A woman taking hormonal birth control
Illustration by Tiphany Jackson, University of the Arts

Hormonal Birth Control Includes Some Lesser-Known Effects

Though the contraceptive is one of the most common prescription medications, relatively little is known about its effects on women’s behavior, emotional regulation and cognitive abilities.

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A woman taking hormonal birth control
Illustration by Tiphany Jackson, University of the Arts

Though the contraceptive is one of the most common prescription medications, relatively little is known about its effects on women’s behavior, emotional regulation and cognitive abilities.

In the United States, hormonal birth control is one of the most prevalent prescription medications. Between 2015 and 2017, 46.9 million women in the United States reported having used birth control, accounting for 64.9% of women aged 15 to 49. As one of the most common low-risk medications, hormonal birth control is usually prescribed to patients readily, and oftentimes, without proper consultation.

Although birth control is considered to be one of the safest medications, the impact of hormonal contraception on women’s behavior, emotional regulation and cognitive abilities remains understudied. For the majority of women, hormonal birth control has no significant impact on brain functioning. However, some preliminary research indicates that birth control may bring about a variety of undesirable side effects in some women. Several studies have revealed that birth control may increase the likelihood of depression and anxiety in some individuals and that it contributes to mood changes and emotional instability in others.

Adverse Mental Health Outcomes

In recent years, numerous research studies have examined the connection between hormonal contraceptives and depression. Notably, women taking hormonal contraceptives are more likely to be diagnosed with depression than women who are not on hormonal birth control. Furthermore, among adolescent girls, hormonal contraceptive users are more likely to be on psychiatric medications, and women taking oral birth control are more likely to be prescribed antidepressants.

For women who already struggle with depression and other mood disorders, hormonal birth control can have far greater negative effects on the brain. It is clear that hormonal birth control has the potential to exacerbate mental health problems; however, the nature of this relationship is highly dependent on context and differs on an individual basis. Nevertheless, it is important to identify the connection between depression and oral contraception, especially since those who have discontinued their use consistently point to depression, mood swings and negative emotional side effects as primary reasons for their discontinuation.

Before beginning hormonal contraception, most women receive no information regarding a potential increased risk of depression. While the exact relationship between birth control and depression is unknown, it is clear that some women are particularly vulnerable to hormonal contraception. Because of this, women should receive careful counseling from professionals before beginning hormonal birth control, especially if they have a history of mental health challenges.

Emotional Response and the Amygdala

It is interesting to speculate on why depression occurs in some women on contraceptives. Sex hormones — including those found in hormonal birth control — have been proven to have effects on the amygdala in the human brain, which is involved in emotional memory and in dictating responses to emotional stimuli. As a matter of fact, some evidence indicates that within the first few months of taking oral contraceptives, the female brain may experience changes in the amygdala, both structurally and functionally. As a result, behaviors that are controlled by or dependent on the amygdala may change with the start of hormonal birth control.

Given that the amygdala has such a crucial role in the human brain in regulating emotions, reactivity and memory, the use of birth control could potentially make women more susceptible to anxiety disorders, as well. At the very least, hormonal birth control has the potential to alter women’s emotional responses to events, situations and any other type of stimuli; in turn, this could alter women’s perceived life experiences and even potentially impact their behavior and personality traits.

Impact on Attraction and Relationships

Hormonal birth control can cause a variety of unpredictable changes within the female brain. Specifically, for some women, sexual satisfaction and partner preferences can fluctuate with changes in hormonal contraceptive use. In fact, there is evidence that birth control can alter women’s sexual preferences, influence perceptions of attractiveness and even fundamentally alter women’s sexual and romantic lives.

If a woman stops or begins taking hormonal contraception after she is already committed to a partner, her attraction to that partner can dramatically change. This can be largely explained by the fact that the use of oral contraceptives can play a significant role in what features heterosexual women find attractive in men. At the normal, natural hormonal level, women are usually drawn to more masculinized faces, while women who are on birth control have a greater preference for less masculine faces. Early romantic inclinations, as well as later satisfaction toward a partner, can be influenced by the use of hormonal birth control. Evidence about these types of changes has just begun to emerge over the past few decades, despite how many women across the globe take hormonal birth control, and how young so many women are when they begin.

The Importance of Education

Not only is there a lack of evidence supporting the safety and harmlessness of birth control, but there is also a severe problem with the depth of information women receive about the risks and consequences of hormonal contraception. Nearly 63% of women who choose to discontinue their use of birth control do so because the side effects are too severe to endure. As recent research has shown, the emotional consequences of birth control can be severe. Furthermore, the mental and emotional repercussions of contraception deter many women from continuing to use hormonal birth control. Nevertheless, very few women are adequately informed of the risks of hormonal contraception before starting their prescriptions.

Gender equality cannot be achieved if women are unwittingly experiencing severe negative consequences from hormonal contraceptives. Prior to starting hormonal contraception, women must be fully educated about the possible detrimental outcomes. This is essential for women to gain autonomy over their bodies and make informed decisions about their reproductive health and overall mental well-being.

Women must also be aware of the potential side effects of birth control for their own safety; without knowledge of its impact, women are unable to properly monitor their own experiences and avoid detrimental outcomes. There is an imperative need for medical professionals and care providers to discuss potential side effects with women so that their decision about birth control can be truly informed, and so that they are vigilant about their mental health when they start contraceptives.

The Need for Further Research

Although millions of women worldwide use hormonal forms of contraception, relatively little is known about its effects on the functions of the brain. In recent years, an accumulating pool of evidence has indicated that hormonal birth control can alter emotional processing, affect sexual and relationship satisfaction and accelerate a propensity toward depression. Still, many of these findings are highly preliminary; more extensive research is required to establish any causal relationships and to safeguard women’s health and well-being.

The overall scarcity of high-quality and long-term research should be deeply concerning to researchers and medical professionals. More extensive research is needed to explore and examine the side effects of birth control and to identify safer alternatives for women who are at risk for mental health complications. Furthermore, more research is needed to accurately identify the risk of these adverse consequences and allow women to make informed decisions regarding their birth control usage.

Writer Profile

Nora Weiss

George Washington University
Political Science, Psychology

Nora Weiss is a rising junior at George Washington University. Writing has been a lifelong passion and tool for self-expression for Nora, and she is very excited to be part of the Study Breaks team.

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