The hormones in BC can have adverse effects on your mood, says a new study
Many women start using hormonal birth control, like the Pill, vaginal ring, and certain types of IUDs in their teenage and early adult years. There are many benefits to using these forms of birth control, like lighter periods, acne control, less cramping, and—of course—protection from unwanted pregnancy. A new study published in JAMA Psychiatry, however, identified a pretty major risk factor for women using these forms of BC: depression. We know that hormonal birth control, especially the Pill, carries some risks (like increased likelihood of developing blood clots, for example), but the relationship between depression and hormonal birth control is still not totally understood.
Scientists have thought for awhile that the hormone progesterone, which is contained in birth control in the form of progestin, plays some kind of role in causing depression. In fact, previous research suggested that there was a link between the two, but that was where the information stopped. (FYI, some pills contain both estrogen and progestin, which are called "combined" pills, and others contain just progestin.) The goal of this new study was to determine exactly which types of birth control carry the highest risk and how big that risk actually is. After a comprehensive evaluation of data from the Danish National Prescription Register of women who took hormonal birth control with no previous depression diagnosis or antidepressant use, the research team concluded that in their findings "use of all types of hormonal contraceptives was positively associated with a subsequent use of antidepressants and a diagnosis of depression." Oof.
If you're wondering which types of hormonal birth control carry the highest risks, Dr. Øjvind Lidegaard, the study's co-author and professor at the University of Copenhagen in Denmark, explains that "there are only small differences in risk between the different pill types, but patches and the vaginal ring carry higher risks than the combined pill." Researchers found that women ages 20 to 34 were at between 1.23 and 1.34 times higher risk (depending on the type of BC they were using) for needing antidepressants for the first time after starting their birth control use. The numbers for adolescent women ages 15 to 19 were, troublingly, even higher. Younger women were between 1.8 and 2.2 times more likely to need first-time antidepressant use, and those who used non-oral hormonal contraceptives (like the vaginal ring or the patch) were at three times the risk.
These findings about younger women are particularly concerning, since unwanted teen pregnancy rates have dropped largely after programs that promote long-acting hormonal birth control like IUDs and implants have been introduced. Luckily, these types of birth control are on the lower end of the risk spectrum according to this study, but the hormone-related depression risk to young women is certainly a compounding public health issue. (BTW, here are 3 birth control questions you must ask your doctor)
So what's the takeaway here? Since we still don't know exactly why progestin is linked to depression, Lidegaard says doctors "should be more selective in which women we prescribe these pills for." For example, those "with recent depression or current depression should possibly choose another type of contraception (like a copper, non-hormonal IUD)." Of course, if you have depression and you want to use hormonal birth control that is 100% your choice, but awareness of the potential risk is half the battle.