Sexual Health Birth Control Hormonal Methods Can Birth Control Make You Tired? By Heather Jones Heather Jones Facebook Twitter Heather M. Jones is a freelance writer with a focus on health, parenting, disability, and feminism. Learn about our editorial process Updated on April 27, 2022 Medically reviewed by Monique Rainford, MD Medically reviewed by Monique Rainford, MD Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Research Hormonal Birth Control PMS Other Reasons FAQs Some people who menstruate have noticed they feel tired when taking hormonal contraceptives like the birth control pill. Fatigue and menstruation are in fact linked, but it's more complicated than simple cause and effect. Read on to learn more about how hormones, menstruation, and birth control can affect sleep and tiredness. Maskot / Getty Images What the Research Shows There is conflicting research on how hormonal contraceptives affect sleep and fatigue. A 2020 study found that people who used hormonal contraceptives had subjectively worse sleep and more self-reported sleep problems, including insomnia and daytime sleepiness, than those not using it. Progestogen-only contraceptives appeared to be worse for sleep than combined hormonal birth control. The authors of this study noted that these results contradict evidence that shows female sex hormones, especially progesterone, have hypnogenic effects (induce sleep). They hypothesized that the timing of taking the pill may play a factor, suggesting that taking it in the morning may lead to daytime sleepiness, while taking it at night could promote sleep. They note that this is highly speculative and would need to be studied to confirm. In contrast, a 2012 study found that hormonal birth control was associated with improved sleep efficiency and lowered severity of sleep apnea (a sleep disorder that causes breathing problems during sleep). Many organizations, including Planned Parenthood and the U.S. Food and Drug Administration (FDA), do not include fatigue in their lists of common side effects of hormonal contraceptives. The FDA does mention tiredness as a side effect of emergency contraception (the "morning after pill"). Progestin vs. Progesterone Though the terms sound similar, progestin and progesterone are not the same:Progesterone: A hormone that is made in the ovariesProgestin: A synthetic form of progesterone Hormonal Birth Control May Be the Culprit How might hormonal birth control induce tiredness? The two major female sex hormones, estrogen and progesterone, are thought to influence sleep. Progesterone is believed to be particularly sleep-inducing. Estrogen, though less studied in this area, may also have a sleep-inducing effect, as suggested by estrogen replacement therapy, improving the sleep-related complaints of perimenopausal people. The use of hormonal birth control may indirectly affect sleep and wakefulness. Though more research is needed, the use of hormonal contraceptives has been associated with depression. Fatigue is a known symptom of depression. While the research is conflicting, some people who menstruate report feeling fatigued while on hormonal birth control, but it improved when they stopped taking that specific method. Are You Prone to Fatigue With Your Period? If you are prone to fatigue during your menstrual cycle, discuss this with your healthcare provider before starting hormonal birth control. Types of Hormonal Birth Control Types of hormonal contraceptives include: Birth control implant Hormonal intrauterine devices (IUD) Birth control shot/injection Combined oral contraceptives (estrogen and progestin) Progestin-only pills ("mini pills") Skin patch Vaginal ring If you want a non-hormonal birth control option, non-hormonal IUDs are available, as well as barrier methods. How to Switch Birth Controls If you want to switch birth control pills, talk to your healthcare provider. There are different strategies to choose from, depending on the type of pills you are using. Options for switching between combination pills: Finish the entire pack, including the fourth week placebos, from your old method. Start the pack of the new method on the day you would have started the first day of the old pack. Or, Start the new combination pill right away, but if it has been more than five days since menstrual bleeding started, use a backup method (such as a condom) or abstain from sex for the next seven days. Switching from combination pills to mini-pill: Take your mini-pill immediately, abstain from sex or use a backup method for the next two days if it has been more than five days since you experienced menstrual bleeding. Switching from mini-pill to combination pill: Start the combination pill right away, but if it has been more