Women who use birth control are closely involved with men. Men are a leading cause of female depression.
178
It is dangerous and irresponsible for Mr. Carroll to attempt to spin the results of a study as important as this. He is writing it out of fear that the teenage pregnancy rate may rise if birth control pills lose their good reputation. However, the response to a study like this should be an article that spreads awareness about the non-hormonal birth control methods available (like IUDs) or calls for more research into alternative methods, not a fear-based attempt to dismiss the issue. Studies that look into a medication's side effects are just that, and should be allowed to be heard, un-spun, by the community of women who may be affected by them.
As someone who spent 5 years on birth control, in and out of depression, and never connecting the two until I stopped taking it, this kind of behavior angers me. When you think about the few teenage pregnancies you may prevent with a spin article like this, remember the millions of young women whose lives you may be debilitating with unnecessary depression. If this information was more available, I would have stopped the pill and gotten the copper IUD and avoided all that misery.
This is very different from the risk of myelosuppression that comes with your ulcerative colitis medication. There, your doctor tells you about the risk beforehand and may monitor you as you are taking it. With birth control, no one told me about the risk of depression because of articles with headlines like this.
As someone who spent 5 years on birth control, in and out of depression, and never connecting the two until I stopped taking it, this kind of behavior angers me. When you think about the few teenage pregnancies you may prevent with a spin article like this, remember the millions of young women whose lives you may be debilitating with unnecessary depression. If this information was more available, I would have stopped the pill and gotten the copper IUD and avoided all that misery.
This is very different from the risk of myelosuppression that comes with your ulcerative colitis medication. There, your doctor tells you about the risk beforehand and may monitor you as you are taking it. With birth control, no one told me about the risk of depression because of articles with headlines like this.
67
I don't mind when a man writes about women's health issues, but when you know it's a man writing it immediately... that's a major problem.
You can't just throw out "maybe having sex causes women to be depressed," without any explanation. Also, because birth control does not implicitly mean sex, its prescribed for a whole host of reasons.
You can't just throw out "maybe having sex causes women to be depressed," without any explanation. Also, because birth control does not implicitly mean sex, its prescribed for a whole host of reasons.
67
Depression is easy to dismiss if you haven't experienced it. When I was taking birth control pills in the early 70's, I did suffer from depression. Had no Idea why, at the time. Later, during both of my pregnancies, the depression came back, and lifted immediately as soon as I gave birth. Birth control pills work by inducing a hormonal"false pregnancy" to stop ovulation. So the hormones are very similar in pregnancy and when taking birth control pills.
It's very easy to trivialize women's emotions, especially when a woman is pregnant. People said "but you look so radiant" and "are you sure you really want this baby." Oddly enough, none of this improved my mood.
This article seems to be s similar attempt to trivialize women's feeling. "It's just hormones, get over it."
Yes, we need better methods of birth control. Yes, many women can use the pill without side effects.
And yes, we need to take emotional side effects seriously. This is a real effect that causes real problems.
It's very easy to trivialize women's emotions, especially when a woman is pregnant. People said "but you look so radiant" and "are you sure you really want this baby." Oddly enough, none of this improved my mood.
This article seems to be s similar attempt to trivialize women's feeling. "It's just hormones, get over it."
Yes, we need better methods of birth control. Yes, many women can use the pill without side effects.
And yes, we need to take emotional side effects seriously. This is a real effect that causes real problems.
42
Mr. Carroll, have you ever suffered with depression? Have you ever planned to commit suicide, or attempted suicide? Have you ever taken birth control? I found your article extremely dismissive.
For me, hormonal contraceptives triggered major depression and thoughts of suicide. My doctor said that couldn't be possible. However, when I stopped taking birth control pills my thoughts of suicide also stopped. Just coincidence, I was told. I was 17. At 24, I started taking birth control pills for a second time. Again, I became suicidal. Again, as soon as I stopped taking the pill the thoughts of suicide stopped. Again, the doctor said it was just coincidence. Several years later I tried for a third time, with the same results. This time, I didn't listen to my doctor and struggle for years. I stopped taking the pill, paid out-of-pocket for an IUD, which wasn't covered by my plan, and I found a new doctor who didn't tell me, "it's all in your head."
