Abstract Objective: Hormonal birth control (HBC) is widely used among college-aged women for pregnancy prevention and menstrual regulation, yet its psychological side effects remain underexplored. This study investigates the incidence and impact of HBC-related side effects, particularly mood changes, among female students at Louisiana State University. Methods: A cross-sectional web-based survey was administered to a convenience sample of 446 female students aged 18 and older. Participants completed validated scales measuring perceived stress, everyday college experiences, and affective lability. Results: The study found that mood changes, such as anxiety, sadness, and irritability, were the most reported side effects among both current and former HBC users. Weight gain and menstrual irregularities also ranked highly. Notably, participants with diagnosed mental health disorders reported significantly more adverse effects, including depression, decreased libido, and headaches. Qualitative responses highlighted emotional instability and dissatisfaction with provider communication as the main reasons for discontinuing use. Conclusions: These findings highlight the importance of better education and counseling about HBC’s psychological effects. Healthcare providers should actively discuss potential mood-related side effects and suggest alternative dosing options to reduce distress. Since mental health diagnoses are common among college students, personalized contraceptive counseling is crucial. This study adds to a growing body of evidence supporting more comprehensive reproductive health care and informed choices for young women.