Can Birth Control Cause Fatigue? What the Science Says

Does Birth Control Make You Feel Fatigued When You First Start? Here’s What the Research Says

While some people have reported feelings of fatigue upon taking birth control, the research is not conclusive. Conversely, some people who take birth control report having the opposite experience, noticing improved sleep and enhanced energy levels.

So, what are we to make of this?

Some birth control options do list fatigue as a potential side effect. This is true specifically of hormonal birth control, which is often the main culprit when it comes to side effects related to birth control.

Additionally, a person may opt to take birth control for reasons separate of contraception. For example, women experiencing menstrual cycle irregularities may take birth control to bring their hormones into balance. If birth control offers relief from debilitating PMS symptoms, it may, in turn, improve or alleviate disruptions to sleep.

Conflicting research on hormonal contraceptives and sleep

Hormonal contraceptives, a type of birth control that provides hormones to prevent pregnancy, have been found in some studies to negatively impact sleep. However, the research is conflicting and therefore inconclusive.

In a 2022 study, women who used hormonal birth control self-reported more instances of sleep disturbances and a 17% greater likelihood of coming up short on recommended sleep hours compared to those who used non-hormonal birth control.

Another study showed that oral hormonal birth control can lead to sleep disturbances but increase sleep duration. Women taking oral contraceptives during this study had significantly more stage-2 sleep (non-REM) during the luteal phase while taking the pill, compared to naturally cycling women who experienced more stage 3 sleep, or deep sleep, which experts believe is critical for restorative rest.

Although the research is conflicting, a consistent finding across studies is that oral contraceptives do not appear to affect sleep efficiency.

Progesterone, the hormone usually dominant in the luteal phase of the menstrual cycle, is known for impacting sleep. It does so by increasing melatonin secretion and stimulates GABA-A receptors, which can help induce calm. One observational study compared the impact on sleep duration of different forms of oral contraceptives compared to a control group (women not taking these medications). The types of oral contraceptives that resulted in the longest nightly sleep duration were the progesterone derivatives, which resulted in longer sleep than both estrogen-based contraceptives and no oral contraceptives.

What forms of birth control can cause fatigue?

There are many different types of birth control available – some that affect your hormones directly, and others that do not.

Overview of birth control methods

Non-hormonal birth control include:

• Barrier methods (condoms, vaginal gel, cervical caps/diaphragms, and sponges-with-spermicide)
• Intrauterine device (copper IUD)
• Natural family planning or the Fertility Awareness Method (cycle tracking using BBT or Basal Body Temperature, tracking LH surge, and figuring out fertile windows, without the use of hormonal or barrier method contraception)

The fertility awareness approach can be used for pregnancy prevention, avoiding conception, to gain a better understanding of menstrual cycle and health. Non-hormonal methods of birth control have varying levels of effectiveness, and none of them work 100% of the time.

Forms of hormonal birth control include:

• Oral contraceptives (often referred to collectively as “the pill”, but including estrogen, progestin, or both, as well as emergency contraception options)
• Intrauterine device (levonorgestrel-containing IUD)
• Vaginal ring
• Transdermal patch (also called a skin patch)
• Contraceptive implant
• Medroxyprogesterone injection (birth control shot)

Types of hormonal birth control and their potential to cause fatigue

Hormonal birth control options contain either estrogen-only, estrogen plus progestin (synthetic progesterone), or progestin-only. Not everyone responds the same, but women who take hormone-based contraceptives may be more likely to have insomnia or daytime sleepiness compares to those who cycle naturally. If this is a concern, you can talk to your OB/GYN about low-hormone birth control options, or even non-hormonal options.

How birth control can affect energy levels

Hormonal contraceptives can lead to depletion of certain key nutrients, including:

• B vitamins (folic acid, B2, B6, B12)
• Vitamin C
• Vitamin E
• Magnesium
• Selenium
• Zinc

The copper IUD, a non-hormonal contraceptive, can negatively impact zinc levels due to the delicate balance between zinc and copper in the body.

