When it comes to contraception, making informed, personal choices is vital: experts Premium

Experts emphasize the importance of informed contraceptive choices, considering both physical and mental health effects for women's well-being.

Modern contraceptives, defined as methods that are not tubectomies or vasectomies, have increased in popularity over the years, worldwide. According to the World Health Organisation, between 2000 and 2020, the number of women using a modern contraceptive method increased from 663 million to 851 million. An additional 70 million women are estimated to be added by 2030.

These modern methods include hormone-based contraceptives, such as progestogen-only pills (mini-pills), combined oral contraceptives (the pill), and contraceptive patches. Even in India, as per National Family Health Survey (NFHS), use of modern contraceptives has increased in almost all States/UTs. The Overall Contraceptive Prevalence Rate (CPR) has increased substantially from 54% to 67% in the country.

But while hormonal contraceptives, have given women more control over their reproductive choices, their side effects on women’s health are under-researched CHECK, complex and vary in different individuals.

Sapna Raina, senior consultant, obstetrics & gynaecology, Narayana Health City, Bengaluru, explains that the mental health effects of contraceptives stem from the hormones they contain, primarily estrogen and progesterone. “When we talk about contraceptives, it’s basically the hormonal contraceptives that affect both the physical and psychological health of women,” she says.

Estrogen has a strong influence on the brain’s neurotransmitters, like serotonin and dopamine chemicals that regulate mood, emotions, and overall mental stability. “Estrogen has a greater impact than progesterone because it may affect neurotransmitters, leading to mood swings, irritability, anxiety, and even depression,” she says.

The combined oral contraceptive pill is often linked to more pronounced psychological effects, followed by progesterone-only pills, also known as mini-pills. While mini-pills tend to have slightly milder side effects, they can still cause fatigue, mood instability, and irritability.

“For some women, particularly those with a history of depression or anxiety, the use of hormonal contraceptives can intensify their mental health struggles,” says Dr. Raina She also points out that contraceptives administered in the form of injections, such as Depo-Provera, can produce similar psychological effects. The intrauterine hormonal device (IUD), like Mirena, however, has a more localised effect and is less likely to cause systemic mental health issues, though mood changes are not entirely ruled out.