My "side effects" never were reported because the first three doctors didn't believe they existed. For me, there was little benefit to hormonal birth control when the side effects were life-threatening.
For me, hormonal contraceptives triggered major depression and thoughts of suicide. My doctor said that couldn't be possible. However, when I stopped taking birth control pills my thoughts of suicide also stopped. Just coincidence, I was told. I was 17. At 24, I started taking birth control pills for a second time. Again, I became suicidal. Again, as soon as I stopped taking the pill the thoughts of suicide stopped. Again, the doctor said it was just coincidence. Several years later I tried for a third time, with the same results. This time, I didn't listen to my doctor and struggle for years. I stopped taking the pill, paid out-of-pocket for an IUD, which wasn't covered by my plan, and I found a new doctor who didn't tell me, "it's all in your head."
My "side effects" never were reported because the first three doctors didn't believe they existed. For me, there was little benefit to hormonal birth control when the side effects were life-threatening.
65
I got depressed my first year in college. While I am not sure it was the birth control pills, I did feel better when I ditched the pills and switched to another method.
My hypothesis for me is that the progesterone is depressing for me. Now that I am past menopause, I decided not to take the hormones partially because of depression risk.
It's interesting how one hormone might make Person A feel better, while Person B feels worse.
My hypothesis for me is that the progesterone is depressing for me. Now that I am past menopause, I decided not to take the hormones partially because of depression risk.
It's interesting how one hormone might make Person A feel better, while Person B feels worse.
18
If a depressed person begins to use a hormonal contraceptive, they will remain depressed. Depression is a separate condition. All the current hype about contraceptives causing depression have to be carefully evaluated. There are too many out there who welcome any adverse findings about contraception - simply because they oppose contraception - they are not motivated by concerns about the health of women.
12
The only thing the study in Denmark can say for certain is that those who are willing to go to a doctor to get a prescription for birth control are willing to go back to get another for anti-depressants. If you chose to take drugs, prescription or not, then there is always a tradeoff. Women who are predisposed to depression would fare a lot worse if they had an unintended pregnancy.
13
How much of the reduction in pregnancy rates while women are on the pill is attributable to the lack of desire for sex? A reduced amount of intercourse actually occurring? Do we even know?
8
Interesting article. While I have had struggles with depression, most of it seemed situational. I took The Pill most of my life and felt good on it. No more losing 4 or 5 days a month to heavy bleeding and debilitating cramps.
That being said, a friend's 17 year old daughter recently had a near fatal blood clot while on it.
Risks and benefits. Still, more women die giving birth than die from side effects of The Pill.
Many things to consider, as the article makes clear.
That being said, a friend's 17 year old daughter recently had a near fatal blood clot while on it.
Risks and benefits. Still, more women die giving birth than die from side effects of The Pill.
Many things to consider, as the article makes clear.
15
Two reactions:
1. A lot of commenters have said they don't like that a male author wrote this. I don't know if that's the problem, necessarily, because there are extremely empathetic, wise male gynecologists out there. I think the issue is more the tone that the author takes - he uses a lot of conjecture, which isn't a good match for a supposed research study, and it makes him sound very overbearing/patronizing.
2. A key point that the author didn't emphasize is that birth control can result in weight gain. That excess fluid buildup can be uncomfortable physically and make one feel slow and groggy. There also may be unhappiness with gaining 10 or 15 pounds, particularly at a time when a woman is sexually active, and may not want to feel less attractive at that particular moment.
1. A lot of commenters have said they don't like that a male author wrote this. I don't know if that's the problem, necessarily, because there are extremely empathetic, wise male gynecologists out there. I think the issue is more the tone that the author takes - he uses a lot of conjecture, which isn't a good match for a supposed research study, and it makes him sound very overbearing/patronizing.
2. A key point that the author didn't emphasize is that birth control can result in weight gain. That excess fluid buildup can be uncomfortable physically and make one feel slow and groggy. There also may be unhappiness with gaining 10 or 15 pounds, particularly at a time when a woman is sexually active, and may not want to feel less attractive at that particular moment.
