The Pill and Stress: How Hormonal Contraception Might Make it Harder for You to Cope

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Medically reviewed by Amy Fathman, DNP, FNP-BC

Did you know that the Pill affects how we process stress? Sometimes this is viewed as a positive, since research shows women on hormonal contraception do not exhibit the body’s classic response to stress (i.e., elevated levels of the stress hormone, cortisol, courtesy of HPA-axis signaling) in stressful situations. But this aspect of the Pill isn’t all positive; unfortunately, it can lead women to feel out of touch with healthy stressors, and it can also lead to chronic stress.

Hormonal birth control disrupts healthy stress processing

While at first glance it may seem that the Pill’s disruption of stress responses would lead to less stress—which sounds good—the problem is that hormonal contraceptives disrupt our bodies’ normal way of processing stress, even good stress. As a matter of fact, there is such a thing as healthy stress. The stress response is our body’s way of letting us know that something significant is happening and helping us react accordingly. Some stress is normal (in fact, needed) to help us live meaningful, interesting, lives—and to make a quick getaway in dicey situations. That’s why a healthy person will exhibit increased cortisol in dangerous or exciting situations, but will also experience a drop in cortisol once the precipitating event has passed.

But what happens if your body doesn’t experience that drop—if the stress response is always on? This is what is known as chronic stress, and it’s when stress becomes chronic that it causes all sorts of negative effects, such as depression and anxiety, memory and concentration impairment, weight gain, and headaches. Unfortunately, the bulk of the research on stress and hormonal contraception indicates that the bodies of women on hormonal contraception seem to react to stress similarly to bodies under chronic stress. 

Women’s bodies on hormonal contraception mimic bodies under chronic stress

In her new book, This is Your Brain on Birth Control, Dr. Sarah E. Hill discusses the effects of hormonal contraception on women’s stress response, describing how current research indicates that the HPA-axes of women on the Pill appear to be in “shutdown mode”:

“The Pill-taking women’s pattern of HPA-axis function looks suspiciously similar to that of someone who has experienced chronic stress, suggesting that the Pill might actually cause the HPA axis to go into overdrive, requiring it to take coordinated action to blunt itself.” 

It is perhaps this self-shutdown of the HPA-axis that negatively affects a woman’s body on birth control from being able to effectively cope with stress, paving the way for all sorts of other issues associated with hormonal contraception, like depression and anxiety. 

Further, Hill points out, “despite the fact that too-much cortisol signaling can increase women’s risk of brain-volume loss, serious depression, and certain health problems, no one really knows why this happens, how it unfolds, or whether it is reversible.” 

No one knows the full effects of birth control on the brain

I think Hill’s finding above is so disturbing I had to put it in bold. Certainly, more research and awareness in this area is needed. But, for now, we can keep sharing articles like these, so women can grow in the knowledge of how their birth control may be affecting their health.

So, what does this mean for you if you’re on the Pill, or thinking about going on it? It’s hard to say, as the research into the relationship between hormonal contraception and its effects on the stress response is fairly preliminary, and because the Pill (and different formulations of hormonal contraception) seem to affect different women in different ways. But if potentially throwing your body’s response to stress way out of whack sounds like a gamble you’d rather not take, then rest assured that there are other options available that will keep your brain and body intact while still allowing you to effectively postpone pregnancy. Fertility Awareness Methods (FAM) are science-backed, effective, natural forms of family planning that rival and sometimes exceed the effectiveness of the Pill. 

To benefit from the high, research-backed effectiveness rates of Fertility Awareness Methods, begin by connecting with a trained FAM instructor. You can expect to find life-changing knowledge in a judgment-free zone, and begin a journey toward greater wellness and better-informed health decisions. And best of all, you can say goodbye to days of chronic stress. 

Read more: A Case for Organic Birth Control

Last updated March 1, 2021.

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