At the most general level, there are two types of birth control: hormonal and non-hormonal. For the sake of not writing a novel, I will just focus on hormonal birth control in this post. Generally, non-hormonal methods haven't been associated with a negative effect on mood, but that's not to say they don't come with their own stressors (for another time).
Ever shed an unexpected tear because that baby goat video was just so cute? Or maybe that leaky tap sets you off some days more than it does others? Spoiler alert!
Your birth control could be the culprit of these changes in your mood.
There are so many variables that impact our mood from micro-chemical levels to causes in our environment, so it is difficult to pinpoint exactly what causes these mood swings we all so commonly feel. Doctors and researchers have been exploring this relationship for decades trying to figure out what the connection might be. The first step in the process of figuring this out is to start at the very beginning and ask “what is in hormonal birth control and why might it affect me?”
Let’s start with the very basics: what are hormones?
To put it simply, hormones are chemical messengers. Okay, let me break this down a bit more - basically they carry messages from our brains to other organs in our bodies to regulate a wide range of functions from eating, sleeping, sexual desires, reproduction, emotions, and mood (you get it). Our bodies circulate around 50 different hormones that work on these systems. When one or more of these hormones work overtime for a certain function, our brains compensate by adjusting the levels of the other hormones.
For example, the two main hormones that control the female reproductive system are estrogen and progesterone. Throughout our menstrual cycle, estrogen will peak and collapse, which in turn, affects the levels of other hormones circulating in our bodies. These other hormones, such as serotonin and endorphins, are shown to have an important role in regulating our emotions. See where I’m going with this? These complex processes work together and affect our mood!
For us vulva owners particularly, estrogen is closely linked to emotional well-being. I'll take an order of estrogen with a side of well-being please!
Case in point being, how the prevalence of depression correlates with hormonal changes in women, specifically when sex hormones flucuate, like during puberty or pre-menstruation. You know, like being really sad for no reason, then really horny while having an uncontrollable appetite? Well this is all because of the interaction between estrogen and our other hormones.
All in all, when it comes to understanding our mood, hormones play a large part.
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Okay, now I know a little more about how hormones work, what does this have to do with birth control?
Some birth control options contain synthetic versions of estrogen and progesterone. The contraceptive works by changing the levels of the naturally occurring hormones. As you know now, because these hormones interact with each other and are involved with mood regulation pathways, whether we like it or not, it makes sense that hormonal contraceptives will have an impact on how we feel.
Because the association between hormonal birth control and negative mood changes are so wildly common, many researchers are interested in understanding more. (We can pay to go to space but we’re still figuring this out...) There have been several large-scale studies that shed some more light on this association.
In 2016, a study that looked at over a million women aged 15-34 in Denmark explored the relationship between hormonal birth control, diagnosis of depression, and frequency of depression medication prescriptions. And duh, the researchers reported a link between antidepressant prescription and hormonal contraceptive use. In these women, the risk for a first diagnosis of depression 6 months after starting birth control was 1.8x higher than women on no birth control.
What is great about this study is that they also took a closer look at each form of birth control. For example, they looked specifically at women using combined oral contraceptives, the mini pill, the levonorgestrel-only IUD, the patch, and the ring and found women were more likely to be diagnosed with depression and prescribed antidepressants for the first time than people who were not using them.
And if you thought this study couldn’t get any better, it compared the results by age! They found that adolescent women who used hormonal contraception experienced higher risks than women in general. Who would’ve thought?!
Other researchers tested hormonal combined birth control pills vs a placebo and mood and well-being in a random, double-blind placebo-controlled studies (considered the gold standard of research studies). These study results show that over the course of three months, women taking the hormonal birth control reported significantly lower scores on self-reported well-being, however average depression scores did not differ.
There’s been several other large-scale studies that have produced similar results.
Okay but what are the risks?
It is important to consider the fact that every person is different and side effects of any drug will vary between you and your best friend. Chat with your squad about their experience, but don’t solely base your decision off of them - what works for her probably won’t work for you. What could help your decision making is the following...
Research suggests you might have a greater risk of experiencing negative mood effects on the pill if:
You have a history of depression or other mental illness
You have a personal or family history of mood-related side effects on birth control
You are taking progestin-only pills (the mini pill, levonorgestrel-only IUD)
You are 19 or younger
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Considering many of these large-scale studies, data indeed supports mood-related side effects from birth control. However, it is always important to remember that just because there is an association, does not necessarily mean that hormonal birth control is the direct cause. In any case, whether we know the exact cause or not, it is reassuring to know that it is not just you!
There’s definitely issues and progress to be made in the birth control industry; there’s not a perfect option for everyone. We are all unique and so are our experiences with different birth control methods.
When starting birth control, it is important to talk to your doctor and do your own research to understand what risks you may have and which form could be best for you. If you want that extra layer of protection (wink wink) then Reya can help navigate you to the best option for your body!
What we can do about it
Take a hot shower or bath - and why not, add some aroma therapy! Whether feeling down from your period or any other reason, a hot shower or bath with some essential oils can help calm your mind and body. Even treat yourself to a spa night! Apply a face mask, play some music, turn your phone off, anything you need to do to make yourself feel relaxed.
Exercise - meaning anything from going on a walk, run, or your favourite work out class. Exercising releases endorphins (those hormones I mentioned earlier) which can help elevate your mood! Of course, there are many other benefits to regular exercise, especially on your period, including: combating cramps, improving circulation, and reducing anxiety.
Get your beauty sleep - there is nothing like getting a restful night's sleep to restart yourself.
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Editors: Lisa Hou, Dallas Barnes