It’s not uncommon to notice physical and emotional changes when stopping birth control. With that being said, can stopping birth control cause depression? The short answer: it’s possible.
When you stop taking birth control, you may experience mood changes like anxiety and depression. To date, most studies examining the link between hormonal contraceptives and depression have found an association, while some have not.
This article will dive deep into the research and delve into how post-birth control syndrome may actually be the cause of your symptoms. You will also learn how to manage mood changes associated with post-birth control syndrome using a functional medicine approach.
What to Expect When You Transition Off Birth Control
To understand what happens when you stop birth control, it would be helpful to first learn about the menstrual cycle.
The first half of your cycle is called the follicular phase. During this phase, estrogen levels rise and peak right before ovulation, or the release of an egg from the ovary. The surge in estrogen plays an important role in ovulation.
The second half of your cycle is called the luteal phase. It takes place after you ovulate and lasts until right before your next period. During the luteal phase, progesterone levels peak. If you become pregnant, progesterone levels stay elevated to help you maintain the pregnancy.
However, when you are on hormonal birth control, synthetic estrogens and progestins help prevent pregnancy by blocking ovulation. In fact, these synthetic hormones interrupt your natural menstrual cycle by completely suppressing your reproductive hormones.
Now, when you transition off the pill, your hormones must work hard to help reestablish your natural cycle. Your brain and ovaries also need time to restore their natural pattern of communication. It is normal to wait up to 1-3 months to get your period after coming off the pill.
In some cases, it can take even longer for your period to return. This is known as post-pill amenorrhea. This occurs when periods do not return within 3-6 months of stopping birth control. I would recommend getting a full evaluation from your physician to help uncover the root cause of the amenorrhea.
After discontinuing the pill, it is also common to experience symptoms like changes in mood and libido, anxiety, and acne. Unfortunately, in my practice, I see this all too often. This phenomenon is commonly known as “post-birth control syndrome.”
Related Post: Looking to transition off the pill? Here’s what you need to know before making the change
What is Post-Birth Control Syndrome?
Post-birth control syndrome refers to a set of symptoms that arise after you stop taking birth control. Symptoms begin to present within the first 3 to 6 months after discontinuing the pill.
There are several reasons why post-birth control syndrome can cause a tsunami of unwanted symptoms.
First, research shows that certain nutrients may become depleted while a woman is taking oral contraceptives. Key nutrients that hormonal birth control can deplete include vitamins like folic acid, B2, B6, B12, C, and E, as well as minerals such as magnesium, selenium, and zinc.
These key nutrients are needed to drive multiple biochemical reactions in the body, especially as it relates to hormone health. In fact, B vitamins play a critical role in boosting progesterone levels, which can help minimize the effects of PMS, including depression, during the luteal phase of the cycle.
Second, birth control may have suppressed an underlying hormone issue like premenstrual dysphoric disorder (PMDD), polycystic ovarian syndrome (PCOS), or endometriosis.
If you have been using birth control for a long time, you may not be aware of these underlying conditions. Coming off the pill can be problematic because the exact symptoms the pill was designed to suppress are now returning with a vengeance.
Side Effects of Post-Birth Control Syndrome
Mood disorders such as anxiety and depression are common symptoms of post-birth control syndrome. Here is a list of other symptoms that you may experience after stopping the pill:
- Amenorrhea (loss of period)
- Dysmenorrhea (painful periods)
- Menorrhagia (heavy periods)
- Mood swings
- Brain fog
- Headaches and migraines
- Acne and rosacea
- Weight gain
- Hair loss
- Sore or swollen breasts
- Decreased libido
- Nutrient deficiencies
- GI symptoms like gas and bloating
- Gut dysbiosis (an imbalanced gut microbiome)
Can Stopping Birth Control Cause Depression?
It is clear that discontinuing birth control can cause a variety of health issues, but can stopping birth control cause depression?
While anecdotal evidence is strong, preliminary research from the past several years is more elusive. Several studies are compelling and suggest there might, in fact, be an association between stopping birth control and depression, whereas another study suggests the opposite.
Studies Suggesting a Correlation Between Birth Control and Depression
One of the more significant studies is a 2016 study that investigated the association between birth control and depression in women aged 15 to 34. Researchers collected data over a 14-year period and found that all forms of hormonal contraception were associated with an increased risk for depression.
