Will the Pill Make Me Happy?

Recently, a study was done at the University of Copenhagen by Charlotte Wessel Skovlund, MSc et al looking at the correlation between depression and the use of hormonal contraceptives. The study itself took place in Denmark and spanned the course of thirteen years, looking at over one million women of ages 15 – 34.

The results of this longitudinal study suggest that there is a higher incidence of mood disturbances among women once they had been prescribed hormonal contraceptives, with the risk of being prescribed antidepressants higher for adolescents than it was for older women. In fact, depending on the kind of contraceptive used, adolescents could have up 3 times the risk of being prescribed antidepressants for the first time after being started on hormonal contraception. For example, teenage girls who used hormonal contraceptives in the form of the patch, or ring or IUD, experienced a 3 fold increase in the risk of being diagnosed with depression. Those who used progestin-only pills experienced a 2.2 fold risk increase, and those who used combined oral contraceptives experienced a 1.8 fold increased risk of subsequent use of antidepressants. At the very least, this means that young teenage women who use hormonal contraception are almost twice as likely to be subsequently diagnosed with depression, and the rate at which these women are diagnosed is highest during the first six months of use. All of the hormonal contraceptives that were analyzed in this study were progestin based. The information pamphlets that accompany these drugs do mention depression as a potential side effect, and women who already have a high risk of depression are not expected to be prescribed hormonal contraception. Therefore, given the increased incidence of first time depression diagnoses and subsequent use of antidepressants, this means that women who were originally at low risk for depression were prescribed these hormonal contraceptives and now have to suffer from these negative side effects. Young adolescents of ages 15-19 in particular have an even higher risk of depression as a result of these contraceptives. Depression is a major risk factor for suicide, and suicide is now the leading cause of death for women ages 15-19. Contrary to hormonal contraception, learning to chart their menstrual cycle will empower these young women with greater understanding of their bodies. Sometimes depressed mood is tied to a particular phase of the cycle and proactive steps can be taken ahead of time to minimize the impact. We must advocate for and protect the young women in our society, and we can do so by encouraging those we know to invest the time to learn fertility awareness and become empowered to take charge of their own bodies.

Association of Hormonal Contraception With Depression Charlotte Wessel Skovlund, MSc1 et al. JAMA Psychiatry. Published online September 28, 2016. doi:10.1001/jamapsychiatry.2016.2387