Women who take oral contraceptives are less likely to report being depressed compared to women who used to take the pills, according to a new report.

In the cross-sectional study, the researchers looked at data on 6,239 women in the US who were between 18 and 55 years old. People who used oral birth control had lower rates of depression than people who used to take them. In fact, 4.6% of women taking oral contraceptives reported depression, while 11.4% of former users reported depression.

It’s commonly thought that oral contraceptives can cause depression, the researchers noted in a statement. A study out this past June in Cambridge University Press found that women using birth control pills could have as much as a 130% higher risk for depression. That risk is especially high in the first two years of starting oral birth control pills, and is higher if women started taking the medication in adolescence. 

One reason why the researchers say that current users may not be depressed is because being able to rely on “the pill” may remove some of the stress about unwanted pregnancy–improving a woman’s mental health. On the other hand, “survivor bias” may play a role—that’s when women who have depression on the pill stop taking it and therefore fall into the category of former users who report depression. 

Women who were divorced, widowed or separated were more likely to report being depressed—so were women who had a history of cancer and those who were considered clinically overweight. Black and Hispanic women, current smokers, women with lower levels of education, and women dealing with poverty (all who used to take the pill) were more likely to report depression.

“Most women tolerate taking the oral contraceptive pill without experiencing depressive symptoms but there is a subset of women that may experience adverse mood side effects and even develop depression, and the reasons are not entirely clear,” said Julia Gawronska, a postdoctoral research fellow at Anglia Ruskin University in the UK. “However, stopping taking the pill without a suitable alternative increases the risk of unintended pregnancy. It is important that women are fully supported, provided with full information, and offered alternative forms of contraception if necessary.” More research is needed, but it’s important to pay attention to your mental health when starting any new medication—and reach out to your primary care provider for support if you’re noticing side effects that are tough to handle.