Depo provera shot reviews

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Can Birth Control Cause Anxiety?

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Around 264 million people worldwide suffer from an anxiety disorder. For women, they are nearly 5 times as likely to be diagnosed with an anxiety disorder than men. Anxiety can cause many significant problems in daily functioning, and severely impact a person’s quality of life. For women, can taking hormonal birth control cause or alleviate the symptoms of anxiety? The following article will explore what an anxiety disorder is and if birth control has any impact on anxiety.

Can hormonal birth control alleviate symptoms of anxiety?

TLDR: Yes hormonal birth control can alleviate symptoms of anxiety. Hormones are complicated things, and the impact of hormonal birth control on each woman can vary significantly.

Some women’s anxiety about getting pregnant is very strong. Birth control would decrease that type of anxiety.

However, some women experience “pill anxiety” the fear of running out of birth control, the stress of having to run to the pharmacy each month to get their birth control. Pandia Health takes care of this by providing FREE delivery and automatic refills and reminders.

Those with uteruses who choose the birth control pill, patch, or ring may also be anxious from having to remember to take the medication every day, every week, every month, respectively.

Estrogen increases levels of the neurotransmitter serotonin, which generally causes positive mood and emotional well-being.

However, too much serotonin can cause increased anxiety.

Should women who have a history of depression or anxiety steer clear of hormonal birth control?

TLDR: No. Most women benefit from having a stable level of hormone on hormonal birth control vs. the ups and downs of NOT being on hormonal birth control. When you are not on hormonal birth control, then your hormones cycle up and down. When you are on monophasic birth control, then your hormones are maintained at a steady, smooth level. And if you skip the optional bleeding week, even smoother.

The research is still not clear as to whether hormonal birth control pills make symptoms worse in women who are prone to anxiety and depression.

The 2017 Medical Eligibility Criteria for Contraceptive Use report by the Centers for Disease Control and Prevention (CDC) concluded that depression is not a contraindication to hormonal contraception for women with depression, citing a lack of evidence supporting a causal relationship.

One study indicated that women who take combination oral contraceptives or progesterone-only minipills were more likely to be prescribed an antidepressant than women who did not take these types of contraceptives. However, this could be due to other factors such as women on birth control are more likely to be in a relationship and at risk of pregnancy, both of which can cause depression and anxiety.

What is an anxiety disorder?

Feeling anxious, or having anxiety is a typical response to a stressful situation, and it can sometimes be beneficial. Anxiety alerts someone to danger and compels them to be aware of their situation and take action to keep themselves out of harm’s way. But an anxiety disorder is a different matter entirely.

An anxiety disorder is when someone feels intense fear or stress about a future concern, and anxiety disorders are usually characterized by avoidant behaviors and physical symptoms that interfere with a person’s daily functioning. An anxiety disorder can cause someone to avoid normal situations, and the symptoms can significantly interfere with a person’s work, school, and personal relationships.

For a person to be diagnosed with an anxiety disorder, their fears must be considered out-of-proportion to the situation, not age appropriate, and also impair the person’s ability to function normally. There are different types of anxiety disorders:

  • Generalized anxiety disorder (GAD)
  • Panic disorders
  • Phobias
  • Social anxiety disorder
  • Separation anxiety disorder
  • Agoraphobia

Anxiety disorders are incredibly common and will affect up to 30% of all U.S. adults at some point in their lives. Anxiety disorders, although they are common and the symptoms debilitating, are highly treatable. A combination of medications and talk therapy can treat most cases of anxiety. Medications commonly used to treat depression, such as SSRIs and SNRIs, are also used for anxiety disorders.

However, it’s crucial that anxiety sufferers know and understand what triggers their symptoms and how to cope with stressful situations to prevent anxiety from getting out-of-hand.

The causes of anxiety are not completely understood, but genetic factors, temperament, and unique, biochemical characteristics can increase a person’s risk of experiencing anxiety symptoms. Mental health conditions like anxiety cannot be cured, but they can be effectively managed, and people can live symptom-free for life.

