Drive Me Crazy

Meghan Dawson had been using the NuvaRing hormonal contraceptive for a couple of months when the freak-outs started. “I would pick huge fights over the tiniest things and cry uncontrollably for no apparent reason,” the 22-year-old Dawson says. “I even started having minor panic attacks and was in therapy for several months.” 

Dawson's periods had never sent her into an emotional tailspin before. After surviving a series of mental breakdowns, recurring yeast and urinary tract infections, and a perpetually zapped sex drive, she decided the ring was to blame and took it out. Within two months, her body and her brain had returned to normal.

Her story might make you think that hormonal birth control is a bad, bad thing. And yet, at the same time, there's Tammy Peck. For this 32-year-old Californian, it was going on the pill at 18 that saved her (and her loved ones) from out-sized, uncontrollable emotional reactions and debilitating cramps.

So what's the deal? How can hormonal contraception cause such vastly different reactions? The answer may be as simple as looking in a mirror. “It depends on your personal body chemistry,” says Dr. Ruth Merkatz, director of clinical development with the Population Council.

In general, hormonal birth control works by taking two hormones found in the body, estrogen and progesterone, and upping their levels so that they suppress the process of ovulation by keeping eggs from growing large enough to be released from your ovaries. But the natural balance of estrogen and progesterone isn't a one-size-fits-all kind of thing. In fact, if we're talking metaphors, it's more like a box of chocolates. And when you start adding additional hormones to the mix, you never know what you're going to get.

Ups and Downers

This used to be a big problem. There wasn't much variation in the early generations of birth control pills. Most of them were made using the same synthetic hormones and nearly all carried what we now know to be excessively high doses. Worse, says Merkatz, the chemical used to mimic progesterone had a tendency to bind to receptors that triggered an increase in androgen, a hormone that's more associated with guys than gals.  Their systems flooded with excess hormones, many women experienced severe levels of weight gain, breakouts, and changes in libido.

Today, however, we know that the body only requires a very slight uptick in hormones to stop ovulation. There are also many more types of pills on the market, offering more choice in hormone levels and types of synthetic hormones used. The good news: You and your doctor can pretty much tailor your birth control to fit your natural hormone personality. The bad news: Until you start trying things out, there's no way to know how you'll react to a specific pill or hormone formulation.

“It's just trial and error,” Merkatz says.

Not complicated enough for you yet? Try this. According to Dr. Kate O'Connell, an OB-GYN with New York-Presbyterian Hospital and Columbia University Medical Center, doctors don't really know why women experience some side effects. “When they do clinical trials testing oral contraceptives versus placebo, women in both groups report similar rates of headache, nausea, breast tenderness, and emotional problems,” she says.

But don't abandon all hope just yet. You can still have a great experience with hormonal birth control. You just need to look at the prescription process differently than you would for, say, an antibiotic or antacid.

One Size Fits You

First, it's up to you to communicate effectively with your OB-GYN or nurse practitioner. For instance, don't go in having already settled on a specific pill because that's what your friends use. Instead, Dr. Merkatz suggests having an in-depth talk with your doc about your lifestyle and what you want out of your birth control. Certain factors—how many sexual partners you have, whether you travel frequently for work, if you're a smoker, or if you're trying to lose weight, and others—can all have an impact on which birth control method your provider recommends.

In addition, it's not uncommon for insurance to only fully cover one OB-GYN visit per year. So if you are going to try out new birth control, you should talk to your provider and work out a plan that will allow you to switch prescriptions if necessary without getting stuck with a bigger medical bill than you can handle.

Secondly, you need to be prepared to try out several different types of birth control before you find one that fits. Dr. Vanessa Cullins, vice president for medical affairs for the Planned Parenthood Federation of America, says many women don't realize that they may have to switch between different birth controls, or that they can do so without losing effectiveness. But unless the side effects are particularly bad, she adds, it's best to give each type you try a three-month test run. Initial problems often smooth themselves out in that period.

Find More on MSN Health & Fitness:

• Pounds and the Pill
• Birth Control FAQ
• Medications That Interfere With Birth Control
• Most Men Not Ready for Personal Birth Control