Every form of Hormonal Contraception I used caused Hormonal Imbalanced depression and manic depression for me- Mirena IUD being the worst. I never want kids and non hormonal methods are not as effective at all, especially with Abortion being illegal still in many places. Finally at 33 I was approved for tubal ligation. If someone had only believed I knew myself and my body earlier, and respected my body autonomy I could have avoided over 15 years of horrible, horrendous side effects. Not being on Hormonal Birth control has given me my life back.
1
I was on Ortho Tri Cyclen for five months many years ago.
1. I gained weight.
2. I was depressed.
3. I had no sex drive.
5. On every fourth Sunday, I turned into a raving lunatic.
When I figured that out, I said, "No more!"
1. I gained weight.
2. I was depressed.
3. I had no sex drive.
5. On every fourth Sunday, I turned into a raving lunatic.
When I figured that out, I said, "No more!"
So finally someone tells me?
I just quit hormonal birth control after more than a decade of use and I feel better. I have suffered from depression and no one even mentioned this as a possible cause. 40%!! That's huge.
Few easy choices in life.
I just quit hormonal birth control after more than a decade of use and I feel better. I have suffered from depression and no one even mentioned this as a possible cause. 40%!! That's huge.
Few easy choices in life.
I understand that statistics and studies matter more than anecdotal reports. I remember telling a woman who was prescribing my anti-depressants that someday there would be a study linking estrogen to depression. I am so glad to be vindicated after years of suffering.
I have major depressive disorder. My depression is just barely manageable with anti-depressants. Back in day, as one commenter said, there were only rudimentary anti-depressants. I tried them all. I have used most that are on the market today. And generic anti-depressants often do not work the same as the original drug for me.
I was just plain crazy on birth control pills. I made a connection for me and used IUD's until I was finished having children. I absolutely refused hormones for menopause. I got through the worst of it with soy in small quantities, thankfully.
I am neither a scientist nor a researcher. I figured out the hormones caused my depression to worsen. Why didn't someone figure this out years ago? I am sure there was anecdotal evidence everywhere. Is it because birth control pills were strictly for women? I've often wondered.
I have major depressive disorder. My depression is just barely manageable with anti-depressants. Back in day, as one commenter said, there were only rudimentary anti-depressants. I tried them all. I have used most that are on the market today. And generic anti-depressants often do not work the same as the original drug for me.
I was just plain crazy on birth control pills. I made a connection for me and used IUD's until I was finished having children. I absolutely refused hormones for menopause. I got through the worst of it with soy in small quantities, thankfully.
I am neither a scientist nor a researcher. I figured out the hormones caused my depression to worsen. Why didn't someone figure this out years ago? I am sure there was anecdotal evidence everywhere. Is it because birth control pills were strictly for women? I've often wondered.
5
I was on the Pill, briefly, about 40 years ago. In my opinion, they made me fatter, more prone to acne, and more short-tempered. Whether or not they made me depressed, I don't know, but I do know that gaining weight, having more zits, and being short-tempered did not improve my mood, and as soon as I stopped taking the Pill, things got better.
2
Nicholas: Just a note that the facebook thumbnail for this article still states 80% increased risk and could use a correction.
This is a huge study and the implications are far-reaching. I would urge anyone interested in a more detailed report with additional information in other newspapers. I am disappointed that TNYT offers such limited information. That corrected 80% is not true overall, but it is true for teens taking the combined pill. Those of any age using a hormonal IUD were also at much higher risk of being diagnosed with depression.
The statement, "If you use certain anti-depressants, you're 80% more likely to become depressed." is true overall.
Saying that it's only an increase from 1.0% to 1.8% is misleading and politically motivated.
Saying that it's only an increase from 1.0% to 1.8% is misleading and politically motivated.
To the surprising number of snide comments that an unplanned pregnancy might also trigger depression:
1) Luckily, there are a number of other effective contraceptive methods! So there's no reason that an unplanned pregnancy should be a "control" for hormonal contraceptives.
2) Advil can cause nausea/upset stomach. Just because Advil is not the ONLY POSSIBLE cause of stomach ulcers doesn't mean it's not useful to know that this side effect exists. Personally I would rather know all the side effects of a medication I'm taking, even if some of them are somewhat uncommon.
