Is there a link between contraceptives and mental health?

‘Anxipro’, a mock term I use to describe my experience on various contraceptives since the age of seventeen.

Three years ago, if you asked any person that knew me, anxious, would be the last word to describe me. The idea of being able to relieve the pain that unfortunately occurs to most women every month was enticing to say the least, so, at quite an early age I underwent various ‘trials’ of contraceptive pills. After three years on roughly five different pills, the results weren’t great. That’s when the option for an IUD (Intrauterine Device) came about and I had the Implanon inserted. It was at this stage my anxiety worsened; it became noticeable to those around me, family, friends, housemates; before I even realised what was happening. Getting that removed quickly after a year, I went on to use Depo-Provera, an injection that lasts up to three months. The anxiety worsened and I am now on anti-anxiety medication. A realisation that still takes time to sink in some days. Every single form of contraception I have used over the last eight years contained the hormone Progesterone. This is my investigation into the link between Progesterone and mental health.

Upon researching this idea that there is a viable correlation between Progesterone and mental health, such as anxiety, depression, severe mood changes, it baffled me to find few academic articles on the issue. Looking up multiple journal articles on any kind of information linking anxiety and birth control pills I’ve come up so short I feel about 3 feet tall. There’s ample research on how birth control pills are supposedly linked to breast cancer, weight gain, all the good things in life, however, on the bright side, apparently the pill is actually good for your bone density; yet absolutely nothing on the risks of mental illness.

The only reliable, academic paper I have found on the subject was a study done by Harvard Medical School in 2008 on whether or not oral contraceptives caused mood swings or depression. These oral contraceptives were of a combined pill which contains both oestrogen and progesterone. Unfortunately I was unable to find a study that was based solely on the ‘mini pill’ which uses progesterone only.

The Harvard Study of Moods and Cycles examined the effect of oral contraceptives on mood. In this study, data from 658 women were analysed to determine the proportion of women whose mood either improved or worsened while taking an oral contraceptive. In the overall sample, 107 women (16.3%) noted worsening of their mood on oral contraceptive, 81 (12.3%) experienced mood improvement, and 470 (71.4%) had no change in their mood. They noted that women with a history of depression were more likely to experience mood worsening on the pill than those with no history of depression. However, most women with a history of depression experienced either no change in their mood (61%) or mood improvement (14%); only a small number (25%) experienced mood worsening on the pill.

I feel I must give a little context here, after all, I’m basically going on a rant to prove Progesterone as the “bad” guy. Yet, that’s not quite right. It would be ridiculous to attack a hormone or contraceptive device that clearly has worked for so many women; Australia has recently celebrated it’s 50th year in being the second nation to have gained access to “The Pill”.

As Nicola Davis discovered in her article written for The Observer, there are still a lot of women, particularly young women, who see their choice as the pill or condoms, when actually, there are other methods that are 20 times more effective at preventing a pregnancy. Professor Judith Stephenson and Margaret Pyke professor of sexual and reproductive health at University College London agree.

“Besides the two main forms of pill (combined and progestogen only), the injections, the implant and, of course, condoms, there’s a host of other options including intrauterine gadgets that can last for years. While the plastic Mirena, or IUS, sits in the womb and offers a local dose of progestoren, the copper coil, or IUD, kills off sperm and creates an inhospitable environment for implantation. It’s an option for those who aren’t keen on pumping their body full of extra hormones.”

At the end of the day, every single person will react differently to medication. Birth controls, IUD’s are all types of medications and with the range of contraceptives out there it is hard to pin down the specifics. Unfortunately the lack of a ‘try before you buy’ option is what gets me most. Here we are playing around with our hormones, and for some like myself, the effects can be severely life changing. What I have high hopes for is bringing this topic into the spotlight and creating a discussion. Without help and knowledge from GP’s, without the option for natural hormones instead of synthetic ones, we may be aiding the rapidly increasing rate of mental illness in Australian women. Perhaps it sounds so simple, cut down on combined hormones and increase testing progesterone based supplements and everyone will be happy again, but then I think, well, what if?

Statistics from the Australian Bureau show that [in 2007] Women (41%) were more likely than men (28%) to have used services for mental health problems. This is consistent with higher usage of health services by women in general. Note: selected mood, anxiety and substance use disorders.

