Around 264 million people worldwide suffer from an anxiety disorder. For women, they are nearly 5 times as likely to be diagnosed with an anxiety disorder than men. Anxiety can cause many significant problems in daily functioning, and severely impact a person’s quality of life. For women, can taking hormonal birth control cause or alleviate the symptoms of anxiety? The following article will explore what an anxiety disorder is and if birth control has any impact on anxiety.
Can hormonal birth control alleviate symptoms of anxiety?
TLDR: Yes hormonal birth control can alleviate symptoms of anxiety. Hormones are complicated things, and the impact of hormonal birth control on each woman can vary significantly.
Some women’s anxiety about getting pregnant is very strong. Birth control would decrease that type of anxiety.
However, some women experience “pill anxiety” the fear of running out of birth control, the stress of having to run to the pharmacy each month to get their birth control. Pandia Health takes care of this by providing FREE delivery and automatic refills and reminders.
Those with uteruses who choose the birth control pill, patch, or ring may also be anxious from having to remember to take the medication every day, every week, every month, respectively.
Estrogen increases levels of the neurotransmitter serotonin, which generally causes positive mood and emotional well-being.
However, too much serotonin can cause increased anxiety.
Should women who have a history of depression or anxiety steer clear of hormonal birth control?
TLDR: No. Most women benefit from having a stable level of hormone on hormonal birth control vs. the ups and downs of NOT being on hormonal birth control. When you are not on hormonal birth control, then your hormones cycle up and down. When you are on monophasic birth control, then your hormones are maintained at a steady, smooth level. And if you skip the optional bleeding week, even smoother.
The research is still not clear as to whether hormonal birth control pills make symptoms worse in women who are prone to anxiety and depression.
The 2017 Medical Eligibility Criteria for Contraceptive Use report by the Centers for Disease Control and Prevention (CDC) concluded that depression is not a contraindication to hormonal contraception for women with depression, citing a lack of evidence supporting a causal relationship.
One study indicated that women who take combination oral contraceptives or progesterone-only minipills were more likely to be prescribed an antidepressant than women who did not take these types of contraceptives. However, this could be due to other factors such as women on birth control are more likely to be in a relationship and at risk of pregnancy, both of which can cause depression and anxiety.
What is an anxiety disorder?
Feeling anxious, or having anxiety is a typical response to a stressful situation, and it can sometimes be beneficial. Anxiety alerts someone to danger and compels them to be aware of their situation and take action to keep themselves out of harm’s way. But an anxiety disorder is a different matter entirely.
An anxiety disorder is when someone feels intense fear or stress about a future concern, and anxiety disorders are usually characterized by avoidant behaviors and physical symptoms that interfere with a person’s daily functioning. An anxiety disorder can cause someone to avoid normal situations, and the symptoms can significantly interfere with a person’s work, school, and personal relationships.
For a person to be diagnosed with an anxiety disorder, their fears must be considered out-of-proportion to the situation, not age appropriate, and also impair the person’s ability to function normally. There are different types of anxiety disorders:
- Generalized anxiety disorder (GAD)
- Panic disorders
- Social anxiety disorder
- Separation anxiety disorder
Anxiety disorders are incredibly common and will affect up to 30% of all U.S. adults at some point in their lives. Anxiety disorders, although they are common and the symptoms debilitating, are highly treatable. A combination of medications and talk therapy can treat most cases of anxiety. Medications commonly used to treat depression, such as SSRIs and SNRIs, are also used for anxiety disorders.
However, it’s crucial that anxiety sufferers know and understand what triggers their symptoms and how to cope with stressful situations to prevent anxiety from getting out-of-hand.
The causes of anxiety are not completely understood, but genetic factors, temperament, and unique, biochemical characteristics can increase a person’s risk of experiencing anxiety symptoms. Mental health conditions like anxiety cannot be cured, but they can be effectively managed, and people can live symptom-free for life.
Can birth control impact or alleviate anxiety?
First, it’s important to understand how hormonal birth control works to appreciate its effects on emotions and moods fully.
During the menstrual cycle, the hormones progesterone, estrogen, and testosterone are continuously rising and falling. The rise and fall of each of these hormones trigger different biological responses, including ovulation and menstruation.
When a woman starts taking hormonal birth control, hormones are prevented from rising and falling continuously, and in some cases, the hormones should be pretty stable. The body is exposed to a continuous level of hormones to trick the body into thinking it is already pregnant, thus preventing ovulation from occurring. If a woman takes monthly hormonal birth control pills, she will get a withdrawal bleed, which mimics a period, at the end of each month. For those on regular birth control pills, women can choose to skip the monthly bleed by skipping the last week of pills of a 4 week pack and going straight into the next pack.
Hormonal birth control can cause some side effects, such as decreased libido, spotting, and nausea. Also, there are mental health side effects that can occur, including mood swings, depression, and increased feelings of nervousness or anxiety. However, TLDR: most people do not experience changes in mood or any adverse side effects while taking hormonal birth control, but it is a risk.
Both progesterone and estrogen are known to affect mood, and the hormonal birth control pill contains synthetic versions of these hormones. Research has found that women with a history of depression are at increased risk of experiencing mood swings and anxiety when taking hormonal birth control.
What types of contraceptives can women who are prone to anxiety use?
TLDR: Women who have anxiety and depression can use all forms of contraception. Each woman is different and responds differently to hormones.
It’s common for women to try several different types of birth control before settling on an option that fits with both her lifestyle and specific biochemistry. For the birth control pill, there are 8 different types of progestins with 2 different levels each (or more) that women can take and see which one will work for her. But it’s important to talk to your provider about any history of depression or anxiety before trying a new hormonal contraceptive method.
Currently, there is no known risk of depression or anxiety when using a non-hormonal method of birth control such as the copper IUD and/or condoms. However, some women with the copper IUD have reported copper toxicity with symptoms of “brain fog and fatigue” and 2-5 months post insertion with decreased energy and increasing depression and irritability which resolved with copper IUD removal.
The research is mixed on progestin only methods such as the IUD with hormone, implant, and progestin only pills.
In 2016 in a study of 1 million Dutch women, women on hormonal birth control (the pill, patch, ring, IUD with hormone, implant) had a 2.2% chance of being prescribed antidepressants vs 1.7% of those not on hormonal birth control. So, that’s a 0.5% greater chance. A flaw in the study is that you can have depression and not be prescribed medications e.g. refuse medications or prefer therapy to medications, so perhaps those not on hormonal, are also anti-medication and refused the anti-depressant prescription.
A 2018 review of 26 studies concluded there was no increase in depression with progestin only contraceptives.
IUDs and implants are long-acting, reversible birth control methods that can be removed whenever a woman wishes to become pregnant. IUDs and implants are also relatively easy to remove in case a woman has an adverse reaction to the hormonal cocktail present in the implant and hormonal IUD. The copper IUD does not use hormones and is effective for up to 10 years.
For women with a history of anxiety, there are many different and effective birth control methods she can try until finding one that’s right for her. But it’s critical that women thoroughly communicate with their medical provider about their concerns and needs. Sign up with Pandia Health today to find out which birth control method would be right for you.
The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.
Updated 8.13.19 sy