Use birth control to stabilize your hormones. Get your birth control delivered to your mailbox by signing up for Pandia Health’s FREE delivery services of birth control = #PandiaPeaceOfMind.
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Can birth control impact or alleviate anxiety?

First, it’s important to understand how hormonal birth control works to appreciate its effects on emotions and moods fully.

During the menstrual cycle, the hormones progesterone, estrogen, and testosterone are continuously rising and falling. The rise and fall of each of these hormones trigger different biological responses, including ovulation and menstruation.

When a woman starts taking hormonal birth control, hormones are prevented from rising and falling continuously, and in some cases, the hormones should be pretty stable. The body is exposed to a continuous level of hormones to trick the body into thinking it is already pregnant, thus preventing ovulation from occurring. If a woman takes monthly hormonal birth control pills, she will get a withdrawal bleed, which mimics a period, at the end of each month. For those on regular birth control pills, women can choose to skip the monthly bleed by skipping the last week of pills of a 4 week pack and going straight into the next pack.

Hormonal birth control can cause some side effects, such as decreased libido, spotting, and nausea. Also, there are mental health side effects that can occur, including mood swings, depression, and increased feelings of nervousness or anxiety. However, TLDR: most people do not experience changes in mood or any adverse side effects while taking hormonal birth control, but it is a risk.

Both progesterone and estrogen are known to affect mood, and the hormonal birth control pill contains synthetic versions of these hormones. Research has found that women with a history of depression are at increased risk of experiencing mood swings and anxiety when taking hormonal birth control.

What types of contraceptives can women who are prone to anxiety use?

TLDR: Women who have anxiety and depression can use all forms of contraception. Each woman is different and responds differently to hormones.

It’s common for women to try several different types of birth control before settling on an option that fits with both her lifestyle and specific biochemistry. For the birth control pill, there are 8 different types of progestins with 2 different levels each (or more) that women can take and see which one will work for her. But it’s important to talk to your provider about any history of depression or anxiety before trying a new hormonal contraceptive method.

Currently, there is no known risk of depression or anxiety when using a non-hormonal method of birth control such as the copper IUD and/or condoms. However, some women with the copper IUD have reported copper toxicity with symptoms of “brain fog and fatigue” and 2-5 months post insertion with decreased energy and increasing depression and irritability which resolved with copper IUD removal.

The research is mixed on progestin only methods such as the IUD with hormone, implant, and progestin only pills.

In 2016 in a study of 1 million Dutch women, women on hormonal birth control (the pill, patch, ring, IUD with hormone, implant) had a 2.2% chance of being prescribed antidepressants vs 1.7% of those not on hormonal birth control. So, that’s a 0.5% greater chance. A flaw in the study is that you can have depression and not be prescribed medications e.g. refuse medications or prefer therapy to medications, so perhaps those not on hormonal, are also anti-medication and refused the anti-depressant prescription.

A 2018 review of 26 studies concluded there was no increase in depression with progestin only contraceptives.

IUDs and implants are long-acting, reversible birth control methods that can be removed whenever a woman wishes to become pregnant. IUDs and implants are also relatively easy to remove in case a woman has an adverse reaction to the hormonal cocktail present in the implant and hormonal IUD. The copper IUD does not use hormones and is effective for up to 10 years.

For women with a history of anxiety, there are many different and effective birth control methods she can try until finding one that’s right for her. But it’s critical that women thoroughly communicate with their medical provider about their concerns and needs. Sign up with Pandia Health today to find out which birth control method would be right for you.
Disclaimer:

The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.

Updated 8.13.19 sy

“It’s just never got off the ground in a big way in Australia.”

Have you ever heard of the Depo injection? Also known as Depo Provera or simply Depo, it’s a cheap, long-lasting and effective birth control option.

The injection contains the hormone progestogen and works by preventing the ovaries from releasing an egg each month. Depo is injected into your arm or buttocks once every three months at a medical clinic, and it’s quick and not too painful to get.

It’s 99.8 per cent effective with perfect use, or 94 per cent effective with typical use (when mistakes, like not getting an injection at the right time, are factored in).

