The Link Between IUDs and Depression That We Need To Talk About
IUDs and depression

The Link Between IUDs and Depression That We Need To Talk About

At 15, having my painful and irregular periods managed, manufactured, and scheduled by the Pill seemed like The Best Idea Ever. But at 27, I started to question the long-term effects of the artificial hormones that had been coursing through my body for over 12 years. The rest of my self-care routine was in the midst of an all-natural makeover—organic vegetables, grass-fed beef, skincare ingredients straight from Mother Earth—and the Pill didn’t seem to make sense for me anymore. I researched some other birth control options, and landed on an IUD; specifically, Mirena: One appointment, three to 10 years of baby-free sex, and a lower dosage of localized hormones.

My OB-GYN was just as enthusiastic about my decision as I was; I had the IUD implanted 20 minutes after my initial consultation. But in the weeks following my birth control switch, I felt decidedly less enthusiastic. Besides the bloating, acne, and slight mustache that had sprouted on my upper lip (true story), I fell into a deep pit of depression. I blamed my constant state of general blah-ness on a recent move, job drama, and the stress of planning my upcoming wedding…but after months of living under this heavy haze with no end in sight, I started to wonder, was my IUD causing my depression?

CAN HORMONAL IUDS ACTUALLY CAUSE DEPRESSION?

In short, yes. “A 2016 study of over a million women in the the Journal of the American Medical Association revealed that progestin-only contraceptives, like the IUD, were associated with a higher risk of depression,” reveals Dr. Jolene Brighten, a Functional Medicine Naturopathic Medical Doctor and the author of Beyond the Pill. This isn’t exactly an uncommon side effect, either. “Some studies have stated that progestin intrauterine devices (IUDs) were shown to nearly triple the number of both depression diagnoses and antidepressant use among young women [as compared to those not on birth control],” Dr. Jessica Shepherd, an OB-GYN and women’s health expert, tells Blood and Milk.

STUDIES SHOW THAT HORMONES IN IUDS CAN AFFECT OUR BRAIN CHEMISTRY

Dr. Brighten concedes that there hasn’t been enough research in the space to fully understand why hormonal IUDs like Mirena can cause mood swings and depression, but there’s evidence to suggest that it comes down to progestin, the synthetic hormone found in many contraceptives. “It appears alterations in brain chemistry that lead to increased production of neurotoxins, elevations in inflammation, alterations in gut health, and nutrient depletions are some of the reasons hormonal birth control may alter mood in some women,” she explains. “We also understand that your [naturally-produced] progesterone stimulates GABA, a calming neurotransmitter in the brain, but progestin, the synthetic hormone in contraceptives, does not.”

Upon hearing all of this, my mind was kind of blown. The reason I opted for an IUD in the first place was because of its localized hormone delivery system, specifically targeted at the uterus—so how, exactly, do these hormones end up messing with our brain chemistry? “Although the intrauterine system primarily works locally, it still delivers [hormones] to the systemic circulation,” Dr. Shepherd explains. Which leads me to another question: Why aren’t people talking about this?

THE LINK BETWEEN IUDS AND DEPRESSION IS REAL, BUT OFTEN IGNORED

If you Google “IUDs and depression,” over 5 million search results prove that people are talking about it. But why aren’t doctors and OB-GYNs talking about it with their patients? Why wasn’t I told that my whole localized-hormones-must-be-better theory didn’t check out? Why wasn’t I asked, “Do you have a history with depression or anxiety?” before being implanted with a one-inch piece of plastic that had the potential to turn my world upside down? Yes, it turns out that women with a history of mood disorders have a higher likelihood of developing IUD-induced depression.

“From what is understood in the research, women with a personal or family history of depression or other mood disorders are more susceptible to experiencing these side effects with hormonal contraceptives, including the progestin-based IUD,” Dr. Brighten shares. Dr. Shepard even goes so far as to say that women with significant depression “are not ideal candidates for the hormonal IUD.”

One reason OB-GYNs may not be addressing this issue? “The package insert on the Mirena states that only around 5 percent of women in clinical trials have depressive mood and nervousness as a side effect,” Dr. Brighten says—in other words, not a significant percentage. “But that doesn’t account for what happens in the general population,” she adds, citing that outside of control groups, the adverse effects of Mirena and other hormonal IUDs may be more widespread than we think.