than five days since you have had menstrual bleeding, abstain from sex or use a backup method (such as a condom) for the next seven days. Premenstrual Syndrome (PMS) The menstrual cycle can also affect sleep and wakefulness. People who menstruate can experience increased sleepiness and insomnia during the premenstrual period (also called luteal phase). People with premenstrual syndrome (PMS) can experience symptoms such as: Depression Irritability Difficulty concentrating Anxiety Social withdrawal Insomnia Fatigue Breast tenderness Bloating Headache Hands/feet swelling Aches and pains Changes in thirst and appetite Gastrointestinal symptoms and abdominal pain Premenstrual dysphoric disorder (PMDD), a more serious and disruptive form of PMS, can come with symptoms in addition to those seen in PMS, including: NervousnessAgitationAngerSevere fatiguePoor sleepConfusionMemory problemsMoodinessParanoiaEmotional sensitivityCrying episodes Other Reasons for Fatigue Whether or not you are on hormonal birth control, fatigue that is recurrent, intrusive, or not relieved by rest should be taken seriously and discussed with a healthcare provider. Fatigue can be a sign of a number of conditions, including: Celiac disease Chronic fatigue syndrome Depression Diabetes Generalized anxiety disorder (GAD) Iron deficiency anemia Mononucleosis Restless legs syndrome Sleep apnea Hypothyroidism Reasons for Feeling Sleepy All the Time Summary Some people who menstruate report feeling tiredness or fatigue while taking hormonal birth control. Research is conflicting about whether or not hormonal contraceptives can cause fatigue. Potential reasons include sleep disruption, association with depression, and the sleep-inducing effects of sex hormones, such as progesterone. Fatigue can be a symptom of many other conditions, including PMS, anemia, hypothyroidism, depression, and sleep disorders, such as sleep apnea. A Word From Verywell Birth control is not one-size-fits-all. If you feel your birth control is making you feel tired, talk to your healthcare provider about other available options. Regardless of whether or not you are taking hormonal birth control, it's important to speak with your healthcare provider if you are experiencing fatigue in case it is a symptom of something more serious. Frequently Asked Questions How does hormonal birth control work? The birth control pill prevents pregnancy by:Changing hormone balance to prevent the release of an egg (ovulation)Thickening cervical mucus, making it harder for sperm to enter the uterusThinning the lining of the uterus, making it less likely a fertilized egg will implant What are the side effects of birth control? Some common side effects of hormonal birth control include:Spotting/bleeding between periodsBreast tendernessNauseaHeadache 14 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Bezerra AG, Andersen ML, Pires GN, et al. Hormonal contraceptive use and subjective sleep reports in women: an online survey. J Sleep Res. 2020;29(6). doi:10.1111/jsr.12983 Hachul H, Andersen ML, Bittencourt L, Santos-Silva R, Tufik S. A population-based survey on the influence of the menstrual cycle and the use of hormonal contraceptives on sleep patterns in São Paulo, Brazil. International Journal of Gynecology & Obstetrics. 2013;120(2):137-140. doi:10.1016/j.ijgo.2012.08.020 Planned Parenthood. What are the side effects of the birth control pill? U.S. Food and Drug Administration. Birth control. MedlinePlus. Progestin-only (norethindrone) oral contraceptives. American College of Obstetricians and Gynecologists. Progestin-only hormonal birth control: pill and injection. Bezerra AG, Andersen ML, Pires GN, Tufik S, Hachul H. Effects of hormonal contraceptives on sleep - a possible treatment for insomnia in premenopausal women. Sleep Science. 2018;11(3):129-136. doi:10.5935/1984-0063.20180025 National Health Service. 10 medical reasons for feeling tired. Skovlund CW, Mørch LS, Kessing LV, Lidegaard Ø. Association of hormonal contraception with depression. JAMA Psychiatry. 2016;73(11):1154. doi:10.1001/jamapsychiatry.2016.2387 Alspaugh A, Reibel MD, Im EO, Barroso J. “Since I’m a little bit more mature”: contraception and the arc of time for women in midlife. Womens' Midlife Health. 2021;7(1):3. doi:10.1186/s40695-021-00062-7 Planned Parenthood. Birth control. American College of Obstetricians and Gynecologists. Premenstual syndrome (PMS). Johns Hopkins. Premenstrual dysphoric disorder (PMDD). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Hypothyroidism (underactive thyroid). By Heather Jones Heather M. Jones is a freelance writer with a strong focus on health, parenting, disability, and feminism. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit