you do experience a change in mental health, contact your provider to be evaluated for clinical depression and to discuss alternative contraception. If suicidal or homicidal, you should seek emergency care immediately. Please call the Suicide and Crisis Lifeline at 988.
Emerging Research: Nomegestrol Acetate With 17
Currently, all available oral contraceptive pills affect mood. We have shown that nomegestrol acetate with 17-beta estradiol is better tolerated by women with mood disorders.30 Our pilot study was a single-site clinical follow-up study that assessed the tolerability and subjective mood response to nomegestrol acetate 17-beta estradiol. Based on a sample of 49 women, we showed that women report a positive mood response and reduced self-reported overall DASS-21 score after taking nomegestrol acetate with 17-beta estradiol compared to previously used oral contraceptive pills.30 Future research with a larger sample is required.
Nomegestrol acetate with 17-beta estradiol is a monophasic preparation with an extended regimen of 24 active pills followed by four placebo pills. The drug can cross the bloodbrain barrier, interact with serotonin receptors and regulate cerebral blood flow to the amygdala, dorsolateral prefrontal cortex and many other areas of the brain involved in depression.31 Women who develop depression soon after taking other oral contraceptive pills may better tolerate nomegestrol acetate with 17-beta estradiol. This is consistent with its successful use in clinical practice for the off-label treatment of mood symptoms associated with premenstrual dysphoric disorder.30
Do Antidepressants Such As Lexapro Affect Birth Control
No, antidepressants such as Lexapro do not affect birth control. However, if you are taking any other medication, it is critical you talk to your doctor before starting birth control to avoid any negative reactions.
Disclaimer: The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.
For a person to be diagnosed with an anxiety disorder, their fears must be considered out-of-proportion to the situation, not age-appropriate, and also impair the persons ability to function normally. There are many different types of anxiety disorders:
- Generalized anxiety disorder
Anxiety disorders are incredibly common and will affect up to 30% of all U.S. adults at some point in their lives. Though anxiety disorders are common and often debilitating, they are highly treatable. A combination of medication and talking therapy can go a long way to treating most cases of anxiety. Medications commonly used to treat depression, such as SSRIs and SNRIs, are also used to treat anxiety disorders.
Adolescents And The Pill
Adolescents using COCs in the Danish study had a higher risk for being diagnosed with depression and prescribed an antidepressant than adults in the study .
Adolescents in the study Finnish study were more likely than people not using hormonal birth control to be prescribed an antidepressant for every COC formulation they studied .
A study of adolescents in the U.S. who were currently or had ever used the pill showed an increased risk for ever having experienced depression, but no increased risk for current depression . But when other factors such as age, smoking, BMI, family socioeconomic status, and whether the adolescents were sexually active were considered along with the use of birth control pills, there was no increased risk for depression .
A small study where adolescents were randomly assigned to use COCs containing ethinyl estradiol/levonorgestrel or placebo for three months showed no difference in depression scores between the two groups at the end of the study .
The key takeaway: The pill may increase the chance of being diagnosed with or treated for depression, but the specific pill formulation may make a difference. Overall, it appears as though COCs do not have a harmful effect on mood reported by users, but this may vary between individuals.
Read Also: What Percentage Of People Have Depression
Cooper Iud Implants Condoms
No formal connection between the use of non-hormonal methods of birth control such as the copper IUD or condoms and increased risk of depression and anxiety has been made. However, some women who use the copper IUD have anecdotally reported copper toxicity, with symptoms of brain fog and fatigue, decreased energy, and increased levels of depression and irritability which have been resolved once the copper IUD has been removed.
IUDs and implants are long-acting, reversible birth control methods that can be removed when a woman wishes to become pregnant. IUDs and implants are also relatively easy to remove in case a woman has an adverse reaction to the hormones present. The copper IUD does not use hormones and is effective for up to 10 years.
How Do You Know If Any Change In Mood Is Tied To Your Method Of Birth Control
As no cause and effect has been proven between birth control and mood swings, there isnt a definitive checklist to tick off.
But, when you start taking hormonal contraception, its always a good idea to keep a note of how youre feeling.
You can use daily diary entries to track changes in your mood and ask a close relative or friend to let you know if they notice changes in your behavior.
If youre experiencing more down days than happy ones, thats a sign to connect with a doctor or other healthcare professional.
still a mystery in some ways, requiring more research.
But much of the research that has been carried out focuses on the pill. So, how can the pill cause changes to your mood?
Well, it contains synthetic hormones, which can affect neurotransmitters, Adib explains. These are chemical messengers that the brain uses to communicate with itself and the different organs in the body.
GABA is an inhibitory neurotransmitter that slows down that communication for a calmer effect. Its released when its receptors are stimulated by the likes of alcohol and a type of natural steroid produced in the body when progesterone breaks down.
