It’s not uncommon for women to experience increased anxiety when taking hormonal birth control like the pill, patch, or ring. There are a few reasons why this may happen:
Hormone Changes
The synthetic estrogen and progestin in birth control can cause fluctuations in hormones like estrogen, progesterone, and testosterone. These hormones influence neurotransmitters like serotonin and GABA which regulate mood. Changing hormone levels may tip the scales leading to increased anxiety in some women.
Estrogen Dominance
Most types of hormonal birth control contain a combination of estrogen and progestin. When taking the pill, estrogen levels rise in the body while progesterone levels decline. This can create a state of “estrogen dominance” where there is more estrogen than progesterone in your system. Estrogen dominance has been linked to various symptoms like anxiety, irritability, and mood swings.
Progesterone Effects
Progesterone naturally has anti-anxiety and calming effects on the brain. Birth control methods like the pill and Depo-Provera shot significantly lower progesterone levels in the body. With lower progesterone, its relaxing properties disappear which may worsen anxiety. This seems especially likely for women already prone to anxiety issues.
Nutrient Depletion
Hormonal birth control can also deplete the body of essential mood-regulating nutrients like magnesium, vitamin B6, and zinc. Deficiencies in these nutrients are associated with increased symptoms of depression and anxiety. If your birth control is causing nutrient levels to drop, it may exacerbate underlying mood issues.
Gut Microbiome Changes
Recent research indicates your gut microbiome – the bacteria in your digestive system – may influence brain health and anxiety levels. Birth control pills seem to significantly alter the balance of gut bacteria in some women by suppressing “good bacteria” like Lactobacillus. These changes to gut microflora may be tied to negative mental health symptoms.
Withdrawal Symptoms
For some women, stopping birth control pills may also lead to increased anxiety in the short-term. Your body can undergo a sort of withdrawal as it adjusts to the hormonal changes. Mood swings, anxiety, and depression can occur as your natural hormone production ramps up again. These withdrawal effects should subside within a few months.
Premenstrual Exacerbation
Many women with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) report higher anxiety in the lead up to their period. Birth control pills can exacerbate these premenstrual mood symptoms in the week before your withdrawal bleed. This may present as worsening anxiety before you start your monthly off-week from active pills.
Underlying Condition
For some women birth control seems to trigger or worsen an underlying condition like generalized anxiety disorder, panic disorder, or obsessive compulsive disorder (OCD). The hormonal fluctuations may bring out anxiety symptoms that were previously well-managed or unnoticed.
Increased Stress Response
Studies show that estrogen can amplify the effects of stress on brain regions like the hippocampus. For women already under high stress, birth control may heighten the stress response and lead to greater feelings of anxiety. Trying to manage stress through lifestyle changes may lessen anxiety.
Risk Factors
Certain women appear more prone to anxiety side effects from hormonal birth control:
- Previous anxiety or mood disorder diagnosis
- PMS or PMDD history
- Postpartum depression
- Major life stress
- Nutrient deficiencies
- Drug or alcohol dependence issues
- Migraines
If you already struggle with anxiety, you seem more likely to experience worsened symptoms from birth control’s effects on hormones, brain chemistry, and stress response.
Birth Control Types
Certain forms of hormonal birth control seem more linked to increased anxiety than others:
- The pill – Various pill brands have been associated with anxiety side effects.
- Hormonal IUDs – The Mirena and Skyla IUDs release progestin which may cause mood changes.
- The patch – Directly absorbs estrogen through your skin which can amplify anxiety.
- The ring – Also delivers estrogen into the bloodstream which may alter mood.
- The shot – Depo-Provera prevents ovulation via progestin which reduces calming progesterone.
Your individual reaction varies though. Some women report the lowest anxiety levels taking non-hormonal birth control like the Paragard IUD or condoms.
Duration of Side Effects
For most women, negative mood side effects seem to occur within the first 3-6 months after starting hormonal birth control. Anxiety may steadily worsen as your body adjusts to the new medication. However, side effects can also come on suddenly after taking birth control for years with no issues.
| Time on Birth Control | Likelihood of Anxiety |
|---|---|
| First 3-6 months | Highest risk of side effects |
| 6 months – 1 year | Side effects may stabilize or improve |
| > 1 year | Low risk but can still occur |
For most, anxiety seems to either level out or lead to quitting the birth control after about 6 months. But side effects can persist or arise suddenly at any point while taking hormonal birth control.
What to Do
If your anxiety seems related to birth control use, here are some options to consider:
Wait it Out
If it’s been less than 3 months, give your body more time to adjust to the hormones. Anxiety may improve over the next few months. Stay in close contact with your doctor.
Switch Methods
Talk to your doctor about switching to a lower dose pill, non-hormonal IUD, or another method like the patch, ring, or shot. A different formulation with unique hormone types and amounts may work better.
Take a Break
Stop birth control use for 2-3 months and see if anxiety decreases. This may help confirm it’s the main cause. Use condoms or another backup method in the meantime.
Nutritional Supplements
Start supplements to replenish mood-regulating nutrients like magnesium, vitamin B complex, and zinc which are depleted by birth control.
Anxiety Treatment
Start therapy or medications to directly treat anxiety if it persists. Cognitive behavioral therapy (CBT) and SSRIs can help manage symptoms.
Switch to Non-Hormonal Methods
Discuss transitioning to non-hormonal birth control like copper IUDs, condoms, diaphragms, or fertility awareness which won’t impact hormones or mood.
The Bottom Line
Many women do experience increased anxiety and mood changes from hormonal birth control. However, symptoms tend to improve over time or can be managed with medication, therapy, diet, or lifestyle changes. It may take some trial and error to find the right birth control method without anxiety side effects. Talk to your gynecologist if your mood seems significantly worse after starting birth control.