The Most Common Side Effects Of An IUD: Depression, Uterine Cramping, And More

Reviewed by Melinda (Santa) Gladden, LCSW

Published 06/24/2022

Birth control has long been lauded as one of the most important discoveries for women, as it afforded women freedom that is more sexual and a more significant say in their reproductive health and habits. That being said, birth control—and hormonal birth control, in particular—is not without its risk and has been linked to many common side effects. One of the most pressing, though not the most common, is the increased risk of developing mental health issues, including depression. What are the most common side effects of an IUD?

What Is An IUD? 

Understanding precisely what an IUD is and does is essential to understand how it has the potential to influence mental health. The term “IUD” stands for “Intrauterine Device,” and is so named because it is a birth control device that is literally inserted directly into a female’s uterus. This method is considered an ideal birth control method because it provides direct interference into the fertility cycle, and does not require the consistency and painstaking attention required of the pill. Not everyone is considered a candidate for an IUD and women’s health providers will typically take a detailed background and history to make sure the physical health of a woman is receptive to implanting an IUD.

There are two types of IUDs: copper IUDs and hormonal IUDs. Hormonal IUDs are inserted and release hormones into the uterus in order to prevent pregnancy, while copper IUDs do not emit hormones, but instead utilize their structure and natural properties to prevent the joining of sperm and egg. Although copper IUDs come with their own potential drawbacks and possible side effects, the side effects that most commonly accompany birth control are due to the hormones used in contraceptives, such as the hormonal IUD and oral contraceptives.

IUDs are increasingly seen as the best type of birth control, because they offer a long-term solution to birth control needs, and are relatively inexpensive, when compared to a monthly pill prescription. IUDs make up 3-7% of the contraceptives used today, and continue to grow in popularity. Although they are extremely useful and effective in preventing pregnancy, with a success rate of 99.2-99.8%, they are new enough that many people are unfamiliar with them or leery of the prospect of implanting a device within their bodies.

Birth Control, Hormones, And Mental Health 

Although people may not immediately associate mental health, hormones, and birth control, they are actually closely linked. A preliminary investigation into potential side effects of birth control reveals a known linked between mood changes, mental health, and birth control: many birth control methods specifically list mood changes and mental illness as potential side effects of any type of hormonal birth control. These links, though somewhat known, are often not openly discussed or closely evaluated, leaving many women confused, bewildered, and overwhelmed by unexpected mood changes and mental health difficulties after starting hormonal birth control, including hormonal IUDs.

The onset of declining mental health has been tied specifically to hormonal birth control, such as hormonal IUDs, but there are often other factors involved, such as existing risk factors. Women who have a history of mental illness; including depression and anxiety, may be at increased risk to develop depressive symptoms following contraceptive use. Although it should be a matter of course to discuss mental health history before selecting a birth control method, the links between mental health and hormonal birth control are still not widely known or understood, and some physicians may not know enough about the links to speak to their patients about the increased risks of using hormonal birth control with a personal or familial history of mood disorders. If mood changes are present, but you are unsure if depression is at play, an online depression quiz can help clarify some of the things you may be feeling.

Common Side Effects Of An IUD: Physical Symptoms 

Physical side effects of IUDs are not typically linked to mental health, but they certainly exist. The most prolific symptom is cramping, ranging from small uterine cramps when the IUD is initially inserted, to long-term, regular cramping that can worsen and improve like an ebb and flow over time. In some cases, cramping is linked to improper insertion of the IUD, in others it is an indication of a poor match, and in still others, it is a standard response that will fade as the body grows accustomed to the IUD.

The hormonal IUD is linked to an increase in pain and discomfort for the first 6 months after insertion as well as an increase in the duration and unpredictability of menstruation. In some users, the loss of a period altogether has been reported. The copper IUD is linked to ongoing changes to menstruation, including increased pain during menstruation and increased volume of blood during menstruation. Although both of these potential side effects are typically seen as minor in comparison to not using any form of birth control at all, the prospect of additional pain and discomfort during a period can dissuade some females from using the IUD.

Hormonal IUDs can also be blamed for other physical symptoms, such as the onset of adult acne, weight gain, and bloating. These side effects are not guaranteed, but are common side effects of any form of hormonal birth control. These have the potential to contribute to depressive symptoms, particularly if a great deal of self-esteem is wrapped up in appearance, or weight is a long-standing issue for someone who has just begun using hormonal birth control. While they seem unrelated, the many side effects associated with hormonal IUDs can all interact with one another and compound issues.

Common Side Effects Of An IUD: Mental And Emotional Impact

The link between IUDs and mental or emotional upset are numerous. Because hormones have a substantial impact on overall health and wellness, and are intrinsically involved in mood and mental health, hormonal birth control has the potential to interfere with typical mental health and mood function. Although the studies regarding depression and IUDs are typically small and not well designed, there is at least one reputable study demonstrating a reliable and distinct connection between hormonal birth control and the onset of depression, suggesting that hormonal birth control can be at the root of declining mental health—particularly when depression is involved. 

Oral contraceptives have been linked to mood changes, including depression and greater feelings of anxiety or irritability, which may extend to hormonal IUDs; because hormone changes are at the root of oral contraceptive use and mood changes, it is possible that hormonal IUDs can have similar effects, and create substantial mood changes, including anxiety, depression, and increased irritability.

Because hormonal changes have the potential to interfere with and influence emotional behavior, some mood shifts and changes can be expected once a hormonal birth control method has begun. This does not necessarily mean that depression, anxiety, or any other clinically diagnosed mood disorders will develop following the use of hormonal birth control, but it does mean that it may be wise to expect some amount of emotional change or distress following hormonal birth control use. These changes can be small, such as an increased level of irritability or an increased emotional response to triggers, or can morph into more severe changes, such as qualified mental disorders.

IUD And Depression: Next Steps

Learning that your depressive symptoms are being caused by your birth control can be overwhelming, but typically the best course of action is speaking with your doctor. Your doctor can identify the likelihood of your birth control being at the root of your depressive symptoms, and can identify any next steps that need to be taken—including the removal of your IUD. Although IUDs have been hailed as an ideal form of birth control, they do not work for everyone, and someone who reacts strongly with mental illness may need to consider another form of birth control.

Conversely, if the IUD is at the root of depressive symptoms, but is otherwise working well and is still the ideal form of birth control for someone, antidepressants may be considered, or another type of therapy used to ease depressive symptoms. Because birth control can be an important part of a woman’s reproductive and sexual health, not all women who experience depressive symptoms are willing or able to forego hormonal birth control altogether. Speaking with a mental health provider can lead to therapeutic intervention, while speaking with a general health practitioner could lead to enlisting a new type of hormonal birth control, or switching to a new type of birth control altogether.

Although it can be straightforward and simple to take control of reproductive and sexual health, the process can be muddied by the addition of mental health issues, including depression and anxiety. No one should have to choose between reproductive health and mental health, so speaking openly and often with healthcare providers about any symptoms experienced while on hormonal birth control is essential to maintaining overall health, and making sure IUDs and mental health are working synergistically.