You’ve just started a new birth control method. Your skin’s clearing up, your periods are lighter, and you’re protected from pregnancy. There’s just one problem: you’re tired. Really tired. But can your birth control be causing this?
There is research showing birth control can make you tired, but there’s also evidence showing it may improve your sleep, so that’s not a straightforward question.
Below, we’ll dive into what the research says so far, which types of birth control can cause tiredness, and how you can use the RISE app to get more energy, whether you’re on birth control or not.
Disclaimer: The scientific literature uses gendered language when talking about birth control. We have used the term “women” in this article, but this advice is for anyone who was assigned female at birth — or anyone who’s interested in the effects of birth control!
“It’s not clear whether birth control can make you tired," says Dr. Chester Wu. "Hormonal birth control may cause fatigue and sleep problems. But there’s also research suggesting it can improve your sleep, which can boost your energy. Try switching to a different kind of birth control, like low-dose hormonal birth control or non-hormonal birth control, to see if that helps you feel less tired.”
Dr. Chester Wu is double board certified in Psychiatry and Sleep Medicine, and provides sleep medicine services, medication management, and psychotherapy to adults at his private sleep medicine and psychiatry practice.
Birth control that uses hormones — like the pill, implant, or hormonal intrauterine device (IUD) — may make you feel tired. Fatigue is listed as a side effect of many hormonal contraceptives, and they can cause sleep problems in some women, which can lead to tiredness.
But for others, hormonal birth control can improve sleep and, therefore, energy. So more research needs to be done.
Non-hormonal birth control — like condoms — is unlikely to make you feel tired.
Here’s what some recent research has to say:
Heads-up: This study defines the recommended sleep duration as seven to nine hours. But that’s just a guideline. Your sleep need — the amount of sleep you need a night — is individual to you and determined by genetics.
To find out your sleep need, turn to RISE. RISE uses a year’s worth of phone use data and proprietary sleep-science-based models to calculate your sleep need in hours and minutes.
Sleep needs can vary widely. We looked at 1.95 million RISE users aged 24 and older and found sleep needs ranged from five hours to 11 hours 30 minutes.
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Women may not need more sleep than men, but they are more likely to suffer from sleep problems and so need more time in bed to meet their sleep needs.
If you’re not meeting your sleep need, you’re going to feel tired, irritable, and have trouble focusing, whether you’re on birth control or not. A small study on women both using and not using oral contraceptives found, after 24-hours of sleep deprivation (the same as pulling an all-nighter), alertness, vigilance, and reaction time got worse the more sleep deprived they became.
RISE users on iOS 1.202 and above can view their sleep need here.
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It’s not clear why birth control can make you tired. It may be down to hormonal changes, nutritional deficiencies, an increased body temperature, or mood disorders.
Here’s what we know so far.
The hormones in hormonal contraceptives may make you feel tired.
In the body, progesterone (the natural version of progestin found in many contraceptives) and estrogen can make you feel sleepy. So when you take more of these hormones, you may feel tired as a result. These hormones may also cause changes in your sleep.
A 2020 survey found women taking contraceptives reported more:
Women taking progestagen-only contraception reported lower total sleep duration than women taking combined contraceptives (which include both a form of progesterone and estrogen).
The researchers stated that when you take your birth control could be to blame. They said, “if women take their contraceptives early in the morning or close to lunch it would probably lead to an impairment in sleep and quality of life.”
They added that as sex hormones like progesterone can cause sleepiness, taking it in the morning could lead to increased daytime sleepiness. But this is just a theory, more research is needed to back it up.
Learn how hormones can cause female fatigue here.
Birth control may cause nutrient deficiencies, which can make you feel tired.
One study found oral contraceptives can lower your folate levels. And research from 2019 states oral contraceptives may interact with vitamins A, B1, B2, B6, B12, C, and E, folic acid, and the minerals magnesium, selenium, and zinc.
Heads-up: The research is inconclusive, but birth control may also cause weight gain, and being overweight can contribute to sleep problems and tiredness.
Sleep research shows hormonal contraceptive use is linked to getting less slow-wave sleep (a.k.a. deep sleep).
This research found the body temperature of those taking contraceptives was similar to women not taking them when these women were in the luteal phase of their menstrual cycles (the phase from ovulation to your period).
But the contraceptive users’ body temperatures were higher than women not taking them when these women were in the follicular phase (the phase from your period to ovulation).
A higher body temperature can make it harder to fall and stay asleep.
You can learn more about how your temperature affects sleep here.
Hormonal birth control can cause mood changes, anxiety, and depression in some women. These mental health issues can make it harder to get enough sleep and make you feel tired.
A 2016 study found a link between hormonal contraceptives and first depression diagnosis and subsequent use of antidepressants (which can make you feel tired, too).
A 2004 study found hormonal contraceptive users, compared to non-users, were found to have higher rates of:
But more research needs to be done into this theory. A 2022 study found women taking hormonal birth control had lower depression scores than those not taking it. The study even concluded, “the results suggest that hormonal birth control use may help to reduce depressive symptoms.”
