This post was written by Elizabeth Barnes, examined by Prof. Lorna Johnson & Dr. Kelechi Onuoha, and edited by Lani Sodunke.
Astoundingly, over 60% of women between the ages of 20 to 29 currently use birth control, while as many as one in ten women will experience depression according to CDC (centers for disease and control prevention). Despite this fact, research into women’s health, especially mental health, is severely understaffed and underfunded, leaving many questions unanswered. To compound the issue, new forms of antidepressants and birth control methods are released every year.
Women have unique levels of hormones which makes the body respond to medication in different ways. This is why it is crucial to consult with your doctor before starting or stopping any medication.
Read on to discover the interactions between these popular and much-needed medications while learning what to do to have the best experience possible with minimal negative effects.
All About Birth Control
Birth control can do a lot more than simply preventing unplanned birth. Birth control can help manage premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), polycystic ovarian syndrome, acne, and so much more.
Types of Birth control:
- Oral (pills)
- Arm Implant
- Vaginal Ring
- Intrauterine device (IUD)
- Contraceptive shot
Unlike some contraceptives that can even be easily obtained online, birth control has never been easier to get with each type working differently.
Hormonal birth controls work by supplying the body with a synthetic form of either estrogen, progesterone or sometimes both to halt ovulation and essentially put the menstrual cycle on pause. While on hormonal birth control, you may or may not get your period depending on the type, but you definitely will not ovulate and thus should not get pregnant. This type of birth control usually comes in the form of a pill. If taken properly (every day and on time) has a 99.7% effectiveness rate. That means less than one woman out of every 100 could get pregnant even with the pill.
On the other hand, non-hormonal birth control prevents the chance of pregnancy without affecting your hormone levels directly and consists mainly of the Intrauterine Device (IUD). This small device, usually made of copper, must be inserted and removed by a doctor and does not supply synthetic hormones the way hormonal contraceptives do.
Each form of birth control may come with its unique risks and side effects. It is always important to discuss these with your doctor before starting anything new. Below are simply the most common side effects, but there may be more depending on your specific type of birth control.
Common Birth Control Side Effects:
- Chest Tenderness
If you are dissatisfied with your birth control, another may likely provide a better experience. Arm implants and IUDs will require a doctor visit to be removed.
Birth control pills can be stopped at any time. However, if you are concerned about pregnancy, condoms must be used right away until another method, such as the contraceptive shot, can take over. It may be better to finish the whole pack of birth control pills rather than abruptly stopping to help minimize the negative effects of coming off the pill, such as menstrual irregularities, spotting, and unusual bleeding. NB – once you stop hormonal birth control, many preexisting conditions such as acne may reappear.
All About Antidepressants
Depression therapy has made giant leaps since the rudimentary early and downright horrifying years of electrotherapy.
Each year new and exciting medications and approaches are being released to the public making the stigma surrounding mental health is weakening. This helps people openly discuss their mental health concerns with doctors, friends, and family without fear or shame. Depression can manifest in different ways and can range from mild to severe.
Symptoms of Depression:
- Feelings of intense sadness
- Mood Swings
- Disinterest in activities and relationships
- Difficulty concentrating
- Food disorders
- Insomnia or excessive sleeping
Depression can affect every aspect of your life and can be quite debilitating. If you experience any of the symptoms of depression, please do not hesitate and talk to a doctor on CribMD right away. There is no reason to suffer when there are so many treatment options available.
Types of Antidepressants:
- SSRIs (Zoloft, Prozac, Lexapro, Celexa)
- SNRIs (Venlafaxine, Duloxetine)
- Bupropion (Wellbutrin)
- TCAs (Amitriptyline, Nortriptyline)
- MAOIs (Phenelzine, Tranylcypromine)
- St. Johns Wort
- Anticonvulsants/Mood stabilizers (Felbamate, Lamotrigine, Phenobarbital, Primidone)
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant and tend to be the most effective for many people. Typically, therapy will be administered along with medication to reap the most benefits. Maintaining a healthy lifestyle will also allow you to make the most of your treatment. Try eating healthy, getting enough sleep, daily exercise and avoiding alcohol and nicotine to give yourself the best fighting chance.
When starting any medicine, there may be some side effects. While most of the side effects associated with antidepressants may disappear after your body gets used to the medicine, some will not, and it is important to always keep in contact with your doctor when starting a new medication.
Common Side Effects of Antidepressants:
- Suicidal thoughts (especially in young adults taking SSRIs)
It may take trying a few different types before the best solution for your unique circumstance is found. There is definitely no one size fits all answer for depression. Different dosages will be appropriate for different people, and since it will take about three months for the full effects of new medicine to completely kick in, it can take quite some time to find the best method for you. Be patient; keep track of your symptoms and side effects while staying in contact with your doctor.
How Antidepressants Affect Birth Control
Many drugs will influence the effectiveness of birth control, especially hormonal birth control pills. Antidepressants that affect levels of estrogen and progesterone in the blood may reduce the ability of birth control pills to stop ovulation, thus resulting in a possible pregnancy.
Changes in hormone levels affect every woman differently, but for most women, SSRIs and SNRIs will not cause those contraceptive hormone levels to fall low enough for birth control to fail. If using an antidepressant that will affect hormonal birth control, you may need to seek a non-hormonal alternative, such as an IUD, if switching antidepressants is not an option.
St. Johns Wort is a common herbal remedy obtained over the counter that can help manage depression. When taking hormonal birth control, this option should be skipped. St. Johns Wort over stimulates the kidneys (an organ responsible for breaking down substances in your blood and prepping them for excretion). This means the herb will effectively reduce the amount of those synthetic hormones found in birth control.
If levels of those hormones dip low enough, there is a risk of pregnancy. St. Johns Wort can affect birth control up to 28 days, or a full cycle, after stopping the herb. Therefore, it is important to use another method of birth control, such as a condom, during that time frame.
Other antidepressants that can wreak havoc on your birth control are TCAs or tricyclic antidepressants. These, along with monoamine oxidase inhibitors (MAOIs), may cause your birth control to fail. Certain anticonvulsants and mood stabilizers prescribed for depression will also disturb birth control effectiveness.
The safest route when trying to treat depression and prevent pregnancy will, in most cases, be an SSRI or SNRI. However, other methods may be required, and it is always of paramount importance to have a discussion with your doctor about what combination is best for you.
How Birth Control Affects Antidepressants
The effect of contraceptives on antidepressant effectiveness can be more complicated than the converse. In a research carried out by Danish, women on pills are 23% more likely to get treated for depression. Certain methods of birth control have been known to cause certain mental or emotional side effects.
Emotional Effects of Birth Control:
The above symptoms are commonly listed as side effects of some hormonal birth controls. However, doctors admit it is hard to say if these emotional changes are directly caused by birth control due to women’s health research deficiency. If you are newly incorporating birth control into your life, it may be helpful to start a symptom journal. Every day log any mood changes and new feelings you are having so you will be able to discuss them with your doctor at your next appointment.
For some women, hormonal birth control may increase the effectiveness of antidepressants. This may be because PMS and PMDD are sometimes treated with this type of birth control. Since these syndromes can cause depression, it makes sense one may have a better mood once their PMS or PMDD is under control. Similarly, if birth control is prescribed for severe acne, moods may be lifted once the face clears up and confidence returns.
Antidepressant and Birth Control Outlook
The good news is that most people will have nothing to worry about when simultaneously treating their depression and taking contraceptives. Most modern antidepressants will have no negative interaction or will even benefit your birth control regimen. That being said, everyone is unique and may be affected differently by certain combinations of medications.
It is important to closely monitor any new feelings and symptoms when starting a new drug. Many doctors suggest keeping a journal that you can bring with you to your appointment to have documentation of your changing symptoms. This will make it much easier for your doctor to pinpoint the cause of the new symptom and have you on your way to relief even quicker.
Your doctor will also need to know your family’s medical history, making it crucial to keep track of any mental illness or adverse effects to certain medications that may run in your family. Providing an accurate family medical history for your doctor can make it that much easier for you to get on the best treatment plan possible.
This is how CribMD can help
From underfunded studies that contradict each other to the topic being less discussed in the medical community, it can feel overwhelming and daunting when choosing the right antidepressant and birth control.
Our doctors at CribMD are here to help guide you along the way and will enable you to find the best combination of medications tailored just for you and your medical needs.