Is There A Link Between Depression And The Pill?
A study published in Jama Psychiatry shows a firm relationship between use of the pill and heightened rates of depression. The study looked at all types of hormonal contraceptives, including the pill, the patch, the vaginal ring, and hormonal IUDs. It’s the largest study of its kind, and the results are sobering — and probably not altogether surprising for some women on the pill.
Previous studies have attempted to evaluate how low-dose hormonal contraceptives affect the risk for depression, with varying results. Two studies found that teens who used progestin-only contraceptives had an increased chance of using antidepressants compared to non-users; one study found absolutely no association between oral contraceptives and shifting moods; and two studies found that hormonal contraception was associated with better mood.
The aim of this particular study was to assess if (and by how much) hormonal contraceptives increased women’s risk of needing an antidepressant for the first time or receiving a diagnosis of depression for the first time.
Researchers from the University of Copenhagen studied one million Danish women between the ages of 15 and 34, and tracked them for 13 years. From January 1, 2000, to December of 2013, every female in the system was tracked by an identification number. Using a national prescription database as well as a national psychiatric registry, researchers could track how many participants received (and filled) prescriptions for hormonal birth control and how many of those participants went on to be prescribed antidepressants or received a diagnosis of depression.
In addition to age requirements, participants had to meet certain medical criteria. The women in the study had no prior depression diagnosis, had never redeemed a prescription for antidepressants, and were clear of any other major psychiatric diagnosis. They also had not been diagnosed with cancer or venous thrombosis, and had not received any infertility treatment
The data was collected from as early as January 1, 1995, up until December 31, 2013. It was then analyzed from January 1, 2015, through April 1, 2016.
Women taking a combined oral contraceptive (progestin and estrogen) were 23% more likely to be diagnosed with depression. Women using progestin-only pills (also known as “the mini-pill”) were 34% more likely to be diagnosed with depression. Women taking a non-pill form of hormonal contraceptives – such as the patch, the vaginal ring, or hormonal IUDs – were even more likely to be diagnosed with depression, at a rate much higher than either kind of pill. Teens had it the worst, though. They were 80% more likely to be diagnosed with depression when taking the combined pill, and were twice as likely to experience depression with the progestin-only pill.
The study sums it up: “Use of hormonal contraception, especially among adolescents, was associated with subsequent use of antidepressants and a first diagnosis of depression, suggesting depression as a potential adverse effect of hormonal contraceptive use.”
Birth Control & Cancers
This Copenhagen study only focused on depression risk. However, there have been studies done on the relationship between birth control and breast cancer risk in the past. According to the National Cancer Institute, birth control has been linked to an increase in risk for cancers of the breast, liver, and cervix — but it greatly lowers the risk of ovarian cancer and endometrial cancer.
The amount of hormone and the type of hormone play pivotal roles in breast cancer risk. One study found that risk decreased with the amount of estrogen in the pill. High-dose estrogen pills resulted in 2.7 times higher breast cancer risk in women who took it compared to women who didn’t take any oral contraceptives. Moderate-dose estrogen pills resulted in 1.6 times higher risk. However, women taking low-dose estrogen pills were not found to have an increased risk of breast cancer at all. This study indicated that pills with other formulations such as ethynodiol diacetate (a type of progestin) or triphasic combination pills with 0.75 milligrams of norethindrone (a type of progestin) increased a woman’s risk by 2.6-fold and 3.1-fold, respectively.
What This Means For You
The results of the study may make some women question being on the pill, and by all means, question away! However, be aware of other factors at play, and talk to your doctor about your specific needs if you’re considering going on or off the pill. The researchers of the study made sure to note that women are twice as likely as men to experience depression throughout their lifetime. This is possibly due to fluctuating levels of the two female sex hormones, estrogen and progesterone — in particular, raised progesterone levels.
Though there is a strong correlation between using the pill and rates of depression, the study does not prove causation, and more studies need to be done to determine that. Ultimately, you know yourself best, and if you think the hormonal contraceptives you’re taking are affecting your mood, talk to your doctor.
Did you take contraceptives and experience depression? Let us know in the comments.