12
I started birth control pills when I went off to college; what followed was a year of crippling depression, suicidal thoughts, and eventually hospitalization when I didn't trust myself to not follow through with the suicidal thoughts. The only thing that saved me was that over the summer I did not have health care coverage and ran out of pills, whereupon I discovered that within a couple of weeks all my depression was gone (and it never reared it's ugly head again, thank goodness!)
It didn't occur to me that it was the pills not only because the onset was so gradual and insidious, but also because nobody at the health center told me it might be a problem and to watch out for signs of depression, which are apparently especially common with tri-phasic pills (what they had given me). When I finally talked to the health center months after this harrowing year they told me it happens "a lot." Well, thanks for telling me!
I have since tried different methods with various different symptoms and now have an IUD with no symptoms at all.
The benefits of birth control are, of course, essential, but patients but be informed about mental health risks so they know what to look for and they must know that there are many options available. This simple omission nearly cost me my life.
It didn't occur to me that it was the pills not only because the onset was so gradual and insidious, but also because nobody at the health center told me it might be a problem and to watch out for signs of depression, which are apparently especially common with tri-phasic pills (what they had given me). When I finally talked to the health center months after this harrowing year they told me it happens "a lot." Well, thanks for telling me!
I have since tried different methods with various different symptoms and now have an IUD with no symptoms at all.
The benefits of birth control are, of course, essential, but patients but be informed about mental health risks so they know what to look for and they must know that there are many options available. This simple omission nearly cost me my life.
16
My first thought: Seriously? This must have been written by a man.
My second thought: No, that can't be, NYTimes wouldn't be that tone-deaf.
But in fact.....
Access to birth control is incredibly important. What really frustrates me, though, is when studies on male birth control get canceled because the side effects are deemed too severe, while women are supposed to suck it up. I think there's space for innovation in non-hormonal methods that aren't gaining as much momentum because that's not where the money's at. Like the male birth control injection being developed in India with little support from the pharmaceutical industry.
My second thought: No, that can't be, NYTimes wouldn't be that tone-deaf.
But in fact.....
Access to birth control is incredibly important. What really frustrates me, though, is when studies on male birth control get canceled because the side effects are deemed too severe, while women are supposed to suck it up. I think there's space for innovation in non-hormonal methods that aren't gaining as much momentum because that's not where the money's at. Like the male birth control injection being developed in India with little support from the pharmaceutical industry.
49
The times in my life when I've been on the pill have correlated with the times when my mood and energy have been the highest. I've never experienced anything like depression or low mood on the pill (and I have at many other times in my life). Yes, this is a meaningless anecdote. So are all the other anecdotes from people saying "I used to be depressed, and I used to be on the pill!" The point of this article is that not everyone will get depressed on the pill and that women should be empowered to find out for themselves how the pill affects them and whether any side effects are worth it to them to not have to worry about pregnancy. It's not about stuffing the pill into the mouths of depressed women who don't want to take it, which is how so many people inexplicably seem to be reading it.
43
The other side of this is women who are addicted to the hormones of pregnancy and spend their lives in a sedated fog which is socially excused because it's "all for the baby."
7
"...women who choose to have sex" are more likely to be depressed -? Did you really write that? What a ridiculous and moralistic statement. Married women (who are morally "allowed" to have sex even in Indiana, where this doctor practices) are just as likely to seek birth control as single women.
31
Did you just say women who "choose" to have sex? Having sex is part of being human. Making it sounds like a choice rather than a way for women to fully express their humanity is the kind of thinking that allows politicians to cut contraceptives from insurance plans, I respectfully request that you speak of sex as something that women will have (and the data support that) and finding the right kind of contraception a way to reduce the risk of death from childbirth.
39
People have different reactions to medications. There is nothing so surprising about some women becoming depressed while taking BC pills. Some women get less depressed when taking the medication. What is important is that we do not dismiss women's experiences.
