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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33 Comments

  • 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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  • 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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  • 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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    • did anyone ever reply to you on this? I would love to know the answer because I’m in the same boat! I hope you found relief.

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  • 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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    • Wow! After seeing all this post gave me the courage to make and appointment to get my IUD from minera out of my system. I put mine last year and although my doctor said I will have no issues with it, and it’s the best think ever, it turn out to be the worst decision I have ever take. I believe that this is a doctor business. I am sure they are getting some money for each patient they prescribe with Minera. I believe this is true because when I went to the hospital to get mine implanted, there were many women waiting for there’s to be implanted too. The OBG had a patient every 30 min, wow, and all of them were bringing the Minera box. Any way, for me the procedure was very painful and after the pain came the mood swings, tiredness, toughs that I am done with my self and thinking that I most be depressed. As many of you say, I was looking for a reason of my anxiety and depression. Went to therapy, use CBd drops and nothing help. The last couple of weeks I have been feeling even more irritable, emotional, anxious and I am not able to function as mother, partner or daughter, finishing the day is almost imposible. Feel like I am pushing my self every day and looking forward for the day to end. I feel like I just want to take this think out of my self with my own hands. After a talk with my dad and partner, who have notice my change I decided to get this thing out. I can wait to be my self again. Please listen to your body and don’t let the doctors convince you that is your self and not the IUD. Good luck to all of you.

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  • 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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  • Thank you! I’ve been in “a mood” for the past 7 months to the point of my 16yo son asking if I have a brain tumor because I am so moody. 🙁 was going to have it removed due to bad smells after sex but now I have another reason! It’s coming out day after tomorrow!

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  • Thanks for the article. I struggled with the same and am about to take it out as it’s due (5 yrs). Hope to see the happier me again.

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  • Thanks Sadie for mentioning the Cooper IUD. I’ve only had it for 3 months however I can most definitely feel a difference in my moods and energy levels. I’ve been super moody and very sad for no apparent reasons. I was really starting to worry 🙁 until I came across this page and though maybe its the IUD after all cause nothing else changed. Already booked my apt to have it removed next week 🙂

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  • thank you so much for posting this! I’ve had it in for 4.5 years because I can’t take the pill due to a blood clotting gene & I was bleeding every day for over a year and no one could tell me why. They put me on the mirena & it has been amazing in stopping the bleeding but ever since then I’ve had anxiety & panic attacks, mood swings to the point I think I am bipolar & going for drives so I can sit somewhere and cry. I thought all of that was “normal” but looking back to before the mirena was inserted I NEVER experienced any of those feelings… I don’t know what else to do because no other contraceptive has stopped the bleeding for me but is it worth feeling miserable & pushing away my loving family & boyfriend?
    again, thank you so much for posting this

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  • I’ve had my iud for 6 months, the copper one. It actually blows my mind. I’ve always been this happy, constantly-energetic-person and ever since I had this iud; my emotions have been all over the place. I stress more, I have absolutely no sex drive, I’m constantly wanting to be in bed rather than out doing my job that I truly love. I can’t even enjoy the fact that I’m getting married soon. I’m literally digging a hole for myself. I am so glad I came across this amazing article. I’ve been searching for answers. I have booked an appointment and I want this out! I want my life back. Most of all not destroying relationships and not being able to explain why I feel a certain way. It needs to come to an end. It’s worth the wait but I really need my brain to balance!

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  • Thank you for sharing this, it’s validation of everything I’ve been feeling. 2 days out and I feel like the fog has lifted. I used to wake up and dread the day, AND was sleeping 9 hours to feel functional. My moods have been impacting my job, my family, my marriage, and I’ve been feeling like it’s all so hard. Looking forward to the recovery and glad to know it’s not just me.

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  • Hi there, great article, really makes me feel like i am making the right decision to get my iud out! Could I ask what contraception you swapped to, if any, and how you feel on that?
    Thanks

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  • I’ve had my IUD for a little over a year and it has been the saddest year of my life. I have been anxious and depressed, extremely insecure, and filled with self doubt. Every time I get my period I have a meltdown. I have a good life but for the past 2 weeks I have been able to do nothing else but cry and think about how life would be better if I wasn’t here. My mom realized that my behavior changed when I got my IUD and after finding this article it was confirmed that despite doctors saying that IUD’s don’t cause depression. I read this article yesterday, today is the first day I haven’t cried or been anxious. Thank you for writing this and ladies, thanks for sharing your stories. I’m removing mine today!

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  • I had the Mirena iud put in 5 days ago. I have had a worsening of my depression. I’m already on medication for mood disorders. I thought my mood was due to emotions surrounding the past time I had been to the clinic for an abortion 1.5 years ago and our family decisions about children, but now I wonder. Could symptoms happen this quickly?