The invention of hormonal contraceptives unquestionably changed the world for the better. That being said, that doesn't mean we shouldn't study their effects, especially since they are an incredibly common medication that most women will probably take at some point in their lives.
1) Luckily, there are a number of other effective contraceptive methods! So there's no reason that an unplanned pregnancy should be a "control" for hormonal contraceptives.
2) Advil can cause nausea/upset stomach. Just because Advil is not the ONLY POSSIBLE cause of stomach ulcers doesn't mean it's not useful to know that this side effect exists. Personally I would rather know all the side effects of a medication I'm taking, even if some of them are somewhat uncommon.
The invention of hormonal contraceptives unquestionably changed the world for the better. That being said, that doesn't mean we shouldn't study their effects, especially since they are an incredibly common medication that most women will probably take at some point in their lives.
5
No surprises here--the anecdotal evidence for this is really strong. I never took the pill but heard all kinds of complaints from women who did, from the late seventies through the nineties.
http://www.thecriticalmom.blogspot.com
http://www.thecriticalmom.blogspot.com
1
Many commenters have been pointing out how this might be exaggerating the risks due to the relatively low base rates in the sample - however, I wonder if the study might actually underestimate the risks. What about women who quickly discontinued use of the pill due to "feeling weird" on it. Anecdotally, I know numerous women who said they couldn't take the pill due to the emotional changes they felt on it. I would think that it is more likely that a woman would stop taking the pill rather than start taking another one.
6
I can;t help but laugh reading this because, as a woman with PMDD, hormonal contraceptives are the ONLY thing that alleviate my depression. Having a hormonal IUD has been life changing in that respective (and it's intended use). Some women with PMDD do have success with anti-depressants, but strikes me as a little ironic that the same thing that apparently causes depression in some women cures it in others. It's almost as though everyone's body chemistry is different and reacts differently to similar chemicals?
7
My own experience with birth control pills also included depression, reduced libido and suicide attempts, all of which cleared immediately on cessation of the pill. However, the clear take-away of this study is that we should be focusing our research attempts of ways to make non-hormonal methods AS EFFECTIVE AS hormonal methods, and to make them comfortable to use as well.
5
Exactly! If we could have some non hormonal options that were 99.9% effective that would be much better. Barrier methods, fertility tracking etc just are not effective enough, especially for those who always want to be child free by choice. The copper IUD is 'non hormonal" but the copper has a lot of negative side effects. We can't win :(
1
I took a combination pill for a few months about 40 years ago, and felt so horribly depressed I thought I would spontaneously drop dead. Fortunately, I wasn't suicidal.
I stopped it, and the depression was much better.
With menopause, I haven't taken any hormones because I don't want to go through that again!
I stopped it, and the depression was much better.
With menopause, I haven't taken any hormones because I don't want to go through that again!
3
The relationship *may* be causal, but it may not be.
Women who begin hormonal contraception may be moving into a new phase of their intimate relationships, which alone might increase risk of depression. The researchers nod to this sort of possibility this by looking at a the subset of their study that were already sexually active (participants who had previously had sex, but with, for example, condoms for birth control). They found comparable results. However, the move from condoms to hormonal birth control is a shift from an ad hoc to a long term birth control strategy, and thus may well reflect a corresponding relationship shift, from a pattern of occasional sex to an anticipated long term intimacy. That shift can perhaps bring great emotional rewards (not measured here, btw), but also emotional risks.
To claim that the effect is due to the hormonal nature of the birth control method, not merely its long-term aspect, one would need a comparison to other long-term birth control methods, like IUD's. This was not done.
Another point: it is possible that the move to hormonal birth control brings the participant in closer contact to the medical/pharmaceutical world, which alone could increase the diagnosis rate of depression and frequency of anti-depressant prescription.
Women who begin hormonal contraception may be moving into a new phase of their intimate relationships, which alone might increase risk of depression. The researchers nod to this sort of possibility this by looking at a the subset of their study that were already sexually active (participants who had previously had sex, but with, for example, condoms for birth control). They found comparable results. However, the move from condoms to hormonal birth control is a shift from an ad hoc to a long term birth control strategy, and thus may well reflect a corresponding relationship shift, from a pattern of occasional sex to an anticipated long term intimacy. That shift can perhaps bring great emotional rewards (not measured here, btw), but also emotional risks.