Sounds like it would be a popular form of contraception, right? While Depo is a favoured method of birth control in the UK, the US and numerous professional organisations, it never really took off in Australia.

ABC Life wanted to find out why.

What are the benefits of the Depo injection?

For starters, Depo is affordable — we’re talking about one-third of the cost of some brands of contraceptive pill.

The injection will set you back around $28 (or $7 if you have a concession card) at some GPs or Family Planning clinics around Australia — plus the consultation fee, which will be bulk-billed at Family Planning clinics if you have a concession card. (Keep in mind that the hormonal IUD and the contraceptive implant can be even cheaper.)

The Depo injection is also slightly more effective than the pill: 3 per cent more effective with typical use, or 0.1 per cent more effective with perfect use.

Women who feel squeamish at the thought of getting an object inserted into them (as with the hormonal IUD or the contraceptive implant) might prefer the Depo injection, although those two inserted options are the most effective types of contraception of all.

Why isn’t everyone using the Depo injection?

The Depo injection has been a very popular form of contraception in some countries, says Melissa Kang, an associate professor at the University of Technology Sydney, who’s otherwise known as advice columnist Dolly Doctor.

“It’s just never got off the ground in a big way in Australia and GPs have perhaps not offered it as a frontline,” Dr Kang explains.

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That’s partly because, to be effective, it requires users to get an injection every 12 weeks — so it’s not “set and forget” to the same extent as long-acting reversible contraception (LARC) options such as IUDs or the contraceptive implant, explains associate professor Kirsten Black from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Depo has also been less popular in Australia because it’s not immediately reversible, says Dr Kang. That is, unlike an IUD or contraceptive implant, Depo can’t be ‘removed’ if you experience unpleasant side effects; it has to metabolise itself out.

Amanda Newman of Jean Hailes for Women’s Health explains Depo is “on its way out”, noting she hasn’t given one of these injections for around a decade.

“It’s really been superseded” by LARCs, Dr Newman adds.

Still, the Depo shot remains available at many — but not all — GP clinics, as well as Family Planning clinics around Australia.

What are the side effects of the Depo injection?

There are a number of potential side effects you should know about before settling on the Depo injection as your contraception of choice.

Side effects include a decrease in bone mineral density, which may put women at higher risk for osteoporosis and bone fractures later in life. (The bone density returns once the injections have stopped.)

Depo is also associated with weight gain, with about 20 per cent of users experiencing this side effect, as well as changes in periods. While about 50 per cent of women lose their periods altogether (a side effect loved by many users), 50 per cent will bleed or spot at least occasionally.

These side effects can last for 14 weeks or longer — and may be stronger in the weeks immediately after the injection, Dr Kang says.

“You get a big bolus of hormone with the Depo Provera injection, it goes deep into muscle tissue and is released into the body immediately with a big boom,” she explains.

“And then the amount in the body gradually decreases over the three months, so you might expect some side effects to hit you harder at the beginning.”

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What if I want to get pregnant after stopping the Depo injection?

Your fertility may not bounce back for up to 18 months after your last Depo injection.

That said, 78 per cent of women who tried to conceive after stopping the contraception have been able to do so within 12 months, says Deborah Bateson, medical director at Family Planning NSW.

And while up to 18 months is the standard time it takes for fertility to come back, “I’m sure there would be some women who have taken a bit longer than that, and I’m sure with some women no delay whatsoever,” says Dr Kang.

So if you’re planning a baby in the near to mid-term, Depo may not be the right contraceptive choice for you.

This article contains general information only. It should not be relied on as advice in relation to your particular circumstances and issues, for which you should obtain specific, independent professional advice.

Injectable birth control with both progestin and estrogen

Birth control methods that can be injected may contain two hormones, a progestin and an estrogen. These combined injectable contraceptives (CICs) are effective in preventing pregnancy and can be stopped when a woman wants to get pregnant. This review looked at CICs for how well they prevented pregnancy and for the bleeding patterns and other side effects that may occur. We also studied whether women stopped using them early and whether women liked them.

