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People have been using birth control for a long time. There are historical pieces of evidence of different methods used by humans for protection during reproduction and with time, various methods have evolved like implants and IUDs.
People use birth control for many reasons now other than avoiding pregnancy like during PMS and to reduce period pain. Often, women report feeling depressed and other symptoms of mental illness like bipolar disorder. However, depression is common, affecting 7.1% of all adults in the United States, including 8.7% of females.
There have been various studies with their own limitations, all leading to contradictory conclusions explored below. So if you often ask- can birth control cause depression? The possible answers are explained below.
1. What are Birth Controls?
As explained, birth controls are measures to avoid pregnancy but are also used to reduce period pain and other varied reasons. The consumers of birth control fear the risk of depression but the science has failed to reach a clear conclusion.
The possibility of a link between birth control and depression is explained below but before that, it is important to understand the types of birth- controls available and depression as a medical illness.
2. Types of Birth Controls-
There are many types of birth control but it can be broadly divided into two groups: hormonal and non-hormonal.
2.1 Non-Hormonal Birth Control-
Unlike hormonal birth control which adds hormones artificially into our body, non- hormonal are safe and do not interfere internally or have any major side effects.
Some examples of this category include-
2.1.1 Copper IUD-
Unlike hormonal IUDs, copper IUDs don’t need hormones because copper kills sperm. It can be easily placed and removed by any medical practitioner, lasting for 10 years maximum.
2.1.2 Barrier Method-
In the barrier method, with the help of condoms, cervical caps, or diaphragms, the sperms are prevented from entering the vagina by making a barrier.
2.1.3 Permanent and Natural Birth Controls-
With procedures like vasectomy in males and tubal ligation or tube tying in females, you can also opt for permanent pregnancy prevention, whereas, for a natural approach, you can always practice abstinence.
2.2 Hormonal Birth Control-
Hormones play an important part in depression. The (young) women are more likely to suffer from depression because of low estrogen, especially during the follicular phase (when it’s supposed to be high). This is also why menstruate people have a depressive phase during PMS, perimenopause, and postpartum.
Hormonal birth control supplies artificial hormones to reduce period pain and other factors leading to the risk of depression sometimes. The types of hormonal birth control methods known are as follows.
2.2.1 Pill of Combined Hormonal Birth Control-
The combined oral contraceptive pill is most common as it has both estrogen (synthetic and commonly in the form of Ethinyl estradiol) and progestin hormonal contraception to control ovulation.
A birth control pill should be taken simultaneously every day for maximum benefit. Some common brands of combined hormonal contraception are Yaz, Levora, and Yasmine.
2.2.2 Progestin-Only Pill or Mini-Pills:
Another oral method of hormonal contraceptives is in (mini) pill form. They contain only progestins like norethindrone, desogestrel, drospirenone, and lynestrenol. Mini pills should also be consumed simultaneously every day for better results than combined hormonal contraceptives.
2.2.3 The Vaginal Ring-
It contains a combination of Ethinyl estradiol/etonogestrel. The flexible vaginal ring is inserted into the vagina and is supposed to stay inside for 21 days and is taken out on the 7th day, which leads to a period. The ring is changed every month, and this hormonal contraception has fewer side effects than others.
A transdermal patch has hormones absorbed by the body through the skin. A patch is a combination of estrogen and progestin hormonal contraception. It is applied every 3 weeks, and on the fourth, it is taken off for withdrawal bleeding.
A shot is a progestin-only hormonal contraception method and is of many types. It prevents ovaries from releasing eggs. You can get it from a doctor every 3 months.
The most popular progestin-only shot contains medroxyprogesterone acetate. Many studies on the link between birth control and depression have used the same shot to reach their separate conclusions.
IUDs are also one of the many hormonal contraceptives. It contains levonorgestrel. It is a T-shaped device that is placed and removed by healthcare providers only. IUDs help to control pregnancy for between 3 to 10 years.
The implant is a progestin-only hormonal contraceptive method. It is a rod-shaped device placed under the skin of the upper arm by a health official.
The single-rod implant has progestin etonogestrel, and two-rod implants have levonorgestrel. It’s a type of LARC, similar to an IUD, and is useful for up to three years.
3. What is Depression?
It is a mental illness with some long-lasting effects. It harms your daily life and affects it severely.
The depressive symptoms include sadness, laziness, hopelessness, guilt, irritation, no motivation for activities you once enjoyed, no interest in studying or working, no energy, irregular/unhealthy sleeping pattern, bad eating habits like no appetite, suicidal thoughts or attempts, problem in concentrating and decision-making.
Depression is becoming highly common. It affects 1 out of every 10 women in the US alone. Females are more likely to feel depressed than males due to various reasons like lack of social support, family history, reproductive health, everyday sexism and gender inequality, preterm labor, delivery, and birth complications.
4. Can Birth Control Cause Depression?
As explained, hormonal birth control is found in many forms from birth control pills to IUDs as they provide the body with artificial hormones which change the natural course of the body, which then affects your mental health.