To claim that the effect is due to the hormonal nature of the birth control method, not merely its long-term aspect, one would need a comparison to other long-term birth control methods, like IUD's. This was not done.
Another point: it is possible that the move to hormonal birth control brings the participant in closer contact to the medical/pharmaceutical world, which alone could increase the diagnosis rate of depression and frequency of anti-depressant prescription.
5
IUDs also use hormones. The comparison would have to be with condoms or diaphragms, which would be very difficult indeed to study since it would be entirely self-reported.
3
@Sarah: There is a non-hormonal IUD—ParaGard.
1
I am puzzled by your "correction", stating that the real increase of risk was 40%. The risk stated in the article is 70%.
Here is the last sentence from the results section of the abstract in the original article:
"When the reference group was changed to those who never used hormonal contraception, the RR estimates for users of combined oral contraceptives increased to 1.7 (95% CI, 1.66-1.71)."
That's a 70% increase, not a 40% increase.
For some users, the risk was much higher:
"Adolescents (age range, 15-19 years) using combined oral contraceptives had an RR of a first use of an antidepressant of 1.8 (95% CI, 1.75-1.84) and those using progestin-only pills, 2.2 (95% CI, 1.99-2.52). "
The first figure is an 80%increased risk for adolescents.
The last figure translates into a 120% increased risk--or differently stated, these users have a risk that is 220% the risk of non-users, more than double. That should be the headline. Why is the Times downplaying the risks of contraceptives? If this was an honest mistake, please hire someone with a basic understanding of statistics.
Here is the last sentence from the results section of the abstract in the original article:
"When the reference group was changed to those who never used hormonal contraception, the RR estimates for users of combined oral contraceptives increased to 1.7 (95% CI, 1.66-1.71)."
That's a 70% increase, not a 40% increase.
For some users, the risk was much higher:
"Adolescents (age range, 15-19 years) using combined oral contraceptives had an RR of a first use of an antidepressant of 1.8 (95% CI, 1.75-1.84) and those using progestin-only pills, 2.2 (95% CI, 1.99-2.52). "
The first figure is an 80%increased risk for adolescents.
The last figure translates into a 120% increased risk--or differently stated, these users have a risk that is 220% the risk of non-users, more than double. That should be the headline. Why is the Times downplaying the risks of contraceptives? If this was an honest mistake, please hire someone with a basic understanding of statistics.
9
I have never taken oral contraceptives in my life, luckily I have had a very predictable cycle with minimal problems. My husband and I always used "barrier" methods with great success. I have also heard that hormonal contraceptives blunt a woman's sex drive. I also never suffered from depression, I did suffer from anxiety after having a baby until my hormones stabilized. Thankfully it passed.
2
Today’s pills contain much lesser doses of estrogen and progestin, and alternate methods of contraception (such as ring and IUDs) have an even lower concentrations of hormones. Women using modern combined hormonal birth control methods experience a variety of moods. Speaking both psychologically and scientifically, everyone reacts to birth control differently. It's 2016 and we have a choice. Every woman should be equipped with the knowledge to decide what she wants to put into her body.
3
A shame that the diaphragm is no longer available for women. Yes, it wasn’t as effective as the pill or IUD, but it was good option for those of us who wanted a hormone-free birth control method back in the day.
7
Condoms. (Setting aside improper use, they really should be 100% effective, entirely safe. I can't help wondering about anyone who claims their condom "broke," having blown them up like balloons.)
I agree about the whole "broke" condom puzzle - what are people doing, catching their rings on the condom and snagging it?
"Over all, compared with non-users, users of hormonal contraception had an 80% increased risk of depression."
80% over what base?
Is it 1 in 1000 women rising to 1.8 in 1000? Is it 1 in 100 rising to 1.8 in 100? Is it 3 out of 10 rising to more than 5 out of 10? Without the numbers the study has no real information.
And did they follow up to try to find if it was causative or correlative, or is this the result of a study done to demonstrate a viable hypothesis rather than a viable conclusion?
It makes a difference.
