Does birth control cause tiredness?

In this article, we’ll do a quick dive into the mixed research available on hormonal birth control and fatigue, and explore why some women might experience this phenomenon while others may not. We’ll also share some information on the distinction between tiredness and fatigue, and what you can do to manage these symptoms — whether birth control is the root cause or not (nobody wants to feel sleepy all day, no matter what medications you’re taking).

Can hormonal birth control make you tired? 

Let’s get straight to it: although it’s possible that hormonal birth control can make you feel tired, there is currently a lack of strong evidence to support this connection and explain why this might happen to some users and not others. In fact, some people have reported feeling more energized once they started taking hormonal birth control.

Remember that hormonal birth control comes in various different forms — like the pill, intrauterine devices (IUDs), the implant, the depo shot, the patch, and the vaginal ring — and they all work in slightly different ways. With that in mind, it’s feasible that different methods could affect your energy levels in different ways.

So while it’s possible that your hormonal contraception method is causing you to feel more sleepy than usual throughout the day, it may be difficult for a doctor to determine if your fatigue is a direct side effect of the medication itself.

The science behind birth control and tiredness

Linking tiredness to hormonal birth control is difficult because more medical research is needed in this area. Let’s go through what’s currently available:

Recent studies in the United States [1] and Brazil [2] found that hormonal birth control users reported worse sleep and more sleep problems overall — like insomnia and fatigue — during the day than those who didn’t take hormonal birth control. In the Brazilian study, progestin-only oral contraceptives (the mini-pill) seemed to be worse for self-reported sleep quality compared to other combined oral contraceptives or progestin-only intrauterine devices.

On the other hand, a 2012 study showed that birth control was associated with less sleep apnea and less snoring, resulting in increased sleep efficiency [3]. Sleep efficiency is measured by comparing the time spent asleep to the time spent in bed. The faster you fall asleep when your head hits the pillow, and the less you wake up during the night, and the better your sleep efficiency. 

A clinical trial performed in 2015 tested combined oral contraceptives versus another solution to adult acne. In that study, sleep quality was monitored but the pill was not found to have a significant effect in that small sample [4].

The authors of the study in Brazil speculated that the time of day you take a daily hormonal birth control pill may be important due to the hypnogenic (sleepiness) effect of the body’s natural progesterone hormone that is mimicked by synthetic progestin. Basically, if you take it in the morning, you may feel more tired as the day goes on. If you take it at night, the sleepiness effect might feel more natural as you’re slowing down for sleep. They were clear that this was speculative and more studies are needed to confirm or deny this theory [2].

Ultimately, most major medical organizations like the United States Food and Drug Administration (FDA) don’t officially list fatigue or tiredness as a side effect of birth control. This means that researchers haven’t yet found enough evidence of birth control causing this symptom.

Fatigue vs. tiredness

Now that we’ve explored the limited research available on this topic, let’s get really specific on the definitions of fatigue versus tiredness so that you can have productive conversations about what you’re feeling with your doctor.

Words like fatigue, tiredness, sleepiness, and exhaustion are typically used interchangeably in everyday life (even in this article a few times!), but there are a few important distinctions to note so that you can feel more knowledgeable about what’s going on in your body.

While it’s normal to feel tired or sleepy after a busy day or poor night of sleep, chronic tiredness that doesn’t seem to go away with ample rest can be classified as fatigue. Fatigue is an unshakeable feeling of sleepiness and low energy that persists over a longer period of time, and it can mess with your mood, concentration, memory, and daily life. 

Being tired or sleepy is a temporary condition that will likely go away in a day or two with appropriate lifestyle changes (such as making sure you get enough sleep). If it persists beyond that and starts affecting your quality of life, that’s when things move into fatigue territory.

As many as one in three people in the United States often feel tired, even after a good night’s sleep. If this happens to you consistently, it may be a sign of an underlying medical condition, a lifestyle that’s draining you, and/or a poor reaction to an external stimulus like birth control [5].

How to know if fatigue is related to your birth control

Your ultimate question here might be, “what’s causing my fatigue and how can I treat it?” Chronic fatigue can be draining, so it’s important to identify the root cause with your doctor so they can help you feel better ASAP.

Again, while it’s not currently possible to directly link birth control and fatigue, better understanding of your individual symptoms may help you (and your health care professional) make connections. For example, tracking the timing of your fatigue symptoms throughout the day and month can help you see if patterns emerge over time. You can bring these findings to your healthcare professional to help inform your consultation [6].

You should also talk to your doctor if you’re experiencing any of the other potential side effects of birth control in conjunction with fatigue, as this may also indicate a link. These symptoms include:

• Acne
• Breast Tenderness
• Changes in bleeding patterns
• Headaches
• Mood swings
• Nausea
• Weight gain [7]

If these side effects are affecting your quality of life, talk to your doctor about exploring alternatives such as a lower dose, a different form of hormonal birth control, or a non-hormonal method like Natural Cycles.

