Image courtesy of Women's Health

Feeling sad or anxious? Your reproductive health might be at risk. Women with symptoms of depression or stress are significantly less likely to use birth control consistently, according to a study recently presented at the American Public Health Association's annual meeting. Inconsistent use of birth control can lead to greater risk of unwanted pregnancy and contracting STIs. (Are the winter blues bumming you out? Here are 5 Ways to Beat Seasonal Affective Disorder.)

Researchers assessed the mental health of 689 18-to-19-year-old women and then asked them to report their sexual activity and birth control usage every week for two and a half years. While the study participants used contraceptives consistently 72 percent of the time, women with moderate-to-severe symptoms of depression were 47 percent less likely to use birth control consistently, and women with moderate-to-severe symptoms of stress were 69 percent less likely to use contraceptive consistently. The reasons given: 31 percent said they forgot, 21 percent didn't have their contraceptive method available, 6 percent weren't happy with the method, another 6 percent said their partner didn't want to use the method, and 4 percent weren't trying to avoid pregnancy. The remaining 33 percent didn't specify a reason for not using protection.

Your mental health impacts how well you take care of your physical--and reproductive--health, says Kelli Stidham Hall, Ph.D., research investigator at the Population Studies Center at the University of Michigan's Institute for Social Research, who presented the study findings. "Feeling sad, down, in despair, and worthless can impact general thought processing and can interfere with your ability to make decisions," she says. That includes decisions about contraceptive use, and it's especially true when it comes to birth control that requires actual effort--like remembering to take a pill at the same time every day. Stidham Hall points out that symptoms of depression, like lack of energy or interest, or feeling moderate-to-severe stress, which can make everything you do feel overwhelming, can be major roadblocks to appropriate birth control use. (Are you feeling overwhelmed? Roll out your mat and relax with this Stress-Busting Yoga Routine.)

For women who suffer from stress or depression (either occasionally or as a diagnosis), the best birth control options are those that are easiest to use, Stidham Hall says. She recommends long-acting reversible contraceptives (LARCs), such as intrauterine devices (IUDs) and subdermal implants.

"For women who don't want to deal with taking daily pills, or using a condom every time, LARCs can be ideal, and allow these women to tend to other issues that need more attention," she says. LARCs require no thought at all once they're implanted, and have been shown to have over 99 percent effectiveness in protecting against unwanted pregnancy. Check out our chart of The Best Birth Control Methods to compare their cost and effectiveness against other options, and make your gynecologist aware of your mental state so he or she can help identify the contraception that's best for you.