10+ Health Concerns Linked to Hormonal Birth Control

Hormonal birth control (HBC) includes many different types—like the pill, patch, ring, shot, implant, and progestin-only pills. These are often used to prevent pregnancy, but they can also be prescribed for other reasons like managing acne, endometriosis, or heavy periods.

While birth control can be helpful for some, research shows it can also have a range of short-term and long-term effects on a woman’s health. Knowing the possible risks can help you make an informed decision about what’s best for your body.

More than 10 Health Concerns Linked to Hormonal Birth Control

1. Loss of Important Nutrients

Studies show that the synthetic hormones in birth control can lower levels of certain vitamins and minerals—like folic acid, several B vitamins, vitamin C, vitamin E, magnesium, selenium, and zinc. These nutrients are important for energy, mood, immunity, and metabolism. The body is an intricate and fragile web of connections and feedback loops and when one deficiency occurs it affects other parts of the body.

2. Higher Risk of Blood Clots and Heart Problems

Birth control that contains synthetic estrogen can increase the chance of blood clots, which can lead to deep vein thrombosis (DVT), pulmonary embolism, stroke, or heart attack. The risk is higher for smokers, women over 35, and those with clotting disorders.

3. Liver and Gallbladder Issues

Some types of hormonal birth control have been linked to rare but serious liver problems, including benign tumors and certain types of liver disease. They can also raise the risk of gallbladder disease.

4. Mood and Mental Health Changes

Some women notice more anxiety, depression, or stress after starting birth control. Research has found that both combined and progestin-only methods can affect mood, though the impact can vary from person to person.

5. Changes to Thyroid Function

The synthetic estrogen in birth control can raise levels of a protein called thyroid-binding globulin. This can make less thyroid hormone available for the body to use, which may cause or worsen symptoms of low thyroid, like fatigue and weight gain.

6. Lower Sex Drive

Some women experience reduced libido while on hormonal contraception. This can happen because the synthetic hormones can raise sex hormone-binding globulin (SHBG), which lowers the amount of free testosterone in the body.

7. Bone Density Loss

Long-term use of certain birth control methods—especially the Depo-Provera shot—can reduce bone density. This increases the risk of fractures and is a bigger concern for teens and young women who are still building peak bone mass. [One other downside to the shot is that you can’t stop it or remove it as you can with other forms of hormonal birth control.]

8. Hiding Underlying Health Problems

Birth control can make periods lighter or stop them altogether, which may hide symptoms of conditions like PCOS, endometriosis, or thyroid disease. This can delay proper diagnosis and treatment.

9. Changes in Cancer Risk

Birth control can slightly raise the risk of breast and cervical cancer, but it may also lower the risk of endometrial, ovarian, and colon cancers. The overall risk depends on the type used and how long it’s taken.

10. Other Uncomfortable Side Effects

Headaches, nausea, weight changes, breakthrough bleeding, bloating, and changes in skin or breast tissue can all happen.

Other Long-Term Considerations

Fertility After Stopping Birth Control

Most women, about 83%, regain fertility within a few months to one year of stopping birth control. Some methods, like the shot, can take longer before fertility returns to normal.

Possible Epigenetic Changes

Epigenetics is the study of how lifestyle and environment can change how our genes work. While there’s no strong proof yet that birth control causes harmful epigenetic changes, scientists know that hormone exposure can sometimes affect reproductive health and could possibly have effects on future generations. Research in this area is ongoing.

Conclusion

Hormonal birth control is not without risks. Possible side effects include nutrient loss, heart and liver issues, mood changes, lower bone density, and shifts in cancer risk.

It’s important for the sake of you health to learn about the potential benefits and risks and how it will impact your health goals.

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How Hormonal Birth Control Affects the Liver

Your liver is the body’s chemical processing plant. It filters toxins, processes medications, and breaks down hormones — including the synthetic hormones in birth control. It’s already working very hard in our modern-day lifestyle, hormonal birth control adds to the toxic load we put on the liver.

When you take hormonal birth control (especially those containing ethinylestradiol, a synthetic estrogen), the liver has to process these hormones every day. Over time, this can lead to changes:

1. Changes in Liver Protein Production
   • Estrogen can cause the liver to make more clotting factors (proteins that help blood clot). This is one reason why estrogen-containing birth control can raise the risk of blood clots.
   • The liver also produces more thyroid-binding globulin and sex hormone–binding globulin when estrogen is present, which can change how other hormones behave in the body.
2. Risk of Liver Tumors
   • Long-term use of high-dose estrogen birth control has been linked to a higher risk of benign (non-cancerous) liver tumors, called hepatic adenomas.
   • These tumors are rare, but when they happen, they can sometimes rupture and cause internal bleeding.
   • The risk is much lower today than in the 1960s and 1970s when hormone doses were higher, but it’s not zero.
   • One large study found that women who used oral contraceptives for over 5 years had a 30- to 50-fold increased risk compared to non-users — though the absolute risk is still small (Rooks et al., NEJM, 1979; Stoot et al., World J Gastroenterol, 2010).
3. Liver Function Stress
   • Because the liver metabolizes these hormones, long-term use increases the liver workload.
   • Women with pre-existing liver disease (like hepatitis, cirrhosis, or certain genetic liver disorders) are usually advised not to use estrogen-containing birth control.

