We’ve all heard the jokes about how women tend to be “moody” and “hormonal,” especially when it comes to PMS. Often any sign of emotion is quickly explained away by hormone fluctuations. However, while hormones do affect our mood, mental-health diagnoses such as depression and anxiety are more than just moodiness or hormone fluctuations. And with depression affecting women at a rate almost two times greater than men (5.5 percent vs. 3.2 percent), it is an issue that deserves our attention.

Depression is characterized by a depressed mood, feelings of hopelessness, loss of interest, changes in appetite, changes in sleep patterns, changes in energy, difficulty concentrating, and thoughts of death, suicide, or suicide attempts. And there are many factors that contribute to someone developing depression or worsening depression. Genetics, stress, and environmental changes are generally known as risk factors. Oral contraceptives might not be something you’d think to include on that list, but the birth-control Pill has been identified as one of several medications that may cause depression.

Even though depression is listed as an “uncommon” but serious side effect of oral contraceptives, it is often dismissed as a real possibility when it comes to taking the Pill. But with 62 percent of women in the United States taking some form of birth control, according to the Centers for Disease Control and Prevention (CDC), and with the Pill (oral contraceptives) being the most common form of birth control used, should we take it more seriously?

A 2017 study published in The American Journal of Psychiatry that took place in Denmark found that the use of hormonal contraception (such as oral contraceptives) was associated with an increased risk for depression and suicide attempts compared to those women who were not taking hormonal contraception. Additionally, women who were taking oral contraceptives were 23–34 percent more likely to be diagnosed with depression. Use of IUDs, the study found, was associated with depression across all age groups. While this doesn’t mean that every woman who takes hormonal birth control will develop depression, it does mean that doing so may put some women at risk for developing depression.

Some doctors say that the benefits of oral contraceptives outweigh the risks or negative side effects of taking them, arguing that the percentage of women likely to be affected is so small that most women won’t be affected. However, the risk of depression, among the other possible“serious” side effects of oral contraceptives, is not something to take lightly. If you are a woman who is at risk for developing depression, the small chance of developing this serious side effect matters. And even if depression is not a known pre-existing risk, we know that, according to Harvard Medical School, women, in general, are at a greater risk for developing depression than men.

Listening to Your Body

It’s important to underscore here the importance of monitoring your mental health and knowing how different medications and lifestyle changes can impact your mental health. For example, in an article for The Guardian, Alice Roberts writes how she experienced an increase in mood swings and depressive symptoms when she took a certain type of oral contraceptive. In an interview with the lifestyle website, GOOP, Dr. Maggie Ney, says that it’s important to know your body. If you recognize any changes in mood, don’t dismiss them. Bring them up to your doctor who can help you figure out what might be affecting your mood.

You know your body best. Don’t be afraid to bring up your concerns to your doctor or therapist. When my psychotherapy clients report a significant change in mood, I always ask my female clients if they have started any new medication or experienced any significant lifestyle changes. Don’t be afraid to speak up.

While great strides have been made in studying mental-health issues unique to women, there is still a great deal of work that needs to be done. Further studies are needed to help women be informed of the risks and benefits of their options when making decisions related to their physical and mental health. Women deserve to have all of the resources they need readily available and not buried in research papers and professional jargon. Knowing your risk factors for depression and other mental-health diagnoses, and how your mental health may be impacted by the medications you take is a crucial part of taking control of your mental and physical health. Empower yourself by working with your healthcare professional to identify your risk factors and by making decisions that increase your physical and mental wellbeing.