15
I absolutely disagree with this article. Hormones definitely cause anxiety and depresson. I struggled for years and years and fought with anti-depressants. So has my daughter. Saying that this is better than a house full of kids kind of dismisses the real issue. of course being able to control when and if you have a baby is better than no control but how about we fund the male birth control already and make men more involved and responsible instead of leaving this tremendous burden for women to deal which makes us feel very alone
17
Birth control may cause depression? I think an unwanted pregnancy - regardless of the outcome - would cause a much greater depression.
22
I totally disagree with this article. Hormones absolutely cause anxiety and depression. I always struggled with this and fighting it with antidepressants for years and years and so has my daughter. Saying that it's better than having a house full of kids is kinda like dismissing the real issue. Of course being able to control when and if you want to have a baby is better than not having the control. But how about let's fund male birth control and lessen the burden on women, making men a bit more involved and responsible. This a tremendous burden that makes women feel very alone in.
5
"Women need to discuss with their physicians ..."
You assume that most or even many physicians have any knowledge of the mood-hormone axis other than what they read in PubMed or the latest edition of their specialty's medical journal. Most physicians do not understand the symbiotic relationship between estrogen, progesterone and serotonin. Most do not understand the individual algorithm that exists in each woman having to do with the ratio of E to P, and how this affects S levels. When you add a medication that inserts itself into this individual axis, you affect the individual outcome. When doctors can have fluent conversations about any of the above, and know how to assess for predisposition based on a patient's history, then studies will be worth paying attention to. Until then, any evaluation of women's health, and statistics about it, are ham-fisted. How can there be so many other mood effects from endogenous hormones (pms, ppd ...) and yet the mood effects of ingesting hormones is questioned? I would love to "discuss with my physician", if only they knew half as much about endocrinology and mood as I have learned.
You assume that most or even many physicians have any knowledge of the mood-hormone axis other than what they read in PubMed or the latest edition of their specialty's medical journal. Most physicians do not understand the symbiotic relationship between estrogen, progesterone and serotonin. Most do not understand the individual algorithm that exists in each woman having to do with the ratio of E to P, and how this affects S levels. When you add a medication that inserts itself into this individual axis, you affect the individual outcome. When doctors can have fluent conversations about any of the above, and know how to assess for predisposition based on a patient's history, then studies will be worth paying attention to. Until then, any evaluation of women's health, and statistics about it, are ham-fisted. How can there be so many other mood effects from endogenous hormones (pms, ppd ...) and yet the mood effects of ingesting hormones is questioned? I would love to "discuss with my physician", if only they knew half as much about endocrinology and mood as I have learned.
24
Religious fundamentalism has caused far more depression than contraception ever will.
24
Thank you, male-doctor, for mansplaining this to me. I had suicidal thoughts each time I went on and off the pill, and while that is perhaps anecdotal evidence, it was powerful enough for me to decide to never go on it again. The physical and psychological side effects of the pill have cost me a lot. Maybe I'm an outlier but your writing completely negates the emotional component of this medication. issues of sexuality, mental health, pregnancy...are not the same as when people are dealing with heart disease, for example.
19
The bottom line of the article is reasonable: that hormonal birth control can sometimes cause depression and that we each need to weigh the risks and benefits of using it, and it's legitimate to consider alternatives. But the article has a dismissive tone that pushes buttons in women, especially older women like me, who remember when men denied or minimized our experiences as imagined, or, to use the technical term, "hysterical." As a young woman I read that menstrual cramps weren't real because not all women had them and that insertion of an IUD should not hurt. (Later, when I told a gynecologist that mine had been very painful, he admitted to me that he had seen women "faint dead away" during the process.) When I suffered depression while taking birth control two separate times, before and after the birth of my daughter, I didn't try to argue with doctors about the reality of my experience; I just stopped the pills and went to other methods -- and felt vindicated years later when the connection between the pill and depression was finally recognized. The article's implication that depression from hormonal birth control doesn't really matter because it isn't a common side effect echoes those dismissive attitudes from decades ago.
33
As a woman who also experienced depression coincident with hormonal birth control, my biggest wish is that there was more emphasis (and research) on non-hormonal alternatives. My doctor also brushed aside my significant mood changes but after a decade of being ambivalent towards my own life, I finally asked to be fitted for a diaphragm to use as a backup. My doctor wasn't very receptive towards the idea but it's a decision that I'm glad to have made.
