Earlier this month some surprising results new research was presented at a conference. At the Virtual European Congress of Psychiatry, Elena Toffol and her team from the University of Helsinki in Finland reported that they had found that the number of suicide attempts was lower in women who used hormone contraception compared to those who did not. In fact, the latter group was nearly 40 percent more likely to attempt suicide than the former, they reported.
These results (which have not yet been peer-reviewed) may be the opposite of what you have heard – or experienced: Does hormonal contraception not have a reputation for exacerbating mental illness? Your confusion would be forgiven. Maybe you remind of headlines from 2017, where one Danish study found that hormonal contraception was associated with one increase in suicide attempts.
This gigantic contradiction is just one of many in years of research that have attempted to answer the question of whether hormonal contraception causes psychological side effects – and the jury is still out. In September 2016 New York Times published one Article with the heading “Contraceptives linked to the risk of depression.” Six months later, the same publication came out with a piece the headline “Birth control causes depression? Not so fast.”
Oral contraceptives, which first came on the market more than 60 years ago, are astonishingly popular. Over 100 million women worldwide are estimated to be current users. The pill, as the medicine is known, comes in two forms: a version with only progesterone and a combined estrogen and progesterone version. Both contain synthetic hormones designed to stop or reduce ovulation – the release of the egg from the ovary.
But the decision to use hormonal contraception is not always borne out of a desire to remain pregnant. The name is rather a misleading designation; a more appropriate term would be “hormone medication, often used as contraception.” Hormonal contraception is prescribed for a veritable smear table of conditions including migraine, cystic acne, chronic menstrual pain, polycystic ovary syndrome (PCOS) and endometriosis.
Fears of the pill’s psychological side effects fall into a growing trend that has emerged in recent years: a widespread distrust of hormonal contraception and vigilance over its disadvantages, now that the satisfaction of hard-fought victories for women’s self-determination has disappeared. ONE shower of books questions about how hormonal contraception negatively affects its users have been published in the last decade. Coming out as the biggest concern are mood swings, which are reported to be reason number one women choose to go from birth control pills.
But we do not yet have a clear answer as to whether the connection between birth control pills and mood is real. The biggest problem is that most studies to date have been cross-sections in design, meaning they involve taking a group of women using the pill and comparing them to a group not using it. “It does not take into account that women who tried the pill and had negative moods or negative effects on sexuality would get out of it,” says Cynthia Graham, professor of sexual and reproductive health at the University of Southampton and editor-in-chief of Journal of Sex Research. “For me, that’s a big reason why it’s hard to answer the question.” This is called survival bias or healthy user bias.