I was very fortunate to get the sex education I had. Our school nurse was extremely experienced, knowledgeable, and realistic. So, rather than shying away from the topic of sexual health, she saw to it that we all knew the importance of protection. Thanks to her straightforward attitude, I made sure I was always on some form of protection while sexually active.
While I’m a big fan of hormonal contraceptives, they don’t seem to be a big fan of me. Every form I’ve tried has resulted in many side effects, like weight gain, mood swings, worsened ADHD, anxiety, and depression.
It wasn’t until I did some research on hormonal birth control and its effects on ADHD that I realized why.
This article will explore ADHD, hormonal contraception, and their interaction. It’ll also go over potential birth control options for those who are looking!
Too long; didn’t read
- Hormonal contraceptives (HC) are birth control methods that use hormones to prevent pregnancy.
- Hormonal birth control may reduce ADHD symptoms by reducing hormonal changes during the menstrual cycle.
- Women and people who are AFAB (assigned female at birth) with ADHD have a higher risk of developing depression using oral HC.
- For ADHDers who want to use hormonal contraception, the implant or hormonal IUD may be better options to consider.
❤️ Note from the editors: Hormonal fluctuations and birth control can affect anyone’s ADHD symptoms, regardless of their gender. While some of the studies cited are women-centric, this article uses gender-inclusive terminology whenever possible.
What are hormonal contraceptives?
Hormonal contraception (HC) is a type of birth control that uses hormones - a combination of estrogen and progesterone - to prevent pregnancy.
HCs prevent pregnancy by blocking the release of eggs from the ovaries, thinning the lining of the uterus, or thickening cervical mucus to keep sperm from reaching the egg. This steady supply of hormones prevents ovulation, so there is no egg to fertilize.
Hormonal contraceptives come in various forms, including:
- Birth control pill (combined or progesterone only)
- Contraceptive patch
- Vaginal ring
- Injection
- Contraceptive implant
- Hormonal IUD
When used properly, hormonal contraceptives are a reliable way to prevent pregnancy (though they don’t offer protection from sexually transmitted infections).1 Hormonal contraceptives can also be used to manage polycystic ovarian syndrome (PCOS), hormonal acne, PMS and PMDD, endometriosis, menstrual migraines, and more.2
Still looking for extra support? The Inflow app has in-depth learning modules on many female-specific ADHD topics and a community of ADHDers who really get it. Join us in the Inflow app!
How does hormonal birth control affect ADHD?
Hormonal birth control may help reduce ADHD symptoms, likely because it minimizes hormonal fluctuations — after all, estrogen influences the same brain receptors that release dopamine, serotonin, and norepinephrine.
Hormonal changes during a menstrual cycle have a noticeable effect on ADHD symptoms and the efficacy of stimulant medication:3 Low estrogen and high progesterone levels during the second half of the cycle (aka the luteal phase) are associated with an increase in ADHD symptoms.4 So, if you feel like your ADHD is worse right before your period, you’re not alone.
Does hormonal contraception increase depression risk in people with ADHD?
Unfortunately, taking oral hormonal contraceptives seems to increase the already higher risk of developing depression in people with ADHD.
A 2022 study found that even without HC use, women with ADHD had a 3-fold higher risk for developing depression. With oral hormonal contraceptive use, ADHDers had a 6-times higher risk than non-ADHDers using HC.5
That said, ADHD women who used non-oral HCs (such as an implant or hormonal IUD) fared a little better, with only a moderate risk of developing depression — the same as the risk of the non-ADHDers.
What birth control is best for ADHD?
The link between oral contraceptive use and an increased depression risk suggests that non-oral HC may be a more appropriate choice for ADHDers. In particular, contraceptive implants and hormonal IUDs were associated with lower depression risks than other hormonal contraception methods. They also have the added benefit of not having to remember them daily.
For those who’d prefer to move away from hormonal birth control altogether, there are several non-hormonal alternatives to try.
Barrier methods of birth control work by creating a physical barrier to block sperm from reaching the egg. Some of these methods can also help avoid STIs by preventing the skin from coming into contact with bodily fluids.
Barrier methods include:
- Internal and external condom
- Diaphragm
- Sponge
- Cervical cap
- Spermicides — these come in several forms, such as foams, creams, gels, tablets, films, and suppositories
Final thoughts
It is important to note that birth control is an incredibly personal choice and affects people differently. What may work for you may not work for someone else. So you might have to try different products before you find what works best.
As for me, this research has validated many of my concerns and difficulties with the pill, so I’m excited to try out the other methods explored here!
Sources
1 InformedHealth.org | Contraception: Hormonal contraceptives. (2017)
2 Open Access Journal of Contraception | Contraceptive options for women with premenstrual dysphoric disorder: Current insights and a narrative review (2016)
3 Curr Psychiatry Rep | Ovarian Hormones and Drug Abuse (2014)
4 Psychoneuroendocrinology | Reproductive Steroids and ADHD Symptoms Across the Menstrual Cycle (2018)
5 Journal of the American Academy of Child & Adolescent Psychiatry | Hormonal Contraceptive Use and Risk of Depression Among Young Women With Attention-Deficit/Hyperactivity Disorder (2022)