In January and February 2013, we did computer searches to find randomized trials of combination injectable contraceptives. We included studies that compared a CIC with another birth control method. The other method could be another injectable contraceptive, either combined or having only a progestin. The CIC could also be compared to another hormonal method (like the pill) or to condoms, the diaphragm, or a placebo (or ‘dummy’).

We found 12 trials that studied four types of CICs. The combined methods required monthly injections. Four trials compared a CIC to ‘depo’, which has only a progestin. ‘Depo’ injections should be taken every three months. Five trials compared a CIC with a different combined injectable. Three trials compared a combined injectable with a different dose of the same hormones, with a progestin-only injectable, or with an intrauterine device (IUD).

More women using combined injectables had normal bleeding than women using progestin-only injectables like ‘depo.’ Also, fewer women using CICs stopped using them because of bleeding reasons than progestin-only users. However, users of combined injectables were more likely to stop using them overall and to stop for other medical reasons. Many factors can affect whether women keep using the method, including whether the women liked it.

Depo-Provera

SIDE EFFECTS

See PRECAUTIONS for possible adverse effects on the fetus

Reproductive System And Breast Disorders
  • breakthrough bleeding
  • spotting
  • change in menstrual flow
  • amenorrhea
  • changes in cervical erosion and cervical secretions
  • breast tenderness and galactorrhea
  • erectile dysfunction
Nervous System Disorders
  • headache
  • dizziness
  • somnolence
  • convulsions
Psychiatric Disorders
  • nervousness
  • euphoria
  • mental depression
  • insomnia
General Disorders And Administration Site Conditions
  • edema
  • pyrexia
  • fatigue
  • malaise
  • injection site reaction, injection site pain/tenderness, injection site persistent atrophy/indentation/dimpling, lipodystrophy acquired, injection site nodule/lump

In a few instances there have been undesirable sequelae at the site of injection, such as residual lump, change in color of skin, or sterile abscess.

Investigations
  • change in weight (increase or decrease)
Hepatobiliary Disorders
  • cholestatic jaundice, including neonatal jaundice
Skin And Subcutaneous Tissue Disorders
  • skin sensitivity reactions consisting of urticaria, pruritus, edema and generalized rash
  • acne, alopecia and hirsutism
  • rash (allergic) with and without pruritis
Immune System Disorders
  • anaphylactoid reactions and anaphylaxis
  • angioedema
Gastrointestinal Disorders
  • nausea
Endocrine Disorders
  • corticoid-like effects (e.g., Cushingoid syndrome)
Metabolism And Nutrition Disorders
  • hypercalcemia

A statistically significant association has been demonstrated between use of estrogen-progestin combination drugs and pulmonary embolism and cerebral thrombosis and embolism. For this reason patients on progestin therapy should be carefully observed. There is also evidence suggestive of an association with neuro-ocular lesions, e.g. retinal thrombosis and optic neuritis.

The following adverse reactions have been observed in patients receiving estrogenprogestin combination drugs:

  • rise in blood pressure in susceptible individuals
  • premenstrual syndrome
  • changes in libido
  • changes in appetite
  • cystitis-like syndrome
  • headache
  • nervousness
  • fatigue
  • backache
  • hirsutism
  • loss of scalp hair
  • erythema multiforma
  • erythema nodosum
  • hemorrhagic eruption
  • itching
  • dizziness

The following laboratory results may be altered by the use of estrogen-progestin combination drugs: Â

  • increased sulfobromophthalein retention and other hepatic function tests
  • coagulation tests: increase in prothrombin factors VII, VIII, IX, and X
  • metyrapone test
  • pregnanediol determinations
  • thyroid function: increase in PBI, and butanol extractable protein bound iodine and decrease in T3 uptake values

Read the entire FDA prescribing information for Depo-Provera (Medroxyprogesterone)

WHAT IS IT?

The contraceptive injection is typically referred to by its brand name, Depo Provera, as ‘Depo’ or as the birth control shot. It is a type of synthetic progesterone but does not contain estrogen. It is a very effective and reversible form of birth control that is given by injection via a needle. A doctor or nurse will give the injections once every 3 months (11-13 weeks). Depo is potentially a good option for people who have difficulty remembering to take their pills, or like the convenience of only having to get a shot 4 times a year.

