In 2023, approximately 43 million women in their reproductive years were using a form of contraception provided by a prescribing healthcare provider. Birth control has multiple uses, including preventing pregnancy, treating hormonal acne, regulating menstrual cycles, managing hormonal symptoms, and preventing ovarian cysts.
Because hormones affect many systems throughout the body, including the brain, some people wonder whether hormonal birth control can also affect mood, memory, concentration, or other aspects of brain functioning. Research in this area is still developing, and individual responses to hormonal contraception can vary.
Key Takeaways
- Hormonal birth control can affect mood and cognition differently from person to person.
- Research on its effects on mood, memory, and concentration is still developing.
- New or concerning symptoms should be discussed with your healthcare provider.
What Types of Birth Control Are We Talking About?
It is important to remember that birth control is an umbrella term that includes many different types of contraception. This article focuses primarily on hormonal methods, including long-acting reversible contraceptives (LARCs), such as hormonal intrauterine devices (IUDs) and hormonal implants, as well as short-acting hormonal methods, such as birth control pills, the patch, and the vaginal ring (Office on Women’s Health, 2026).
Before discussing how birth control can affect mood, memory, concentration, or other aspects of brain functioning, it is helpful to understand what these methods actually contain.
Hormonal birth control uses synthetic versions of hormones that naturally occur in the body. There are two main types of birth control pills:
- Combination pill: Contains estrogen and progestin.
- Progestin-only pill: Often called the “mini-pill,” this method does not contain estrogen (Cleveland Clinic, 2023).
Hormonal LARCs work in a similar way by releasing hormones into the body over an extended period. For example, hormonal IUDs and implants release small amounts of progestin to prevent pregnancy.
Although these methods are highly effective at preventing pregnancy, the hormones they contain can also interact with systems throughout the body—including the brain.
How Does Birth Control Affect the Brain?
To understand how hormonal birth control might affect the brain, it helps to start with the basics. Hormones are chemical messengers that travel throughout the body and help regulate many different processes, including reproduction, metabolism, stress, sleep, and mood.
Two hormones that are particularly important when discussing hormonal birth control are estrogen and progesterone. Birth control methods use synthetic versions of these hormones. Progestin (for progesterone) is a synthetic form of progesterone, while synthetic estrogen is used in some contraceptives. These hormones work together in different ways to prevent pregnancy.
Although hormonal contraceptives have been widely used for approximately 60 years, researchers have only more recently begun to investigate how hormonal contraception may influence the brain and its functioning (Jain et al., 2024). This is an important area of research because hormones produced by the ovaries can influence how the adult brain functions. For example, sex hormones interact with brain systems involved in emotion, memory, stress, and decision-making.
Because hormonal contraceptives change the body’s usual hormonal environment, researchers have questioned whether these changes may also influence brain functioning. However, this does not mean that everyone who uses hormonal birth control will experience changes in mood or cognition. In fact, research findings have been mixed, suggesting that individual responses can vary considerably.
What Are the Effects of Birth Control on Mood?
There is strong evidence that sex hormones, including estrogen and progesterone, influence much more than reproductive health. These hormones affect many systems throughout the body and brain, including cardiovascular functioning, immune functioning, appetite, emotional regulation, and aspects of executive functioning (Abrams, 2025).
This helps explain why some people notice changes in their mood after starting hormonal birth control. However, the relationship between birth control and mood is complicated, and research has not produced one simple answer.
There has been particular concern about whether hormonal contraception increases the risk of depression. Some studies have found an association between hormonal contraceptive use and depression-related symptoms, while other studies have found little or no increase in depression. Importantly, an association does not necessarily mean that birth control caused the depression.
For example, a large Danish study found that women who were prescribed hormonal contraceptives had an increased risk of subsequently being diagnosed with depression or receiving treatment for depression. The study also found an increased risk of suicidal thoughts. However, the increase in risk was greatest relatively early after starting contraception and decreased over time. Findings such as these suggest that some individuals may be particularly sensitive to hormonal changes, especially during the initial period of contraceptive use (Jain et al., 2024).
Other research has produced different results. Some studies suggest that oral contraceptives may actually be associated with improvements in certain mood symptoms, including anxiety and mood swings. Research involving women who already have psychiatric disorders has generally not found that hormonal contraception consistently worsens depression (McCloskey et al., 2021).