Tips for managing tiredness caused by birth control (and other things)

In addition to talking to your doctor about switching birth control methods, there may be environmental or lifestyle factors contributing to your fatigue that you can address on your own. Below are some tips that may make a huge difference in your sleep quality no matter the cause:

• Make a cozy sleep space: Your bedroom can truly determine your quality of sleep. If you sleep with a light on, have loud noises outside of your bedroom window at night, or sleep on an uncomfortable mattress or pillows, you may not be getting the rest you need. Make sure the room is completely dark and cool, noises are limited, and your bed feels like a sanctuary at the end of the day.
• Move your body regularly: Any level of regular physical activity like workouts, taking the stairs, or even stretching throughout the day will help regulate your body. This can help you achieve deeper and more restorative sleep. Try to finish your workouts at least three hours before bed, and be careful not to over-exercise (e.g. working out more than six times a week), as that can make it more difficult to fall asleep and stay asleep [8].
• Set a sleep schedule: Do your best to go to bed and wake up at the same time each day (yes, even weekends) and aim for 6 to 9 hours of sleep.
• Limit alcohol and caffeine intake: Both of these substances can mess with your natural sleep rhythms, so try to consume these in moderation. It is especially recommended to avoid caffeine in the afternoon or evening.
• Eat well: Having a healthy diet has a host of benefits, including regulating sleep and preventing some of the chronic conditions mentioned above. Try not to eat too close to bedtime, as indigestion can cause sleep disturbances [9].

You may see your quality of sleep improve just by making one of these adjustments [5, 10], let alone the whole list. These holistic changes can help manage sleepiness symptoms, but remember to stick with them over time to maintain high-quality sleep.

What else could be causing tiredness/fatigue?

It’s worth noting that there are other potential causes of fatigue that may have nothing to do with hormonal birth control or lifestyle factors. Fatigue is associated with certain chronic health conditions, and may also be the result of circumstantial factors such as recent parenthood, bereavement, or lack of light exposure.

Fatigue has been linked to several chronic conditions, including:

• Diabetes: The abnormal fluctuation of blood sugar levels associated with diabetes can cause sudden energy level shifts throughout the day. Other symptoms of diabetes include being excessively thirsty, urinating very frequently (specifically at night), and losing weight. 
• Heart disease: If you have a heart condition, you may have abnormal or low blood circulation, which reduces the level of oxygen flowing through your body and leads to chronic fatigue.
• Thyroid disorders: Your thyroid helps regulate your metabolism. Whether you have an over- or underactive thyroid, a disruption in your metabolic rate can lead to fatigue.
• Mental health: There are strong links between fatigue and mental health issues like anxiety and particularly depression, as they often impact sleep quality and quantity. The emotional strain of depression can make everyday tasks feel entirely exhausting. There have been studies suggesting a link between hormonal birth control and developing depression symptoms, especially among younger women, so make sure to reach out for support from your loved ones and a health care professional if you think this may be the case for you. [11,12]
• Iron deficiency/anemia: If your fatigue is accompanied by heart palpitations, shortness of breath, and/or pale skin, this may indicate an iron deficiency.
• Sleep apnea: Characterized by waking up in the night gasping or choking, sleep apnea is a condition that leads to a lower quality of sleep and overall fatigue.

If no other symptoms or lifestyle changes accompany your fatigue and it persists for more than three months, it’s also possible that you have chronic fatigue syndrome (CFS). Together with the list above, these medical disorders can benefit from specialized attention and treatment, so make sure to talk to your healthcare practitioner to help you identify the possible causes in your case [5, 10].

When to see a doctor 

As we’ve mentioned throughout this article, if you seem to be making healthy choices and you’re still experiencing chronic fatigue that affects your quality of life (especially in conjunction with other symptoms), it’s probably time to talk to your doctor. They can do testing and subsequent treatment if needed for the health conditions mentioned above. 

If you believe your birth control is making you tired, they can also explore this with you and suggest alternatives. You can work together to lower the dosage if possible, or switch birth control methods altogether to find a better fit for you.

So, does birth control make you sleepy?

The short answer is maybe (frustrating, we know). Unfortunately, there is truly not enough scientific evidence at the moment to confirm or deny a link between hormonal birth control and tiredness. 

The good news is that there are still diagnosis and treatment options available that can help you feel more energized and regulated throughout the day. It’s important to listen to your body and track different activities and symptoms that may be related to your fatigue so that you can test the solutions mentioned above and see what works best. 

Go hormone-free with Natural Cycles

If you suspect that your hormonal birth control is causing fatigue, a non-hormonal option like Natural Cycles might be worth exploring. Natural Cycles is 100% hormone-free, and based on the science of your cycle so you can get to know your body better.

With a variety of temperature tracking devices available like a Bluetooth thermometer or integrations with wearables like the Oura Ring and Apple Watch, Natural Cycles syncs to your lifestyle. See if Natural Cycles is right for you today.