80% over what base?
Is it 1 in 1000 women rising to 1.8 in 1000? Is it 1 in 100 rising to 1.8 in 100? Is it 3 out of 10 rising to more than 5 out of 10? Without the numbers the study has no real information.
And did they follow up to try to find if it was causative or correlative, or is this the result of a study done to demonstrate a viable hypothesis rather than a viable conclusion?
It makes a difference.
10
Did you NOT read the sentence that said over a million Danish women were studied?
2
John Bosch, sorry, that still doesn't answer her question. (You should be sure you've read carefully and thought carefully before you scold someone for not reading carefully.) She didn't ask about the number of people in the study. She asked about what the rate of depression was among the women in the study. If only 1 in 1,000 (which, to help you out, would be 1,000 of the million women) in the non-using group became depressed, that would mean that 1.4 per 1,000 would become depressed among those who used contraceptive pills, which makes the risk rather minimal. If, on the other hand, 200 per 1,000 became depressed in the non-using group (200,000 of the million women in the study), then 280 per 1,000 women (280,000 women total) would become depressed in the using group (this is 200 x 1.4, just to be super clear), which is much more worrisome. So, you can see how these "base" numbers have an impact on how we view these results. Again, please don't be so ready to scold. Especially, don't scold women who know much more than you do. (Note, I'm using the 40% increase cited in the edited article, not the originally stated 80% that Cathy's comment was based on.)
2
Throughhiker,
And yet, if a 17 year old girl asked her doctor, "Does this study say that if I take hormone altering birth control, will I be at an 80% increased risk of depression?", the answer would be Yes.
Saying that it's only an increase from 1.0% to 1.8% (a classic example of Yes, but...) is misleading and politically motivated.
And yet, if a 17 year old girl asked her doctor, "Does this study say that if I take hormone altering birth control, will I be at an 80% increased risk of depression?", the answer would be Yes.
Saying that it's only an increase from 1.0% to 1.8% (a classic example of Yes, but...) is misleading and politically motivated.
Is it possible that the desire to avoid pregnancy while being sexually active exacerbated the tendency to feel depressed, especially when 'tracked'/questioned, especially among teens? It seems reasonable that, unless celibate or with a medical contraindication, women not taking hormonal contraception would tend to be in committed relationships or otherwise at the point of welcoming a pregnancy, less likely to feel depressed or to risk taking a drug during the early weeks of pregnancy.
Another point: prescribing antidepressants is influenced by the intensity of symptoms, which is heavily influenced by the amount of attention given to eliciting symptoms. One wonders how many of these women might have reported symptoms (we all go through mild bouts of being 'down') to their providers if they weren't more intensely questioned. Just these two points added together could slant the results.
Another point: prescribing antidepressants is influenced by the intensity of symptoms, which is heavily influenced by the amount of attention given to eliciting symptoms. One wonders how many of these women might have reported symptoms (we all go through mild bouts of being 'down') to their providers if they weren't more intensely questioned. Just these two points added together could slant the results.
1
Major, major stretch to assert that the stress of being interviewed caused as much as an 80% increased risk of depression. That risk would be visible in every psychological study involving an interview, which is practically every psychological study.
6
Yeah no kidding.
I used Ovulen-21 for the three years of my first marriage, almost 50 years ago. Of course, that was just one part of my triple whammy--chemical depression tied to my menstrual cycle. Going off the pill and using an IUD instead--God bless you, Dr. Lippes!--gave me much of my life back.
When I finally did get a diagnosis of double dysthemia--many years later--I finally understood why I spent all of my first marriage crying and why so much of my strength and sense of humor had mysteriously disappeared.
How many other women had so much of their lives destroyed by that little miracle pill?
PS: I had that lovely little Lippes loop in place for 17 years. I got pregnant with a wanted, planned child a month after having it removed--at the age of 39. Too bad the horrible Dalkon Shield took so many good alternatives down with it.
I used Ovulen-21 for the three years of my first marriage, almost 50 years ago. Of course, that was just one part of my triple whammy--chemical depression tied to my menstrual cycle. Going off the pill and using an IUD instead--God bless you, Dr. Lippes!--gave me much of my life back.
When I finally did get a diagnosis of double dysthemia--many years later--I finally understood why I spent all of my first marriage crying and why so much of my strength and sense of humor had mysteriously disappeared.
How many other women had so much of their lives destroyed by that little miracle pill?
PS: I had that lovely little Lippes loop in place for 17 years. I got pregnant with a wanted, planned child a month after having it removed--at the age of 39. Too bad the horrible Dalkon Shield took so many good alternatives down with it.
11
I never felt right when I was taking the birth control pill. I was neither happy or sad I was just O.K. The moment I decided to stop taking the pill I felt like I had my old self back. Of course that meant that my husband had to be the one to get a vasectomy. I was not going to tie my tubes either. Too many friends who had warned me about their loss of libido. Long story short. Stop messing with the woman's body. Its so much easier for the man to either wear a condom or get a vasectomy.
20
Now if we could only get vasectomies covered by the Affordable Care Act!
7
Snark aside, now let's get down to details.
This article and the publication it cites is VERY misleading for the general public. "80% increase in depression risk" sounds exciting, maybe scary. But the actual numbers are far from scary.
Take the most basic finding in the study. First use of antidepressant occurred 50,346 times among 3,041,595 person-years of non-contraceptive users. That's a rate of 0.0166 or 1.66% of non-contraception users who started first use of antidepressant. First use of antidepressant occurred 74,126 times among the 3,518,381 contraception users (combined hormone contrac) for a rate of 0.0211 first-use per person-year, or a rate of 2.11%.
Now compare. This association study (NOT causation study) suggests that going from non-contraception use to contraception use increases the risk of starting an antidepressant from a tiny 1.66% all the way up to an also tiny 2.11%. It's an 80% relative increase. But in absolute terms it is a miniscule increase! Based upon these numbers, a physician (like me) would have to treat 221 women with a combined hormone contraceptive in order to cause ONE extra first use of an antidepressant. 221!
And since this is an association study rather than causation, it may be that there is no increase at all. Perhaps there are other factors than contraception which lead to slightly more antidepressant use.
NY Times, you should know better than to report stuff in relative terms only!
--Joshua Steinberg MD
This article and the publication it cites is VERY misleading for the general public. "80% increase in depression risk" sounds exciting, maybe scary. But the actual numbers are far from scary.
Take the most basic finding in the study. First use of antidepressant occurred 50,346 times among 3,041,595 person-years of non-contraceptive users. That's a rate of 0.0166 or 1.66% of non-contraception users who started first use of antidepressant. First use of antidepressant occurred 74,126 times among the 3,518,381 contraception users (combined hormone contrac) for a rate of 0.0211 first-use per person-year, or a rate of 2.11%.
Now compare. This association study (NOT causation study) suggests that going from non-contraception use to contraception use increases the risk of starting an antidepressant from a tiny 1.66% all the way up to an also tiny 2.11%. It's an 80% relative increase. But in absolute terms it is a miniscule increase! Based upon these numbers, a physician (like me) would have to treat 221 women with a combined hormone contraceptive in order to cause ONE extra first use of an antidepressant. 221!
And since this is an association study rather than causation, it may be that there is no increase at all. Perhaps there are other factors than contraception which lead to slightly more antidepressant use.
NY Times, you should know better than to report stuff in relative terms only!
--Joshua Steinberg MD
32
As a physician you should know that first use of anti depressants is not equivalent to incidence of depression. Most depression goes untreated. In American women the rate of depression is 12%. You site a rate of 1.66% for first use of antidepressants. Extrapolating from the rate of depression, rather than first use of antidepressants, you get a rate of 5.3% of women using hormonal birth control suffering from depression as a result of such use. In that case of your 221 women 12 would suffer unnecessary depression, with only one going on antidepressants.
Big Pharma makes big money off both birth control and antidepressants. I wonder if that is why this story is buried and you trivialize the impact.
Big Pharma makes big money off both birth control and antidepressants. I wonder if that is why this story is buried and you trivialize the impact.
9
I used first use of antidepressant because it was the convenient first result shown in the study. I could have scrutinized any of the results similarly.
