Hormonal birth control, including intrauterine devices (IUDs), might come with an increased risk for depression. While the risk is relatively low, it’s something women should consider when deciding whether to get an IUD. Copper IUDs, which do not contain hormones, have not been linked to increased rates of depression.
IUDs and Depression
Scientists have done many studies on the connection between hormonal contraception and mood changes in women. However, studies specifically investigating depression and its potential link with birth control use have been lacking until recently.
One of the most influential studies was conducted in Denmark and published in 2016. In following more than 1 million women nationwide, the researchers found that those who used hormonal contraception were at an increased risk for a first diagnosis of depression. In addition, women in this group had an increased risk of going on antidepressants for the first time.
Other important findings from the study included:
- Over the course of a year, 2.2% of women using hormonal birth control were prescribed antidepressants compared to 1.7% of women not using hormonal birth control.
- The risk for depression was greater among teens and young adults (women ages 15 to 19) using hormonal birth control.
- Non-oral forms of hormonal birth control, such as the ring, patch, and IUD, were associated with a higher risk of depression than the birth control pill.
- Women who used a hormonal IUD were 1.4 times more likely to be prescribed antidepressants than women who were not on hormonal birth control.
This data strongly suggest that women using any type of hormonal birth control are at increased risk of depression. The fact that IUDs had a higher risk than other forms of hormonal contraception might be concerning to some potential IUD users.
Hormonal vs. Nonhormonal IUDs
Not all IUDs are linked to depression. Only hormonal birth control increases your risk of depression. Hormonal IUD brands include:
Hormonal IUDs work by releasing a progestin called levonorgestrel into the body. Progestin makes it difficult for sperm to enter the uterus and fertilize an egg by thickening the cervical mucus and thinning the uterus lining. These IUDs can last for three to seven years, depending on the brand.
Nonhormonal IUDs, on the other hand, are not linked to a risk of depression. This type of IUD, which has the brand name ParaGard, is made with copper, which prevents pregnancy by acting as a spermicide. The copper essentially kills sperm before it has the chance to fertilize an egg. Depression is not considered one of the possible ParaGard side effects. A copper IUD can last up to 10 years before you need to have it replaced.
Weighing Pros vs. Cons
If you’re concerned about a link between hormonal birth control use and depression, remember that the researchers from the study in Denmark found that, overall, only about 1.7 out of 100 women who weren’t using hormonal contraceptives developed depression. For those who were using birth control containing hormones, that number increased to just 2.2 out of 100 women. The rates were only slightly higher for hormonal IUD use specifically.
So, while hormonal birth control does come with an increased risk of depression, it’s somewhat negligible when you look at the big picture.
At the same time, it’s important to consider whether the benefits of using a hormonal IUD outweigh the potential drawbacks. On the plus side, this form of birth control:
- Is cost-effective.
- Is long-lasting.
- Is reversible.
- Only needs to be replaced every three to seven years — you don’t have to remember to take a pill or change a patch frequently.
- Is private and discreet, so you can use it without your partner knowing.
For some women, these benefits might be more important than the relatively small risk of developing depression.
However, it’s perfectly reasonable to decide that the potential risks of hormonal birth control are not a good fit for you. For example, if you currently have depression or have been on antidepressants in the past, you might worry that using an IUD could exacerbate the condition or cause your depression to return. Fortunately, you can use other, nonhormonal contraceptive options, such as:
- A copper IUD.
- Male or female condoms.
- Cervical caps.
Symptoms of Depression
If you’re concerned about the possibility of developing depression after you get an IUD, learn what symptoms to watch for so you can recognize when something’s wrong. Common symptoms of depression include:
- Feeling sad, hopeless, guilty, or worthless.
- Frequent tearfulness or crying.
- Frustration, irritability, or anger, sometimes over small things.
- Loss of interest in the things you typically enjoy, such as hobbies, socializing, or sex.
- Fatigue or feeling like you don’t have the energy to do simple tasks.
- Difficulty concentrating.
- Slow thinking, speaking, or body movements.
- Unexplained physical ailments such as recurring headaches or back pain.
- Reduced appetite and weight loss or increased cravings with weight gain.
- Trouble sleeping or sleeping too much.
- Suicidal thoughts.
Some people can experience more severe symptoms, which usually indicate a major depressive disorder or clinical depression. However, it’s also possible to have persistent depressive disorder, which has less severe symptoms. People with this type of depression can function well most days, but just because their condition isn’t as bad as clinical depression doesn’t mean it should be ignored.
If you’re having symptoms of depression, talk to your medical provider. Seek help immediately, or call the National Suicide Prevention Lifeline at 1-800-273-8255 if you experience suicidal thoughts.
Your mental health is just as important as your reproductive health, so it’s important to carefully consider what type of contraceptive is right for you. If you’re worried about the potential risks of IUDs, talk to your Nurx™ medical provider to learn more about the possible side effects and to discuss all your birth control options.