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Can Birth Control Make You Tired? 4 Reasons & How to Fix It
Find out more about the link between hormonal birth control and fatigue.
This article was reviewed by Dr. Monica Faut, Ph.D. in Biology
If your birth control is making you tired, you're not alone.
In a study of 9,168 women on hormonal birth control, one of their most common complaints was fatigue.
Along with feelings of tiredness, the potential side-effects of hormonal birth control include weight gain and depression.
It's no wonder that many women are worried about the effects the pill will have on their bodies. An analysis of data from 47 countries found that one of the reasons women didn’t use contraception was health concerns.
You need to find a reliable, safe way to prevent pregnancy - without a doubt. But finding the best birth control method for you may take time and experimentation.
Below, we look at the reasons your birth control may be sapping your energy and what to do about it.
Why does birth control make you tired?
The most common type of birth control pill contains synthetic forms of estrogen and progesterone (progestin). Estrogen is known to affect your energy levels and can lead to fatigue. Progestin on its own can also make you feel tired.
One study of 1,286 women found participants using contraception reported more daytime sleepiness and insomnia symptoms. But study authors called for more research into the effects of birth control on women, adding:
“...the effects of hormonal contraceptives in women of reproductive age are still scarcely understood.”
In addition to hormones, birth control can cause other side effects that may affect your energy levels. Specifically, it may lead to weight gain, mood swings, depression, and nausea. In fact, ten-year-old research has established that women taking hormonal birth pills reported higher levels of depression and fatigue. All of these can contribute to a lack of energy.
1. Increase in progesterone levels
It's possible that the progesterone in birth control pills may leave you feeling tired.
A study of 108 women published in the 2020 Gynecological Endocrinology journal investigated the impact of combined progesterone and estrogen pills on sleep. Results showed that “low-doses of progestins affect various aspects of sleep”.
Additional research suggests that hormonal contraceptives may have effects similar to those of prescription sleeping pills.
On the other hand, different research found women who used progesterone-only birth control had lower total sleep time.
2. Increases in cortisol levels
Birth control can drive up cortisol levels, which may affect sleep and energy levels. One study found oral contraceptives containing estrogen can increase cortisol levels.
Sara Gottfried, a medical doctor, and Melissa Blake, a naturopathic doctor, explain that “women on birth control therapy exhibit “altered cortisol rhythms with lower levels upon awakening, delayed peaks, and higher overall levels’ compared to women, not on hormonal therapy.
A case study published in the Journal of the Endocrine Society shows that hormonal birth control can raise cortisol levels to similar levels to Cushing’s syndrome. Cushing’s syndrome is an illness where the body produces too much cortisol. Its symptoms include fatigue and mood changes.
Indeed, hormonal birth control can cause false-positive results, leading to a wrong diagnosis of Pseudo-Cushing Syndrome, a condition where people exhibit many of the clinical features of Cushing's Syndrome. Lethargy is listed as one of the symptoms of Pseudo Cushing Syndrome.
3. Causes changes to the brain region responsible for sleep
Research shows birth control can alter the region of the brain that plays a role in sleep.
One study published in the 2021 PLoS ONE journal examined the effect of oral contraception on the hypothalamus.
Located in the brain, the hypothalamus contributes to regulating bodily processes such as hunger, thirst, and sleep-wake cycles. The hypothalamus is involved in regulating sleep and hormones, like cortisol and melatonin.
For the study, MRI (Magnetic Resonance Imaging) scans were performed on women who were taking oral contraception and those who were not. Researchers revealed that women taking birth control had smaller hypothalamic volumes.
Presenting their findings to the Radiological Society of North America (RSNA), researchers noted that smaller hypothalamic volume was linked with “greater anger” and depressive symptoms.
4. Causes a vitamin deficiency
The birth control pill can cause a deficiency in several important vitamins. Lacking these vitamins can lead to fatigue and low energy levels.
Low levels of vitamins B6, 12, and vitamin D have been associated with birth control, according to a research paper published in PCOM Capstone Projects. Additionally, another study showed a link between oral contraceptives and magnesium deficiency.
Taking a multivitamin or supplementing with these vitamins may help prevent these deficiencies from becoming an issue.
3 other side effects of birth control
47% of women stop taking birth control within six months because of side effects, according to this paper.
Side effects of birth control include breakthrough bleeding (bleeding between periods) and weight gain. More serious side effects include high blood pressure and blood clots.
Almost 22% of US women take birth control pills during their lifetime. Scientists are making tremendous efforts to understand the side effects of hormonal contraceptives. However, in a Vogue interview, Dr. Annabel Sowemimo, reproductive health doctor and co-director of the Reproductive Justice Initiative, said the scientific community lacks information about the impact of hormonal birth control pills on women's health.
Here's the thing: when the developers of the birth control pill wanted to bring the medication to market, they were less concerned about side-effects and more worried about whether it worked to prevent pregnancy.
As a result, they engaged in a series of secretive, unethical clinical trials during which three women died, reports History.com. No autopsies were conducted and the cause of their deaths remains unknown. And the women participating in the trial weren't aware they were taking an experimental drug.
