The Mental Health Side Effects of Birth Control That No One's Talking About
A new study found that hormonal birth control may actually impair your ability to recognize emotions. Here's what docs have to say about how your Pill may be affecting your brain.
You know the Pill comes with side effects: Freshman 15–like weight gain, acne flare-ups that give you high school PTSD, and breakthrough bleeding are just a few of the joys that can come with preventing unwanted pregnancies. But-as you may know from your own monthly mood swings-the Pill can affect your brain, too.
Hormonal birth control may actually impair your ability to recognize emotions, according to a small study published in the journal Frontiers in Neuroscience. When researchers had 95 women-42 of whom were on the pill and 53 who were not-complete an emotion recognition task, they found that neither group had trouble recognizing basic expressions like happiness or fear, but women on the Pill were 10 percent less accurate at identifying more complex emotional expressions like pride or contempt than women who were not on the Pill. (Related: Everything You Need to Know About Going Off the Pill)
Here's a quick science lesson: Birth control pills contain a combination of estrogen and progesterone, two hormones that naturally occur in your body. "When you give your body external hormones that it's also responsible for producing, your body recognizes that it doesn't need to produce it," explains Roohi Jeelani, M.D., a reproductive endocrinologist with Vios Fertility Institute. That's the connection to your brain. "The brain's hypothalamus and pituitary gland create the signal to your ovaries to produce these hormones; when you take birth control, these signals in your brain are suppressed," she said. (Related: How to Balance Your Hormones Naturally for Lasting Energy)
But before you freak out about misreading your S.O.'s self-satisfaction on their promotion as cocky arrogance, know that a 10 percent difference isn't a guarantee that your emotional IQ will veer off-course. "There's certainly something to [this study], but it's a very small study and there are just too many other variables-like thyroid disorder or pre-existing hormone imbalances-to consider this cause and effect," says Alyssa Dweck. M.D., a gynecologist and coauthor of The Complete A to Z for Your V.
Why is the thyroid a possible variant? "Your thyroid is the control center for all your hormones," explains Dr. Jeelani. "Birth control only suppresses a portion of your endocrine system, not all of it-so you would have to control for the level of every hormone of a patient before determining a direct link between the Pill and mental health responses."
Regarding the emotional responses in their study, the researchers, led by Alexander Lischke, Ph.D., a psychology researcher at the University of Greifswald in Germany, noted that while the difference was clear, it was also pretty subtle-and that further research is needed before they can tell whether these impairments actually affect women's relationships.
This isn't the only study to suggest a link between oral contraceptives and mental health. Hormonal contraception increased women's rate of taking antidepressants by 23 percent, according to a 10-year Danish study. It also negatively affected mood, well-being, self-control, energy levels, and general happiness with life, according to a study published in the journal Fertility and Sterility. And the Pill actually shrinks your brain, according to another small study published in the journal Human Brain Mapping, which found that women taking oral birth control pills had a thinner cortex (the outer layer of the brain) in two areas associated with controlling emotions, making decisions, and responding to rewards.
The link between hormonal birth control and mental health is still very much a gray area, though-and these studies don't change that. Case in point: When researchers from Ohio State Wexner Medical Center reviewed 26 studies on the risk for depression from progestin-only contraception (like the minipill and IUDs) in 2018, they found no link between the two, according to research published in the journal Contraception.
"There's a slew of hormones that are in the brain, and while studies have made weak associations, nothing has proven a direct link between birth control pills and altered levels of mental stability," says Dr. Jeelani. Yes, when you take birth control pills, you're suppressing your internal estrogen and progesterone release. And you may feel a change in your mood. "But there's been no direct correlation, no cause-and-effect relationship established," she explains. (Related: Is Your Birth Control Pill to Blame for Your Crappy Vision?)
Just like any other medication, the Pill comes with risks and benefits, says Dr. Dweck. "And there are many, many different types of birth control pills in the sense of their ingredients, particularly with different progesterone components," she adds. "What we do know is that there are hormone receptors for progesterone and estrogen in the brain, and so, of course, we would expect some sort of effect on the brain from altering hormone patterns via birth control pills."
Before leaping to any conclusions about the Pill based on headlines or studies (people *are* really hating on the Pill right now) talk to your doctor. An open dialogue can make sure you find the right birth control for your needs, whether that's for contraception, controlling a heavy or irregular flow, or PMS symptom management. "There's no one-size-fits-all birth control," says Dr. Dweck, so don't feel like you're stuck with the first one prescribed.