Learn how to sleep with anxiety here.
Research suggests that combined oral contraceptives can lower your levels of testosterone. If this is the case, this could cause fatigue.
Low testosterone has been linked to:
This is also just a theory and a lot of the research on testosterone and sleep is done in men, so more studies are needed to confirm.
Learn more about testosterone and sleep here.
Heads-up: More research needs to be done into how birth control affects women’s energy levels and sleep. Not much is known about how the hormones used in contraception affect sleep. The studies we do have are often small, done on different contraceptives and types of hormones, use subjective data, or find conflicting results.
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Hormonal birth control may make you feel tired.
Hormonal forms of contraception include:
Birth control with higher doses of hormones (like the combined pill, injection, or morning after pill) are more likely to make you tired compared to methods that use lower doses (like the progestin-only pill).
Non-hormonal birth control is unlikely to make you feel tired. Non-hormonal birth control options include:
Unfortunately, there’s not much research on the different types of contraception and how they affect your energy levels.
Hormonal contraceptives may be more likely to cause tiredness, but that’s not always the case.
A 2023 study found links between contraceptive use and insomnia in women aged 34 or younger. But those who took a fixed combination of drospirenone and ethinylestradiol or cyproterone and ethinylestradiol had significantly decreased odds of insomnia compared to non-users.
And those who used a levonorgestrel-releasing IUD and those with a vaginal ring with etonogestrel and ethinylestradiol had significantly increased odds for insomnia compared with non-users.
Birth control may help some women sleep better. For one, it can reduce your stress around unplanned pregnancy, and lower stress levels can make it easier to fall asleep. But it may also improve your breathing at night, make you feel sleepy, and reduce period pain, which can keep you up.
Here’s how it might help.
One study found a lower percentage of women who took hormonal contraceptives reported snoring and they woke up less often during the night.
A 2013 survey found women on hormonal birth control had a significantly lower apnea-hypopnea index (a measure of how often your breathing stops or slows down during sleep, indicative of sleep apnea) than women who were not on birth control.
In the survey above, women taking birth control tended to have better sleep efficiency.
A 2022 systematic review and meta-analysis found women taking contraceptives were awake for seven minutes less during the night compared to women not taking contraceptives. But this review concluded that contraceptives were not linked to clinically relevant changes in sleep patterns.
A 2019 study compared women on different types of contraception to a control group who didn’t take hormonal contraceptives.
Results showed, on average:
But these sleep times were measured with a sleep diary, so this data may be inaccurate.
There’s a theory that as progesterone can make you feel sleepy, hormonal contraceptives that use progestagens (types of progesterone) could be used to treat insomnia in premenopausal women.
Birth control may also affect your sleep hormone melatonin.
A small study from 1999 found oral contraceptives appeared to increase melatonin levels towards the end of the night. But other studies have found no link between birth control and melatonin. This may be because light suppresses melatonin and light exposure varies from study to study.
This study also found contraceptives didn’t affect circadian rhythms, which is your roughly 24-hour body clock.
Birth control may make your periods less painful, so cramps don’t keep you up, or lighter, so you lose less blood and are less likely to be anemic.
Depending on the type of birth control you take, it may stop your periods altogether, meaning less pain, blood loss, and stress.
All this could help you get more sleep and feel less tired.
Learn more about how your period can affect your sleep here.
As with everything to do with birth control and sleep, more research is needed.
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It can be hard to tell if birth control is causing tiredness. If you’re on the pill, look out for clues like feeling tired after taking it each day.
You might also notice other side effects of hormonal contraceptives like:
You can also check the RISE app to see how much sleep debt you have. Sleep debt is the amount of sleep you owe your body. If birth control is causing sleep problems, your sleep debt might be creeping up night after night.
RISE users on iOS 1.202 and above can view their sleep debt here.
Other causes of fatigue include:
You can learn about why you’re always sleepy here.
Speak to your healthcare provider to get tested for underlying health conditions and sleep disorders.
Heads-up: We’ve covered advice on how to get more sleep during times you might not be on birth control, such as during pregnancy, menopause, and after a c-section.
Feel less tired on birth control by lowering your sleep debt, getting in sync with your circadian rhythm, improving your sleep hygiene, taking the contraceptive pill before bed (if you take it in the morning), or trying a new birth control method.
Here’s more on those top tips.
The more sleep debt you have, the more tired you’re going to feel. We recommend keeping sleep debt below five hours to feel maximum energy.
RISE can work out how much sleep debt you have and keep track of it night after night.
Got more than five hours? Here’s how to lower your sleep debt:
A 2023 update from the National Sleep Foundation says, “Consistency of sleep onset and offset timing is important for health, safety, and performance. Nonetheless, when insufficient sleep is obtained during the week/work days, weekend/non-work day catch-up sleep may be beneficial.”
Check out our guide on how to catch up on sleep here.
Your circadian rhythm is your roughly 24-hour body clock that helps to control your sleep-wake cycle.