Thats important, because a synthetic version of progesterone is found in all forms of hormonal contraception.But, unlike natural progesterone, the
. Think: less caffeine, sugar, and alcohol, and more fruits, vegetables, nuts, and fish.
Relaxation techniques, like meditation, can also help if stress levels are impacting your mood.
Can Hormonal Birth Control Trigger Depression
- By Monique Tello, MD, MPH, Contributor
Over the years, more than a few patients in my womens health practice have told me that their hormonal birth control the pill, patch, ring, implant, injection, or IUD made them feel depressed. And its not just my patients: several of my friends have felt the same way. And its not just me who has noticed this decades of reports of mood changes associated with these hormone medications have spurred multiple research studies.
While many of these did not show a definitive association, a critical review of this literature revealed that all of it has been of poor quality, relying on iffy methods like self-reporting, recall, and insufficient numbers of subjects. The that it was impossible to draw any firm conclusions from the research on this birth control and depression.
How Does Birth Control Affect Your Mood
A normal menstrual cycle involves fluctuations of hormones like estrogen and progesterone, Gersh says. However, when you take hormonal birth control, your hormones remain more stable, and change less throughout your cycle.
“Without these fluctuations, the normal stress responses of the body are negatively altered,” Gersh says. This means that when you’re taking birth control, you may have higher levels of a stress hormone called cortisol.
When you have higher cortisol levels, you may feel stronger negative emotions like stress and fear. “This modification of the normal levels of cortisol results in altered moods and mood swings,” Gersh says.
But in some cases, higher cortisol levels can have a benefit if your cortisol levels are too low, it can increase your risk for depression. This means that hormonal birth control could protect against depression for people with naturally low cortisol.
You May Like: Why Does My Anxiety Get Worse At Night
Effects Of Oestrogen And Progesterone On Mood
Oestrogen and progesterone influence neurochemistry, brain function and the activity of neurotransmitters gamma-aminobutyric acid, serotonin and dopamine.2 Oestrogen receptors – alpha and ER-beta are widely distributed in the brain, with ER-alpha mainly found in the hypothalamus, hippocampus, amygdala and brainstem. Progesterone receptors alpha and beta are most abundant in the amygdala, cerebellum, cortex, hippocampus and hypothalamus.
There is evidence to suggest that oestrogen is neuroprotective in the hypothalamus, hippocampus, amygdala and brainstem, protecting the brain from neurodegenerative disease, cognitive decline and affective disorders.3–5 Functional brain imaging studies have indicated that oestrogen regulates the activation of brain regions implicated in emotional and cognitive processing such as the amygdala and dorsolateral prefrontal cortex.6 In animals, oestrogen has been shown to modulate neurotransmitters including serotonin,7 dopamine8 and noradrenaline in depression,9 as well as adrenocorticotropic hormone.10
Unlike oestrogen, progesterone is not neuroprotective. Progesterone can worsen mood symptoms.11–13 Plausible links include progesterone augmentation of GABA-induced inhibition of glutamate transmission,14 and progesterone increasing the concentrations of monoamine oxidase, resulting in decreased serotonin concentrations.15
How Can Birth Control Pills Help With Postpartum Depression Symptoms
Birth control may serve as a form of hormone therapy to counteract the drop in estrogen and progestin that occurs following childbirth. However, until more research is done regarding the relationship between birth control and postpartum depression, it can not be concluded that this form of treatment is more effective than others.
Don’t Miss: Can Anxiety Give You Chills
If It Does Happen What Can Cause It
Certain forms of birth control can cause anxiety simply because people worry they wont use it properly.
A big example of this is, of course, the pill. Users may stress that theyve forgotten to take it, or that they wont take it at the same time each day.
The other cause of anxiety is thought to be the effect synthetic hormones can have on the body.
Most of the research into this has focused on the pill, which can contain forms of estrogen and progesterone, or the latter on its own.
Both progesterone and estrogen are hormones that impact mood, Lakhani explains.
And the hormone fluctuations that result from the pill especially the estrogen have been linked to anxiety, she says.
Hormone contraceptive pills are believed to affect different regions of the brain, Lakhani continues.
Indeed, a 2015 study found a link between oral contraceptive use and significant thinning in two brain areas.
As Abood explains, they were the posterior cingulate cortex, linked to emotional stimuli based on our internal state of mind, or what is referred to as the view of self.
The second was the side orbitofrontal cortex. This is linked to emotion and behavior in relation to external stimuli, Abood says.
Further research is needed to confirm whether the pill is causing brain thickness changes.
But, Abood says, these changes suggest that hormonal contraceptives not only affect how view external circumstances, but may also affect their view of themselves.
Benefits Of Birth Control
Hormonal birth control has, without a doubt, changed lives simply by making it possible to choose when to start a family.