“Sadly, women are often dismissed in medicine when it comes to mood symptoms,” Dr. Brighten admits; so those who do take these concerns to their OB-GYNs may not be taken seriously. That’s precisely what happened to me when, after doing some independent study and concluding that my IUD was messing with my mood, I confronted my doctor. “It’s in your head,” he said, with a smile and a wave of his hand. “This is just stress from the wedding.” Needless to say, I booked it out of his office (and maybe kind of cursed him out just a little bit) and set up an appointment with a new OB-GYN, who respected my decision to have the IUD removed.

Doctors estimate that it takes about three months for our systems to completely clear IUD-delivered progestin from the body, so my symptoms didn’t immediately go away. But today, six months later, I’m not only happy with my decision—I’m also just plain happy.

WHAT TO DO IF YOU’RE EXPERIENCING IUD-INDUCED DEPRESSION

Having the hormonal IUD removed isn’t the only solution, though. “There are several progestin-based IUDs that have varying amounts of progestin,” Dr. Brighten says, noting that a lower dose of progestin may be all your body needs to re-stabilize. “There are also non-hormonal contraceptive options, like barrier methods and the fem-tech devices approved by the FDA”—as well as the hormone-free copper IUD. That being said, she doesn’t condone mixing hormonal IUD with psychiatrist-prescribed mood stabilizers or antidepressants. “I don’t recommend women begin medications to manage side effects caused by a medication if it is possible to have an alternative contraceptive that wouldn’t cause side effects,” she says.

With issues as complex and nuanced as reproductive health and mental health, there’s no single approach that will work for everyone. That being said, there is one universal truth: Birth control exists to offer women freedom. It shouldn’t leave you feeling trapped under the weight of depression; and if it does, talk to your doctor—preferably one who will present you with the facts, individualize your care, and listen when you tell them that something’s not right.

Featured image by Jack Antal
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5 Responses to “The Link Between IUDs and Depression That We Need To Talk About”

Kim

April 29, 2019 8:25 am

This article makes me want to cry. I have had my IUD for 5 years and it has been the hardest 5 years of my life. Anxiety attacks, mood swings, massive bloating and of course major depression. I went to see a psychiatrist and she immediately put me on antidepressants. But something didn’t feel right about me taking them so i haven’t. Then i read this and I’m like omg. There it is. I want to thank you for writing this because it really helped me. My depression has affected my relationship, my job, and my social life. It’s nice to know I’m not crazy. Already got an appointment to have it removed…5 years too late but whatever.

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Sadie Petiford

May 03, 2019 3:42 pm

I’d like to add that the copper iud is not as innocent as it sounds. Copper is actually linked to a wide variety of mental health issues (as it fights and depletes zinc) so do be aware that this (or worse) can happen to you with the copper iud as well. Thanks for this article.

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Vanessa

May 08, 2019 1:03 am

Thanks for the article, my experience is more like I’m in a permanent bad mood (permanent PMS), irritable and anything can set me off, not good when having two small kids…. I’ve had the Mirena now for about a year and also want it removed after reading the article. But what would be the replacement? I suffer from heavy periods and being iron deficient I had to do something about the blood loss.

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Kelly

May 12, 2019 10:41 am

I have had an iud for two years this time. Wasn’t sure if it was me getting older or what but it’s mother’s day & instead of enjoying it with my son & husband I am laying in bed crying because I feel miserable inside. I would rather be left alone I feel I can’t get along with either of them anymore I am always in a bad mood & very snappy. I have no sex drive & it is nearly impossible to have an orgasm I have told my OB-GYNs but her response was I have never heard this as a side effect before. I am currently scheduled next month for removal & after reading this I’m happy about that decision. My problem is w high blood pressure I don’t have many options.

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Patty

May 15, 2019 5:21 pm

I recently took my IUD off! And I had never suffered from depression and anxiety and mood swings! Its horrible! I thought it was stress cause I am planning my wedding but i just felt different!!! And I started reading about the mirena crash and all made sense! I really do hope with in a couple months I will be back to being my normal happy self! Fingers crossed!

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