There may also be differences based on age. Research has found a stronger association between hormonal contraceptive use and depression among adolescents compared with adult women, although more research is needed to understand why this may occur (Jain et al., 2024; McCloskey et al., 2021).
One possible explanation involves the body’s response to stress. Some research suggests that people who use hormonal birth control may have a different cortisol response to stressful situations. Cortisol is a hormone involved in the body’s response to stress. Rather than producing a sharp increase followed by a gradual return to baseline, some people using hormonal contraception show a more muted cortisol response (Abrams, 2025). Researchers are still working to understand what these differences mean for mood and mental health.
Some people also report changes in sexual desire after starting hormonal contraception. Hormonal birth control can influence androgen levels, including testosterone, which plays a role in sexual functioning. Changes in libido can, in turn, affect relationship satisfaction and emotional well-being for some individuals.
Overall, the research suggests that hormonal birth control may influence mood for some people, but the effects are not universal. Some individuals may experience:
- Irritability
- Anxiety
- Depressed mood
- Mood swings
Others may experience no noticeable change or even improvements in certain symptoms.
Can Birth Control Affect Memory and Concentration?
Many people who use hormonal birth control report concerns about feeling more forgetful, having difficulty concentrating, or experiencing what they describe as “brain fog.” Researchers have begun investigating these concerns, but the evidence regarding hormonal contraception and everyday cognitive functioning is much less established than the research on mood.
Hormones can influence several brain systems involved in memory. For example, estrogen and progesterone interact with areas of the brain involved in emotional memory, including the amygdala. Sex hormones can also influence how people remember the central meaning—or “gist”—of an emotional experience compared with specific details.
Stress hormones also affect memory. Because hormonal contraception changes the levels and patterns of sex hormones in the body, researchers have proposed that it may also change the way sex hormones and stress hormones interact during memory formation (Nielsen et al., 2011).
In other words, hormonal birth control may influence how certain types of memories are formed or experienced, particularly emotional memories. However, this is different from demonstrating that hormonal birth control causes broad cognitive problems such as poor concentration, significant memory loss, or reduced intelligence.
At this point, research does not provide a simple answer about whether hormonal birth control causes everyday “brain fog.” More research is needed to understand whether certain contraceptive formulations affect attention, memory, mental fatigue, or other aspects of cognition—and whether some people may be more sensitive to these effects than others.
If you notice changes in your memory or concentration after starting birth control, it is still worth paying attention to those changes. Even when research has not established a clear cause, your individual experience is important and can be discussed with your healthcare provider.
Birth Control and Risk of Stroke
The relationship between hormonal birth control and cardiovascular health is another important consideration. Some hormonal contraceptives, particularly those containing both estrogen and progestin, have been associated with small increases in blood pressure and an increased risk of blood clots (Cameron et al., 2023).
Estrogen also has important effects on the cardiovascular system. Naturally occurring estrogen supports healthy blood vessels, blood flow, and other processes involved in cardiovascular health. This may be one reason why premenopausal women generally have a lower risk of stroke than men of the same age and postmenopausal women.
However, estrogen-containing contraceptives can increase the risk of venous thrombosis, which occurs when a blood clot forms in a vein. In some circumstances, blood clots can travel through the bloodstream and cause serious complications, including stroke.
It is important to put this risk into perspective. For an otherwise healthy woman of reproductive age, the absolute cardiovascular risk associated with hormonal contraception is relatively low, and the small increase in blood pressure associated with oral contraceptives is unlikely to be clinically significant for most healthy women (Cameron et al., 2023).
However, cardiovascular risk is not the same for everyone. Factors such as:
- Age
- Smoking
- High blood pressure
- Migraines with aura
- A history of blood clots
- Certain medical conditions
can affect which contraceptive methods are safest. This is why choosing a contraceptive method should involve an individualized conversation with a healthcare provider.
Why Does Birth Control Affect Some People Differently?
One of the most important things to understand about hormonal birth control is that there is no single experience that applies to everyone. Two people can use the same contraceptive and have very different responses.
