What’s the 411 on Birth Control and Depression Risk?

Author(s): Jesse Lacasse, PhD, Postdoctoral fellow, Centre for Addiction and Mental Health | Editors: Tashi Stampp and Romina Garcia de leon (blog coordinators) 

Published: February 20th , 2026

Some studies claim “birth control” can increase the risk of depression. How do we disentangle this? Is there any truth to it?

There is some truth to this statement, but it’s important that we understand that there is a lot of nuance surrounding the relationship between depression and use of hormonal contraceptives. Not everyone who takes hormonal birth control will have an increased risk of developing depression. That said, some vulnerable individuals may be at an elevated risk of mood changes or depressive symptoms when they use hormonal contraceptives.

The challenge in unpacking this link is that most of the largest studies are observational, meaning they can identify associations but can’t prove that hormonal contraceptives cause depression. This is partly because people often start or switch contraception during life phases such as relationship changes or use them for symptoms that can also affect mood, such as painful or heavy periods, and acne. In other words, the timing and reasons for starting contraception can overlap with the timing of mood changes, which makes the relationship between hormonal contraceptives and depression risk difficult to parse apart.

Before we go on, we should note that the term “birth control” is a broad umbrella term. Often people think this refers mainly to the birth control pill, but there are many forms of birth control, including non-hormonal forms like the copper intrauterine device and even condoms. For the purposes of this blog, we are focusing on hormonal birth control methods, as these are the type of birth control reported to be associated with depression risk. 

Which age groups are more vulnerable to the effects of birth control?

Several large-scale epidemiological studies suggest that adolescents, often between ages 15 and 19, may be more vulnerable to an elevated risk of depression-related outcomes after starting hormonal contraceptives compared to older users [1] [2] [3] .

It’s not yet understood exactly why this risk appears higher in adolescence. Adolescence is a period of significant development for both the brain and the body. Many of these changes are influenced by naturally produced hormones, like estrogens and progesterone, that rise during puberty and fluctuate in cyclical patterns [4]. Many hormonal contraceptives suppress natural hormone production and alter those natural rhythms [5]. Some researchers speculate that disrupting typical hormone patterns during adolescence, which may be a sensitive developmental window, could contribute to increased vulnerability in some individuals.

Importantly, age isn’t the only factor. Other factors matter as well, including individual and family history of psychiatric conditions [6], and the specific formulation and delivery method of the contraceptive being used [2].

How do different forms of birth control methods interact with the body and brain? 

There are many different forms of hormonal birth control, and two ways to distinguish them are route of administration and chemical composition [7].

Route of administration refers to how synthetic hormones are delivered to the body. For example, hormonal contraceptives can be taken orally, which is often referred to as “the pill”, but there are other methods as well. Hormonal intrauterine devices, or IUDs, are small T-shaped devices placed in the uterus that release hormones over time. Other methods include transdermal patches, implants placed in the arm, and vaginal rings. These different routes can change how hormones are absorbed, which can influence their effects throughout the body and brain.

The second major distinction is chemical composition, meaning which synthetic hormones are included. All hormonal contraceptives contain a synthetic form of progesterone called a progestin. There are many types of progestins, and that becomes important when thinking about effects in the body and brain. Many birth control pills also contain a synthetic form of estrogen, most commonly ethinyl estradiol. Ethinyl estradiol is similar to natural estradiol, but it can produce strong estrogenic effects even at low doses, which is part of why it’s effective.

Progestins vary widely. This is an oversimplification, but some progestins are more progesterone-like, while others are more testosterone-like [7] . These differences can matter because they may shape downstream effects in the body and brain, and potentially side effect profiles, including mood, for some people.

Where this becomes important in the context of hormonal contraceptives and depression risk is that some routes of administration and chemical make-ups pose a greater risk than others. Some large epidemiological studies have reported that higher dose levonorgestrel-containing hormonal IUDs are associated with an elevated risk of depression-related outcomes [2] [8] [9] [10]. At the same time, many people use these IUDs without any mood issues and find them to be a great option. That said, much more research is needed for us to unpack why certain hormonal contraceptives pose a greater risk than others. 

What can mental health researchers do to efficiently capture the real-world experiences of birth control use and depression risk? 

One of the most important things we can do as mental health researchers is to acknowledge that a person’s hormonal state can influence their mental health. That includes recognizing that some individuals may have an increased risk of mood symptoms after starting hormonal contraception.

If researchers understand this fact, they can begin to design their studies and experiments bearing this in mind. This can be as simple as including questions on their participant intake forms related to hormonal state or contraceptive use. For example, they can ask whether a participant is currently using hormonal contraception, which method and formulation they are using, and when they started, stopped, or switched. Even these basic questions can provide critical context that can be included in analyses later. If more researchers measured hormonal contraceptive use routinely, we would likely gain a much clearer understanding of when, and for whom, hormonal state meaningfully contributes to mental health outcomes.

For women with a history of depression, how can they be better supported when choosing a birth control method that works for their mental health? 

For women with a history of depression, there are a few helpful considerations. First, it’s important to keep in mind that the majority of women who begin using hormonal contraceptives do not develop depression as a result. At the same time, because some individuals may be more vulnerable to mood changes, it’s reasonable to take a monitor-and-support approach, especially when starting a new method or switching formulations.

One practical recommendation is to monitor symptoms closely, particularly within the first three to six months after starting, switching, or stopping a hormonal contraceptive. If someone notices that something feels different, such as persistent sadness, anxiety, hopelessness, loss of interest, or changes in sleep or appetite, that’s worth discussing with the prescribing healthcare practitioner right away.

It can also be helpful to track mood briefly before and after starting a method (such as with period tracking apps), even if it is just a simple weekly note, so that any changes can be evaluated alongside timing. If mood symptoms do emerge, it doesn’t necessarily mean hormones are the problem, but it does mean the person deserves a thoughtful discussion about options, whether that is continuing with support, switching methods, or considering non-hormonal approaches.

Are there any ongoing studies that we should be aware of to follow the latest on the effects of birth control on the brain?

There are many ongoing research projects aimed at understanding the effects of hormonal birth control on the brain and mental health. I’m currently involved in a large national survey designed to better understand the experiences of people who are currently using hormonal contraceptives, have used them in the past, or have never used them. If anyone reading this post is interested in sharing their experience with our research team, I encourage them to click this link and fill out the survey.

Beyond that, there is an abundance of research on this topic that has recently been covered in special issues in scientific journals: Frontiers in Neuroendocrinology, Hormones & Behavior.

The study of hormonal contraceptives and the brain is a growing field, and we still have a lot to learn. With ongoing scientific research and public attention on this topic, we will continue to refine our understanding of who may be most vulnerable, why, and how to best support people in making informed choices that work for both their physical and mental health.