Big Pharma no longer makes big money off contraceptives and antidepressants. All the antidepressants are cheap generics now. And there are plenty of cheap generic safe birth control pills. Even the contraceptives like Mirena IUD or Nexplanon implant seem expensive at first but if used for the 5 or 3 year duration, respectively, they also turn out to be inexpensive.
I do not find the subject here trivial. Contraception and unintended pregnancy are very serious matters. Same for depression.
--JS
Big Pharma no longer makes big money off contraceptives and antidepressants. All the antidepressants are cheap generics now. And there are plenty of cheap generic safe birth control pills. Even the contraceptives like Mirena IUD or Nexplanon implant seem expensive at first but if used for the 5 or 3 year duration, respectively, they also turn out to be inexpensive.
I do not find the subject here trivial. Contraception and unintended pregnancy are very serious matters. Same for depression.
--JS
1
As a doctor, do you routinely assert that 80% increases in depression "could be caused by other factors", or do you cite research explaining what those other factors are, how much each factor contributes to depression, and that those factors add up to exactly 80%?
3
Bigger picture: this is a lower risk than the risk of postpartum depression:
http://postpartumprogress.org/the-facts-about-postpartum-depression/
So by preventing pregnancy, contraceptives lower the risk of pregnancy-related depression.
http://postpartumprogress.org/the-facts-about-postpartum-depression/
So by preventing pregnancy, contraceptives lower the risk of pregnancy-related depression.
14
It's an 80% increase. So if the rate is normally, say, 1% it would increase to 1.8%. An increase, yes. But the absolute number depends on the base rate which they don't give.
And if you really want to consider all possibilities, they also didn't measure the increase in depression between a control group without an unintended pregnancy and a group with an unexpected pregnancy due to no contraception.
And if you really want to consider all possibilities, they also didn't measure the increase in depression between a control group without an unintended pregnancy and a group with an unexpected pregnancy due to no contraception.
9
This is important to note. I would also like to know the depression rate for teenage mothers. Which would be more likely to cause depression? Contraceptives or being a teenage mother?
13
It's not an either or choice. It's comparing a specific form of birth control to not taking that form of birth control.
And how is this news? I have known this for 30 years. Ask a woman on the pill. She will tell you.
9
These figures are very significant. Depression is horrific and almost 1 in 4 women in America take an antideperessant at some stage of their life. I am aware for many years that the standard contraceptive pill and the copper coil increase the copper level. High copper is involved in anxiety,depression, panic attacks, post-natal depression and even paranoid schizophrenia. Copper is essential for life in about 20 chemical reactions. Zinc is involved in 200 reactions in the brain and is useful for bringing down high copper. Taking zinc to neutralise high copper may be a feature of contraceptives in future.
Why isn't this front page news? Twelve million women in America suffer from depression each year. Many of those, especially the young, attempt suicide. If this study is to be believed, 5,300,000 cases of depression could be prevented EACH YEAR. How many lives are lost needlessly each year?
Certainly that news demands more than a few paragraphs in the health page?
Certainly that news demands more than a few paragraphs in the health page?
7
"...while those who used those who used the levonorgestrel IUD (brand name Mirena) tripled their risk."
the copper IUD (brand name ParaGard) would have been (was?) a good control.
the copper IUD (brand name ParaGard) would have been (was?) a good control.
7
I've often wondered, which is the real method of contraception here? The synthetic hormones or the fact that they make you gain weight, break out in acne, have headaches, have greasy hair and scalps, create fatigue and make you depressed? I mean, who wants to have sex after dealing with all that?
8
Strange comments mention getting acne because a lot of pills actually suppress acne.
You think contraception causes depression? Try unintended pregnancy...
30
An 80 percent risk is extremely high. I kept reading the article to see if I misunderstood. 80 percent is alarming isn't it????
2
It's not an 80% risk. It means that those who used these contraceptives are 80% more likely than those who don't. A little less than twice the risk. So, for example, if 10 out of 1000 women who didn't take the hormonal contraceptives became depressed, 18 out of 100 who did would similarly become depressed. A significant increase, to be sure, but still not a huge number.
14
Not an 80% risk - it said an 80% increase. Two very different things!
2
Susan's reply is good except for a typo: if 10 of 1000 control women became depressed, 18 of 1000 (not 100) who used hormonal contraceptives would.