Beyond Birth Control: Why Contraceptive Counselling Should Include Mental Health

When the World Health Organisation (WHO) released its new evidence brief in July 2025 on contraception, one recommendation stood out: the call for personalised contraceptive counselling that integrates mental health considerations.

The advice reflects a growing recognition that contraceptive choice is not just about preventing pregnancy — it is about supporting women’s overall wellbeing. So what might this shift look like in practice?

The Link Between Contraception and Mental Health

The WHO brief highlighted a nuanced picture. For some women, especially those with pre-existing depression or anxiety, hormonal contraceptives were linked to improvements in mood and reduced symptoms. Yet for others — particularly first-time users without a history of mental health issues — certain methods such as implants and hormonal IUDs were associated with a slight increase in depression risk.

This does not mean hormonal contraception is unsafe. Rather, it underscores the importance of tailoring advice, asking the right questions, and recognising that mental health and reproductive health are deeply intertwined.

What Personalised Counselling Could Look Like

A new model of care would go beyond listing available methods. It could involve:

• Mental health screening at the start: Asking about mood, stress levels, and any history of depression or anxiety when discussing contraceptive options.

• Exploring preferences and concerns: Some women may prioritise menstrual regulation, others may want the lowest possible risk of mood change.

• Collaborative decision-making: Shifting from a “doctor knows best” approach to a dialogue where the woman’s values, lifestyle and mental health needs shape the choice.

• Follow-up check-ins: Scheduling a review within three months of starting a new method to assess both physical and psychological side effects.

• Cross-referrals: Building stronger links between reproductive health services and mental health providers so women can access timely support.
  

Barriers to Change

Implementing such counselling will not be easy. Health systems in many countries are under strain, and clinicians often face limited consultation times. Mental health remains stigmatised in some settings, and family planning services may lack training to address it.

Yet experts argue that failing to integrate mental health into contraceptive care risks missed opportunities: women discontinuing effective contraception due to unaddressed side effects, or struggling in silence with symptoms that could have been managed.

A More Holistic Model of Women’s Health

By embedding mental health into contraceptive counselling, services would recognise women as whole people rather than just potential mothers. The shift could improve continuity of use, increase satisfaction with chosen methods, and support women’s autonomy over both their bodies and their wellbeing.

As the WHO put it, contraception is more than a medical tool. It is a driver of equality, empowerment and quality of life — and addressing mental health openly within contraceptive care is the next frontier.