How Hormonal Birth Control Can Affect Your Mood

Medically Reviewed by Brunilda Nazario, MD on May 17, 2024
3 min read

Lots of people get irritable, depressed, or feel out of sorts just before their monthly periods. These can be symptoms of a common condition called premenstrual syndrome (PMS).

But could your birth control pills and other hormonal contraceptives trigger similar emotional swings? Or might they actually improve your mood?

Most birth control pills, patches, and rings combine two lab-made female sex hormones, estrogen and progestin. “Minipills” have only progestin, and in a smaller amount.

Combined hormonal contraceptives stop the normal rise and fall of your body’s natural hormones. That blocks your body from ovulating and releasing an egg to be fertilized by sperm.

People have complained about mood-related changes like depression and anxiety ever since the pill came out in 1960. The newest generation of pills have lower doses of hormones. Even so, a sizeable number still quit the pill because of side effects.

During a typical 28-day menstrual cycle, estrogen levels reach their peak around day 14. That’s when many feel their best emotionally and physically. Most hormonal contraceptives smooth this mountain-shaped hormonal cycle into an even line for the first 21 days. Then the levels of estrogen and progestin plunge during the final 7 days.

Limited research suggests that compared with women who don’t use hormonal birth control, those who do are more likely report feeling depressed, anxious, and angry. But those symptoms don’t make the list of common side effects. Other studies have turned up no significant link between hormone combinations or concentrations and differences in mood. Still more research has found that women on the pill and those taking dummy pills report similar symptoms, suggesting that any effects they noticed were unrelated to the actual pills.

Doctors sometimes prescribe hormonal contraceptives to ease the discomfort some feel at one point or another during their monthly periods.

Symptoms of premenstrual syndrome can include:

You might also have:

The FDA has approved combination birth control pills drospirenone and ethinyl estradiol (Yaz) and drospirenone, ethinyl estradiol, and levomefolic acid (Beyaz) to treat a more serious form of PMS called premenstrual dysphoric disorder. But the hormones may work better to ease physical symptoms than mood-related ones. It also can take some trial and error for your doctors to hit the right medication and dosage.

If scientists can’t firmly connect the dots between birth control hormones and emotional turbulence, why do some people believe there’s a link?

  • Greater sensitivity to changes to levels of estrogen and other hormones
  • Stress from the need to avoid pregnancy and to take the pill as prescribed
  • Heightened perception of possible symptoms among people with existing depression, anxiety, or other mental health conditions

If your mood swings are mild or moderate, these may bring you relief: 

  • Exercise 
  • Healthier eating 
  • Relaxation techniques such as massage, yoga, and biofeedback 
  • Other lifestyle changes

See your doctor if you feel depressed, feel no energy, or have other severe symptoms that impact with your daily life.