The authors went on to conclude that hormonal contraception, especially among adolescents, was associated with a diagnosis of depression and subsequent use of antidepressants, suggesting depression as a potential side effect of hormonal contraceptive use.
Another 2018 study investigating the impact of birth control on mood disorders found that the association was most pronounced in adolescent girls aged 12-14 years. In this adolescent population, the use of hormonal contraceptives was later linked to the use of antidepressant or anti-anxiety drugs, while this association was non-existent for adult women.
This study suggested that the age at which hormonal contraceptives were first started could play an important role in the development of mood disorders.
In 2019, another review study analyzed the relationship between hormonal contraceptives and mood disorders. The authors of this paper summarized the research and concluded that it is likely that hormonal contraceptives contribute to mood-related side effects. This review found this to be especially true for women with a previous history of depression.
Another 2018 retrospective study analyzed postpartum depression events from 2004 to 2015. Researchers found that prior use of hormonal contraceptives or an intrauterine device with progestins may carry an increased risk for postpartum depression.
Studies Finding No Correlation Between Birth Control and Depression
On the other hand, an interesting 2019 study interviewed 4,765 women with a history of oral contraceptive use. Based on this questionnaire, researchers did not find a relationship between ever having used oral contraceptives and lifetime depression or between current use of oral contraceptives and current depression.
The authors of this paper concluded that hormonal contraceptives are not associated with an increased risk of depressive disorders, either while taking oral contraceptives or after discontinuing oral contraceptives.
Risk Factors for Developing Mood Changes Post-Birth Control
While it’s not exactly clear why some women go on to develop mood disorders like anxiety and depression post-birth control, there are a number of factors that can increase the risk of depression in women.
These risk factors include:
- Age (when hormonal contraception is first introduced)
- Low levels of social support and isolation
- A family history of depression
- Stressful life events
- Diagnoses such as PMDD, PCOS, or endometriosis
How to Manage Mood Disorders Associated with Post-Birth Control Syndrome
Mood disorders like anxiety and depression can significantly affect your quality of life. If you have recently stopped taking the pill and are experiencing these mood-related side effects, you might be wondering how to bring some calm back into your life.
The best place to start is by increasing the nutrient density of your diet. Next, you can consider supplementation and lifestyle changes to support your body’s natural ability to balance hormones.
Ultimately, prioritizing diet and lifestyle changes can help you address the frustrating symptoms of post-birth control syndrome. I see this time and time again—simple adjustments to diet and lifestyle can result in a big transformation!
Here is a detailed outline of the changes you can make today to help improve your symptoms of depression:
Eat an Anti-inflammatory Diet
While many factors play a role in the development of depression, numerous studies indicate an association between depression and inflammation.
Interestingly, research is also finding a correlation between what we eat, its impact on our inflammatory levels, and the risk for depression.
In 2018, a review study examining the association between inflammatory diets and the risk of depression found that adopting an anti-inflammatory diet may be an effective intervention for reducing depression risk and symptoms.
Another 2022 study exploring the relationship between diet and depression in healthcare workers found that an anti-inflammatory diet can play a key role in the treatment of depression.
While the science is still young, it appears there is a correlation between our diet and mental health.
Based on this research, it’s important to prioritize high-quality proteins, organic fruits and vegetables, whole grains, legumes, and healthy fats such as olive oil, coconut oil, and grass-fed butter.
It is also vital to decrease, and in some cases eliminate, the intake of red meat, refined carbohydrates, dairy, sugar, processed foods, and alcohol due to their inflammatory properties.
Consider Nutritional Supplementation
Supplements can play a vital role in helping you manage the symptoms of post-birth control syndrome. In particular, the science around nutritional supplementation and depression is expanding. This means that more non-pharmacological options can be considered before starting medication.
Here is an outline of some of the more well-researched supplements with regards to depression management:
- B vitamins
- Fish oil
B vitamins are essential for neuronal function and play a critical role in the synthesis of neurotransmitters, which are key chemicals that affect mood and related brain functions.
It is not surprising then that a deficiency in B vitamins as a consequence of hormonal contraceptive use, poor diet, and/or poor absorption (due to a gastrointestinal disease like celiac disease) may lead to mood changes and depression.
