For many young women, the study published by scientists at the University of Copenhagen in regards to the risk of depression while on birth control might not mean anything. But for others, it validated something that they’ve experienced for years.
The study reported that women using combination birth control pills – which include estrogen and progestin (and are the most commonly used pills) were 23% more likely to have been prescribed an antidepressant, in comparison to nonusers. And those on a progestin-only pill were 34% more likely.
While similar studies have been published before, this particular one has the largest study sample of over 1 million women between the ages of 15 and 34. It followed them over the course of 13 years, from January 2000 to December 2013, and included any woman who had been on birth control in the previous six months. Often, women experience symptoms of depression and take themselves off birth control, which means they’re not included in the “user” group in previous studies.
The study also showed that some of the highest risk rates were seen among teenage girls, who were 80% more likely to be prescribed an antidepressant when they were on combination birth control pills, and 120% more likely when they were on progestin-only pills, compared to those who didn’t use any hormonal birth control.
Ojvind Lidegaard, lead author and clinical professor, explains that the reason they are more vulnerable to this association is “because teenagers generally are sensitive to many medical, social, and psychological events, which is why it isn’t very surprising that they are also more sensitive in that age for external hormones. They already experience hormonal changes within their own hormones.”
Holly Grigg-Spall, author of Sweetening the Pill, has been researching and writing on emotional and psychological side-effects of hormonal birth control for the past eight years. As a woman who had a similar experience with birth control, she was frustrated when shortly after the study came out, the medical community rushed to discredit it.
Dr. Cora Breuner, a Seattle pediatrician and chair of the committee on adolescents for the American Academy of Pediatrics, seemed to take the results with a grain of salt. In an interview with NYMag, she emphasized that most women use hormonal contraception with no mental health effects and noted that contraceptives are regularly used to help regulate their menstrual cycles. Regardless of the study’s results, she also stressed that “an unintended and unwanted pregnancy far outweighs all the other side effects that could occur from a contraceptive.” Which led Holly to question, why bother researching the side effects in the first place?
These seemingly unsympathetic points of views are why Holly does the work that she does. “Just because it’s not happening to you, doesn’t mean it’s not a valid experience,” she stressed. In her 8 years of research, Holly found that the other women she spoke with seemed to blame other things before they blamed the pill.
“Some women have reached out independently, but in general it’s a difficult topic because women feel it’s their responsibility to prevent unplanned pregnancy. When they look back on their experiences, they blame themselves for not figuring it out and they often feel judged,” explained Holly.
She also noted that in her research, “It seems very normal for women to be on medication even if they’re healthy. For example, they’re usually on the pill to regulate their period, even though that’s not what it’s meant for.”
People often suggest alternative forms to the pill like an IUD or a patch, but this study shows that those other forms of contraception actually have higher risks. Compared to nonusers, the rate of antidepressant prescriptions increased by 40% for those using a progestin-only IUD, 60% for those using a vaginal ring, and 100% for those using a patch.
Jackie Roman, a senior in college, has been on birth control since she was 17. She was on the pill for almost three years before she decided to switch to Implanon, which is a tiny plastic rod inserted in her arm. She was using Implanon for the past four months, but is currently in the process of switching to NuvaRing due to the effects that it had on her menstrual cycle. However, she felt that while on Implanon her hormones were far more balanced. After three years on the pill, she caught on to the fact that the mood changes she was experiencing had to be from the additional hormones.
“There’s no way the pill doesn’t affect your mood. It made me easily upset, easily irritated, and far more emotional,” said Jackie. “People are quick to prescribe any kind of birth control, but the pill especially. When I went to my doctors with my concerns, they always seemed to enforce that there were other doses of the pill instead of giving alternate options.”
Jackie believes this side effect of the pill shouldn’t be accepted, but that it should be improved upon. She discussed different ways her experience could’ve benefitted.
“If you’re on birth control, a gynecologist or physician should want to see you more often. A year is too long to go with no one to express these grievances to. There should be some kind of check-in process, otherwise you’re left on your own to know if what you’re feeling is connected to it,” expressed Jackie.
When asked what they would like to see change now that the study has been published, Øjvind and Holly both agreed. “That women are informed about this potential risk with use of hormonal contraception, and that doctors are aware of this association when they prescribe the pill, especially to adolescents,” said Ojvind.
“Don’t prescribe the pill if women have already had a history of depression. There should be a warning to women so they can make informed choices and be educated on what’s going on with their body,” affirmed Holly.