These nutrients are all essential for various metabolic processes and energy production. So it is possible that these forms of birth control taken over a longer period of time could lead to fatigue, although studies have yet to test this specifically.

If taking hormonal contraceptives, consider supplementation or increased nutrient intake through adjustments in food intake in order to replace and maintain adequate nutrients. Working with a registered dietitian experienced in the impact of birth control on nutrient levels may help.

Potential reasons for fatigue when on birth control

As discussed above, oral contraceptives have been linked to deficiencies of essential vitamins and minerals. These can affect your body’s ability to function at an optimal level and even possibly contribute to feelings of fatigue and daytime sleepiness. If you do experience such deficiencies, a supplement routine might be a good option for you – just be sure to talk to your medical provider first.

Other potential causes of fatigue

While birth control may lead to fatigue, other nutrition and lifestyle factors can also contribute. These could include:

• Lack of sleep
• Dehydration (which includes water and electrolyte intake)
• Excessive sugar intake
• Lack of regular physical activity
• Frequent alcohol use
• Emotional stress
• High caffeine intake

Additionally, fatigue can be a sign of other underlying issues, so be sure to address concerns with your doctor. These can include iron deficiency, B vitamin deficiency, thyroid issues, sleep issues, and more.

Weighing the benefits of birth control vs. the side effects

Birth control may be recommended for various reasons, whether for pregnancy prevention, reducing symptoms related to menstrual cycle dysfunction, or acne.

For anyone considering the use of birth control, it’s important to understand the potential risks and side effects. These vary depending on the type of birth control used and your individual health and genetic factors.

Most side effects of birth control are mild and either disappear as the body adjusts to the medication, or are resolved by switching to a different form.

Some common side effects of birth control are:

• Breakthrough bleeding
• Nausea
• Headache
• Cramps
• Breast tenderness
• Reduced libido
• Weight changes

Health conditions or tobacco use can increase the risk for side effects or complications, so be sure to talk with your medical provider about risks and use.

Managing Birth Control-Induced Tiredness

Since fatigue may occur for some people as a result of taking birth control, let’s discuss what you can do to manage this and get your energy back.

Changing birth control methods

As discussed previously, there’s quite a few types of birth control, from various hormonal options to several non-hormonal options. Some people may not feel best on certain types of birth control. Talk to your doctor if you experience any negative symptoms and discuss the potential of changing to a method of birth control that may better suit you. Also discuss with your doctor before changing birth control to ensure a safe transition. Some changes require time for the body to adjust.

Lifestyle changes to combat fatigue

Sometimes nutrition and lifestyle changes can help to counteract the fatigue caused by some types of birth control.

Prioritize getting adequate sleep. In addition, consider speaking with your healthcare provider about supplements that can offset potential nutrient depletion from contraceptive use. Consider asking about B-complex or a high-quality multivitamin that contains your essential vitamins and minerals. Ask your provider about additional magnesium, which can get depleted from birth control and may not always be included in multivitamin formulations.

Supplements never replace a healthy diet, so it’s important to ensure that you’re consuming a balanced, nutrient-rich with plenty of fruits, vegetables, whole grains, healthy fat, and protein.

When to speak to your doctor

If you’re feeling a little off, it’s important to keep track of how your symptoms are affecting your life. If you’re consistently feeling fatigued, get in touch with your doctor. Discuss concerns about the effects of birth control on your energy levels. Be open about your health history and current lifestyle.

A doctor can run lab tests to figure out whether you’re experiencing any underlying condition or have a nutrient deficiency and come up with a treatment plan tailored to your needs. Such a plan may include switching your birth control.

The Bottom Line

Nobody likes to feel fatigued. If you’re constantly feeling tired, it’s important to get down to the root cause. Talking to your doctor can help you do that. Your birth control may be part of the problem, but that’s far from certain. Considering other possible causes of fatigue is important, such as nutrition and lifestyle factors. Of course, you can always switch to a contraceptive option that you and your doctor feel will work better for you. It’s possible that non-hormonal methods of birth control are less likely to contribute to fatigue. Don’t hesitate to ask questions and seek guidance.