You can get out of sync with it if you:
When you’re out of sync with your circadian rhythm, you can feel low on energy.
Get back in sync by:
RISE can predict the timing of your circadian rhythm to make it easier to get in sync.
RISE users on iOS 1.202 and above can see their circadian rhythm on the Energy screen here.
Sleep hygiene is the name for the daily behaviors that can help you fall asleep faster and wake up less often during the night.
If birth control, or something else entirely, is causing trouble sleeping, good sleep hygiene can help you get the most sleep possible.
Here’s what to do:
RISE can tell you when to do 20+ sleep hygiene habits at the time that’ll make them the most effective for you each day.
RISE users on iOS 1.202 and above can set up their 20+ in-app habit notifications here.
If you’ve just started taking birth control, your body may be getting used to the new medication and your fatigue (and any other side effects of birth control) may pass in a few weeks or months.
Try giving it a few months or so to see if you feel less tired.
While you’re riding out the fatigue, focus on keeping your sleep debt as low as possible to boost your energy levels.
You can also check your circadian rhythm prediction in RISE to see when your energy levels will be at their highest each day. This is usually mid-morning and early evening. Schedule your toughest tasks for this time to make the most of the energy you do have.
Learn how to feel more awake here.
If you’re taking the birth control pill, try taking it before bed instead of in the morning or during the day.
It’s only a theory, but as sleepiness is a potential side effect, taking the pill before bed could help you sleep or at least eliminate any daytime fatigue it can cause.
You may feel tired if you’re on birth control with high hormone levels, such as the injection or the combined pill.
You can switch to a birth control option that uses lower doses of hormones, such as the progestin-only pill.
You can also try non-hormonal birth control methods such as:
Seek medical advice. Your healthcare provider can help you determine whether birth control is causing your fatigue or whether the root cause is something else entirely.
They can test you for underlying health conditions and sleep disorders, and recommend the best treatment options.
They can also test you for nutritional deficiencies and recommend if supplements could help.
If you want to switch up your contraceptives, they can recommend the best way to do this without risking pregnancy.
Coming off birth control may make you tired. But there’s not enough research to know for sure. Some women don’t experience any symptoms when they stop birth control. But others aren’t so lucky.
You may notice changes to your:
These changes could impact your sleep. Anxiety, cramps, and other PMS symptoms can keep you up as can sleeping with a tampon again if you haven’t had periods while on birth control.
Learn more about how to sleep on your period here.
You may also become more stressed about unwanted pregnancy, which can impact your sleep and energy levels.
It’s not clear how long fatigue can last after coming off birth control. It may take your body a few weeks or months to adjust.
On the flip side, you may feel less tired when you come off birth control if mood symptoms improve or if you were taking the pill in the morning, for example.
Some women experience fatigue while on birth control. It may disrupt your sleep and make you feel tired. But it may also help to improve your sleep and boost your energy levels. More research is needed to know for sure, and contraceptives can affect everyone differently.
If you’re feeling tired on birth control, try lowering your sleep debt and getting in sync with your circadian rhythm — these are two of the best things you can do to improve your energy levels.
RISE can work out how much sleep debt you have and predict the timing of your circadian rhythm each day, so you can sync up. The app can also guide you through 20+ good sleep habits to make it easier to get a good night’s sleep.
You don’t have to wait long — 80% of RISE users feel more energy within five days.
Birth control may make you tired. Hormonal birth control may cause fatigue, mood changes, depression, nutritional deficiencies, and sleep disruptions, which can make you tired. But there’s also research showing birth control can improve your sleep, so more studies are needed to confirm.
Surveys have found that hormonal birth control can cause excessive sleepiness. Hormonal birth control may cause mood changes, depression, nutritional deficiencies, and sleep disruptions, which could make you feel tired. But there’s also research showing birth control can improve your sleep, so more studies are needed to confirm.
Some studies show that birth control could help you sleep better. You may wake up less often during the night, snore less, have less severe sleep apnea, and get more sleep overall. Birth control could also make your periods less painful, which could help you sleep better. But more research is needed as there’s research showing birth control can negatively impact your sleep, too.
It’s not clear whether birth control can help with insomnia or not. There’s a theory that the progestin-only pill could treat insomnia, as progesterone (the natural form of the hormone) can make you sleepy. But there are also reports of increased insomnia in women taking some forms of hormonal birth control. So more research is needed.
Taking melatonin supplements may help you sleep while on birth control. However, melatonin supplements work best when used to change the timing of your body clock, not as a traditional sleep aid. Plus, it’s not clear if they’re safe to take long term. It’s also not clear how melatonin and birth control affect each other. Your best bet is to improve your sleep hygiene to sleep better while on birth control.
Stop birth control insomnia by improving your sleep hygiene. This includes keeping a regular sleep schedule and avoiding caffeine, large meals, intense exercise, bright light, and alcohol too close to bedtime. You can also try switching to a different birth control method. Lower hormone doses or non-hormonal birth control may help.
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