Every day, many women take the pill as their number one form of birth control. A few believe it leads to weird mood swings on some days, while others don't. Now, researchers at Karolinska Institutet in Sweden in collaboration with the Stockholm School of Economics suggest a possible link between oral contraceptive pills and women's overall wellbeing.

Angelica Linden Hirschberg, lead author of the study published in Fertility and Sterility, and professor at the Department of Women's and Children's Health at Karolinska Institutet, and her colleagues, found use of combined oral contraceptive pills is associated with a significantly lower quality of life on specific measures, including mood/well-being, self-control, and energy levels. However, there was no notable increase in depressive symptoms.

Read More: Does The Birth Control Pill Cause Depression?

"Despite the fact that an estimated 100 million women around the world use contraceptive pills we know surprisingly little today about the pill's effect on women's health," said Hirschberg in a statement.

Several women report mood changes as one of the top reasons they discontinue using the pill within the first year. There is ample anecdotal evidence on the pill's effect on quality of life and depression, but very limited scientific data. Previous research has found a link, but no causation, between hormonal contraceptives and depression.

For example, researchers at the University of Copenhagen note women taking combined oral contraceptives were 23 percent more likely to be diagnosed with depression; those using progestin-only pills were 34 percent more likely; and teens were at the greatest risk of depression, with an 80 percent increase when taking the combined pill. This means if 10 women not taking hormonal birth control develop depression, then 18 women on the birth control pill will develop depression. Skeptics argue since depression is common, and birth control is common, it's natural that both of these things are commonly going to occur together; they may or may not be linked.

To shed some light on the controversial topic, Hirschberg and her team recruited 340 healthy women aged between 18 and 35 to be randomly treated over the course of three months with either placebos or contraceptive pills containing ethinylestradiol (an estrogen) and levonorgestrel (a progestin). This is the most common form of combined contraceptive pill in Sweden because it carries the least risk of thrombosis — blood clots in the circulatory system. Neither the leaders nor the participants knew which treatment was given to the women.

Similar to other studies, Hirschberg and her colleagues noted changes in mood related to depression were relatively small. They stressed the pill's negative effect on quality of life should be considered of clinical importance when it comes to prescribing birth control to women.

“This possible degradation of quality of life should be paid attention to and taken into account in conjunction with prescribing of contraceptive pills and when choosing a method of contraception," said Niklas Zethraeus, associate professor at the Department of Learning, Informatics, Management and Ethics at Karolinska Institutet.

Read More: 4 Ways Hormonal Birth Control Affects Men And Women

The risk of depression and other psychological side effects may be small, but its real. Doctors shouldn’t stop prescribing hormonal birth control, but rather should discuss this with their patients when talking about birth control’s side effects — not just the physical effects. Studies like these can only help doctors and patients to discuss such topics more openly.

In reality, any medication will come with potential risks and benefits.

Source: Zethraeus N, Dreber A, Ranehill E et al. A first choice combined oral contraceptive influences general well-being in healthy women - a double-blind, randomized, placebo-controlled trial. Fertility and Sterility. 2017.

See Also:

How Does Birth Control Work?

Why You Should Take The Pill At The Same Time Every Day