Last Updated on January 14, 2026
Quick answer: Does Lexapro affect birth control?
In general, Lexapro does not make hormonal birth control less effective. Lexapro is an SSRI, and it does not act like the main drugs that lower birth control hormone levels.
If a pregnancy happens while someone is taking Lexapro and birth control, the cause is often one of these issues:
- Missed pills, late pills, or starting a new pack late.
- Vomiting or severe diarrhea that keeps an oral pill from being absorbed.
- Another medicine or supplement that speeds up how the liver breaks down hormones.
Which birth control methods are most sensitive to drug issues?
Drug interactions matter most for methods that depend on steady hormone levels in the blood, such as the pill, patch, and ring. Some long-acting options, like IUDs, are not affected by stomach illness and are less likely to be impacted by other medications.
Some drugs are known to lower how well combined hormonal methods work, including certain tuberculosis drugs (like rifampin) and some seizure medicines. The CDC reviews these drug-interaction situations. CDC guidance on birth control and drug interactions
What if you take the pill and you get sick?
If you vomit soon after taking a birth control pill or you have severe diarrhea, your body may not take in the dose. The safest step is to follow your pill’s instructions and contact a pharmacist if you are unsure. In some cases, you may need backup contraception for a short time.
If you start a new prescription, over-the-counter product, or supplement, ask a pharmacist if you need backup birth control.
How Lexapro and birth control work in the body
Knowing what each medicine does can make the topic less scary and more practical.
What Lexapro does
Lexapro is the brand name for escitalopram. It is a selective serotonin reuptake inhibitor (SSRI) used for depression and anxiety. SSRIs mainly change serotonin signaling in the brain. They do not replace birth control.
What hormonal birth control does
Hormonal birth control includes the pill, patch, ring, shot, implant, and some IUDs. These methods use progestin, with or without estrogen, to prevent pregnancy. Depending on the method, they may stop ovulation, thicken cervical mucus, and thin the uterine lining.
Where true “interactions” come from
A true interaction usually happens when another drug changes how the liver breaks down hormones, or when illness prevents an oral pill from being absorbed. Lexapro is not expected to lower estrogen or progestin levels in a way that makes birth control unreliable.
Also keep in mind that “no interaction” does not always mean “no symptoms.” If two medicines share side effects, you can feel worse even when both are working as intended.
Side effects that get confused with “interactions”
Many people worry about an interaction because they feel different after starting a new pill, a new antidepressant, or both. Often, what they are feeling is a normal side effect pattern, especially in the first few weeks.
Common overlap symptoms
- Nausea, appetite changes, or stomach upset.
- Headache, fatigue, or sleep changes.
- Breast tenderness or bloating.
- Mood shifts during the first few weeks of a change.
Mood changes: what is “normal,” and what needs a call?
Lexapro can take a few weeks to reach full effect, and some people feel more restless early on. Hormonal birth control can also affect mood in some patients, especially during the first few months. If you notice new or worsening depression, panic, or thoughts of self-harm, contact a medical professional right away.
Changes in sex drive are also common with SSRIs and can look like a “hormone problem.” MedlinePlus lists sexual side effects and other common effects of escitalopram. MedlinePlus: escitalopram side effects
Bleeding changes and spotting
Spotting can happen with hormonal birth control, especially early in a new method or after missed pills. Some people also notice easier bruising or heavier bleeding on SSRIs, because serotonin affects platelets. If you have very heavy bleeding, repeated nosebleeds, or bruises that appear often, tell your doctor soon.
When side effects can indirectly affect birth control pills
If Lexapro causes vomiting soon after you take a birth control pill, the pill may not be absorbed. This is not Lexapro blocking birth control. It is the same issue you would have with any cause of vomiting or severe diarrhea.
Myths and facts about Lexapro, birth control, and fertility
Online posts can make this topic sound simple, but real life is more detailed. Here are common myths, along with the facts that matter most.
Myth: Lexapro makes birth control fail
Fact: There is no strong evidence that escitalopram reduces how well birth control works. If a pregnancy happens, missed doses, absorption problems, or another interacting drug is often the more likely reason.