In 2007, 45% of Australians aged 16–85 years, (or 7.3 million people), had at some point in their lifetime experienced a mental disorder. In the 12 months prior to the survey, women were more likely than men to have had symptoms of mental illness. A higher rate of anxiety disorders among women was the main contributor to this difference.

Anxiety disorders generally involve feelings of tension, distress or nervousness. In 2007, anxiety disorders were the most common class of mental disorders, affecting 14% of all people aged 16–85 years in the 12 months prior to the survey. Women were more likely to have experienced anxiety disorders than men, 18% to 11%. Anxiety disorders were most common in women aged 16–54 years, (21%), compared with women aged 65–85 years (6.3%).

Where I find myself invested in this finding is the fact that a young, happy woman such as myself can then find herself fainting in public from a panic attack. If someone had told me three years ago that I would suffer from anxiety to the point where I was having panic attacks perhaps two or three times a month I would have laughed in disbelief. Where the heck did this come from? After only reading about other peoples experiences on forums such as Reddit did I start to realise it may be more than me turning into a crazy person (thankfully).

I had Mirena for about 5 months and my mood gradually got worse. In the beginning I had lot’s of moodswings, but the last months I cried every day for two weeks before my period. It was exhausting. I decided to remove it when I got so depressed I wanted to off myself. I also got headaches, was tired all the time, had cramps and spotting most of the time. For me, Mirena was worse than the pill.

[–]Esoterria 1 point 1 year ago

I had the exact same symptoms on implanon, but they went away completely when I switched to mirena. It may be the hormone dose or type not agreeing with you, but a good doctor should be able to figure out a way around that, whether it’s an additional pill or whatever.

Reddit thread here.

[–]natalink 3 points 4 months ago

That’s actually the exact reason why I stopped the pill and got an IUD. I was taking OTC Lo, switched to the generic, and it all KIIINDS of effed me up. I was bitter, cried easily, very anxious and depressed, almost immediately after switching to the generic. Which is weird, really, because they’re essentially the same thing. Either way, switching to the IUD cleared that up almost immediately. It’s insane how much a small hormonal change can affect you.

[–]ElvishEm 1 point 5 months ago

I’m 21 yrs old and childless. Was on a few different combination pills for two years and went completely hormone free about a year ago because I had about every possible bad side effect (weight gain, loss of libido, depression, anxiety). I got a skyla IUD inserted about two months ago.

In general, I’m already really happy with my skyla IUD. My anxiety and depression got way better when I stopped the pill and I haven’t seen any change with the IUD.

Reddit thread here.

[–]lalisaurusrex 2 points 2 years ago

Ugh, the birth control dilemma. I was off it for almost a year until my skin suddenly started breaking out REALLY bad -presumably from hormones and my lamictal. I begrudgingly went back on ortho tri cyclen and my skin has cleared up like a charm but I’m experiencing a pretty noticeable change in my mood swings. Like you I am prone to rage episodes and I’m finding that they cluster in that last week of active pills.

You might need to go on something with a lower hormone dosage (OT Lo, NuvaRing) or with a constant dose throughout (Ortho Cyclen) to regulate. Everyone’s body is different and unfortunately we BPDs are often more susceptible to the emotional side effects of hormonal birth control. One important thing is to always give it a couple months unless it’s really unbearable — mood swings are a pretty common side effect of hormonal birth control that can clear up after 2 or 3 packs. Source: I used to work at Planned Parenthood.

Reddit thread here.

An online article titled Your Contraceptives Can Affect Your Mental Health stated that for women who are already experiencing mental health problems before taking contraceptives, it can be a gamble to starting taking pills with hormones. The question here is, in circumstances like mine, does that mean I had a mental health problem before I started taking these contraceptives? If so, how would any woman know, if their symptoms were dormant, that they are at risk of heightening any mental health issues that were there? And, just to throw my hat in the ring, how do we not know, that even without prior knowledge of mental health issues, that the inclusion of hormones such as Progesterone in our systems would not cause further problems?

If you’re experiencing any feelings of mental illness, I would highy suggest talking to your GP and looking into your options. Going on the Mental Health Plan doesn’t mean you’re crazy, it just means affordable and accessible health care to benefit yourself. Talk to someone. And if you do think there is a link between your current choice of contraception and your change of mood, again go talk to your GP or find one that will listen to you!

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