(NewsNation) — New research shows women taking hormonal birth control pills experience the same changes in mental health during their menstrual cycle as those who are not on the pill.

Researchers studied women taking combination-type contraceptive pills, which contain both progestin and estrogen. They found women reported significant mood deterioration during the pause or placebo week of the pill, similar to mood changes related to menstruation in those who were not on the pill.

Birth control pills have been used to help address mental health issues associated with the menstrual cycle. As levels of estrogen rise and fall, some women experience worsening of moods, including mental health symptoms associated with premenstrual syndrome. Taking birth control may help level out hormonal fluctuations and improve mood stability.

The latest study, however, found women who were taking the pill also experienced mood changes during the placebo week, when users experience withdrawal bleeding (because hormonal birth control prevents the body from releasing an egg, the bleeding is not technically considered a period).

Many doctors believe the placebo week isn’t necessary, and some forms of birth control are designed to be taken with continuous hormones. However, some people feel it’s more natural having period-like bleeding, and it may provide additional reassurance that the pill is effective and they aren’t pregnant.

Researchers studied women using different brands of pills and administered mood surveys to judge the effect of the placebo week on mood stability. They found changes were similar between different formulations, suggesting the type of progestin used in the pill didn’t make a difference in mood.

They found mood worsening during the hormone-free week was similar to mood changes during the menstrual cycle in women who were not taking birth control.

Researchers did note it is possible the mood changes were connected to the physical discomfort during withdrawal bleeding rather than the hormones.

In the future, researchers suggested more research be done into the necessity of placebo pills and whether they are useful in those taking hormonal birth control to help with mood stabilization.