Birth Control Pill Linked to Anxiety, Study Suggests – Even After Discontinuation

New research suggests a potential link between anxiety and contraceptive pill use, with effects potentially lingering even after discontinuation. A study conducted at the Université du Québec à Montréal (UQAM) explored this connection in a laboratory setting, revealing differences in fear responses between women who currently use, previously used, or have never used oral contraceptives.

It’s important to emphasize that the study demonstrates correlations, not causation, according to Lisa-Marie Davignon, a doctoral student in psychology and the study’s lead author. “I am cautious because I don’t want to unnecessarily worry people,” Davignon stated. “I think it’s a topic worth discussing and one that raises awareness about women’s health, but my goal isn’t to alarm anyone, just to open up the conversation.”

Women are statistically more likely than men to experience anxiety disorders. Existing research indicates that sex hormones may play a role in the development of anxiety. Davignon’s study aimed to investigate whether the hormones contained in contraceptive pills could influence fear, a core component of anxiety.

The experiment involved exposing participants to images of an office and a library. In one setting, participants received mild electric shocks repeatedly. “After a certain amount of time, the women learned to fear that context because they anticipated receiving an electric shock. Simultaneously, there was a second context that was never paired with a shock, which was therefore a safe context,” Davignon explained.

The following day, participants were re-exposed to both settings. As expected, everyone exhibited fear in the context associated with the shocks. However, responses differed in the safe context depending on contraceptive use. Women currently taking the pill displayed heightened fear responses in the safe context compared to those who had never used oral contraceptives. Notably, even women who had stopped using the pill more than a year prior showed increased fear responses in the same safe environment.

To measure fear, researchers utilized functional magnetic resonance imaging (fMRI) to monitor brain activity during the experiment. Results focused on the hippocampus, a brain region crucial for memory and known to be sensitive to hormonal effects. The study found that the hippocampus was more active in women who had never taken the pill. Davignon suggests this increased activation might have been beneficial, though further research is needed to explore this possibility.

Participants also wore sensors in their palms to measure sweat, an indicator of nervous system activation. Consistent with the fMRI findings, women who had discontinued pill use long ago exhibited fear responses in the safe context comparable to those currently on the pill.

The study included 147 participants divided into four groups: current pill users, former users (discontinued for over a year), never-users, and men. This sample size is considered standard for this type of research, given the need for participants in excellent physical and psychological health and the expense of data collection protocols.

The findings underscore the need for continued research into the effects of hormonal contraception on mental health. “We know that women have historically been understudied compared to men. It’s quite concerning, in my opinion, that it’s been 65 years since the first pills were commercialized and we are only beginning to realize there may be potential correlations with mental health,” Davignon noted. The next step, she suggests, would be to conduct randomized controlled trials.

Recent trends indicate a decline in pill usage in several developed countries. In England, uptake of oral contraceptives fell from 39% in 2020-2021 to 27% in 2021-2022. Similarly, American pill users decreased from 31% in 2002 to 24% between 2017 and 2019, while Canada and Australia reported declining use from 23% to 11% (2006-2016) and 23% to 11% (2008-2016) respectively. This decline may be influenced by growing concerns about side effects, amplified by discussions on social media platforms, though misinformation also plays a role.

A September 27, 2023 study published in JAMA Network Open also explored mental health symptoms in oral contraceptive users during short-term hormone withdrawal, finding similar mood worsening after withdrawal from oral contraceptives as from natural hormone fluctuations during menstruation. This suggests a broader impact of hormonal shifts on emotional well-being.

The potential link between hormonal contraception and mental health is a complex issue requiring further investigation. While the UQAM study highlights a possible correlation, it does not establish a causal relationship. Women considering or currently using oral contraceptives should discuss their individual risk factors and concerns with their healthcare provider.