Contraception Depression: Can the Pill Affect Your Mood?

Big pharma's birth control pills are poorly studied but come with concerning side effects
August 23, 2019 Updated: August 31, 2019

What if I told you that a product is available that can interfere with your hormones to the extent that your daily and monthly rhythms are no longer operational?

And because you will no longer have functional brain-to-ovary signaling, you will likely avoid conceiving if you have sex during what would otherwise have been your six fertile days a month. Of course, this product’s hormonal effects also leave you with the sense that everything is stable and predictable which is something like turning the white noise up so loud that you don’t hear your own baby crying.

For this, you will risk migraines, weight gain, hypertension, gallstones, cancer, and yes, sudden death without warning. Would you believe that millions of women the world over, line up to take it every day? In fact, they even fight for their right to take it.

After four months of post-pill amenorrhea (no return of my natural cycle after stopping 12 years of birth control), I decided to see what the research showed about lesser-known side effects of the pill. I was astounded to find evidence supporting its inflammatory, nutrient-depleting, metabolic, and microbiota-impairing effects.

I’ve also found recent research linking the pill to cancerautism, and even brain-based changes. But because so many critical questions have not been asked about what happens when we manipulate the hormonal pathways and feedback loops in the body, we rely on post-marketing research, including girls and women dying due to contraceptives, sometimes used for acne or so they can avoid having an inconvenient period.

Then I began paying attention to my patients’ stories. Over and over again, I would learn about their onset of anxiety, depression, and even mania after beginning synthetic hormones.

The Pill and Your Mood

Since the 1960s, there has been controversy around the potential mood-altering effects of oral contraceptives. Over 50 years of public use has not settled the question.

There is acknowledgment; however, that depression is the most common reason for discontinuation of use. Pilot studies have demonstrated that women using the combined [estrogen and progestogen] oral contraceptive pill were significantly more depressed than a matched group who were not. The existing research is of fairly compromised quality–mostly reflecting the fact that this topic has not been a research focus over the past several decades. What does exist in the annals of science suggests that there is likely a subset of women for whom oral contraceptives represent a major risk factor for depression and/or related mood disturbance.

Who might these at-risk women be?

From 13 prospective trials, it appears that they have a personal or family psychiatric history (a rapidly growing group of people), one that has been exacerbated by pregnancy/postpartum, and premenstrual periods, and young age. More specifically, women with premenstrual mood symptoms prior to use experience more adverse effects with lower progestin dosages or triphasic oral contraceptives, unlike women without this history who experience more psychiatric side effects with higher progestin preparations.

The Pill and Antidepressants: Perfect Together?

Now we have the largest epidemiologic study of its kind, published in JAMA, out of Denmark, entitled Association of Hormonal Contraception with Depression. One million women ages 15-34 were followed for 13 years.

Here’s what they found:

  • Women who were prescribed the combined pill were 23 percent more likely to be treated with antidepressants
  • Progestin-only treated women (sometimes called the “mini pill”) were 34 percent more likely to be treated with antidepressants
  • Teens were 80 percent more likely if prescribed the combined pill and two-fold more likely with the progestin-only pill to be treated with antidepressants

Epidemiologic data is rife with potential confounders and certainly doesn’t demonstrate a clear causal signal, so this is merely food for thought. But what thought? What should we be thinking about as prescribers, mothers, and women?

I believe in informed consent and free choice.

Because oral contraceptives are poorly studied drugs given to healthy women, prescribers are morally obligated to thoroughly explore the known risks. If you still want to take a pill daily knowing you could develop everything from weight gain to migraines to an unhealthy relationship with your moods, all the way to your very life, then that is your choice.

What We Are Trading to Control Our Cycle

I have come to the perspective that you can never truly own your primal femininity, nor fully know what your symptoms are saying—from irregular periods to PMS—without deep contact with your hormonal self. Your symptoms are telling you that you need to change something, your diet, your sleep schedule, your stress level, or maybe just that plastic you’ve been microwaving.

I’m not sure it’s truly possible to live the life you are here to live while your vitality-supportive sex hormones are hijacked by Pharma.

If you’re taking birth control for your hormonal imbalance, heal your body. Start with food. Add detox and meditation the way we do in our online program, Vital Mind Reset. Consider herbal support.

It’s not hard, and the side effects are incredible—from clear skin to weight loss to a healthy sex drive. When you balance your hormones, you learn that a woman’s experience is cyclical. Energies shift to particular rhythms and you can watch yourself to know exactly when in your life you’re supposed to be doing what. It’s called getting in touch with yourself and it’s what true empowerment is all about.

If you’re taking birth control for contraception, own your right to keep Pharma out of your bedroom, to bring your full vital self to your sexuality, and work with your body, not against it. The Daysy fertility tracker and its birth control protocol and fix your period program, is my favorite gadget for learning how to do that—and it’s 99.3 percent effective.

This is the new feminism. Spread the word!

Kelly Brogan, MD, is a holistic women’s health psychiatrist and author of The New York Times bestselling book “A Mind of Your Own,” the children’s book “A Time for Rain,” and co-editor of the landmark textbook “Integrative Therapies for Depression.” This work is reproduced and distributed with the permission of Kelly Brogan, MD. For more articles, sign up for the newsletter at