Hormonal Contraceptives and Brain Health: What Women Should Know

Your brain may be the most important part of your body to keep healthy, as your brain’s health dictates how you experience everyday life.

So, it’s only natural for women to wonder how hormonal contraceptives affect their brain health, especially after they hear news like Depo-Provera being linked to brain tumors, leading to lawsuits against Depo-Provera’s manufacturer.

The following are ways that hormonal contraceptives can affect brain health:

Depression

A study from 2023, published in Epidemiology and Psychiatric Sciences, discovered that oral contraceptive users could face as high as a 130 percent increase in risk of depression, particularly in the first two years of taking the pills.

A 2016 study published in JAMA Psychiatry found that 2.2 percent of those who begin using hormonal contraceptives get prescribed antidepressants within one year, compared with 1.7 percent of those not using hormonal birth control.

Those using hormonal IUDs were 1.4 times as likely to get prescribed antidepressants than people not using hormonal contraceptives at all.

Studies published in 2019 and 2021 in The Journal of Child Psychology and Psychiatry found that the use of hormonal birth control during adolescence leads to a higher risk of ending up with major depressive disorder during adulthood.

Anxiety

A 2004 study published in Medical Hypotheses found that those who use hormonal birth control experience more anxiety than non-users.

A 2018 study published in PLOS One found that users of hormonal IUDs experienced more anxiety.

The birth control methods more strongly associated with anxiety are progestin-only minipills and combined pills that contain synthetic progesterone and synthetic estrogen. Between 4 and 10 percent of those who use the combined pill report mood changes that are negative.

However, a 2016 meta review published in The European Journal of Contraception & Reproductive Health Care found that most people who use combined hormonal contraceptives, like the vaginal ring, patch and pill, experienced a positive effect on mood or no mood change.

Stress

A 2024 study published in Brain, Behavior, and Immunity discovered that the pill could impair the body’s stress response, leading to it being more difficult to adapt to stress.

This study also discovered that users of the pill have more cytokine TNF-alpha prior to and after stress tests. This may be linked to a stress response which is more typical of males.

The study found that women with menstrual cycles that are natural had higher interleukin-6 levels, which is associated with a stress response which is more typical of females.

The pill could reduce the amount of progesterone produced by the body. Progesterone gets converted into allopregnanolone, which is a hormone that has calming effects.

Sleeping

The pill could impact the sleep-wake cycle because of how it affects estrogen. Estrogen helps to regulate your brain’s circadian rhythm.

Disruptions to this rhythm can influence sleep patterns, body temperature, digestion, eating habits and hormone levels.

A 2014 study published in Frontiers in Behavioral Neuroscience found that depression and anxiety can occur when this internal clock is disturbed.

Migraine and Headaches

A 2021 study published in Social Science & Medicine found that there’s a link between hormonal contraceptives, migraine episodes and headaches.

Changes in estrogen during your cycle may trigger menstrual migraines.

Hormonal contraceptives can change your natural levels of estrogen, possibly leading to headaches.

Healthcare professionals may advise that those with histories of migraines with auras not take combined birth control.

Higher levels of estrogen might increase the risk of stroke.

Libido

A 2013 meta review published in The European Journal of Contraception & Reproductive Health Care found that 15 percent of participants reported a decreased libido.

However, 21 percent reported an increased libido.

Emotional Reactivity and Cognitive Inhibition

Studies published in 2013 and 2016 in Psychoneuroendocrinology and The European Journal of Contraception & Reproductive Health Care found that hormonal contraceptives may influence negative emotional reactivity as well as the neural networks which are involved in cognitive inhibition.

Partner Bonding

A 2016 study published in Social Cognitive and Affective Neuroscience found that while oxytocin treatment increased evaluation of partner attractiveness in groups not given hormonal contraceptives, this did not occur in the group given hormonal contraceptives.

This result implies that hormonal contraceptives could attenuate partner bonding.

Brain Tumors

A 2024 study published in The British Medical Journal found that those who use Depo-Provera have 5.6 times the risk of developing an intracranial meningioma brain tumor if they use the medication for over one year.

A 2025 study published in JAMA Neurology found that Depo-Provera users are 2.43 times as likely to develop a meningioma than non-users of the medication.

A 2025 study published in Expert Opinion on Drug Safety found that Depo-Provera users are 3.55 times as likely to develop a meningioma than those using ethinylestradiol-levonorgestrel oral contraceptives.

Federal regulators, in 2025, approved an update to the warning label of Depo-Provera, having the label warn that cases of meningioma brain tumors have been reported after the drug has been repeatedly administered.

A federal multidistrict litigation, in January 2026, contained 1,775 total lawsuits alleging that women developed meningioma brain tumors because they received injections of Depo-Provera.