The pill and other forms of hormonal birth control can affect mood and premenstrual syndrome (PMS) symptoms. Whether this is a positive or negative effect depends on the person and the hormones involved.

Some people swear that hormonal birth control messes with their moods and causes PMS, while others report the opposite. So which is it?

For answers, we dug into the research and reached out to Nicole Williams, MD, a board certified gynecologic surgeon and the founder of the Gynecology Institute of Chicago.

According to Williams, hormonal birth control is more likely to help PMS than worsen it.

“Although I have many patients concerned that taking a hormonal pregnancy suppression medication will cause or worsen PMS or premenstrual dysphoric disorder (PMDD), exactly the opposite is true,” Williams says.

FYI, PMDD is a much more severe form of PMS that’s considered a chronic condition.

PMS is a combo of physical and emotional symptoms that some people experience before the start of their period. The symptoms can range from mild to severe, and they usually go away after your period starts.

Physical symptoms may include:

Emotional or mental symptoms may include:

Most of the research centers on the combination pill, but any type of hormonal birth control can potentially have an effect on mood and PMS symptoms.

“If [you’re] taking a hormonal medication that keeps estrogen and progesterone levels at a steady state, it’s far less likely that you’ll experience the massive shifts that happen naturally, causing PMS,” Williams says.

“In fact, there are some hormonal birth control pills that are made specifically to combat the symptoms of PMS,” she adds. “Technically, any birth control that maintains hormones in a steady state should help.”

The time between uses appears to be what does it, thanks to that dip in estrogen during your week off.

By “week off,” we’re talking about the week of placebo or sugar pills at the end of your pill pack or the week you don’t wear your birth control ring.

“PMS symptoms occur primarily when estrogen levels drop from their peak,” Williams says. “When you’re hormonally controlled, even during the placebo week, the drop is far less. So the symptoms are either very mild or nonexistent.”

“I do, however, have a few patients who choose to skip the placebo pills or ring-free week because their PMS symptoms are particularly severe,” she adds.

If you want to avoid the time off and subsequent estrogen nosedive, you could consider an extended or continuous dose birth control pill.

With extended or continuous cycle birth control, your hormone-free intervals would only happen 1 to 4 times per year.

Results from studies into the use of extended-cycle birth control for PMS and PMDD have been mixed, but there’s some evidence that an extended regimen can be an effective way to reduce symptoms.

No matter what the research says, if your symptoms flare up during your week off, it may be worth asking your prescribing doctor or another healthcare professional about extended or continuous dosing.

Optum Now is operated by RVO Health. By clicking on this link, we may receive a commission. Learn more.

There’s no way to know for sure. However, hormonal birth control is considered to be more likely to help PMS symptoms than worsen them.

That said, everybody’s different. Some people find that some symptoms get better while others get worse. With so many methods and brands to choose from, you can probably find an option that works for you with a little trial and error.

Being upfront with your prescribing doctor or another healthcare professional about your concerns and symptoms can help narrow down your options.

Tracking your symptoms will help you figure it out. You can try:

  • writing them down in a journal
  • tracking them with an app
  • using a printable tracker (like this one from the International Association For Premenstrual Disorders)

Keeping a record of your symptoms can help you and your healthcare professional spot patterns that can pinpoint or rule out your birth control as the culprit.

Hormonal birth control is mostly well tolerated. Even though side effects can happen, they’re generally mild. They tend to resolve within 2 to 3 months once your body adjusts to the medication.

The side effects you might notice after starting hormonal birth control include:

  • headache
  • chest tenderness
  • nausea
  • spotting

Most symptoms are mild enough that you may be able to ride them out or manage them with treatment at home, including taking ginger or dimenhydrinate (Gravol) for nausea and OTC pain relievers for headaches.

Birth control shouldn’t make you sick or interfere with your ability to function. If you find the side effects disruptive, talk with a healthcare professional.

Hormonal birth control is more likely to help PMS symptoms than make them worse, but that’s not the case for everyone.

If you’re worried about birth control making your symptoms worse, you have other options. Talk with a healthcare professional to find the best fit.