Intrauterine devices (IUDs) are a widely chosen form of birth control, recognized for their effectiveness and long-lasting nature. As with any medical intervention, understanding potential side effects is important for informed decision-making. A common question for those considering or using an IUD is whether these devices can influence mood or lead to depression. This article explores the current scientific understanding of the relationship between IUDs and mood changes.
Types of IUDs and Their Mechanisms
IUDs are devices placed inside the uterus to prevent pregnancy, falling into two main categories: hormonal and non-hormonal. Hormonal IUDs, such as Mirena, Kyleena, Liletta, and Skyla, release a synthetic form of progesterone called progestin (levonorgestrel) directly into the uterus. This progestin primarily works by thickening cervical mucus, which blocks sperm from reaching an egg, and by thinning the uterine lining. It may also partially suppress ovulation. The localized hormone release results in lower systemic exposure compared to oral contraceptive pills.
Non-hormonal IUDs, like the copper IUD (e.g., Paragard), do not use hormones to prevent pregnancy. They are wrapped in copper, which releases copper ions into the uterus. These ions create an inflammatory reaction, producing an environment toxic to sperm and eggs, preventing fertilization. The copper also impairs sperm motility and viability.
Scientific Evidence on IUDs and Mood
The scientific literature on IUDs and mood changes presents mixed findings, often differentiating between hormonal and non-hormonal types. Research indicates copper IUDs are not associated with mood changes. While some anecdotal reports and online discussions suggest a link between copper IUDs and systemic side effects like mood changes, this is not supported by broad scientific evidence.
For hormonal IUDs, the picture is more complex, with some studies suggesting a potential association with mood disturbances. A large Danish study from 2016, involving over a million women, found an increased risk for antidepressant use and depression diagnosis among hormonal contraception users, including IUDs. A 2023 Swedish study, encompassing over 700,000 women, indicated a 57% greater risk of depression for hormonal IUD users, especially among teenagers and new users. Another study observed a dose-dependent association, linking higher levonorgestrel doses to increased depression risk.
However, other reviews and studies have found less convincing evidence or no significant link between hormonal IUDs and depression. A 2018 review of progestin-only contraceptives, including hormonal IUDs, concluded insufficient evidence to definitively link them to increased depression risk. Some studies have shown no association or even a decreased risk of depressive symptoms with hormonal IUD use for certain individuals. It is worth noting that a small percentage of individuals, around 6.4% of Mirena IUD users, may experience low mood or depression within five years. The varying results highlight the challenge of isolating hormonal contraception’s impact on mood, given many individual factors.
Understanding Mood Changes and When to Seek Help
Mood changes can stem from various factors beyond contraception, including stress, sleep patterns, diet, and underlying medical conditions. Hormonal fluctuations, natural or induced by medication, can influence mood by affecting brain neurotransmitters. If you experience shifts in your emotional well-being while using an IUD, consider all potential contributing factors.
If you suspect your IUD is influencing your mood or experience persistent depression symptoms, it is important to consult a healthcare provider. Signs like frequent sadness, hopelessness, emptiness, anxiety, irritability, or loss of interest in activities warrant medical attention. A doctor can assess symptoms, discuss causes, and explore treatment options or alternative birth control methods. Open communication with your healthcare team is essential for personalized guidance and overall well-being.