“Overall, oral contraceptives have a number of benefits,” said Ob-GYN Kecia Gaither, MD, who’s also board-certified in maternal-fetal medicine. Those benefits include pregnancy prevention, of course, but also clearing acne, treating severe cramping and heavy bleeding, decreasing symptoms of endometriosis, preventing ovarian cysts, treating symptoms of PCOS, and .
As the authors of the Current Psychiatry Report paper state, though it’s important to take reports on depressed mood as a potential side effect of oral contraceptives seriously, the reality is that discontinuation of the birth control pill can pose subsequent challenges in family planning. Therefore it’s important to weigh the mood-related side effects of oral contraceptives against their profound benefits for safe family planning.
So the first step isn’t to drop your birth control. The benefits still seem to outweigh the costs for many. Instead, we need more research about what birth control is really doing to our brains. As Dr. Gersh pointed out, “If we aren’t aware of what we’re doing, we’ll never get quality alternatives.”
Read Also: How To Help Your Wife With Depression
Should Women With History Of Depression Avoid Hormonal Birth Control
Studies are still not clear if hormonal birth control pills make depressive symptoms worse in women.
For instance, the 2017 Medical Eligibility Criteria for Contraceptive Use report by the Centers for Disease Control and Prevention found that depression is not considered as a contraindication to hormonal contraceptives for women suffering from depression, citing a lack of enough evidence to prove the relationship between the two.
The CDC, along with the World Health Organization, also added that the use of combined hormonal birth control, the implant, the IUD, and the shot is not linked to worsening depressive symptoms among people who were previously diagnosed with depression or bipolar disorder.
In contrast, a different study concluded that women who take progesterone-only minipills or combination oral contraceptives were more likely to receive prescriptions for an antidepressant compared to women who did not use these types of contraceptives.
Can Birth Control Pills Alleviate Depressive Symptoms
Some of the most commonly reported side effects of birth control pills are depression and mood swings.
And just like any other study conducted to shed light on this controversial topic, researchers have been unable to prove or disprove a link between birth control pills and depression, as studies have found conflicting results.
Another example is a certain pilot study which found that depression is the top reason behind women stopping their use of birth control pills.
The study also found that women using combination birth control pills were significantly more depressed as compared to another group of women not using the pills.
On the contrary, a recently published study in the Archives of Gynecology and Obstetrics found that depression is not considered as one of the most common side effects of birth control pills. This study also maintained that the connection between the two is still unclear.
However, despite this lack of certainty, many women have actually reported feeling depressed while taking birth control pills.
But according to the AGO study, these reports may be because of the inconsistent use of the word depression. Differences in pill formulations can also play a role.
This alleged connection can also be due to an already large number of women with depression in the United states, as an estimated 12 million women in the country are diagnosed with clinical depression each year.
Spotting Or Breakthrough Bleeding
Spotting, or breakthrough bleeding, are the most common side effects of hormonal birth control.
As the body adjusts to the fluctuation of hormones and the uterus lining thins, breakthrough bleeding will sometimes occur.
It can be managed by taking birth control pills at the same time each day to help regulate the bodys system.
The Pills Surprising Effects On The Brain
The Pill is the most popular form of contraception in the U.S. with over 9 million women using it. Oral contraceptive pills contain synthetic hormones that hijack your cyclical hormonal process, replacing it with a steady supply of low levels of synthetic estrogen and progesterone. You may already be aware that OCPs have been shown to cause problems with blood pressure and blood clots and increase the incidence of strokes, especially if you smoke or have a history of migraine headaches. But did you know that OCPs also affect your brain and mental well-being?
Also Check: How To Develop An Eating Disorder
If You Think Your Contraception Is Making You Anxious Or Depressed Youre Not Imagining Things Evolutionary Psychologist Sarah E Hill Explains What Happens To Your Brain On Birth Control
Most women know at least one or two other women who have had a bad reaction to the pill. In fact, the question that many of us have about the pill: Why does the pill make me crazy?
Before I get into what the research says about all this, let me just address the elephant in the room the whole thing about womens sex hormones influencing mood. Which they do. This might be the worlds oldest cliché about women, but that doesnt make it any less true. Womens sex hormones influence womens moods. Mens sex hormones affect mens moods. It would be impossible for them not to.
Back to the question. To start with, all of us feel a little crazy sometimes. Life is hard and can make anyone feel anxious and overwhelmed at times. For some women, being on the pill can magnify these feelings, leading to anxiety disorders and depression. But if these things happen to you, it doesnt mean youre crazy it just means youre on the wrong pill.
Mood-related issues like anxiety and depression are super-common among women on the pill. Almost half of all women who go on the pill stop using it within the first year because of intolerable side effects, and the one most frequently cited is unpleasant changesin mood. Sometimes its intolerable anxiety other times, its intolerable depression or maybe both simultaneously. And even though some womens doctors may tell them that those mood changes arent real or important, a growing body of research suggests otherwise.