Pill developers John Rock, gynaecologist, and biologist Gregory Pincus, with the support of birth control activist Margaret Sanger and philanthropist Katherine McCormick, decided to start large-scale human trials, reports the Washington Post. And they choose to run those trials in Puerto Rico.
"The theories as to why Puerto Rico was chosen as a testing ground, despite its heavily Catholic population, are multiple: It was an easy flight from the U.S. mainland. There were no laws there against birth control. And the location’s overcrowding and poverty made it especially attractive to biologist Gregory Pincus, who was concerned about global population control."
Speaking to NPR, Jonathan Eig, author of The Birth of the Pill, said:
“In a way, we do have women being treated like lab animals so that we may find a form of birth control that frees them.”
1. Depression
Depression is a side effect of the pill.
Scientists don't fully understand the effect of hormonal birth control on mental health, according to this study. Researchers note that even though birth control has been around for more than 60 years, "it is still debated whether (hormonal contraception) use causes mood deterioration and development of depressive episodes."
"Recent findings from large epidemiological studies have suggested that starting on HC is associated with an increased risk of being diagnosed with Major Depressive Disorder (MDD), being prescribed antidepressants, and even attempting or completing suicide."
The authors explain the risk for mental health disorders is higher when women start using birth control in their teens. One theory is the effects may be more severe because adolescence is a critical stage of brain development.
As Olive Cowan writes in the Scientific Kenyon: The Neuroscience Edition, estrogen may play a role in mood changes, but the "route is not completely clear".
“Estrogen may interact directly with the endocrine system and produce effects in areas of the body such as the brain and reproductive organs.
"It is possible that the supplemental synthetic hormones disrupt proper cognitive functioning and lead to mood changes. Another possible mechanism is through gene transcription caused by the estrogen receptors. Scientists do not know which genes the hormones turn on or off.”
2. Dental problems
Birth control pills may lead to dental issues, according to research published in the Journal of Oral Science.
Study authors conclude that there may be a link between combined birth control and inflammation of the gums.
3. Change body shape
Birth control can affect where you store body fat.
The "hourglass figure" results because of the way fat tissues respond to reproductive hormones, writes Zaria Gorvett in this BBC article:
"For example, subcutaneous fat – the kind of chub that women carry around their thighs, hips and breasts – contains lots of oestrogen receptors.
"It’s easy to see how, theoretically, changing a woman’s hormone balance could alter where her fat is stored. Some research has borne this out: one early study found that women on pills with higher levels of oestrogen tended to have pear-shaped bodies and more subcutaneous fat, though not necessarily more fat overall."
What to Do If You Experience Fatigue While on Birth Control
Most side-effects will go away after two to three months, reports Medical News Today.
Talk to your doctor
If you’re feeling tired after taking the pill, seek medical advice. There are many birth control options out there that may be better for you.
I was on and off birth control for about 11 years. During that time, I tried several different brands, and I definitely experienced a ton of mood changes. But I followed an unhealthy lifestyle. I didn’t yet understand the importance of prioritising my mental health and well-being.
All to say, I can't point the finger at the pill for my mental health issues back then.
Fast-forward a few years: my second child was around two years old, and I went back on the pill to clear up my acne. The change in my mood was almost instantaneous. My husband and I decided to try a combination of natural birth control methods. Honestly, we weren't that strict, and I ended up falling pregnant.
In my context, we weren't trying for another child but the new baby was welcome. My third pregnancy didn't affect my life negatively in any way, and we were financially and emotionally ready to grow our family.
Everyone's situation is different, though. I can think of a few times when a pregnancy would 100% have derailed my life.
If you want to avoid unwanted pregnancy, absolutely reach out to a healthcare professional for a birth control method that will offer you sufficient protection.
Figure out the goal of taking birth control
Determine why you’re taking the pill.
Research shows while most women use the pill to prevent pregnancy, 14% use birth control for other reasons, including irregular periods. Some pills are even taken specifically to reduce acne.
Here’s the thing: if you’re taking the pill to fix acne or irregular periods, you’re not addressing the root cause. Once you go off the pill, your acne flare ups will return. Your periods will become irregular again. This is because the underlying hormonal balance has not been addressed.
That’s exactly what happened to me.
Plus, if you want a regular natural period, the pill causes withdrawal bleeding. The only reason we have that week of bleeding today is that the creators of the pills wanted 1) proof that birth control was working and 2) to give women a clear sign they weren’t pregnant.
Find the best birth control method for your needs
Hormonal birth control methods aren't for everyone. Honestly, they didn't work well for me.
Birth control can interfere with your sleep patterns and cause changes to your mood.
We've seen combination birth control pills are associated with side-effects, and this can lead to feelings of fatigue.
Of course, you want to find a trusted way to prevent pregnancy. You may want to speak to your healthcare provider about nonhormonal birth control options. Remember you can change your birth control or try something else.
Featured image credit: Photo by Debashis RC Biswas on Unsplash
