A striking new study published in JAMA Psychiatry links hormonal contraceptives to depression, especially in teenage girls.
The findings aren’t surprising to many women.
A professor at the University of Copenhagen in Denmark and lead supervisor of the study, Dr. Øjvind Lidegaard said:
“We have known for decades that women’s sex hormones estrogen and progesterone have an influence on many women’s mood. Therefore, it is not very surprising that also external artificial hormones acting in the same way and on the same centers as the natural hormones might also influence women’s mood or even be responsible for depression development.” [1]
Here is What the Study Found
For the study, Lidegaard and his team tracked the health of more than 1 million Danish women between the ages of 15 and 34 over the course of 14 years, using data from the National Prescription Register and the Psychiatric Central Research Register in Denmark.
Women who were diagnosed with depression before age 15 were excluded from the study.
The researchers uncovered the following:
- Women who used birth control pills with a combination of estrogen and progestin were 23% more likely to be prescribed antidepressants than non-users.
- Women who took progestin-only oral contraceptives had a 34% greater likelihood of being prescribed antidepressants.
- In women who used a contraceptive patch, antidepressant use doubled.
- The likelihood of being prescribed antidepressants increased 60% for women who used vaginal rings.
- Women implanted with hormonal intrauterine devices (IUDs) had a 40% increased risk of being prescribed antidepressants.
Perhaps the most shocking revelation was that teens age 15 to 19 who took estrogen-progestin oral contraceptives were 80% more likely to be prescribed antidepressants.
Among women who did not use hormonal birth control, an average of 1.7 out of 100 began taking antidepressants in a given year. That rate increased to 2.2 out of 100 if the women took birth control.
While mood swings are often listed as a known side effect on the labels of contraceptives, Lidegaard’s study is the first to directly tie the products to clinical depression.
In the study, Lidegaard and his team theorized the difference in rates among women taking non-oral and oral contraceptives might be attributable to a difference in dose rather than how the contraceptives are administered.
They also noted that this association doesn’t imply that birth control alone causes depression. More research is needed to find out if there’s more to the story.
The team wrote:
“Adolescents seemed more vulnerable to this risk than women 20 to 34 years old. Further studies are warranted to examine depression as a potential adverse effect of hormonal contraceptive use.”
Unconvinced
Some experts take exception to the notion that birth control causes depression. The study did not show that depression is a direct result of contraception. [2]
They’re not surprised, though – many experts have suspected a link between the 2 for years.
Chelsea Polis, a senior research scientist at the Guttmacher Institute, which studies reproductive health, explained:
“This is really resonating with a lot of women.
Part of that has to do with women’s individual experiences. Women do feel that clinicians aren’t taking their concerns seriously sometimes. And part of this reaction is this scientific literacy gap.”
Remember this?
Among women who did not use hormonal birth control, an average of 1.7 out of 100 began taking antidepressants in a given year. That rate increased to 2.2 out of 100 if the women took birth control.
These numbers show that, yes, the risk is higher, but it’s a relatively small risk to begin with.
The rates are even closer for women being diagnosed with depression at a psychiatric hospital. According to the study, 0.3 out of every 100 birth control users were diagnosed with depression versus 0.28 percent of non-birth-control users.
This does not add up to very many more cases in the birth control group, critics of the study argue.
Keyes said:
“You can have something that is twice the risk, but it can be a very rare outcome.”
However…
“This was a very well-conducted study. I think it’s an important piece of information. It lowers my confidence in my hypothesis, which is that hormonal contraception sort of regulates mood.”
Other Problems with Birth Control
Birth control has been linked to other serious health problems, as well. For example, combined estrogen-progestin birth control pills have long been tied to fatal blood clots.
Additionally, the permanent contraceptive device Essure, made by Bayer AG, has been blamed for injuring thousands of women.
Essure is inserted into a woman’s fallopian tubes, where it causes scar tissue to form and block a woman’s egg from becoming fertilized. Thousands of patients complained of adverse events, such as persistent pain, perforation of the uterus and/or fallopian tubes, internal abdominal bleeding, abnormal and irregular bleeding, and allergic or hypersensitivity reactions.
The device can also migrate outside of the fallopian tubes and become lodged in the uterus and other parts of the body.
In February 2016, the U.S. Food and Drug Administration (FDA) placed a “black box” warning on the Essure device’s packaging, but did not ban it, as many women had requested.
Sources:
[1] CNN
[2] Today