HOW DOES IT WORK?

Depo Provera is a medication that one of our doctors can prescribe for you. We can sell you Depo right here in our Centre. A doctor or nurse will give you the injection of Depo Provera in a muscle (usually the upper arm or buttocks). You will get the first shot when you are having your period, and then you must come in every 11-13 weeks for your following shots.

The main way Depo Provera works is by preventing ovulation. This means your ovaries will not release an egg each cycle. It also thins out the lining of the uterus and thickens the mucous in the cervix.

HOW EFFECTIVE IS IT?

Depo is 99% effective at preventing pregnancy if you get your injections every three months. Based on typical use (such as receiving a shot late), it is 94% effective.

Depo Provera does NOT offer any protection against sexually transmitted infections (STIs).

WHAT ARE THE RISKS/SIDE-EFFECTS?

Irregular bleeding is a common side effect that will usually decrease or stop within the first few months of beginning injections. Most people will experience spotting on and off, bleeding more frequently, or may not bleed at all. You may also stop your periods, but this is not harmful. You may continue to experience irregular bleeding for 6-8 months after stopping Depo.

Depo Provera can result in decreased bone mineral density with more loss the longer it is used.. This may increase the risk of bone fractures. The reduction in bone mineral density can be reversed after stopping Depo Provera.

Other side effects include headaches, mood changes, weight gain, dizziness, bloating, and decreased sex drive.

USING DEPO PROVERA

The ideal time to have your first injection is within 7 days of the start of your period. Backup protection (like condoms) should not be required if you receive the injection during this time period.The injection can be started at any time during your cycle. If you have the injection after your period has ended it is recommended that you use backup contraception for at least 7 days.

Back up contraception should not be necessary if you receive your next injections on time.

If you have waited longer than 13 weeks between your injections, you will need to do a pregnancy test and use backup protection for 7 days following your late injection.

DOES IT AFFECT MY ABILITY TO BECOME PREGNANT AFTER STOPPING?

  • People who wish to become pregnant in the next 1 to 2 years should consider a different birth control option first.
  • It is reversible but takes a longer time for people to return to fertility than other methods. 50% of people who wanted to become pregnant were able to do so within 10 months of stopping the injection. It took some people up to 18 months to return to fertility.

ADVANTAGES AND DISADVANTAGES OF USING DEPO

ADVANTAGES:

  • It is very private – no one can tell you’re using it
  • The chances of getting pregnant are very low and it is reversible
  • You only have to get an injection once every 3 months
  • Can reduce periods or you may no longer get a period
  • Can reduce cramping and premenstrual symptoms
  • Is not affected by taking most other medication
  • May reduce the risk of getting uterine (endometrial) cancer and fibromas
  • May reduce symptoms of chronic pelvic pain or endometriosis if you suffer from these conditions
  • May reduce the number of seizures in people with epilepsy
  • You don’t need to keep any birth control supplies at home
  • May be an appropriate option in people who cannot take estrogen
  • May be an appropriate option in people who are breast feeding
  • May be an appropriate option for people over 35 who smoke

DISADVANTAGES:

  • It contains hormones and therefore has side effects. Some people may experience hormonal side-effects such as a change in sex drive, increased acne, headaches, breast sensitivity,mood changes/depression.
  • A common side-effect is irregular bleeding. This can mean lighter bleeding, no periods, heavier bleeding, and/or bleeding more often between periods.
  • Can cause decreased bone mineral density, which may return to normal after stopping
  • Can cause weight gain or change in appetite
  • It is an injection, which may cause discomfort
  • You must arrange to go to the doctor or clinic every 3 months for the injection
  • You are not protected against STIs
  • It may take 6 months to 18 months after stopping Depo Provera injections to become pregnant.