How Hormonal Birth Control Affects the Gallbladder

The gallbladder stores and releases bile — a fluid that helps digest fats. Estrogen from birth control can change the way bile is made and released:

1. Slower Gallbladder Emptying
   • Estrogen can reduce the movement of the gallbladder, meaning bile sits longer than it should.
   • This can cause bile to become thicker and more likely to form gallstones.
2. Changes in Bile Composition
   • Estrogen increases cholesterol in bile. More cholesterol in bile = higher chance of gallstones.
3. Higher Gallstone Risk
   • Multiple studies show that women on oral contraceptives have a slightly higher risk of gallstones and gallbladder disease compared to women not on hormonal birth control (Etminan et al., CMAJ, 2011).
   • Risk is higher with long-term use and in women who are overweight, over 35, or have a family history of gallstones.

Who’s Most at Risk for Gallstones?

• Women with pre-existing liver problems
• Those with a family history of liver tumors or gallbladder disease
• Women who have had gallstones before
• Those using high-dose estrogen pills or taking them for many years

What You Can Do to Support Liver & Gallbladder Health

• Stop putting synthetic estrogen into your body
• Eat a high-fiber diet and include healthy fats to keep bile moving
• Stay hydrated to support liver detox processes
• Consider nutrients like choline, B vitamins, and milk thistle to support liver function
• Get regular check-ups if you’ve been on hormonal birth control for years, especially if you have abdominal pain or digestive changes

How Hormonal Birth Control Can Affect Mood and Mental Health

1. Hormones and Brain Chemistry Are Closely Linked

Your brain has hormone receptors — especially for estrogen and progesterone — in areas that control mood, motivation, memory, and emotional regulation (like the amygdala, hippocampus, and prefrontal cortex).

When you take hormonal birth control, your natural hormone patterns are replaced by synthetic estrogen and/or progestin. These don’t exactly match your body’s own hormones, and they flatten your monthly hormone cycle. For some women, this shift changes brain chemistry in a way that affects mood.

2. How Synthetic Hormones Might Trigger Mood Changes

• Estrogen Effects: Natural estrogen usually boosts serotonin and dopamine — chemicals that make you feel good. Synthetic estrogen can have a milder or different effect.
• Progestin Effects: Synthetic progesterone (progestin) can increase a chemical called GABA, which calms the brain. But it can also raise monoamine oxidase (MAO), which breaks down serotonin — potentially lowering mood.

So you see here that the synthetic estrogen has a milder effect on serotonin and synthetic progesterone raises MAO which breaks down what serotonin is there. Serotonin is a chemical messenger in our body that is very important for regulating mood, sleep, appetite, and more.

Stress Response Changes: Some studies show that birth control alters how your brain responds to stress, possibly making you more reactive to emotional challenges.

3. What the Research Says

A large Danish study of over 1 million women found that hormonal birth control use was linked to a higher risk of starting antidepressants — especially in teens (Skovlund et al., JAMA Psychiatry, 2016).

4. Who Might Be More Sensitive

You may be more likely to notice mood changes if you:

• Have a history of depression, anxiety, or postpartum mood disorders
• Are a teenager (teens in studies showed the largest mood impact)
• Are on a progestin-only method (some studies link these to more mood side effects than combined estrogen/progestin)
• Experience nutrient depletion from birth control (especially B vitamins, magnesium, and zinc — all important for mental health)

5. Possible Mental Health Symptoms

• Feeling sad, tearful, or emotionally flat
• More anxiety or irritability than usual
• Loss of motivation or interest in activities
• Trouble concentrating
• Changes in sleep or appetite
• Less resilience to everyday stress

All of that said, if you were put on hormonal birth control as a teen, do you even know who you are without it?

How Hormonal Birth Control Affects the Thyroid

Hormonal birth control doesn’t directly damage the thyroid gland, but it changes the way thyroid hormones travel and are used in the body. This is because estrogen — especially the synthetic estrogen ethinylestradiol used in many pills, patches, and rings — changes liver function in a specific way.

