Illustration by: Corey BrightDestiny Hosmer - Staff Writerdrhosmer@uab.edu
A new study suggests a link between the use of hormonal birth control and depression, although some experts say that the benefits still outweigh the risks.
Taking hormonal birth control could be correlated with an increased risk for depression as compared to not taking a hormonal contraceptive method, according to an article published in September by JAMA Psychiatry, a peer-reviewed medical journal published by the American Medical Association.
For the study, researchers tracked the health of more than one million Danish women between the ages of 15 and 34 over the course of 14 years. The average age of the participants was 24.
Overall, two percent of all women aged 15 to 34 were diagnosed with depression at a hospital and 13 percent began taking antidepressants.
The study concludes that the “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.”
“Depression and other mood disturbances have been suspected to be associated with hormonal contraceptives before this study, but data [was] conflicting,” Kathleen Pridgen, M.D., associate professor and acting medical director at UAB Student Health and Wellness, said.
According to the study, the users of combined oral birth control pills experienced a higher rate of subsequent antidepressant use during the study period than those not using the birth control.
Women who used progestin-only birth control pills experienced a 1.3-fold higher rate, those who used the transdermal patch had a two-fold increased risk and those who used the vaginal ring had a 1.5-fold increased risk.
Pridgen said that starting birth control is a personal decision, and all women considering birth control should know about the risks versus the benefits.
“Results from these types of studies have to be interpreted cautiously,” Pridgen said. “There is a difference between the absolute risk versus the relative risk. For this study, even though the relative risk of depression associated with contraceptives is higher than with non-users, the absolute, overall risk is still very low. The study only reports the relative risks.”
Pridgen also said that due to the observational nature of this study, the link between depression and hormonal contraception is only an association, not a causation.
“This is one of the first lessons of statistics: correlation does not equal causation. Both depression and hormonal contraceptive use are very common in the general population,” Pridgen said.
The researchers noted that adolescent women seemed more vulnerable to the risk of depression than women ages 20-34 and that further research is needed to examine depression as a potential adverse effect of hormonal contraceptive use.
Although there may be an increased risk of depression among young women taking hormonal birth control, there are numerous risks associated with early pregnancy as well.
“Overall, the risks associated with an unintended pregnancy, especially in the adolescent population aged 15-19, are quite significant,” Pridgen said. “Epidemiological data tells us that about 10% of women in this age group will become pregnant.”
99 percent of U.S. women between the ages of 15-44 who had ever had sexual intercourse used at least one contraceptive method at some point in their lifetime, including 88 percent who used a highly effective, reversible method, such as birth control pills, an injectable method, a contraceptive patch or an intrauterine device, according to the Centers for Disease Control and Prevention’s National Health Statistics Report in 2013.
UAB’s Student Health and Wellness Center provides access to both non-hormonal and hormonal contraceptive methods, including Caya diaphragms, male and female condoms, birth control pills, intrauterine devices, contraceptive rings, birth control patches and contraceptive implants.
Pridgen said that if one method does not work for someone, there are plenty of other options to try.
Purnima Janarthanan, a graduate communication management student, said that she prefers to avoid taking pills, but she is open to finding the right birth control option for her.
“I don’t like taking any kind of pill,” Janarthanan said. “To be more precise, I prefer natural products. I’ve read a lot of articles on side effects caused by different pills and that is the main reason why I don’t prefer pills I’m still in the thought process of narrowing it down to one suitable option for my body.”
Gabrielle Valle, a psychology major, said that she prefers taking oral contraceptives and that it helps to regulate menstrual cycles and control acne. However, she said that women’s health is still a taboo subject.
“As far as contraceptives on UAB’s campus goes, the joke is ‘condoms are handed out like free candy everywhere you go, but you still gotta pay to print,’ which pretty much sums up the readily available knowledge about contraceptives,” Valle said. “It’s not openly advertised to the public because it’s still a taboo and makes people squirm when they hear about periods and pregnancies. The only way you’ll learn about the eight different types of contraception is if you meet with a doctor in private.”
“For many women, hormonal forms of contraception represent the most effective, easily adhered to and easily tolerated way to prevent unintended pregnancy,” Pridgen said. “I think the results of this study should be discussed, but the association of the risk of depression is still just, one, an association and, two, a small overall risk.”
Students can book an appointment to see a women’s health care provider to discuss any of these options at any time via the patient portal on Blazernet.
