Can the progesterone pill cause mood swings? The pharmacological factors at play

October 9, 2025 •

4 min read

A large Danish study involving over one million women found an increased risk for first use of an antidepressant and a first diagnosis of depression among users of hormonal birth control. For a subset of individuals, synthetic progestins, the active component in the pill, can indeed influence mood regulation. This addresses the common question: Can the progesterone pill cause mood swings?

Quick Summary

The progestin-only pill can cause mood swings and depressive symptoms in some users, particularly those with pre-existing conditions or hormonal sensitivity. The effects are often temporary as the body adjusts, but mood changes are a noted side effect. Factors like individual neurochemistry, progestin type, and the presence of underlying mood disorders can influence the impact on emotional health. Consulting a healthcare provider is essential for management.

Key Points

Progestin vs. Progesterone: The mini-pill contains synthetic progestin, not the body's natural progesterone, and these synthetic versions have different effects on the brain.
Impact on Neurotransmitters: Progestins can influence mood-regulating neurotransmitters like GABA and serotonin, potentially leading to mood swings or depression in sensitive individuals.
Individual Susceptibility: Not all users experience negative mood effects. Those with pre-existing mood disorders or PMDD may be more susceptible to mood changes.
Temporary Adjustment Period: Initial mood changes often subside within 3 to 6 months as the body adapts to the new hormone levels.
Management is Possible: Strategies like lifestyle changes, symptom tracking, and discussing concerns with a healthcare provider can help manage and mitigate mood-related side effects.
Consider Alternatives: If mood changes are severe or persistent, a doctor may recommend trying a different progestin type, a combined pill, or a non-hormonal contraceptive.

Understanding Progestin vs. Progesterone

First, it's crucial to distinguish between natural progesterone and the synthetic progestins used in birth control pills. The "progesterone pill," or mini-pill, contains a synthetic version called progestin. These manufactured hormones were designed to mimic some of progesterone's actions but can behave differently in the body and brain. Natural progesterone is often called the "calming hormone" due to its positive effects on mood and sleep via interaction with GABA receptors. However, synthetic progestins have a different pharmacological profile that can affect mood in a variety of ways.

The Pharmacological Link to Mood Swings

Progestins can cause mood swings by influencing neurochemistry and brain function. Progesterone receptors are widely distributed throughout the brain, particularly in areas involved in mood and emotion, such as the amygdala and hippocampus. Here are some of the proposed mechanisms:

Impact on GABA: Progestin metabolites, like allopregnanolone, act as modulators of the GABA-A receptor, which is crucial for promoting relaxation and reducing anxiety. However, some studies suggest that progestin can cause paradoxical, anxiety-inducing effects at certain concentrations, following a bimodal dose-response pattern.
Serotonin and Other Neurotransmitters: Both estrogen and progesterone influence the levels of mood-regulating neurotransmitters like serotonin and dopamine. Altering the natural balance with synthetic hormones can lead to fluctuations that manifest as mood swings, irritability, or low mood. Progestin may increase monoamine oxidase, which can decrease serotonin concentrations.
Interaction with Stress Systems: Research suggests that progestins can interact with the body's stress-response systems, which may contribute to negative mood experiences in some individuals.

Not Everyone is Affected the Same Way

It's important to recognize that a hormonal contraceptive's effect on mood is highly individualized. Many people experience no change or even an improvement in mood. For individuals with premenstrual dysphoric disorder (PMDD), hormonal stabilization with certain oral contraceptive pills can significantly reduce mood-related symptoms. The way a person's brain and body respond to hormonal shifts depends on factors like genetics, underlying health conditions, and personal sensitivities. For example, studies have shown that women with a history of depression or PMDD may be more vulnerable to adverse mood effects.

The Adjustment Period

For many, initial side effects, including mood changes, are temporary and lessen within the first few months of starting a new hormonal contraceptive. This is due to the body adapting to the new, consistent hormone levels. If mood swings persist beyond three to six months and are disruptive to daily life, it is advisable to consult a healthcare provider to explore alternative options.

