Can hormonal contraception affect mood?

It's well known that hormonal contraception can affect mood - sometimes it makes mood worse, but sometimes can help.

  • Some women feel tearful or moody on hormonal contraception, or go off sex ​
  • Most women on the pill, patch, ring, hormonal coil or injection don't notice a difference in their moods
  • Some women find that hormonal contraception improves mood since it can help with premenstrual symptoms like feeling angry, tearful and hungry.

Does hormonal contraception cause depression?

There is a lot of concern in the media about a posssible link between hormonal contraception and depression. 

A study from Denmark in 2016 looked at the medical records of more than one million women aged 15 to 34 with no previous depression

Researchers found that women who used hormonal contraception were more likely to be started on anti-depressants or to be diagnosed with depression in a hospital. The link was stronger for teenage women.

This study has casued worry about hormonal contraception.

How worrying is this?

There are important things to know about this study

  • Firstly, the difference is very small - 1 extra woman received antidepressants out of 200 woman using hormonal methods for a year
  • Secondly, a link doesn't necessarily mean that contraception causes depression. For example, it could be that there's another explanation, say that young women who are on hormones are also more likely to have relationship breakups, more heartbreak and more depression.
  • Some studies from other countries found the same link, some show the opposite (i.e. that hormonal contraception was linked with better mental health), and other studies found no link between depression and hormonal contraception.

What can women do?

If a method of contraception seems to be linked with feeling moody, depressed, tearful, or angry, it's often worth swapping to a different method.

There are lots of different brands of pilll, and one brand can cause problems while another might be much better.

The IUD (copper coil) is increasingly popular since it does not contain hormones. The IUD is very reliable, and women of any age can have it, even if they have not been pregnant before.

Should women stop hormonal contraception?

Doctors are worried that women will stop their contraception suddenly, before they have chosen a good alternative method of contraception.

The last time there was a big media scare about the pill, this led to an estimated 12,400 extra births and 13,600 abortions.

BBC News: More or Less podcast

Faculty of Sexual and Reproductive Healthcare response.


What's right for you?

Frequently asked questions

Most hormonal contraception is very good at making periods lighter.

Women’s hormones naturally go up and down. The hormonal methods of contraception work by levelling the ups and downs, and by stopping an egg being released (ovulation). The hormones in contraception are very similar to women’s natural hormones, but the levels are steady instead of up and down. The steady level of hormones usually means that period bleeding is lighter, and also less painful.

The implant, pills, patches, and the ring are all ‘low dose’ methods. The lowest hormone level of all the methods is the IUS (hormonal coil) which is released into the womb slowly over 5 years.


Recommended methods:

There’s no need to have a period every month – on the pill, patch or ring it’s easy to control when a period comes, by taking the method continuously without a break. A period will come when you stop the method (for a week).

You can decide when a bleed will happen, and can also take the pill, patch or ring continuously to temporarily stop your periods.

It’s safe to use two or three pill packets back to back to delay a period, going straight from one packet on to the next with no break (or changing the patch once a week with no break, or using the vaginal ring continuously). 

The Combined Pill, The Patch and The Vaginal Ring are best for controlling when periods come, since these contain the hormone estrogen.

Recommended methods:

Hormonal contraception makes it possible to have no periods at all.

Some methods are quite likely to stop periods so there is no bleeding at all, or only occasional light bleeding. The best method to stop periods is the [Injection]. Most women (seven out of ten) will have no periods after a year of using the injection. The implant can also cause a pause in periods – periods will stop for about one in five women, and more than half have bleeding which is light and less frequent. Implant.

Periods can be delayed by using the The Combined Pill, The Patch or The Vaginal Ring continuously. So for example a woman can choose to have a period once every three months only.

It is safe, and there is no harm to future fertility in having a break from periods. When there is no period, the lining of the womb stays thin - blood doesn’t build up inside the body. There are some benefits to stopping periods - less bleeding helps to save iron (many women are anaemic because of their periods). Once the contraception is stopped, the body returns to it's normal cycle. Periods.

Having no periods on contraception is a temporary effect which is completely reversible, and makes no difference to future fertility - having no bleeding does not affect the chance of getting pregnant in future. All of the methods are very quickly reversible (except the injection - it can take a few months to get periods back again).

Recommended methods:

The Combined Pill, The Patch or The Vaginal Ring can make breasts bigger, since these contain the hormone estrogen.

Recommended methods:

Premenstrual tension is shortened to PMT. It's also known as PMS (premenstrual syndrome).

Women’s hormones naturally go up and down. There’s a lot more progesterone in the week before a period, and that can cause pre-menstrual symptoms like bad moods and hunger. Hormonal contraception works by levelling out hormones, and so can be ideal for reducing PMT/PMS.

Some women get mood changes when they are not on hormonal contraception, and some women get mood changes when they are on hormonal contraception. Often swapping to a different method solves the problem (e.g. choosing a different brand of pill)

These can help with PMT:


Recommended methods:

The Injection

The injection is the most invisible – there might be a tiny plaster put over the injection place (usually on the bum), but that’s all.

The Implant

The implant is on the inside of the arm, just under the skin – sometimes there is a small scar where it’s gone in, and you can sometimes see the outline of it in women who are skinny. In women with darker skin, a visible line can develop where the implant is resting. Since it’s on the inside of the arm, the implant is discreet.

Coils (IUD/IUS)

Coils are put into the womb, so cannot be seen. Occasionally a male partner can feel the string of a coil, and if this happens, it can be cut short so he doesn’t feel it.

Recommended methods:

Hormonal contraception is very good at reducing period pain. Lots of women find that their periods are much less painful when they are using hormonal contraception. 

Hormonal contraception works by levelling the normal ups and downs of women’s hormones, and by stopping an egg being released (ovulation). If there is no ovulation, there is no pain.

Recommended methods:

Nearly half of all pregnancies are unplanned (45%) – but that doesn’t necessarily mean that they are unwanted.

  • If an unplanned pregnancy would be a big concern, the implant, the injection, the IUS and the IUD are the best at preventing pregnancies.  Because they are long acting, you don't need to remember to use them every day
  • As long as they're taken correctly, the combined pill, the patch, the contraceptive ring, and the mini pill are also great at preventing pregnancies
  • If a woman wants to delay getting pregnant, but wants to get pregnant within a few months, the combined pill, the patch, the contracepive ring, and the progestogen only pill might be suitable as they come out of the body's system very soon after they are stopped, meaning that levels of fertility return to normal very quickly and might help with planning or delaying getting pregnant
  • If pregnancy could be a happy accident, condoms, the diaphragm, fertility awareness and withdrawal are generally less effective methods of contraception, and so could be suitable
  • Currently, contraceptive options for men are limited to condoms, withdrawal, or sterilisation (which is permanent).  An unplanned pregnancy can cause stress for both women and men, and using contraception such as condoms is a way for men to have control over when they become a father.  Men can talk to their partners about when they would like to have a baby, and ask her about her preferred methods of contraception
Recommended methods: