--- title: Does the combined oral contraceptive pill affect mood? | Niyora description: Yes, but effects vary by cycle phase. The pill causes small increases in anxiety and irritability between periods but improves depression in the days before m url: https://niyora.com/research/papers/combined-oral-contraceptive-use-is-associated-with-both-improvement-and-2017/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does the combined oral contraceptive pill affect mood? Randomised trial, 2017 # Does the combined oral contraceptive pill affect mood? Yes, but effects vary by cycle phase. The pill causes small increases in anxiety and irritability between periods but improves depression in the days before menstruation. Strong study design 202 healthy women (84 analyzed on pill, 94 on placebo) ## What they did A randomized, double-blind, placebo-controlled trial with 202 healthy women. Participants took either a combined oral contraceptive (1.5 mg estradiol and 2.5 mg nomegestrol acetate) or placebo for 3 cycles. Mood was measured daily using the Daily Record of Severity of Problems scale. ## What they found During the hormone-free interval, pill users had small but significant increases in anxiety (0.22 points), irritability (0.23 points), and mood swings (0.15 points) compared with placebo. However, in the 5 days before menstruation, pill users had lower depression scores (0.33 points lower) than placebo. Overall, 24.1% of pill users reported clinically relevant mood worsening versus 17.0% on placebo, but this difference was not statistically significant. Women with previous adverse effects from hormonal contraception reported greater mood worsening. ## What it means for you The pill affects mood in different ways at different cycle phases. For most women, changes are small, but some women are sensitive to hormones and can experience significant mood problems, which explains why mood concerns are a major reason women stop using the pill. 202 Healthy women enrolled 0.22-0.23 Point increase in anxiety and irritability 24.1% vs 17.0% Clinically relevant mood worsening with pill versus placebo ## About the study Original title Combined oral contraceptive use is associated with both improvement and worsening of mood in the different phases of the treatment cycle-A double-blind, placebo-controlled randomized trial Authors Lundin C, Danielsson KG, Bixo M et al. Journal Psychoneuroendocrinology Year 2017 Study design Randomised trial Participants 202 What was tested Combined oral contraceptive or placebo for 3 cycles Read the paper [doi.org/10.1016/j.psyneuen.2016.11.033](https://doi.org/10.1016/j.psyneuen.2016.11.033) ## Topics [Menstrual cycle and mood](https://niyora.com/research/topics/condition-cycle-mood/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Anxiety and tension](https://niyora.com/research/topics/symptom-anxiety/)[Irritability and anger](https://niyora.com/research/topics/symptom-irritability-anger/)[Oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Randomised trial, 2017 Does Sepranolone reduce symptoms of severe premenstrual syndrome (PMDD)? Cohort study, 2010 How do anxiety disorders differ across different life stages? Cohort study, 2025 How common is PMS in Chinese teenage girls, and what factors are linked to it? Randomised trial, 1995 Does fluoxetine help premenstrual dysphoria? Study, 2026 What are premenstrual syndrome and premenstrual dysphoric disorder? Study, 2025 Does anger get worse before your period? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