Comparing Progestin-Only and Combined Pills

Different types of hormonal contraception carry different risks and benefits. Some studies have indicated that progestin-only methods might have a greater propensity for mood-related side effects in vulnerable women compared to combined oral contraceptives (COCs), which contain both estrogen and progestin. However, newer COCs and different types of progestins have been developed with varying potential mood impacts.

Managing Mood Swings on the Progesterone Pill

If you believe your progestin-only pill is affecting your mood, several strategies can help:

Lifestyle Adjustments: Regular exercise, a balanced diet, and sufficient sleep are beneficial for overall mental and physical health and can help manage mood changes.
Stress Management: Techniques such as yoga, meditation, and biofeedback can aid in managing stress and anxiety, which may be exacerbated by hormonal changes.
Symptom Tracking: Keeping a mood journal can help identify patterns and triggers, providing valuable information to share with your doctor.
Professional Consultation: Discuss your concerns with a healthcare provider. They can help determine if the pill is the cause and recommend a different type of contraceptive or non-hormonal options if necessary.

Progestin-Only vs. Combined Oral Contraceptives: A Comparison of Mood Effects


Feature	Progestin-Only Pills (POPs)	Combined Oral Contraceptives (COCs)
Hormones	Contain only a synthetic progestin.	Contain both a synthetic progestin and estrogen.
Mechanism	Works primarily by thickening cervical mucus and thinning the uterine lining. May partially suppress ovulation.	Prevents ovulation, thickens cervical mucus, and thins the uterine lining.
Mood Impact	Documented potential for mood swings and depression in some users, particularly sensitive individuals.	Some studies suggest a lower risk of mood disorders, and can be protective against PMDD symptoms.
Individual Variability	Response is highly individual; vulnerability may be higher in those with a history of mood disorders.	Response is also individual, but the combined hormones can provide more mood stability for some.
Initial Adjustment	Mood effects most likely during the first 3-6 months as the body adjusts to the constant hormone level.	Similar adjustment period, with initial side effects often improving over time.

Conclusion

While it is a valid concern, the link between the progesterone pill causing mood swings is not universal. The pharmacological effects of synthetic progestins on brain chemistry can cause mood disturbances in some individuals, especially during the initial adjustment phase or in those with a history of mood issues. However, many users do not experience these side effects, and for some, hormonal contraceptives can provide mood stability. Open communication with a healthcare provider is essential for weighing individual risks and benefits. Discussing your personal and family history of mood disorders and monitoring any changes after starting the pill can help you and your provider determine the best course of action.

For more detailed information on specific contraceptive formulations and their potential side effects, you can consult with your doctor or pharmacist. It's an important conversation that ensures your contraceptive choice supports both your reproductive and mental health.

Visit the NIH for comprehensive information on progestins and mood

Frequently Asked Questions

While mood swings can occur, they are not a universal side effect. Individual responses to hormonal changes vary significantly, and for many, there is no noticeable change in mood. A subset of users, particularly those with a history of mood disorders, may be more susceptible.

If mood swings occur, they typically happen during the first few months as your body adjusts to the new hormones. For many, these symptoms resolve within three to six months. If they persist beyond this period, it's a good idea to speak with your doctor.

Yes, different types and generations of synthetic progestins can have varying effects on the brain. Some studies suggest that anti-androgenic progestins might have a different mood profile than androgenic ones, and newer formulations are often designed with fewer mood-related side effects.

Yes, a history of depression or other mood disorders can increase your vulnerability to experiencing mood changes while on hormonal contraception, including progestin-only pills. It is important to discuss your mental health history with your doctor before starting or switching contraception.

Surprisingly, for some people, stabilizing hormone levels with continuous progestin can help alleviate mood swings related to PMS or PMDD, which are triggered by natural hormonal fluctuations. The effect is highly individual, however.

First, track your symptoms to confirm the correlation. If the mood swings are mild, consider lifestyle adjustments like exercise and stress management. If they are severe or persistent, consult your healthcare provider to discuss alternative contraceptive options or management strategies.

Yes. If hormonal contraception is a concern, non-hormonal methods like the copper IUD or barrier methods are available. These do not affect your natural hormonal cycle and therefore do not cause hormonally-related mood changes.