11
The question isn't really whether hormonal birth control causes depression. Shouldn't it be whether it causes depression in comparison to what? Unintended pregnancy surely causes far more depression than avoiding it, with needing an abortion even more productive of this risk. Balancing tests are needed before any conclusions can be drawn.
5
As a psychotherapist I have seen rather extreme, adverse side-effects in the form of depression in my patients, whose psychological symptoms lifted almost immediately after getting their birth-control implants removed. I understand that this is entirely anecdotal and has no scientific standing. However: the day that the pharmaceutical industry creates a hormonally-based birth control pill or implant for men is the day when I will start to take articles like this - so utterly dismissive of women's mental health - seriously.
23
I am so disappointed in this article. Hormonal contraception unquestionably causes depression. I'd like to share an anecdote about my experience with endometriosis. The only way to attempt to alleviate my pain (but never fully) is by taking hormonal contraception. But after a month I begin to feel very depressed. I'll take the pill for a while but then my endometriosis pain recurs and the depression gets too much so I stop the pill. All of a sudden I'm bright and energetic again - but my pain is that much worse. So then I'll try an even stronger version of the pill - and all of the depression symptoms come back. When can we finally take women's health seriously?
6
More than we care to admit in life, it’s unclear what the difference is between “to know” and “to believe.”
2
Not so fast. Let's follow this to the source: right-wing evangelical christians, and their fellow travelers are busy spreading more of their ideological poison.
We don't need science, we've got god on our side.
We don't need science, we've got god on our side.
4
I had significant depressive symptoms with several different pill formulations. After multiple tries I finally gave up and chose a non hormonal method. Both sisters had the same experience. As a Pharma researcher, it's no surprise that there's a lot of variation in how individuals respond to these drugs, and if they experience adverse effects, women should trust their own responses and choose what works for their body AND mind.
6
I think the point of this article is that Doctors and their patients should have a dialogue about potential side effects. Women and young women should be informed by the medical community upon choosing hormonal pills. . Also, the study quoted might contribute to the discussion about over the counter dispensing of hormonal birth control.
1
Hey NYT - why is a man (albeit a doctor) writing an article about birth control? I would be more interested in a woman's POV about the same subject matter - she's more likely to at least have taken some form of birth control in her life.
12
Maybe if you are willing to take one drug, you are more willing to take a second drug and it really doesn't matter what the drugs are. The focus here is on birth control, but maybe it's completely misplaced. Why don't they look at men who take one drug and find out if taking one drug makes it more likely that men will take a second drug?
Maybe this is just another poorly disguised effort to ensure that women are nothing but breeders.
Maybe this is just another poorly disguised effort to ensure that women are nothing but breeders.
15
I remember my grandmother telling me in the late '60's when the pill came out that now I could choose my own life, and I would not need to depend on some man. I took the pill until I decided to have a child, and again later. Depression was never an issue. If I had ended up with a house full of kids and no money, THAT would have seriously depressed me! And I have been married for 49 yrs.
36
My daughter sounded like a different person when she called from school when she was a senior at Oberlin. She said she hadn't been able to get out of bed for days, hadn't gone to classes, basically bottomed out with paralyzing depression. Brief questioning revealed she had been taking a new (lower estrogen type) BC pill. To corroborate my suspicions, I did a quick google search and found extensive blogs and comments of women who had also suffered severe depression while taking this pill. My daughter stopped the pill and quickly felt better and resumed her life. Yes, this is anecdotal and not part of a scholarly study. But Aaron Carroll's piece is appallingly one-sided and ignorant. I hope the NYT will print some of these comments. We don't need to have human sacrifices for the sake of lower teen pregnancy rates.
38
I agree. I experienced severe depressive episodes on certain formulations of oral contraception. Symptoms remitted within 2 weeks of stopping the Pill.
The first time the doctor actually noticed my depression (hard to miss since I was crying in the office) and took me off the Pill.