Here’s the sequence:

1. Estrogen increases a protein called Thyroid-Binding Globulin (TBG)
   • TBG’s job is to “hold onto” thyroid hormones (T4 and T3) in the bloodstream.
   • More TBG = more thyroid hormone bound and less “free” thyroid hormone available for cells to use.
2. Lab tests may still look “normal”
   • Standard thyroid blood tests often measure total T4/T3 (bound + free), so a woman could have symptoms but still test “within normal range.”
   • Free T4 and Free T3 tests are better for detecting low bioavailable hormone.
3. Possible symptoms from less free thyroid hormone
   • Fatigue
   • Weight gain or slowed metabolism
   • Feeling cold
   • Hair loss or thinning
   • Brain fog
   • Irregular or painful cycles

Your Teen’s Thyroid on Hormonal Birth Control

Starting birth control in the teenage years has a few extra considerations for thyroid health:

1. Developmental Hormone Impact

• The teen years are a critical time for endocrine system “training.”
• Natural estrogen and progesterone rhythms help coordinate the thyroid, ovaries, and adrenal glands into a balanced system.
• Introducing synthetic hormones early can flatten natural cycles and may prevent the body from fully developing normal feedback loops.

2. Nutrient Depletion Risks Are Higher

• Teens need extra iodine, selenium, zinc, magnesium, and B vitamins for healthy thyroid function.
• Birth control can lower levels of some of these, making thyroid function more vulnerable.

3. More Years of TBG Elevation

• If birth control is started at 15 and used for a decade, that’s 10 years of higher TBG and potentially lower free thyroid hormone availability.
• This could cause or worsen “subclinical hypothyroidism” — a condition where symptoms are present but labs don’t show a big enough change for a formal diagnosis.

4. Overlapping Stress on the HPA Axis

• Teens already have higher stress hormone fluctuations.
• Early use of birth control can alter cortisol patterns, which indirectly affect thyroid hormone conversion (T4 → T3).
• High stress + altered sex hormones = more sluggish thyroid conversion.

Research Evidence

• Estrogen-TBG Connection: Multiple studies confirm that oral estrogen increases TBG, reducing free T4 and free T3 (J Clin Endocrinol Metab, 2001; Thyroid, 2014).
• Subclinical Hypothyroidism Risk: Women on estrogen-containing birth control may need higher doses of thyroid medication if they already have hypothyroidism (J Clin Endocrinol Metab, 2001).
• Teen Impact: While direct long-term thyroid studies in teen HBC users are limited, early disruption of the hypothalamic-pituitary-thyroid (HPT) axis is a known endocrine concern.

How Hormonal Birth Control Can Lower Sex Drive

Sex drive (libido) is influenced by a combination of hormones, brain chemistry, physical health, emotional well-being, and relationship factors. Hormonal birth control (HBC) can affect several of these — most notably through changes in testosterone.

1. Testosterone Levels Drop

• Birth control pills, patches, and rings containing estrogen increase a protein called Sex Hormone–Binding Globulin (SHBG).
• SHBG binds to testosterone in the blood, making it “unavailable” for the body to use.
• Even though testosterone is often thought of as a “male hormone,” it’s essential for women’s sexual desire, arousal, and satisfaction.
• Lower free testosterone often means less sexual desire and sometimes less sensitivity or arousal.

Key study: Women taking oral contraceptives have been shown to have up to 4 times higher SHBG levels than non-users, and even after stopping, levels may stay higher than before (J Sex Med, 2006).

2. Vaginal and Physical Changes

• Lower estrogen and testosterone activity can lead to vaginal dryness, making sex uncomfortable.
• Some women report less genital blood flow and sensitivity, which can make arousal harder to achieve.

3. Brain Chemistry Shifts

• Testosterone and estrogen influence dopamine and nitric oxide in the brain — both are important for pleasure and motivation.
• Lower dopamine signaling can make sexual activity feel less rewarding.
• Some synthetic progestins may also have mood-dampening effects, which can indirectly reduce interest in sex.

4. Emotional and Relationship Factors

• If birth control also causes mood changes, weight gain, or fatigue, these can further decrease sexual interest.
• Stress from relationship tension, body image concerns, or chronic fatigue can compound the effect.

The IUD

Even though hormonal IUDs release a much lower overall dose of synthetic progestin compared to birth control pills, they can still cause many of the same systemic effects — including changes in mood, libido, thyroid function, and nutrient status. While the primary hormone action of an IUD is local (thickening cervical mucus and thinning the uterine lining), studies show that the hormone does enter the bloodstream and can affect the entire body. This means sex hormone–binding globulin (SHBG) can still rise, reducing free testosterone and potentially lowering sex drive. The synthetic progestin can also influence neurotransmitters in the brain, which may affect mood, and may alter thyroid hormone balance by impacting liver proteins. Even at “low dose,” the hormonal IUD’s continuous exposure can create ongoing shifts in hormone signaling, and some women experience the same side effects they notice with other hormonal contraceptives — just to varying degrees depending on their individual sensitivity.