Contraception: how the pill promotes depression

Women who take the pill are more likely to develop depression. What is the risk and why are younger women particularly at risk?

Researchers led by Therese Johansson from Uppsala University have analysed health data from around 250,000 women from the UK bio database – from birth to menopause – as part of the largest study on this topic to date.

contraception and depression


Contraception plays a crucial role in family planning and empowering individuals to make choices about their reproductive health. Among the various contraceptive methods available, the pill is one of the most commonly used options by women worldwide. While the pill has proven to be highly effective in preventing unwanted pregnancies, there have been concerns and debates regarding its potential impact on mental health, particularly its association with depression. This article aims to explore the relationship between contraception, specifically the pill, and its alleged promotion of depression.

Understanding the Pill

Oral contraceptives, colloquially known as “the pill,” consist of synthetic hormones, typically a combination of estrogen and progestin, which work together to prevent ovulation and alter the cervical mucus. These hormonal changes ensure a reduced chance of fertilization and implantation, thus serving as an effective method of birth control.

Increased risk of depression in the first two years

According to the results, the risk of depressive symptoms in pill users is significantly higher than in non-users, especially in the first two years of use. Anyone who has not developed any depressive symptoms as a result of taking hormones seems to be less susceptible to them.

“Triggers could be hormonal fluctuations that occur when oral contraceptives are first taken,” the authors write. This would affect women who are particularly sensitive to changes in hormone levels.

Young women are more at risk

Young users were particularly often affected: the depression rate was increased by 130 percent in girls and women up to the age of 20, and by 94 percent in women over 20.

Even after stopping the pill, the researchers observed even higher rates of depression. In some cases, this could be explained by a time gap between stopping and the diagnosis of depression: the women stop taking the pill because of depressive symptoms, but the corresponding diagnosis occurs much later, according to the researchers’ hypothesis.

For women who had been on the pill from a young age, the risk of depression remained higher even for life. The researchers suspect that the early intake of the hormones could have permanently changed the brain chemistry of those affected.

The situation is different for women who started taking the pill at the earliest from the age of 20: their risk of depression has become more similar to that of non-users over the years.

Nurse study confirms causal relationship

To find out whether the pill actually directly promotes the development of depressive symptoms, the researchers compared the depression rates of around 7,300 pairs of sisters, around 80 percent of whom took the pill.

In this way, they were able to take into account influences such as family and social background, but also the partially matching genetic factors in the calculations. The results supported the hypothesis that taking the pill made a difference in the risk of depression.

“Our results show that the use of birth control pills in both adolescents and adults is associated with an increased risk of depression, especially shortly after starting the intake,” the authors conclude.

“The pill is well tolerated by most women”

The researchers also emphasize that the contraceptive pill is well tolerated by most women and has many advantages for women.

However, they call for the users to be given more information about the risk of depression and for screening for depression. In addition, doctors should be better informed about the connection between hormone preparations and depression.

The researchers pointed out some limitations that reduce the validity of the study. There was not enough data to allow an assessment of the possibly different effects of the various pill preparations on the risk of depression. In addition, the information on the start and end of the use of oral contraceptives was based on statements by the participants.

In a next step, they want to investigate the influence of other contraceptives on the risk of depression, including hormonal methods that are not used orally, such as the hormonal IUD or the vaginal ring

The Pill and Depression: Unravelling the Connection

The topic of the pill’s impact on mental health, specifically depression, has been the subject of extensive research and discussion. Several studies have investigated the potential link, and while there is ongoing debate, some evidence suggests a possible association. It is important to note that individual experiences may vary, and not all women who use the pill will experience depressive symptoms.

Hormonal Influence on Mood

Hormones play a crucial role in regulating mood, and altering hormone levels can affect emotional well-being. The synthetic hormones in the pill can disrupt the body’s natural hormonal balance, potentially leading to mood changes and depressive symptoms. Estrogen, in particular, has been linked to mood regulation, and fluctuations in its levels during the pill cycle may impact emotional stability.

Potential Mechanisms

The pill’s effect on mood is believed to occur through various mechanisms. One proposed explanation is that hormonal changes can influence neurotransmitters, such as serotonin, dopamine, and norepinephrine, which are known to regulate mood. Disruptions in these neurotransmitters can contribute to depressive symptoms. Additionally, hormonal changes can also affect the hypothalamic-pituitary-adrenal (HPA) axis, which plays a role in stress response. Altered HPA axis function has been associated with mood disorders, including depression.

Research Findings

Several studies have examined the relationship between the pill and depression, but findings have been inconsistent. Some studies suggest a positive association, reporting an increased risk of depressive symptoms among pill users. However, other research has found no significant correlation or even a protective effect against depression. It is important to consider that factors such as individual susceptibility, pre-existing mental health conditions, and the specific formulation of the pill can influence these findings.

Addressing Concerns

Healthcare professionals recognize the potential impact of hormonal contraception on mental health and take it into consideration when prescribing contraceptive methods. It is essential for women to have open and honest discussions with their healthcare providers about their concerns and experiences. Alternative contraceptive methods can be explored if the pill is suspected to have a negative impact on mental health.


While there is ongoing debate and conflicting research findings, the association between the pill and depression should not be dismissed. The hormonal changes caused by the pill have the potential to influence mood and emotional well-being in some individuals. It is crucial to have a comprehensive understanding of these potential risks and benefits to make informed decisions regarding contraception. Further research is needed to clarify the relationship between the pill and depression and to develop more personalized contraceptive options that consider mental health factors. In the meantime, open communication between individuals and healthcare providers remains paramount in addressing concerns and tailoring contraceptive choices to meet individual needs.