In particular, studies indicate that B vitamins such as B2, B6, folate, and B12 are low in women who take oral contraceptives compared to the general population.
For this reason, supplementing with B vitamins may help to significantly improve depressive symptoms and quality of life.
Fish oil is a rich source of omega-3 fatty acids, a type of polyunsaturated fat that can easily cross the blood-brain barrier and positively affect brain and nervous system function.
In fact, fish oil is a major structural component of the neuronal cell membrane, which helps with neurotransmitter binding and signaling. Because fish oil plays such a critical role in neurotransmitter function, this nutrient has been found to help relieve depression.
For this reason, it’s important to consume high-quality omega-3 fatty acids regularly. Rich sources of omega-3 fatty acids include walnuts, hemp seeds, chia seeds, and wild-caught fish like salmon. Another option would be to take fish oil supplements daily.
Adaptogenic herbs increase your resilience to physical and mental stress and, therefore, help improve depression-like symptoms. In other words, adaptogenic herbs quite literally help you “adapt” to your daily stressors.
Rhodiola is one adaptogenic herb that is known for its ability to stimulate mental focus and energy. Several research studies demonstrate its positive benefits for depression.
A 2015 study found that rhodiola may be preferred by individuals with mild to moderate depression compared to sertraline, a common antidepressant drug. Although rhodiola possessed fewer antidepressant effects, it also resulted in significantly fewer side effects and was better tolerated than sertraline.
In another clinical trial, 150 participants suffering from depression took rhodiola, and the majority of them experienced a significant improvement in their depressive symptoms compared to placebo.
If you suffer from depression after stopping birth control, consider supplementing with an adaptogenic herb such as rhodiola. This can be taken in pill form or as a powder that can be added to a smoothie or latte.
In addition to adjusting your diet and taking supplements, making lifestyle changes can also greatly improve your mood-related symptoms.
For example, exercise has shown great promise in alleviating the symptoms of depression. Depressed adults who took part in a fitness program displayed significantly greater improvements in depression, anxiety, and self-concept than those in a control group after 12 weeks of training.
Further, practicing good sleep hygiene can also help you manage the symptoms of depression. Our body’s natural circadian rhythm, or internal clock, controls hormone release as it relates to a daily 24-hour schedule.
Following a proper sleep-wake cycle is crucial so that the right hormones can peak at the right times during this 24-hour period, which in turn can promote better moods and less depressive symptoms.
Address Underlying Hormone Imbalances
Lastly, in order to manage mood disorders associated with post-birth control syndrome, it is critical to uncover any hormone imbalances that may be exacerbating your depression.
The following hormonal imbalances or conditions could be contributing to or worsening your symptoms of depression:
- Insulin resistance
- Thyroid disorders
- PMS or PMDD
- Irregular or absent periods
- Painful or heavy periods
- Ovarian cysts
It is possible that you received a diagnosis for one of these conditions in the past, and your healthcare provider suggested birth control as a treatment option to help manage this condition.
On the other hand, if you have been using birth control for a long time, you may not be aware that you actually have one of these underlying conditions.
It’s important to get a full hormone evaluation done to determine if one of these imbalances is contributing to your depressive symptoms.
In this case, working with a functional medicine nutritionist can help you figure out if, in fact, you have an underlying hormonal imbalance and the right next steps to take to help address this imbalance.
Related Post: Coming off birth control: do you need to detox?
The Bottom Line: Can Stopping Birth Control Cause Depression?
While preliminary research from the past several years is still in its infancy, several studies are compelling and suggest there may in fact be an association between stopping birth control and depression.
Although no studies definitively prove that coming off birth control can cause depression, post-birth control syndrome can lead to a number of hormonal imbalances that can ultimately give rise to mood disorders such as anxiety and depression.
Work with a Functional Medicine Nutritionist
When it comes to post-birth control syndrome, it’s important to address all the underlying factors that are affecting your hormones.
As a functional medicine nutritionist, I work with women in my one-on-one consultation program all the time and help them either transition off the pill without major side effects or resolve their post-birth control syndrome symptoms, such as depression.
This is achieved through a detailed health history questionnaire, comprehensive functional lab testing, and an action plan that includes personalized diet, supplement, and lifestyle recommendations.
Most clients see significant improvement within 3-6 months of working together.
Are you ready to heal your hormones? Apply to become a client today!