My most recent experience was with the low dose estrogen pill which was touted as lacking many of the side effects associated with previous formulations. Yaz (the new pill) worked out for a while but then I became increasingly depressed, and eventually suicidal as well. I told my doctor and he responded much like the author of this article. "Oh, we can't prove that the pill caused your depression - it could be caused by anything, and anyway the benefits probably outweigh the risks..."
The benefits don't outweigh the risks of you kill yourself.
The first time the doctor actually noticed my depression (hard to miss since I was crying in the office) and took me off the Pill.
My most recent experience was with the low dose estrogen pill which was touted as lacking many of the side effects associated with previous formulations. Yaz (the new pill) worked out for a while but then I became increasingly depressed, and eventually suicidal as well. I told my doctor and he responded much like the author of this article. "Oh, we can't prove that the pill caused your depression - it could be caused by anything, and anyway the benefits probably outweigh the risks..."
The benefits don't outweigh the risks of you kill yourself.
12
How about unwanted pregnancy? Doesn't that cause depression? And for the one who said she'd rather deal with an abortion for her daughter than deal with her depression . . . Are you sure we'll always have the right to abortion? We won't if the republicans and christian extremists have anything to say about it.
23
Maybe just getting married (to the wrong guy?) could bring on depression. Maybe staying home with the kids? If many questions like these are not being asked this this inquiry is a failure.
7
Right, so the bottom line is women need to be able to make their own decisions about their health and healthcare, with as much information and access as possible. It might be the case that some women experience depression due to hormonal birth control (I did). It might be that for some women the benefits of not getting pregnant outweigh the cost (for a while in my life, I made that choice). And then for other women it might not be the right trade off (eventually I became that woman too, who decided to stop birth control).
What is important to note here is that birth control ought to still be available to all women as part of their healthcare options. AND that it is perfectly acceptable for women to choose NOT to take birth control, and to not be blamed that they didn't do all they could have to prevent unwanted pregnancies, when, as the author notes, all drugs have side effects. Birth control is neither an evil, nor a magic cure, but a drug like any other that is nuanced, has different impacts on different people, and requires informed decision making.
What is perhaps most important about this story is that it reveals that women continue to bear the entire burden of getting or avoiding pregnant when it comes to sex, avoiding the fact that there is a male partner involved in any sex that is also potentially procreative. And in these cases, women are often left with a series of non-ideal options, not a perfect solution that will work every time for every person.
What is important to note here is that birth control ought to still be available to all women as part of their healthcare options. AND that it is perfectly acceptable for women to choose NOT to take birth control, and to not be blamed that they didn't do all they could have to prevent unwanted pregnancies, when, as the author notes, all drugs have side effects. Birth control is neither an evil, nor a magic cure, but a drug like any other that is nuanced, has different impacts on different people, and requires informed decision making.
What is perhaps most important about this story is that it reveals that women continue to bear the entire burden of getting or avoiding pregnant when it comes to sex, avoiding the fact that there is a male partner involved in any sex that is also potentially procreative. And in these cases, women are often left with a series of non-ideal options, not a perfect solution that will work every time for every person.
49
I wholeheartedly second Taxpayer's comment! This perspective could only come from a man. And it's outrageous that there is no mention of male birth control! The basic message here is that women should simply deal with any/all potential side effects and stay quiet. Depression is a serious risk with some birth control--my cousin actually became suicidal on a third generation pill. Once she was off the pill, her symptoms immediately subsided. I have never written a comment in my life but this article so enraged me that I was inspired to respond.
27
My daughter was undergoing severe emotional swings during puberty and her doctor suggested the pill. it did wonders for reducing her depression and stabilizing her emotions.
People react differently to drugs. For her, it was a benefit.
People react differently to drugs. For her, it was a benefit.
22
Why is a man writing this? Has he ever been a woman who took birth control? I am so tired of hearing what men have to say about women's health.
121
Possibly because men are equally capable of grasping statistics and analyzing data sets.
5
The writer is a physician and a faculty member at a medical school. He is evaluating the evidence that hormonal contraception could be associated with depression. Many physicians who prescribe these medications are male, as are many physicians who diagnose and treat depression.
I would be interested in knowing how his gender renders him incapable of evaluating the available evidence, or concluding that an evidence-based discussion of risk and benefit is a good idea when prescribing hormonal contraception.