HOW TO BOOK AND PREPARE FOR YOUR APPOINTMENT

BOOKING AN APPOINTMENT

Booking an appointment with us is easy! Give us a call at 902.455.9656 ext. 0. You will be speaking with either a volunteer or a medical administrator. We cannot book appointments by email or Facebook. You cannot book an appointment for someone else, even if they are your partner or child. We will need to speak with them directly. To book, we will need your full name, birth date, phone number, and a very brief reason for your visit. That’s it! The person on the phone will outline anything you need to know to prepare for your appointment. Our average wait time for an appointment is 4-6 weeks from the day you call.

Make sure you bring your valid provincial health card with you to your appointment. Clients without health cards are subject to doctors and lab fees.

Are you a youth? You do not need parental consent for any of our appointments.

Don’t have access to or lost your health card? You are entitled to your health card information! Call MSI toll-free at 1-800-563-8880 (in Nova Scotia) or at 902-496-7008 from Monday-Friday 8am-5pm. We require the number and the expiry date. Another tip: take a picture of your card! You will never lose it again!

Using Birth Control Won’t Make You Depressed, Researchers Say

Is your progestin-only birth control making you depressed? Probably not, suggests research published online today in the journal Contraception.

After conducting a review of past studies, researchers from The Ohio State University found that most data didn’t support a link between progestin-only contraception and depression.

“There’s lots of reasons why people will sometimes get depression, but progestin-only contraception is not likely the cause for most people,” Dr. Brett Worly, lead author of the study and assistant professor of obstetrics and gynecology at The Ohio State University Wexner Medical Center, told Healthline.

“It’s hard to say from person to person,” he added, “but when looking at bigger populations, based on the best scientific evidence, it seems like these medicines are safe and most people should do really well with them.”

Previously, Worly was involved in a literature review that found no consistent link between combined hormonal contraception and depression.

Most studies have found no link

To conduct their latest literature review, Worly and colleagues used several research databases to search for past studies on progestin-only contraception and depression.

They found 26 studies that met their inclusion criteria. They included studies on progestin-only birth control pills, intrauterine devices (IUDs), implants, and injections.

Across these studies, some patients reported increased symptoms of depression after they began to use progestin-only contraception.

However, the most robust studies found no link between depressive symptoms and progestin-only contraception use.

This was true even when the research team focused on patients at higher risk of depression, including postpartum patients, adolescent patients, and those with a history of depression.

“Unfortunately, a lot of people have depression,” Worly said, including some women who use progestin-only contraception.

“But just because they’re both simultaneously there doesn’t mean that one necessarily causes the other,” he added, “and I feel safe at this point saying, for most women, progestin-only contraception should not cause them to have depression.”

Women face an array of choices

In recent decades, many new contraceptive methods have hit the market, including a growing number of hormonal contraceptives that contain progestin but not estrogen.

These progestin-only contraceptives include methods of long-acting reversible contraception (LARC), such as the Mirena IUD and Nexplanon implant.

They also include the birth control shot, which is commonly marketed under the brand name Depo-Provera.

Compared to birth control pills, the Mirena IUD, Nexplanon implant, and Depo-Provera injections are more effective for preventing pregnancy and more convenient for many people.

But some women might be reluctant to try these methods of birth control due to concerns over potential side effects.

“One of the problems that a lot of people have is that they hear that their friend or family member has experienced some sort of depression,” Worly said.

“So I wanted to go and look through the literature from a scientific perspective and really assess the question: Is there a link between depression and progestin-only contraception and is it something that my patients need to worry about?” he explained.

He said his findings might help reassure people about the safety of these progestin-only options, including the Mirena IUD, Nexplanon implant, and Depo-Provera shot.

“Most women should feel safe and reassured that they can use that long-acting contraception,” Worly said, “and they shouldn’t have trouble as far as depression.”

More research is needed

While Worly and his associates found some high-quality studies on progestin-only contraception and depression, he noted that more research is needed.

“The best would be well-done randomized control trials that look at these different issues,” he said.

“Those are hard studies to do because they take a lot of time, a lot of resources, and a lot of money,” he noted, “but those are the type of studies that really need to be done.”

In the meantime, people should work closely with their doctors or other healthcare providers to find a contraceptive method that meets their needs.

“Contraception is not a one-size-fits-all decision,” Dr. Holly Bullock, MPH, a fellow in the Long-Acting Reversible Contraceptive Program of the American College of Obstetricians and Gynecologists, told Healthline.