Myth: Birth control makes Lexapro stop working
Fact: Birth control is not known to block Lexapro’s effect. But hormones can affect mood in some people. If your mood changes line up with a new method, tracking symptoms can help your prescriber adjust the plan.
Myth: Does Lexapro affect fertility?
Fact: Lexapro is not known to directly cause infertility. The more common issue is sexual side effects, like low libido, erection trouble, or delayed orgasm, which can make trying to conceive harder. Depression and anxiety can also reduce desire and make sex less frequent.
Myth: You have to stop Lexapro before trying to get pregnant
Fact: Some people do taper off before pregnancy, but others continue. The safest plan depends on your history, how severe symptoms get without treatment, and your support system.
If you keep seeing older “pregnancy category” letters online, Nova’s guide can help you read what the old system meant. Pregnancy Category X drugs list
Lexapro and pregnancy: what to know before you stop or switch
People searching lexapro and pregnancy often want one safe rule. But the best plan depends on your symptoms, history, and supports. For many patients, the goal is to avoid sudden changes and make a shared choice with the care team.
Can you take Lexapro while pregnant?
Sometimes, yes. For some patients, staying on an SSRI during pregnancy is the right choice when the benefits outweigh the risks. Untreated depression or anxiety can also carry risks, including a return of symptoms and relapse risk for people in recovery.
Lexapro’s FDA label outlines pregnancy risks that have been reported with SSRI exposure later in pregnancy. FDA: Lexapro prescribing information
What to do if you become pregnant while taking Lexapro
Call your prescriber and your prenatal care provider. Do not stop Lexapro on your own unless a doctor tells you to stop. A planned taper, a dose change, or a switch may be safer than an abrupt stop.
What “Lexapro pregnancy category” means today
You may still see the phrase lexapro pregnancy category online. The older letter system (A, B, C, D, X) is now historical shorthand, not a full safety answer. Current labeling uses a risk summary, the best data we have, and clinical guidance for pregnancy and breastfeeding.
Practical planning tips if pregnancy is possible
- Tell your prescriber if you are trying to conceive, not just after a positive test.
- Do not stop Lexapro suddenly without a taper plan, unless a doctor tells you to.
- Review every medicine and supplement you take, including “natural” products.
- If you have a history of mood swings, ask if you should be screened for bipolar disorder.
If you need a structured program while stabilizing mental health and recovery, you can explore Wimberley inpatient rehab and ask how care is coordinated during pregnancy planning.
What to ask your prescriber or pharmacist
The right questions can turn this topic from fear into a clear plan.
- Do I need backup birth control when I start Lexapro or change the dose?
- Does my specific method have any known issues with SSRIs?
- If I vomit or have severe diarrhea, when should I treat it like a missed pill?
- Could spotting, mood shifts, or low libido be from Lexapro, birth control, or both?
- Are any of my other medicines known to reduce how well birth control works?
- If I want to get pregnant, what is the safest way to continue, taper, or switch?
What to bring to the appointment
- A list of all prescriptions, over-the-counter products, and supplements.
- Your birth control type and how you use it (for example, morning vs night dosing).
- Notes on side effects and when they started.
- Any pregnancy plans for the next year, even if they feel uncertain.
If alcohol use is part of your story, ask how it can affect mood symptoms and medication response. Nova’s article on Lexapro and alcohol risks can help you start that talk.
When to get extra support
Questions about pregnancy prevention matter. But sometimes the bigger risk is that alcohol or drugs are making it hard to take medicine on time or make safer choices. If that is happening, added support can protect both mental and physical health.
If you are dealing with withdrawal, repeated relapse, or unsafe substance mixing, medical monitoring can help you stabilize. Nova’s Austin detox program offers 24/7 support so you can get safe, steady footing.
If you ever have severe symptoms such as chest pain, fainting, suicidal thoughts, severe allergic reactions, or very heavy bleeding, seek emergency medical help right away.
