Evidence Linking Depression and Contraceptive Implants

Gynecology consultation about contraception

Many women on hormonal contraception complain of mood changes including depression. This common complaint includes women using the contraceptive implant, a synthetic progestin-only method. There appears to be some evidence that there might be a link between the implant and depression, but the data is not yet definitive.

Hormonal Birth Control Implants and Depression

Although a direct cause and effect is unclear, available information suggests a connection between hormonal contraceptive implants and depression.


Nexplanon is the current version of the etonogestrel-containing contraceptive implant in the United States. The manufacturer lists mood swings and depressed mood as common side effects of the hormonal birth control method. It doesn't state the degree of risk for depression, but the evidence is likely from previous studies on Implanon.


The possible association with depression is also mentioned in the drug information details for the implant, Implanon, the previous version of Nexplanon. In premarket clinical trials for this device, there was a four to thirteen percent chance of an adverse effect on mood, including depression and anxiety.

Studies on Various Hormonal Contraception and Depression

Studies on a connection between various types of hormonal contraceptives and depression give conflicting or inconclusive results. Most of the past studies are criticized for being poorly designed.

More recently, a large, well-designed Danish study on the subject was published in 2016 in JAMA Psychiatry. The researchers found:

  • An increased association between depression and women who used a variety of hormonal birth control, especially in adolescents.
  • For each hormonal contraceptive method the women used, the increased risk for a new depression diagnosis or a new prescription for an antidepressant was small.
  • The risk for depression was higher for girls and women using a progestin contraceptive implant or other progestin-only methods, such as the IUD and the vaginal ring, than those taking combined estrogen-progestin birth control pills.

The authors suggest that the mechanism for mood changes and depression might be through the effect of female hormones, especially natural progesterone and synthetic progestins, on brain neurohormones that control mood, such as serotonin.

More Studies Needed

There appears to be an increased risk for depression in women using the contraceptive implant, but the data is not yet certain. More studies are needed to verify this association and the degree of risk. Discuss the benefits and the pros and cons of the implant with your doctor, especially if you have a history of depression or mood swings.

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Evidence Linking Depression and Contraceptive Implants