Yes, birth control may cause mood swings - here's what you can do about it

GettyImages 88186275 — Birth control may cause you to have higher cortisol levels.
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Birth control may cause mood swings, particularly for teenagers or people with a history of depression.
However, birth control may also help alleviate the depressive symptoms of PMS, resulting in positive mood changes for some.
If you feel like your mood has been negatively affected by birth control, ask your doctor about switching to a non-hormonal method like a copper IUD or condoms.
Visit Insider’s Health Reference library for more advice.

We know hormonal birth control can cause side effects like nausea, but experts are divided on whether it also causes mood swings.

Some studies show that hormonal birth control can improve your mood, but others suggest that it can increase depressive symptoms. Certain groups taking birth control may also be at greater risk for mood swings, including teens and people with a history of mood disorders.

Here’s what you need to know about whether birth control causes mood swings and what factors may increase your risk.

Can birth control cause mood swings?

“It’s very common for hormonal contraceptives to impact mood, typically in a negative way,” says Felice Gersh, MD, the medical director of the Integrative Medical Group of Irvine.

According to Gersh, her patients often describe their mood changes by saying they feel:

Crabby
Short-tempered
Sad
Sluggish
Prone to crying easily

Though some people report negative effects from birth control, others say just the opposite - that it can help balance out moods. While there is some research on how birth control affects your mood, "this is an area still in need of far more studies," Gersh says. And from the studies that we do have, results are mixed.

Research suggests that the type of hormonal birth control you choose may be responsible for mood changes. For example, a large 2017 study found that postpartum women who used birth control implants and vaginal rings were more likely to develop depression, while using hormonal IUDs lowered depression risk.

Another 2017 study looked at people taking combined hormonal birth control pills, the most common form of hormonal birth control in the US. Researchers found that people taking the pill scored significantly lower on scales measuring general well-being and feelings of self-control.

But some studies suggest that hormonal birth control can help reduce symptoms of premenstrual syndrome (PMS). In a 2010 study, people who started taking birth control after giving birth were about a third less likely to have PMS symptoms, which can include anxiety, mood swings, irritability, and crying spells. However, a 2014 trial found different results - this smaller study showed that taking birth control had no effect on PMS symptoms for married women.

Hormonal birth control may also have stronger emotional effects on certain groups of people, such as:

People with a history of mood disorders, like depression.
Those with premenstrual dysphoric disorder, a severe form of PMS, may be at greater risk of having mood issues while using hormonal birth control.
Teenagers who use hormonal birth control are about twice as likely to be diagnosed with depression than other teens, according to a 2016 study.

How does birth control affect your mood?

A normal menstrual cycle involves fluctuations of hormones like estrogen and progesterone, Gersh says. However, when you take hormonal birth control, your hormones remain more stable, and change less throughout your cycle.

"Without these fluctuations, the normal stress responses of the body are negatively altered," Gersh says. This means that when you're taking birth control, you may have higher levels of a stress hormone called cortisol.

When you have higher cortisol levels, you may feel stronger negative emotions like stress and fear. "This modification of the normal levels of cortisol results in altered moods and mood swings," Gersh says.

But in some cases, higher cortisol levels can have a benefit - if your cortisol levels are too low, it can increase your risk for depression. This means that hormonal birth control could protect against depression for people with naturally low cortisol.

Non-hormonal methods of birth control

If you have serious mood changes while taking hormonal birth control, the best solution is to stop taking them, Gersh says.

"Sadly, far too many women are instead prescribed an antidepressant, such an SSRI, which isn't what is needed to address the issues," says Gersh.

Luckily, there are several non-hormonal birth control methods you can use instead:

Condoms are stretchy pouches that fit over the penis and act as a physical barrier to keep sperm from entering your vagina. Condoms are also a good option to prevent sexually transmitted infections.
Copper IUDs are small devices that sit inside your uterus. Copper IUDs can help kill sperm and prevent fertilized eggs from implanting in your uterine wall.
Diaphragms and cervical caps are small rubbery devices that you place in front of your cervix to prevent sperm from entering. You generally use them with spermicide as well to kill any sperm that may get by the barrier.

Insider's takeaway

More research is needed to determine how hormonal birth control affects your mood, but factors like your age, your mental health, and the birth control method you use can increase your risk of mood issues.

If you think your birth control is affecting your mood, talk to your doctor about your options for non-hormonal methods.