At last, science has spoken—it’s not all in your head. A landmark from the University of Copenhagen—the largest of its kind—has confirmed what women around the world have quietly accepted for years: using hormonal contraceptives can increase your risk of depression and the chance that you will be prescribed antidepressants.
And the risk is substantial. The study tracked one million Danish women, aged 15 to 34, and revealed that taking the combined birth control pill (with estrogen and progestin, a steroid hormone) meant women were 23% more likely to deal with depression.
That number rises to 34% for women using progestin-only pills. While an IUD (intrauterine device) ups the risk to 40% and the vaginal ring, 60%. Importantly, these percentages only represent the women who actually sought out medication options for depression—chances are, the true numbers could be higher since they don’t take into account women relying on non-pharmaceutical treatments for mood irregularities.
When the news first broke, FLARE watched as many women breathed a collective sigh of relief on social media and shared their personal battles. So we spoke to four women about their experiences with The Pill and other hormonal birth control methods.
Karolina’s experience with The Pill
Karolina Rembeisa’s adverse reaction to two types of birth control pills led to an increase in anxiety, depression and newfound panic attacks. “First came the tightening of the throat, followed by an all-consuming fear, often about nothing specific. Colours were dulled and everything seemed to vibrate at a low frequency,” she says.
“I was unable to get out of bed for anything other than work. At that point, I realized I was depressed.”
The 24-year-old talked to her doctor and switched from Alesse to Ortho Tri-Cyclen. After three weeks, the symptoms returned—worse this time. “I felt hopeless and irritable to the point of rage. I began to consider suicide.”
Rembeisa doesn’t believe birth control was the sole cause of her depression and anxiety, but found that the disturbance of hormonal levels it triggered seriously amplified any mood disorders she had.
Reilly’s experience with the Nuvaring
For Reilly Stephens, 25, her mood took a sharp turn after she went on the Nuvaring. She felt unusually tired and foggy—and extra irritable prior to her period. Two months in, she hit her lowest point. “I lay in bed with the lights off for two days. I remember calling my Mom and telling her something strange was happening,” Stephens recalls.
“I couldn’t remember what it felt like to be happy. I felt completely out of control.”
Since discontinuing the Nuvaring, Stephens is back to her normal self, but she admits the incident was scarring, and she’s apprehensive about other birth control options. “When I Googled ‘depression and Nuvaring,’ my heart sank. I had done research prior to starting and only saw some mixed reviews—nothing that would have prepared me for what I experienced.”
Jacyln’s experience with a hormonal IUD
Jaclyn (who asked us not to include her last name), 24, had never struggled with serious mood changes before using the hormonal IUD, which she had removed via hysteroscopy this year.
“My two years on the hormonal IUD were awful. It made me sluggish and anxious. I started feeling panicked, out of breath and had trouble sleeping,” she says. “As my symptoms worsened, it was apparent my IUD could be the cause. I was gaining weight and growing hair in weird areas, and my sex drive went down.”
Four months after the removal, Jaclyn feels much better both physically and mentally. She and her boyfriend agreed that condoms are the best option for now.
“I just want to give my body a break,” she says.
Victoria’s experience with the combined birth control pill
Victoria (who also asked us to withhold her last name), 25, had waited four months to see a gynaecologist for a hormone-free copper IUD prescription—only to be told she’d have to wait another two months to get the procedure to insert it. In immediate need of reliable contraception, she was prescribed her third brand of the combined pill: Diane-35.
During her two years on Diane-35, Victoria suffered extreme mood swings, anxiety and depression.
Now that she’s stopped taking hormonal contraceptives, Victoria’s energy has improved and her moods are consistent. She’s relieved that studies like this are gaining traction. “Before this, it was difficult to blame my mental health fluctuations on the pill—a form of birth control I was told was the ‘best’ for over 10 years,” she says.
Her frustrations with birth control echo the shared experiences of way too many women. “The biggest disappointment has been hearing the consensus that the pill was totally harmless. Why wouldn’t I take it? Shouldn’t I be responsible? But I’ve learned that hormones do have a huge impact on my body.”
So, how do you find the best option for you?
After reviewing the results, the study’s senior author, and gynaecologist at the University of Copenhagen, Professor Øjvind Lidegaard says he now encourages women to consider alternatives like condoms or the copper IUD if they are concerned about the effects of hormones, especially if they are predisposed to depression or have previously battled with it.
But accessibility to the copper IUD can be , so girls often settle for quicker, more readily available contraceptives. And many doctors still recommend using the combined birth control pill, since it has a much lower risk of depression than progestin-only products.
Dr. Simone Vigod, a psychiatrist and scientist at Women’s College Hospital who leads the Reproductive Life Stages Program, advises women to stay connected with their doctor and constantly monitor their symptoms.
When asked about when women should consider switching birth control methods, Vigod say it ultimately depends on the severity of your symptoms. Uncharacteristic irritability is another sign to watch out for—it appears in most hormonally-related mood disorders.
“If you’re having serious symptoms after two weeks, you should just stop and tell your doctor,” says Vigod. “If you go through one cycle and have mild signs, try waiting for another [menstrual cycle]. If after two or three cycles you’re still having difficulty, that’s a red flag.”
And when it comes to telling the difference between “the blues” and capital-d depression, Vigod suggests monitoring the persistence and degree of your moods, and checking in with a two-question screening tool:
- “Have you felt down or sad more days than not for the past couple weeks?
- Have you been less interested in the things that normally interest you?”
If the answer is yes to both, you should consider seeking help.
Vigod also stresses that it’s possible to have a negative reaction literally any time you put medication in your body. For most people, hormonal birth control offers huge success rates. But not all contraceptives are one-size-fits-all options.
The key to finding the best option is doing your research, following up with your doctor and regularly checking in with yourself on your mental health. It helps to talk about it, too. The study got the conversation started—it’s our job to keep it going. The more women open up and share, the more we can learn.