Researchers are investigating several factors that may contribute to these differences, including:
- Age
- Genetics
- Individual sensitivity to hormonal changes
- Other biological factors
- Psychological factors
However, healthcare providers cannot currently predict with complete accuracy who will experience mood or cognitive changes after starting hormonal contraception.
Some people may notice depressed mood, irritability, anxiety, dysphoria, mood swings, or changes in energy. Others may notice little to no change. Some individuals may even experience improvements in mood-related symptoms.
Importantly, having a pre-existing mental health diagnosis does not necessarily mean that someone will have a negative reaction to hormonal birth control. Research has not found that psychiatric history alone can reliably predict who will experience mood-related side effects (McCloskey et al., 2021).
This variability is one reason why it is important to pay attention to your own response rather than assuming that a particular contraceptive will affect you in the same way it affects someone else.
What Should You Do If You Notice Changes After Starting Birth Control?
If you notice changes in your mood, cognition, energy, or overall well-being after starting birth control, contact your physician or healthcare provider to discuss your symptoms. Your healthcare provider can help determine whether your symptoms may be related to your contraceptive and whether another explanation or treatment should be considered.
Contact your physician
Let your healthcare provider know about any new or worsening symptoms, including changes in mood, anxiety, sleep, concentration, memory, or energy. Your physician can help determine whether these changes may be related to your birth control and discuss appropriate next steps.
Track your symptoms
Keep track of when your symptoms began, how frequently they occur, how severe they are, and whether they change throughout your menstrual cycle. Writing this information down can make it easier to identify patterns and provide your physician with useful information.
Consider other possible causes.
Mood and cognitive changes can have many possible contributors, including stress, sleep difficulties, other medications, medical conditions, and naturally occurring hormonal changes. Your physician can help evaluate whether factors other than birth control may be contributing to what you are experiencing.
Ask about alternative contraceptive options
If you and your physician determine that your birth control may be contributing to unwanted symptoms, ask whether a different formulation, dose, or type of contraception may be appropriate. Do not stop or change your contraception without first discussing your options with your healthcare provider.
Consider mental health support
If changes in mood, anxiety, or daily functioning continue or begin interfering with your work, relationships, or quality of life, consider speaking with a mental health professional in addition to contacting your physician.
Seek immediate help for severe symptoms
If you experience severe depression, thoughts of self-harm, suicidal thoughts, or other acute mental health symptoms, seek immediate professional or emergency support.
Conclusion
Hormonal birth control is an important and effective tool for pregnancy prevention and can provide additional health benefits for many people. At the same time, hormones affect many systems throughout the body, including the brain, and some individuals may notice changes in mood, energy, memory, or concentration.
Research on these effects is still developing, and people can respond differently to hormonal contraception. If you notice new or concerning changes after starting or changing birth control, talk with your healthcare provider. Together, you can consider other possible causes, review the benefits and risks of your current contraceptive, and determine whether another option may be more appropriate for you.
Resources
Abrams, Z. (2025, April 1). How birth control pills affect the brain. Monitor on Psychology, 56(3). https://www.apa.org/monitor/2025/04-05/birth-control-brain
Brønnick, M. K., Økland, I., Graugaard, C., & Brønnick, K. K. (2020). The effects of hormonal contraceptives on the brain: a systematic review of neuroimaging studies. Frontiers in Psychology, 11, 556577.
Cameron, N. A., Blyler, C. A., & Bello, N. A. (2023). Oral contraceptive pills and hypertension: A review of current evidence and recommendations. Hypertension, 80(5), 924–935. https://doi.org/10.1161/HYPERTENSIONAHA.122.20018
Cleveland Clinic. (2023, July 5). Birth control pills. Cleveland Clinic
Jain, R., & Anand Jain, D. P. R. The Effects of Hormonal Contraceptives on Female Mental Health.
Nielsen SE, Ertman N, Lakhani YS, Cahill L. Hormonal contraception usage is associated with altered memory for an emotional story. Neurobiol Learn Mem. 2011 Sep;96(2):378-84. doi: 10.1016/j.nlm.2011.06.013. Epub 2011 Jun 29. PMID: 21740976; PMCID: PMC3148336.
Office on Women’s Health. (2026, May 4). Birth control methods. U.S. Department of Health and Human Services. https://womenshealth.gov/a-z-topics/birth-control-methods
