Each year, approximately 12 million women in the United States experience clinical depression, and an estimated one out of every eight women will develop clinical depression at some point in their lifetime. Women between the ages of 25 to 44, which are considered prime childbearing years, are the most likely to be affected by depression. Is it possible that these same women are increasing their chances of experiencing depression by using birth control? Depression is commonly listed as a side effect of many different types of birth control, but can birth control cause depression?
What are the different types of birth control?
There are many different ways to prevent pregnancy. Most birth control options are marketed towards women, including implants, intrauterine devices (IUDs) and other types of birth control that impact the body. Birth control can either be hormonal or non-hormonal. Most non-hormonal forms of birth control must be used every time a couple has intercourse, including:
- Internal condoms
- Birth control sponges
- Cervical caps
- Fertility awareness
- Withdrawal/pull out method
- Breastfeeding as birth control
- Outercourse and abstinence
Tubal ligation and vasectomy are two permanent forms of birth control that involve a surgical procedure to prevent pregnancy (tubal ligation) or prevent sperm from being released (vasectomy). Hormonal forms of birth control fall somewhere in between non-hormonal forms of birth control, which are temporary and must be repeated, and permanent surgical forms of birth control. Types of hormonal birth control include:
- Birth control implants
- Hormonal IUDs
- Birth control shot
- Birth control vaginal ring
- Birth control patch
- Birth control pill
It should be noted that copper IUDs do not contain hormones and are a longer-term form of birth control. No link has been established between depression and non-hormonal or permanent types of birth control. However, there may be a link between hormonal forms of birth control and depression.
What are the symptoms of depression?
Everyone feels sad or down occasionally, but depression is a long-term condition that is characterized by intense feelings of sadness or disinterest that interfere with daily life. Depression can cause both emotional and physical symptoms that may range in severity from person to person. Scientists are not exactly sure what causes depression, but it is thought to have biological, psychological, genetic, and environmental causes. Hormonal changes are also commonly linked to depression in women. Symptoms of depression commonly include:
- Persistent sadness
- Feelings of hopelessness or pessimism
- Difficulty concentrating
- Reduced libido
- Suicidal thoughts
- Digestive problems
- Persistent anxiety
- Decreased energy
- A loss of interest in hobbies
- Change in appetite
- Suicide attempts
Can hormonal birth control cause depression?
Depending on the type of birth control that you choose, you may experience a number of different side effects. However, one common side effect that is attributed to many different types of hormonal birth control options is depression. In fact, the number one reason why women stop using hormonal birth control is depression. While many women report experiencing depression as a side effect of hormonal birth control, researchers have struggled to find conclusive evidence of a link between the two. In fact, the Archives and Gynecology and Obstetrics published a study in 2012 that concluded that depression is not a common side effect of hormone-based contraceptives. Still, with so many women reporting depression as the reason that they stop taking hormonal birth control, other researchers have remained skeptical and continued to search for a link between the two. One study of over a million Danish women over the age of 14 found that, when controlling for preexisting psychiatric conditions and women with hormonal issues, all forms of hormonal contraception showed an increased risk of developing depression. It seems that hormonal birth control causes the depletion of certain nutrients that play a critical role in the production of both serotonin and melatonin, which control feelings of well being and influence sleep, respectively. The study also concluded that progesterone-only forms of hormonal birth control, including IUDs, had a higher risk of depression than other forms of hormonal birth control. While the study did recognize a link between hormonal birth control and depression, the number of women who were impacted was still found to be small; approximately 1.7 women out of 100 who did not use hormonal birth control developed depression, while 2.2 women out of 100 who did use hormonal birth control also developed the condition. Overall, the risk of developing depression while using birth control appears to remain small. Nonetheless, most manufacturers of hormonal birth control list depression as a possible side effect.
Why do women use hormonal birth control?
You might be wondering why some women use hormonal birth control if they are concerned about side effects of depression when there are other options available. While it goes without saying that the reason why many women use hormonal birth control is to prevent unwanted pregnancies. However, there are many different reasons that women use hormonal forms of birth control, such as birth control pills. Using hormonal birth control can help reduce the severity of menstrual cramps, lessen menstrual flow for lighter periods, and reduce the risk of experiencing ectopic pregnancy. Hormonal methods of birth control can also help prevent or diminish the following:
- Cysts in the ovaries or breasts
- Serious infections of the ovaries, fallopian tubes, and uterus
- Premenstrual syndrome, or PMS
- Loss of bone density
- Endometrial and ovarian cancers
- Iron deficiency
Clearly, there are many different reasons why women take hormonal birth control, including women who are not sexually active or cannot get pregnant for other reasons. Therefore, rather than suggesting that women use a different form of birth control when they begin to experience side effects, some companies have begun to research how side effects of hormonal birth control can be mitigated or prevented through nutritional support.
How can the risk of depression be minimized while taking birth control?
As researchers work to conclusively establish a link between depression and hormonal forms of birth control, it can be helpful to look at the evidence that has been established regarding the impact of hormonal birth control on women’s health. The World Health Organization (WHO) has stated that hormonal contraceptives can cause the depletion of vitamins and minerals such as folate (vitamin B9), vitamins B2, B6, B12, C, and E, as well as magnesium, selenium, and zinc. The reduction in vitamins C and E, which are important antioxidants, contribute to a state called oxidative stress, in which the free radicals in the body cause damage to cells and DNA in the body, which can affect mental health. A literature review found that oral contraceptives, or birth control pills, have been linked to lower levels of vitamin B2, vitamin B6, and vitamin B12. Vitamin B6 deficiency is linked to depression in women taking oral contraceptives because it reduces the amount of tryptophan in the brain, which reduces serotonin production. Low folate levels have also been tied to depression, as people with low folate levels are significantly less likely to respond to treatment with antidepressants than people with high folate levels.
It’s recommended that women who are considering taking hormonal birth control track their moods prior to taking birth control and also after they begin using hormonal contraceptives in order to determine if mood changes may be linked to their use of contraceptives. Women who are concerned about the potential link between hormonal forms of birth control and depression can reduce their risk and find support from a dietary supplement that is specially formulated to address the nutritional deficiencies that can be caused by the prolonged use of hormonal contraception.When the missing vitamins and minerals are received at therapeutic doses in addition to mitochondrial antioxidants, women are less likely to experience potential side effects from hormonal contraceptives, including depression, low sex drive, mood swings, headaches, weight gain, and fatigue.