Doctor: Birth Control Causes Anxiety, Depression, And Heart Issues

When I called Dr. Gerard Abreo, a highly-regarded cardiologist in the Houston area, to ask him about the complications from birth control he sees in his practice, I fully expected to have a conversation mostly centered around blood clots. Blood clots (and pulmonary embolisms) certainly were part of the conversation, but they took a backseat to other, more common concerns — many of which had to do with (of all things, for a cardiologist) mental health. 

“You want to know what I see more than anything else in otherwise healthy young women, 18-25 years of age? Anxiety.” Abreo told me over the phone one Sunday afternoon. 

Anxiety and Heart Palpitations

I was stunned. Why, I asked, would anyone need to see a cardiologist for anxiety? Wasn’t that under the purview of a psychiatrist or psychologist? “Heart palpitations,” he responded. “Anxiety-related heart palpitations, caused by their birth control.” 

As Abreo explained to me, many of these young women are referred to him by their general practitioners. Heart palpitations — and inappropriate tachycardia — aren’t something to take lightly, even in otherwise healthy, young women, so patients experiencing palpitations are often referred to him for echocardiograms to find the source.

But, according to Abreo, the source is often their hormonal birth control — and his theory is based on data. We already know that hormonal birth control can demonstrably change women’s brains, so much so that it can negatively affect their ability to process fear and cope with stress. It’s not a stretch to see how either of those changes could contribute to increased anxiety and its side effects such as heart palpitations in birth control pill users.   

In fact, Abreo estimates that 95 percent of the referrals he receives for otherwise healthy young women suffering from heart palpitations are really just experiencing anxiety caused by their hormonal birth control. For example, he told me, “Four months ago, a 28-year-old, athletic, married, young lady came to me with palpitations with minimal exertion for the last six months.” He continued: 

She had been to several family physicians and still had the same complaint. Initially, on questioning and examining her, I found no medical reason for these palpitations. Then I happened to ask her if she used birth control. It was not documented in her chart, but she then told me she was currently on the injectable contraceptive Depo-Provera. She suddenly figured out that these palpitations started a week after the injection, and hence I did not do any [further] investigation for the heart but instead asked her to stop receiving any future injections, which she agreed to.

“A few weeks ago,” Abreo continued, “I saw her husband and her mother-in-law as new patients, and they were grateful for my advice, which had led to this young lady no longer experiencing palpitations and a complete resolution of her anxiety.” Abreo estimates that, unfortunately, less than 50 percent of his patients take his advice to discontinue their contraceptives in an attempt to get to the bottom of their anxiety-induced heart palpitations. 

High Blood Pressure

Abreo said the second most common birth control-related complaint he sees as a cardiologist is “high blood pressure.”

This one was not nearly as surprising to me as anxiety. However, while women with high blood pressure (i.e., hypertension) are often steered away from starting hormonal birth control, many are not informed that their birth control can cause high blood pressure. This is similar to how women with a family history of breast cancer are sometimes discouraged from taking hormonal birth control but are not told that birth control itself can cause breast cancer.

Estrogen-containing hormonal contraceptives specifically can cause high blood pressure because of the hormone’s effects on the cardiovascular system. In other words, it’s yet another wake-up call that hormonal birth control does so much more to women’s bodies than simply preventing pregnancy. 

Depression

The third birth control-related complication steers right back into mental health territory. “No. 3,” said Abreo, “is depression.” And the complaint these patients come in for? “Shortness of breath and chest pain.” Again, these patients are referred to Abreo so he can do an echocardiogram to rule out issues with the heart. Often what he finds has nothing to do with their (healthy) hearts and everything to do with their birth control. 

In fact, Abreo suspects that the vast majority of women on hormonal contraception “have some degree of depression and anxiety,” and these conditions can (and often do) “cause cardiac symptoms of palpitations and shortness of breath.”

“These are mistakenly diagnosed as panic attacks, and sometimes [as a result], women are unnecessarily put on beta-blockers to slow the heart, causing severe side effects of fatigue and tiredness,” he said.

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Abreo told me that when he suspects that birth control-induced depression might be the cause of his patient’s cardiac issues:

I encourage them to talk to their primary care providers and OB-GYNs about this, but I feel that most physicians do not want to admit these serious side effects because, in their opinions, [these effects] are not life-threatening but only affect the quality of life. But their anxiety and despair is so clinically and obviously visible that some of them come back to me and agree to stop the contraceptives.

Multiple high-quality, peer-reviewed studies over the past several years have found a strong link between hormonal birth control use and the development of depression. The link is especially strong when birth control is started in adolescence and in the first two years of contraceptive use in adult women. 

Blood Clots

With so much of the conversation revolving around mental health issues, Abreo didn’t even mention blood clots and pulmonary embolisms until the end of our conversation; he estimates they’re only about the fourth most common birth control-related issue he sees. Of course, these are among the deadliest birth control complications, cutting some unsuspecting young women’s lives all too short, to the devastation of their surviving family and friends.  

We also know that women often are not fully informed about birth control risks, and the blood clot risk is no different. In fact, as one researcher found, many women believe that if they’re under 35, of normal weight, and non-smokers, the blood clot risk doesn’t pertain to them. After conducting a survey, the researcher noted that “only one woman out of 311 could correctly identify all of the health risks associated with birth control pills.”

What Women Need to Know

Listening as Abreo described seeing young women with symptoms such as heart palpitations, shortness of breath, and chest pain, I couldn’t help but wonder how many of these young women were put on birth control as teens, for things as innocuous as acne or irregular periods. How many of them were put on it for health issues such as endometriosis and PCOS, for which they’ve never received help beyond the birth control Band-Aid? And how many are now dealing with the double whammy of thinking they have heart problems on top of everything else?

It drove home the point that birth control is bad medicine — “curing” nothing and causing all sorts of unexpected problems of its own.

We’ve made significant strides in communicating to women some of the risks of hormonal birth control, which is evidenced by the fact that many are seeking natural alternatives, such as fertility awareness methods for family planning and restorative reproductive medicine for treating the root cause of issues like painful cycles and infertility.

However, my conversation with Dr. Abreo made clear that there are still so many women out there suffering from the side effects of birth control. Sometimes all they need is someone —whether it’s a friend, family member, or a good doctor — to connect the dots for them and finally give them the confidence to kiss their birth control (and all the problems that come with it) goodbye.

Grace Emily Stark is a freelance writer with published work in multiple outlets, and she is the Editor of Natural Womanhood. Grace is also a current Ramsey Institute Fellow at the Center for Bioethics & Culture, and a former Novak Alumni Fund Journalism fellowship recipient. Follow her writing at GraceEmilyStark.com.