“Reviewing each method, with its benefits and risks, is an important step before starting any new contraceptive method,” she said.

Although progestin-only and combined hormonal contraceptives pose some risks of side effects, they’re generally considered safe.

In rare cases, they may contribute to the formation of blood clots, stroke, and heart attack.

Bullock noted the risk of these adverse events is greater with pregnancy.

Similarly, an “unplanned pregnancy may have more of an impact on mood and mental health than any method of contraception,” she said.

“For women with a history of medical illness or on medications,” she advised, “consult your doctor when starting a method of birth control, as some methods may be safer than others, or drug-drug interactions may make your medications or the contraceptive method less effective.”

If you suspect that you’re experiencing depression or side effects from contraceptives, make an appointment with your doctor.

Explore Methods

With all the stresses in life, it can be hard to know what is bringing you down. Is it the upcoming test that’s stressing you out? Is it the fight you had with your friend? Is it your co-worker being rude for no apparent reason? Or is it your birth control? Let’s take a look at what we know.

FACT: Depression is common.

Depression is a serious health problem that is often overlooked. About one in five people living in the United States will experience clinical depression at some point in their lives and depression is the leading cause of missed school or work in people between ages 15 and 44. Although both men and women can become depressed, women are more likely than men to experience depression.

It’s true that we all feel sad once in awhile, but for most people, these feelings pass in a few days. If you have a depressive disorder, you might not want or be able to do your regular activities like hanging out with friends, going to work, or going to school. For women who started using hormonal birth control around the same time they started feeling low, it can be tempting to blame the birth control for their depression.

Is it the birth control?

When the pill first came out in the 1960s, there was concern that it could be causing depression. But today’s pills contain 8-10 times less hormones (estrogen and progestin). Other methods, such as the ring and IUD, have even lower doses of hormones. Studies of women using our modern combined hormonal birth control methods have shown that they experience a variety of moods. For some women, birth control improved mood and depression.

A Danish study made headlines for showing a connection between hormonal birth control and prescriptions for antidepressants, though the results were complicated to interpret. Other studies have also shown that women taking combined hormonal contraceptives have less variability in their mood than women using non-hormonal birth control.

There have also been studies of progestin-only birth control, such as the shot (Depo), the implant, and hormonal IUDs. There was no difference in likelihood of depression between women using the shot and women using non-hormonal birth control. Even after a year of Depo use, the studies found no change in depression.

The bottom line is that there has been no consistent evidence that the birth control causes depression in most women, but there may still be some unanswered questions. Looking at a woman’s mental health when she starts using birth control is probably the best way to predict how she’ll feel, with or without birth control.

FACT: You know your body (and mood) the best.

Whatever the research says, at the end of the day, you’re the only one who truly knows how you feel. Everyone reacts to birth control differently, so remember that while birth control does not, for most women, cause or worsen depression, some people may have mood changes on birth control. If you’re worried your birth control is making you feel bad, talk with your health care provider about other options. Remember, there are a lot of birth control methods out there—you can find the right one for you!

If you are concerned that you might be depressed, here are some great resources to learn more and find help near you.

Grace Shih, MD, MAS, is an Assistant Professor at University of Washington. She completed her family medicine residency at Brown University and her family planning fellowship at University of California, San Francisco. When she’s not seeing patients, you can find her cooking, playing guitar, or traveling with her family.

read more about: side effects, birth control, myths, provider perspective read our commenting policy ” A NOTE ABOUT COMMENTING /

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Oh! One more thing: We do our best to answer questions in a timely manner, but we can’t guarantee an immediate reply. (And we don’t answer questions that are already answered in the article you’re commenting on.) If you ask a question and need a response right now, we partner with San Francisco Sex Information (SFSI) to give you free, accurate, confidential info on sex and reproductive health. Their phone number is 415-989-SFSI (7374) and here are their hours. And if you have an urgent medical question, please contact your doctor or a local health center. We’re here to help you stay informed, but only a medical professional can advise you on personal health concerns.

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