The Surprising Impact of Synthetic vs. Natural Estrogen on Anxiety

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For millions of women, birth control is an essential part of their daily lives, providing them with the freedom to plan their families and careers. However, recent research suggests that the type of estrogen used in hormonal contraceptives may have a significant impact on anxiety levels, raising questions about the potential trade-offs between reproductive autonomy and mental well-being.

The Anxiety Trap: How Synthetic Estrogen in Birth Control May Be Affecting Your Mood

In the United States, nearly 13% of women aged 15 to 49 rely on oral contraceptives for family planning and other health benefits.1 While hormonal birth control has been a game-changer for women's reproductive rights, some users have reported experiencing mood-related side effects, such as anxiety. A recent study presented at ENDO 2024, the Endocrine Society's annual meeting, sheds light on a potential culprit: the type of estrogen used in these contraceptives.

Synthetic vs. Natural Estrogen: Does It Matter?

Researchers from the Prakapenka Lab at Midwestern University set out to investigate whether the type of estrogen in hormonal birth control influences anxiety-like behaviors. They compared the effects of synthetic ethinyl estradiol and natural estradiol valerate in a rat model study.

"It is plausible that estrogen type is a key player in mood or cognitive related side effects of hormone-based contraceptive use," said Alesia Prakapenka, Ph.D., an assistant professor in the Biomedical Sciences program at Midwestern University.2

The study randomly assigned 36 young adult female rats to one of three treatment groups: synthetic ethinyl estradiol plus dienogest, natural estradiol valerate plus dienogest, or a vehicle control. After four weeks, the rats underwent behavioral tests to assess spatial memory and anxiety-like behavior.

The Anxiety Connection

The results of the study were striking. Female rats treated with synthetic estrogen exhibited elevated anxiety-like behaviors compared to those that received the vehicle control or natural estrogen. While spatial memory remained similar across the three treatment groups, the researchers noticed a difference in navigation strategies.

Rats in the synthetic estrogen group were more likely to use a habitual turn strategy, which is associated with anxiety-like behaviors. This finding suggests that the type of estrogen used in hormonal birth control may indeed play a role in the development of anxiety-related side effects.

"Altogether, our findings support the notion that estrogen type matters for behavioral outcomes associated with contraceptive use, identifying estrogen type as a potential clinical tool for management of behavioral side effects in females," said Abigail Hegwood, M.S., the study's lead author.2

Balancing Contraception and Mental Well-Being

The link between synthetic estrogen and increased anxiety in this animal study raises important questions for women and healthcare providers alike. While hormonal birth control remains an essential tool for family planning and managing various health conditions, it is crucial to consider the potential impact on mental well-being.

Women who experience anxiety or other mood-related side effects while using hormonal contraceptives should not hesitate to discuss their concerns with their healthcare provider. In some cases, switching to a different type of birth control or exploring non-hormonal options may help alleviate these symptoms.

It is important to note that every woman's experience with hormonal birth control is unique, and what works for one person may not work for another. Open communication with healthcare providers and a willingness to try different options can help women find the best balance between contraceptive effectiveness and mental well-being.

The Future of Birth Control Research

The Prakapenka Lab's findings underscore the need for further research into the relationship between estrogen type and anxiety in humans. As more studies explore this connection, healthcare providers may be better equipped to tailor birth control prescriptions to minimize the risk of mood-related side effects.

Additionally, the development of new contraceptive methods that prioritize both efficacy and mental well-being could provide women with more options to suit their individual needs. By investing in research and innovation, the scientific community can work towards a future where women no longer have to choose between reproductive autonomy and emotional well-being.


The link between synthetic estrogen in birth control and increased anxiety in female rats is a compelling finding that warrants further investigation in human studies. As we continue to unravel the complex relationship between hormones and mental health, it is essential to empower women with the knowledge and resources they need to make informed decisions about their contraceptive choices.

By acknowledging the potential trade-offs between contraceptive effectiveness and emotional well-being, and by working towards more personalized birth control options, we can help ensure that women have access to the tools they need to lead fulfilling, healthy lives on their own terms.

To learn more about natural alternatives to synthetic estrogen, read Out With Synthetic Estrogen, In With Natural Black Cohosh For Safer Menopause Care


1. Daniels, K., and Abma, J. C. 2019. "Current Contraceptive Status Among Women Aged 15-49: United States, 2015-2017." NCHS Data Brief, no. 327. Hyattsville, MD: National Center for Health Statistics.

2. Hegwood, A., and Prakapenka, A. 2024. "Synthetic Estrogen in Birth Control Linked to Anxiety." Abstract presented at ENDO 2024, the Endocrine Society's annual meeting, Boston, MA, June 2-5, 2024.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.

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