When wondering if they should get on the pill, many women worry: can birth control cause anxiety? What toll does managing your sexual health take on your mental health? The truth is, it’s complicated. Chemicals in hormonal contraceptives affect the neurotransmitters in your brain, and yes, that could possibly cause anxiety. Some women who use hormonal birth control or an oral contraceptive pill do report increased anxiety. Yet others say that the medication actually reduces their anxiety. 

Birth control causing anxiety really just depends on each woman individually as well as the specific contraceptive in use. There’s a lot to think about if you’re concerned about birth control and anxiety. Read on to discover what researchers know about hormonal birth control anxiety.

Can Birth Control Cause Anxiety?

Is anxiety a potential side effect of birth control? The association between birth control and anxiety is unclear. Different hormonal contraceptives can cause unique effects in every woman. So, unfortunately, there’s no standard to judge how a certain medication might affect you.

There are dozens of different hormonal birth control options available today. Some contain a combination of synthetic estrogen and synthetic progestin. These are called combined oral contraceptives (COCs).

Other types of birth control contain lab-made progestin — these are known as progestin-only contraceptives (POCs).

Hormonal birth control is available in a variety of forms, including: 

  • The Birth Control Pill — including cyclic combination oral contraceptive (COC) or progestin-only pill (POP). Both are oral contraceptives. COC combines both estrogen and progestin and are the most common. POPs only have progestin.
  • Implant — Also known as Nexplanon or Implanon, this form of birth control is a small rod implanted in one’s arm that releases progestin to prevent pregnancy.
  • Injection — The birth control shot, also known as Depo-Provera, is an injection received every 3 months that contains progestin to prevent pregnancy.
  • IUD — There are 5 brands of Intrauterine Devices. These include Paragard, Mirena, Kyleena, Liletta, and Skyla. There are two types of IUDs including hormonal IUDs and copper IUDs (non-hormonal).
  • Vaginal ring — The two types of vaginal rings are NuvaRing and Annovera. The NuvaRing lasts about 5 weeks, switching it out every month. Annovera lasts 1 year, putting it in for 3 weeks and taking it out for 7 days every month. The ring contains both estrogen and progestin and prevents ovulation from happening, in turn preventing pregnancy.
  • A patch — The two brands of birth control patches include the Xulane patch and the Twirla patch. SImilar to the vaginal ring, the combination of estrogen and progestin stop ovulation to prevent pregnancy. 

Currently, available hormonal birth control options are intended for use by women. However, studies concerning male hormonal contraceptives are currently underway.

Can synthetic versions of progestin and estrogen cause anxiety?

It’s difficult to say right now. To date, there hasn’t been sufficient research in randomized human trials to make any definitive conclusions. The research that does exist has shown conflicting results.

While these chemicals mimic the structures of hormones created naturally inside the body, they simply aren’t the same. There’s not enough conclusive evidence for us to fully understand their effects on anxiety, or anything else for that matter.

Some women report that their birth control helps them feel calmer and more collected, while others say they feel it causes them more anxiety.

How birth control can impact your mental health

For some women, hormonal contraception seems to affect different areas of both their mental health and their libido. It might affect sexual appetite, ability to handle stress, and mood. While altering levels of hormones (as birth control does) does have a potential link to mental health, it’s just unclear right now if there’s a true link between the hormones in birth control and anxiety. 

“Birth control can affect mood and anxiety symptoms because hormones like estrogen and progesterone impact the levels of neurotransmitters in the brain system circuits. There are a lot of birth control options available nowadays to choose from, and anyone who’s prescribed medication for mood and anxiety can ask their prescriber to check the interactions between medications and guide you on how that can impact anxiety or mood symptoms.”

Talkspace therapist Dr. Muhammad Munir, MD

What Studies Show About Hormonal Contraception

As we’ve noted, research about birth control causing anxiety is limited. According to some studies, the use of hormonal contraception has been linked to a future depression diagnosis and the eventual use of antidepressants. This seems to be even more likely among adolescents. These findings suggest that symptoms of depression could potentially be an adverse effect of hormonal contraceptives.

Still, more work is needed before we can fully understand what and how much, if any, connection there is between hormonal birth control and anxiety. 

In 2015, researchers from the University of Michigan noted there’s a general lack of attention regarding mental health and family planning. They went on to say that substantial research gaps exist, preventing us from truly garnering a deep understanding of the best way to approach birth control and family planning for women already living with anxiety and depression.   

Side effects of birth control 

According to research done in 2019, it’s not possible (yet) for us to be able to accurately and definitively predict which women might be more likely to experience adverse effects of hormonal contraception. Additionally, we also can’t yet determine which non-oral routes of administration or oral formulations might be most likely responsible for side effects.

“There have been several studies to evaluate the impact of oral contraceptives on mood for people without any pre-existing mood disorders, as well as people with concurrent use of oral contraceptives treated for depression or anxiety disorders. There is a correlation of mood disturbance — mostly agitation, sleep disturbance, and irritability — with use of oral contraceptives. Some individuals feel a worsening of their anxiety with the start of certain combinations of oral contraceptives. There are different options available with various contents of progesterone and estrogen components in the oral contraceptives that can impact mood symptoms.”

Talkspace therapist Dr. Muhammad Munir, MD

Though the research isn’t complete, there are studies that do suggest that birth control causing anxiety is likely. In 2004, a review concluded that hormonal birth control users reported anxiety at higher rates than non-users did. Again in 2018, a study done specifically on IUDs containing the hormone levonorgestrel found that users reported higher rates of anxiety. 

In addition to anxiety, other side effects of birth control might include: 

  • Nausea
  • Breakthrough bleeding (spotting) between periods
  • Weight gain
  • Headaches
  • Migraine
  • Breast tenderness
  • Mood changes
  • Decreased libido (sex drive)
  • Missed periods

How to Manage Anxiety if You’re on Birth Control

As of now, it’s not possible to say for sure whether a specific hormonal contraceptive will cause you anxiety. However, whether you’re taking birth control or not, anxiety is anxiety, and there are several ways you can manage birth control anxiety more effectively.

Consider the following effective tips to naturally reduce anxiety and live a healthier, more relaxed life.

Seek help from a therapist

Sitting down with a licensed therapist can be incredibly beneficial and effective in managing anxiety. Whether your anxiety is caused by hormonal birth control or not, a therapist can teach you how to deal with your symptoms. Left unaddressed, anxiety can progress into more serious conditions. It’s good to get a handle on it as soon as you realize anxiety is affecting your life. Many women find the calming, unbiased atmosphere of therapy sessions very restorative.

Get your thoughts in check through meditation

Practicing mindful meditation can be extremely helpful in reducing anxiety and dealing with the stress of everyday life. When in touch with your thoughts and breathing, you’ll be better able to see when emotions relating to anxiety are developing. Then, you can take steps to intervene in the process and regain your emotional control.

Pranayama (deep breathing)

It’s the air we breathe that connects us first to our lives. There’s much evidence concerning the importance of breath control for emotional management. When you’re paying attention to your breathing, your brain will not be disturbed by anxiety, depression, or other negative emotions.

Studies show that controlling respiration offers a powerful way to relax and calm central autonomic networks. Learning how to slow and deepen your breath as a relaxation technique can have a positive effect on stress-related disorders (as well as cardiorespiratory conditions).

Consider doing deep breathing exercises anytime that you feel anxious. It only takes about one minute to switch your emotional mode from sympathetic to parasympathetic. This can shift your emotional vibration into a lower gear.

Drink water

The importance of water in the human body and brain cannot be overstated. We’re mostly water. Yet so many of us don’t make drinking enough water in our daily lives a priority. Staying well-hydrated is imperative for every cell in the body, including those in the brain. Some research has shown an inverse relationship between water intake and anxiety.

Eat more plants

The foods we eat are crucial for every aspect of our health, including our ability to successfully manage anxiety and other negative emotions. Consider adding vegetables and fruits of assorted colors to your daily menu. The nutrients in plants like green leafy vegetables, garlic, ginger, turmeric, beets, and more provide amazing health benefits that we all need. You can still eat lean meat too, if you like, just add in the veggies!

Give yourself a break

If you’re feeling stressed out or overly anxious, take 5 minutes to yourself. Do some deep breathing. Collect your thoughts. Examine what’s going on internally that is making you feel a sense of dread and hurry. Have a glass of water. Step outside and breathe some fresh air. Enjoy the sun, or the clouds, and know that everything will be OK.

Getting to the Root of Your Anxiety

Does birth control cause anxiety? If you believe that your hormonal birth control is causing you to have anxiety, talk with your OB about how you’re feeling. There are many types of hormonal birth controls available today, and perhaps a different one will work better for you.

University of Michigan researchers found that generally speaking, even women living with anxiety and depression might be able to successfully take birth control. Which they use, however, should be carefully selected with the guidance and help of a medical provider who can oversee and assess individual mental and physical health conditions, future goals for fertility, and preference on the type of contraception.  

Although it’s not possible to say whether a given hormonal contraceptive will definitely cause you to have anxiety, the potential is something to be aware of. So, can birth control cause anxiety? There just hasn’t been enough research completed at this point to answer for sure. Just because you hear about one person’s unpleasant experience with a hormonal contraceptive doesn’t mean you’ll have a similar experience. Work with your family doctor and therapist to determine the best course for you.

If you’re living with generalized anxiety disorder, you should know two things. First, you’re not alone. It’s estimated that 1 in 5 adults in the United States are affected by anxiety disorders (such as sleep anxiety), and women are more than twice as likely to develop anxiety in their life. The second thing that’s important for you to understand is that anxiety is highly treatable. With the help of a therapist and possibly the use of medication, you can learn how to manage your anxiety so you can live a full, productive, happy life that isn’t dictated by symptoms of your anxiety, whether you’re on birth control or not!

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: April 11, 2022