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By Dr Dulcy Rakumakoe

Chief Executive Officer


What you need to know about the link between the pill and depression

Depression has been shown to be one of the most common reasons women stop taking birth control pills.


The many synthetic hormones found in most birth control methods can cause problems with your moods. All hormonal options contain some amount of a lab formulated version of oestrogen and progesterone, the two hormones that, along with testosterone, control your menstrual cycles. Occasionally traditional hormonal birth control can exacerbate depression and anxiety because of the effect hormones have on the intricate balance of serotonin, dopamine, GABA and norepinephrine, all feel-good neurotransmitters in the brain. Oestrogen in particular plays a role in depression, with too little causing a dip in serotonin — and once this happens, the ovaries produce less oestrogen,…

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The many synthetic hormones found in most birth control methods can cause problems with your moods.

All hormonal options contain some amount of a lab formulated version of oestrogen and progesterone, the two hormones that, along with testosterone, control your menstrual cycles.

Occasionally traditional hormonal birth control can exacerbate depression and anxiety because of the effect hormones have on the intricate balance of serotonin, dopamine, GABA and norepinephrine, all feel-good neurotransmitters in the brain.

Oestrogen in particular plays a role in depression, with too little causing a dip in serotonin — and once this happens, the ovaries produce less oestrogen, starting a vicious cycle of feeling bad.  On the other hand, too little progesterone is associated with anxiety since the hormone has a calming effect.

Contraceptives, oral or inserted or injected, are the most popular methods used for controlling fertility and they contain hormones. These hormones change how your reproductive organs work in order to prevent pregnancy.

Combination pills contain man-made versions of the female hormones oestrogen and progesterone. These hormones prevent the release of an egg from the ovary or ovulation. They also thicken your cervical mucus, which makes it hard for sperm to travel to your uterus and fertilise an egg.

Picture: iStock

Low-dose progesterone birth control pills also change cervical mucus. They also take prevention one step further by thinning the lining of the uterus. This makes it difficult for implantation to occur. The side effects of birth control are generally mild.

These may include:

  • Spotting or irregular bleeding.
  • Sore breasts.
  • Nausea.
  • Headache.
  • Changes in libido,
  • Many women also report weight gain and depression or mood swings.

The implant (Norplant) has been linked to major depression and panic disorder because of its high progesterone content. It is important to know how different contraceptives can affect not only your overall physical health but also your mental health before you start taking them.

Researchers at Harvard Medical School conducted a study to determine if oral contraceptives impact mood and found that 16.3% out of the overall sample of 658 participants experienced a worsening of their moods.

Literature over the past 40 years has shown how their numerous side-effects negatively impact many users and even society at large. Three large studies were the first to demonstrate, on a grand scale, certain emotional and behavioural associations with contraceptive use.

Picture: iStock

The studies showed that contraceptive use was associated with an increased rate in depression, divorce, tranquilliser use, sexual dysfunction, and suicide and other violent and accidental deaths.

Depression has been shown to be one of the most common reasons women stop taking birth control pills.

Any woman who has a history of depression, anxiety, panic disorders, mood swings or seasonal affective disorder should consider how well she manages her mental health prior to beginning a hormone-containing contraceptive, because for a subset of women, taking this type of contraceptive can worsen an underlying mental health issue.

Contraceptives come in many forms, such as the birth control pill and IUD, so each type could potentially have varying side-effects, depending on the individual.

For women who experience negative side effects from birth control pills that contain hormones, there are other contraceptive alternatives, such as the intrauterine device (IUD), which can be found with or without hormones. Other options include diaphragms, condoms and tubal ligation.

Picture: iStock

For women who do decide on contraceptives with hormones, there are ways to eliminate other potential negative side-effects.

Any contraceptive that contains hormones has the potential to affect a woman’s mental health due to the effect synthetic hormones can have on a woman’s body. Therefore, any woman who is prone to depression, anxiety, sadness or mood swings, the hormone-containing contraceptives can magnify those responses.

The mechanism is complicated and involves the woman’s innate state of health, her overall toxic burden, and the way her liver processes and her gut excretes the hormones she has taken.

Additionally, oral contraceptives inhibit ovulation, which can blunt a woman’s sexual drive. This can be distressing for many women and their partners, who don’t understand why their sex drive is suddenly diminished.

For women who are already experiencing mental health problems before taking contraceptives, it can be a gamble to start taking pills with hormones.

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