People have been using these methods for quite some time now, it’s being increasingly feared that they might cause depression as a side effect, as experienced by some women in the form of mood swings, anxiety and irritation.
According to 2016, medically reviewed Danish Study can birth control cause depression? Yes. Approx a million people in the age group of 15-34 years who took hormonal birth-control were found likely to be diagnosed with major depression or to get prescribed antidepressants, but the depressive symptoms lessened with time if used continuously.
Similarly, in a 2018 study, approximately 800,000 Swedish women aged 12-30 years on hormonal birth control were prescribed antidepressant or anti-anxiety drugs. Young adolescent girls were found to be at more risk.
Another 2019 medically reviewed study concluded that hormonal birth control does lead to side effects like affecting mood swings, especially amongst adolescent girls and people with a history of depression.
A 2018 medically reviewed retrospective study found that people who took progesterone-containing birth control after a child’s delivery were at a higher risk of depression.
And again a 2017 study concluded that ‘oral hormonal contraception pills’ do lead to negative mood effects among the consumers throughout their menstrual cycle but it also said that the mood changes were positive during the premenstrual phase.
Unlike the above-mentioned, some other studies gave a different conclusion. In a 2019 study, it was found that 4000 people in the US reported that oral hormonal contraception pills didn’t show any sign of depression and in another 2018 study 29 women participated in which the mental health and depressive episodes of using hormonal birth control were examined.
It concluded that hormonal contraception doesn’t necessarily lead to depression as a side effect.
Can birth control cause depression? Well, it seems there is less likely to be any connection between birth control and depression unless you have had a history of mental health. Still, again, as there’s no clear conclusion, if you have any depressive symptoms when using any hormonal birth control, it is advised to seek medical help and consult your doctor right away.
4.1 In Case of an Emergency:
For emergency reasons, you can take the non-hormonal Ella pill, hormonal Plan Bone-Step pill or the copper IUD. Birth control pills can be sought after unprotected sex and all methods are helpful within the next 5 days.
4.2 Shortcomings of Research or Studies-
Some of the reasons for these inconclusive results of these studies are-
Firstly, fewer studies or research has been done on this subject despite this being a major health concern.
Secondly, every individual body reacts differently towards hormones so no matter the number of people in the studies, the results cannot be relied on as they might vary amongst the consumers anyway
Depression is widely known but not socially accepted like any other mental illness, so its causes and symptoms often get unnoticed and ignored. Depressive symptoms are extreme feelings like getting lazy and sad so it can be difficult to draw a line and consider it an ‘issue‘ for some.
Other than this, the wide array of options available when it comes to birth control has different levels of side effects and risks. So a study or research might randomly use various birth control methods on the trial groups/people, leading to distorted or misinformed conclusions.
Some studies gave people the freedom to choose birth control of their choice so the results are unreliable. It is extremely difficult to measure someone’s mood and mental health changes related to the method they opt for. In research, some are measured by questionnaires while some can get asked for subjective answers, so comparing these studies isn’t helpful as much.
In any medically reviewed study, an experiment happens in a group or individually. In most of the studies mentioned above, it was groups, and when measuring their depressive symptoms, as a group it might seem they’re not experiencing anything different but in reality, often there is a small number of people with worsening symptoms often.
And lastly, people taken under experiment are usually sexually active women which is not the only group using hormonal contraceptives.
4.3 Side- Effects of Birth Control Other Than Depression-
Common side-effects of using hormonal contraceptives are- headache, nausea, irregular bleeding, sore breasts, acne, weight gain and changes in libido or lubrication during sex. With a medical history, you also have a risk of other side effects like liver tumors, heart attacks and blood clots.
5. Which Birth Control to Choose?
If you are starting any new hormonal birth control or quitting, it is always beneficial to consult your doctor or healthcare provider. If you are already using any, get a consultation before even changing the method since there might be a connection between your medical history and the risks of the method you’re opting for or of quitting the last one.
It is also always important to discuss the wide options of birth control with your doctor and anything that can fulfill the purpose without using any birth control method.
If you have any depressive symptoms or other side effects, it is best to inform your doctor early rather than late.
6. Benefits of Birth Control-
Everything has its pros and cons and birth control is the best method to get rid of many issues. Some benefits are light periods, less acne and endometriosis symptoms, less period pain, low risk of ectopic pregnancy, osteoporosis, ovarian/ endometrial cancer and ovary/uterus/fallopian tube infection.
During PMS, if you’re having severe pain and mood swings, birth control can lower those and improve your mental health, eventually reducing depression.
Can birth control cause depression? Even after we’ve concluded, the answer is still not definitive. It is because of the inconclusive studies and their own limitations.
Though it can be safely said that birth control might cause depression when you’re starting, quitting, or changing so, you should choose wisely any method, and in case of any symptoms, contact your doctor as prevention is the only easy way out.
As everybody reacts differently to any birth control, depending on any contrasting statement can be harmful in the long run, so prevention and precaution are the keys like in every other medical condition.