Birth control and mood: can the pill cause mood swings?
Hormonal birth control affects mood differently in different people. Many notice no change, some feel steadier because hormone swings are smoothed out, and a minority feel low, anxious or irritable, most often in the first months or as teens. Large studies link hormonal contraception with a higher chance of starting antidepressants. If your mood changes, talk to your doctor: other methods exist.
How hormonal birth control changes your cycle
Most combined pills, patches and rings contain synthetic estrogen and a progestin. They usually stop ovulation, so the natural rise and fall of your own estrogen and progesterone flattens out. The bleed in your pill-free week is a withdrawal bleed, not a true period. Progestin-only methods (the mini-pill, implant, injection and hormonal IUD) work in different ways and some don't always stop ovulation.
That's why birth control can change mood in either direction. Without the luteal hormone drop, some people's PMS improves. But the synthetic hormones themselves act on the brain, and some people are sensitive to them.
What the research shows
The largest study, from Denmark, followed over a million women aged 15 to 34 for an average of six years. Compared with non-users:
| Method | Relative risk of first antidepressant use |
|---|---|
| Combined pill | 1.23 times |
| Progestin-only pill | 1.34 times |
| Vaginal ring | 1.6 times |
| Patch | 2.0 times |
| Hormonal IUD (levonorgestrel) | 1.4 times |
| Teens (15 to 19) on the combined pill | 1.8 times |
Risk peaked around six months after starting and fell with age. Important context: this is an association, not proof that birth control causes depression, and in absolute terms most users never develop depression. Other studies have been mixed. But it supports what many people report: for some, hormonal contraception noticeably affects mood, and teens may be more sensitive.
When birth control can help mood
For people with PMS or PMDD, stopping ovulation can reduce the hormone swings that trigger symptoms. A combined pill containing drospirenone, taken with a short or no hormone-free break, is approved in the US for PMDD, and a Cochrane review found it can reduce premenstrual symptoms, though the effect is moderate. Taking pills continuously to skip the pill-free week helps some people whose mood dips during the break. See birth control for PMDD.
Signs your birth control may be affecting your mood
- Low mood, anxiety or irritability that started within a few months of a new method
- Losing interest in things, or feeling flat or numb
- Mood dips that track your pill-free week
- Lower libido together with low mood
- Feeling better within a cycle or two of stopping or switching (always with backup contraception)
If you think your contraception is affecting your mood, talk to a doctor or nurse before stopping, so you're not left unprotected. There are many options, including non-hormonal ones like the copper IUD and condoms.
How to tell if it's the pill or something else
- Rate your mood daily for at least two months, starting before a change if you can.
- Note the start date of any new method and your pill-free or placebo days.
- Log other factors: sleep, stress, life events.
- Compare before and after, and look for patterns around the hormone-free week.
- Bring the record to your appointment.
Lulu's one-tap daily check-in lets you compare how you felt before and after starting, switching or stopping birth control, and the PMS chart exports as a CSV for your doctor. Lulu is a tracker, not contraception, and doesn't tell you which method to use.
Coming off birth control
When you stop, your natural cycle usually returns within a few months, and so does your natural mood rhythm, PMS included. Some people feel brighter; some rediscover premenstrual symptoms they'd forgotten. See coming off the pill and mood by cycle phase.
you feel persistently low, anxious or numb on hormonal contraception, especially in the first months or if you're a teen. If you ever have thoughts of harming yourself, reach out now: call your local emergency number, or in the US call or text 988. In the UK and Ireland, Samaritans are on 116 123.
Frequently asked questions
Can birth control cause depression?
Large studies link hormonal contraception to a higher chance of starting antidepressants, especially in teens and early in use. Most users aren't affected, but if you are, switching can help.
Which birth control is best for mood?
It varies by person. Some do well on a drospirenone pill, others on a hormonal IUD or a non-hormonal method. A doctor can help you choose.
How long do mood side effects of the pill last?
Some ease after the first 2 to 3 months. If they don't, or they're severe, talk to your doctor about switching.
Can birth control cause anxiety?
Some people report more anxiety on hormonal methods. Track it and discuss alternatives with your doctor.
Sources
- Skovlund CW et al. Association of hormonal contraception with depression. JAMA Psychiatry (2016)
- Lopez LM et al. Oral contraceptives containing drospirenone for premenstrual syndrome. Cochrane Database Syst Rev (2012)
- NHS: Contraception
- ACOG: Premenstrual Syndrome (PMS) FAQ
This page is for information only and isn鈥檛 medical advice. If something worries you, please talk to a doctor.
Keep reading
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