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  • I suffer from chronic depression, and thought that the “localized hormones” would be less likely to increase my depression — no biggie! I got the Kyleena IUD about five months ago. I was told mood swings were to be expected, but I haven’t experienced the level of numbness and dissatisfaction that I feel currently since before I started taking anti-depressants over 7 years ago — even then I don’t feel like I have felt this different from my usual self ever in my life. My doctor even doubled my dose of anti-depressants since I got the IUD (I did not even suspect mt depression was getting worse because of the IUD!) although I have still felt so depressed, empty, unmotivated. I also have experienced a significant loss in sex-drive since having Kyleena put in. I have plans to removing my IUD. Thank you for this article.

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  • Thank you for this!! I’ve had kyleena for about 3 years. I’ve always suffered from anxiety and I was excited to get the IUD because it was localized. The past few years I’ve defibtely felt like something was off emotionally, but recently I’ve been a mess. Every period brought a full mental and emotional breakdown. I’ve gotten trapped in obsessive thoughts and felt extremely foggy and lost. It wasn’t until this months breakdown where I started to think it might be my IUD. I was told it wouldn’t affect my mental health. I don’t know what to do now 😓 I can’t take the pill or the implant because of the hormones, and I don’t feel like just condoms are safe enough.

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  • I had my IUD inserted over 3 years ago. Almost immediately I notice a difference in my emotional mood!
    The normally positive, upbeat, happy person that I was had become moody and tired and I literally withdrew from me!
    After 6 months I visited my GP 6 and asked have it removed.
    Like most, I was questioned and told that due to all the ‘major events’ I had been going through I should reconsider and speak with a counseler…which I did!
    I consider myself quite in tune with myself and didn’t gain any insight to my sudden emotional change.
    3 years forwards with no change to my emotional mindset, I went back to my GP to have a Pap Smear and asked for the IUD to be removed!
    My GP then asked me at least 6 times was I sure with my response being a very clear yeas every time.
    She asked why… I reeled of the list of reasons in my head;
    Depressed emotional state
    Mood swings
    Always tired and lack of energy
    Yucky discharge
    Yucky smell
    Lack of sex drive…(actually NO sex drive at all)
    Not felling like ‘me’ for the past 3.5 years

    Again my GP asked if I was sure, I then cried and said YES…this lead to her asking again was I sure!
    Finally my IUD was removed yesterday!
    I know there will be some discomfort moving forwards such as ‘my period’ but I feel GOOD, really GOOD and generally happy!
    I feel like ME!

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  • I want to share that I had my Mirena for 14 years. I had it removed in May for reasons due to a back injury and my neurosurgeon wanted me to check if the issue had to do with the possibility that my newly replaced IUD could maybe be irritating me. So I decided this time I was going to keep it out. Not sure why I decided that. Not thinking anything, I started a new job in June, a less stressful one at that….come July, August, I just generally started feeling a lot better after years, YEARS of anxiety and recently over the last 3 or so years, some seasonal depression that had been pretty tough and real mood swings, frequent tearfulness and difficulty controlling my emotions. That emotional “me” has always been there or so I thought and I thought I had always been that way. Kind of thought maybe I had a mood disorder. I am a therapist so I diagnosed myself with possibly some sort of depressive issue, def anxiety. So, back to feeling better, I had realized in August, I had been driving to work feeling really, HAPPY, relaxed, smiling, calm….I haven’t felt that way in as long as I can remember. I am actually tearing up as I write this. I wait for the ball to drop when I feel that way and I wasn’t thinking that. Come 6 weeks later and more days than not I feel really really great. My mood is stable, yes I am still on antidepressants but I was moody on them prior. I could never see myself coming off them. I feel so light and calm. Stable. I truly 100% believe it was the IUD. I am susceptible to anxiety and depression, yes I am. It runs in my family, but it had never effected my level of functioning until I was in my 30’s (I am 42 now). Please talk to your doc about this and have them listen. Not saying do not use it. Just pay attention if you notice your mood shifting. It was so long for me, and so subtle, until it wasn’t. I felt so bad for so long that I know what it feels like to feel good and it is amazing. :0)

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  • I had the Mirena put in 7 months ago after having my 2nd son. I thought I could’ve just had post partum for this long but I really think it is the Mirena. It has affected the way I interact with my children, husband, I have secluded myself from my family, called out of work, etc bc of how severe my depression and anxiety has been. I have had panic attacks which literally feel never ending. Almost to the point where I felt as if everyone would be better without me and contemplated suicide. I’m ready to get this thing out of me immediately. Can we sue, bruh? We should most definitely be able to bc i was told this iud is basically Gods gift to women. I was never informed of any of these side effects.

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    • I’m so happy to have found this article, I’ve been questioning this and I’ve only had my IUD in for 5 days! I was very much against a hormonal IUD but that was the only option for the heavy periods AND labor-like pain that comes with them! I have been struggling with my periods since having my youngest, he’s 3 now…I feel like I just want to deal with the week of misery now after feeling this switch since having my IUD put in

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  • I feel like an idiot for getting this horrible piece of plastic implanted inside me. I should have known to research links between IUDs and depression and that the ****ing doctors wouldn’t. I had the Mirena implanted 3 months ago and not only was the procedure, no exaggeration, the worst pain I have ever felt in my whole life, but it has been a nightmare ever since. I’ve had constant pain that has worsened over time, and erratic mood swings and depression that has drastically worsened. I have suffered from severe depression for as long as I can remember and have been taking antidepressants for the last 8 years. Never once did ANYONE mention to me that getting this IUD could potentially worsen my depression. The OB-GYNs I saw knew the meds I was on and said nothing.

    Reading all of these comments from other women really does make me wanna cry (like so many have said) because I cannot believe it is such a problem and Doctors don’t even think about it. I honestly have never once met a Doctor that did their job right. So disappointing and so scary.

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  • I had my Mirena out in late December and I still feel funny. I felt good at first after it being removed and then had two periods which were super heavy and long, I thought I might be having a miscarriage. I feel like I’m crazy. Doctors never care, I think they think you’re being dramatic or are already crazy and it’s just an extension of that. I just had food poisoning, my period hasn’t come in a month after having 2 in a month and I feel very mentally unstable, more than ever before. Just crippling despair and feeling like no one loves me. I feel like it’s an ‘emergency’ but obviously there is no emergency. I tried to talk to my husband and he was mean. I know it’s not true but I just feel so desperate, I’m embarrassed, but I wish I could just be dead

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    • I am so sorry you’re feeling this way. How long did you have the IUD prior to removal and have you had any kids? Many women get their hormonal IUDs postpartum and confuse those mood swings with the device’s (not saying the IUD isn’t contributing, but I’ve found with my IUD, regular stressors in my life are enhanced.) I hope you’ve gotten out of the s*icidal rut. People do love you and cherish you! Not everyone knows how to respond to other people’s sadness.

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  • 3 years I’ve had my IUD in and I finally have realized with all the research questions and answers given. My IUD is cause of my major depression, aniexty and mood swings. Huge weight gain that I cant lose no matter how I discipline and diet myself. Horrible acne and loss of hair. I am scheduled to get it removed in less than 24 hours. It’s been a roller coaster. But who I am today with it inside me over the past 3 years is not who I truly am before it was inserted. Yes, its 100% effective as a birth control. Tho it’s not worth it to let it destroy the real you. I can’t wait to have it out! Idk why I’ve waited so long

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  • How do you ladies feel after having it removed? I still feel depressed with copper iud inside me.

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  • Hi Ladies. I was reading this in doing research for a friend. As I read many of these comments related to IUDs, I also wonder about the hormonal imbalances many are appearing to suffer. If we put just one hormone in our body it can up regulate and down regulate other various hormones in the body getting the body out of balance. Hormones and the copper IUD (through zinc imbalance) can affect food digestion, thus absorption. The very building blocks one needs to stay balanced for body rebuilding can be not absorbed or redirected thus causing further imbalances. If you are still not better after removing IUDs do further research on hormones in general. Theory Hertoghe has great information.

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  • I just had my Mirena removed and it was so painful! Don’t ever let anyone tell you it’s not painful to get them placed and removed. However, and to relate back to the article and all of the women here, I did experience strange behaviors after I got mine placed years ago. My moods were dark and I had erratic behaviors. I have been treated for depression and anxiety for years before I got an IUD, but looking back, i think it may have exacerbated my mood swings.

    When my Mirena was removed, besides the physical pain I experienced, I also experienced this rush of emotions and was thinking it has something to do with an object being positioned inside my womb space for so long. What do y’all think about that theory?

    Take care & blessed be.

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  • The mirena coil ruined my life. My mood and personality totally changed, I developed ovarian cysts, had hair loss, no libido, headaches; eventually it lead to me feeling suicidal. The doctor who finally removed it admitted to me that there are some women who have an allergic reaction to it – those women present with both physical and mental symptoms. I firmly believe that all women should be warned of this BEFORE they have it fitted so that they and their loved ones can keep an eye on how they react to it. For some women its very positive, but for others it can be extremely dangerous. The localised delivery system story that the docs describe as being a more gentle way of absorption is rubbish when it comes to those women whose bodies are extra sensitive to synthetic hormones – those hormones enter the blood stream and can be as powerful as any other form of hormonal ingestion. If you are struggling at all, find a doctor who really listens and have it removed asap. For a lot of people the minute it is removed you will start to feel a difference. But it can take months to completely rebalance.

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  • This has made me feel significantly less crazy for experiencing the side effects I have so far! Within just the first month of getting the device, I noticed being super lethargic yet also hyper-vigilant? Basically, the anxiety/depression I was diagnosed with 2 years ago came back with a vengeance. I had ultimately “cured” my mental health struggles with the combination of counseling and antidepressants. What a defeating feeling it is to be right back to where I was 2 years ago in shy of two months… I have an appointment within the week where I hope to schedule getting it out! Reading about many women being responsive to the removal within a couple days to a week gives me much hope! Trust your gut and body and do what is best for you. I wanted the hormonal IUD to work so bad, but it’s just not for everyone and that is okay! There are too many options when it comes to birth control for anyone to settle with compromising their mental health.

    God bless all you women! Best of luck!

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