Those of us who prescribe any prophylactic or therapeutic medication consider these factors on a daily basis, and it usually involves medications and treatments that we have not personally experienced.
I would be interested in knowing how his gender renders him incapable of evaluating the available evidence, or concluding that an evidence-based discussion of risk and benefit is a good idea when prescribing hormonal contraception.
Those of us who prescribe any prophylactic or therapeutic medication consider these factors on a daily basis, and it usually involves medications and treatments that we have not personally experienced.
13
Science is gender neutral. One does not have to be of a specific gender to examine, speak about, much less comprehend issues pertaining to a specific gender, even complex ones.
Or to put it another way, just be being male, I am not privy to All Knowledge of Men. Knowledge is not innate; it is learned. If to learn knowledge is contingent upon one's gender, then no woman should ever speak about "men" things, and no man should ever speak about "women" things, which bluntly put, is not merely naive thinking, but pretty much ignorant.
Yet, I do understand your meaning...if I can be allowed to say that.
Or to put it another way, just be being male, I am not privy to All Knowledge of Men. Knowledge is not innate; it is learned. If to learn knowledge is contingent upon one's gender, then no woman should ever speak about "men" things, and no man should ever speak about "women" things, which bluntly put, is not merely naive thinking, but pretty much ignorant.
Yet, I do understand your meaning...if I can be allowed to say that.
10
I was one great big happy camper when I was young and on the pill. No worries of contraception ever ... and that was when the estrogen was in much higher doses. I never experienced depression ever, and I stayed on the pill throughout my 20's.
19
This is an issue of fear mongering presented as fact. The bottom line is woman and their physicians, need to decide what is right for them.
27
I am one of those women who, when taking any amount hormones, become abnormally depressed and emotional (my sister does not have these symptoms). I have no history of depression. I have had doctors try over and over again to tell me that these new products use low doses and so I shouldn't be having any symptoms. Well, they're wrong. I have since started using the copper T IUD, and I don't understand why this isn't offered to many more women. I had to battle with well-meaning but woefully unsympathetic doctors to get one. Now, I can have a normal life, without fear of pregnancy.
64
I can't believe we are still having the same discussion, nearly 60 years after the pill was first approved. The only new form of birth control since then is the IUD. How many new drugs have been developed for heart disease in the last 60 years? Why do women not demand research in this field?
On the other hand, I am grateful that we got these imperfect methods before politicians and religious opportunists turned contraception into a political football. Without the pill and IUD, I would most likely have ended up as a heroin addict or dead by now.
On the other hand, I am grateful that we got these imperfect methods before politicians and religious opportunists turned contraception into a political football. Without the pill and IUD, I would most likely have ended up as a heroin addict or dead by now.
18
Sorry, but every single physician I've encountered in 10 years of treatment for a mood disorder mention depression as a potential problem with birth control. It's especially problematic when you are on mood stabilizers because, in some cases, hormonal birth control decreases the level of meds in your system. Hormonal birth control can decrease the level of lamictal in your system somewhere between 30 to 60 percent, depending on the person. Many of the first line antidepressants are not an option for people like me.
On more than one occasion I've had psychiatrists and GPs say that options are few other than barrier methods. Copper IUDs are very expensive (around 900 last time I checked) and sometimes quite painful for women who haven't had children. And do I want to risk the potentially long, heavy periods? Diaphragms are considered old school and it's downright time consuming to find someone to fit one. Good luck if you lose weight because then it has to be fitted again. And let's be honest, condoms are not ideal. Did I mention that women with my diagnosis are actually encouraged to be on birth control because hypersexuality is a thing for us. I'm sure you see our predicament.
So yeah, I'm thankful birth control is available for women, but the author is too quick to dismiss the side effects. And I say this as someone who has zero objections to "unnatural" modes of medical treatment. But it's very hard to determine which I value more- sex or sanity.
On more than one occasion I've had psychiatrists and GPs say that options are few other than barrier methods. Copper IUDs are very expensive (around 900 last time I checked) and sometimes quite painful for women who haven't had children. And do I want to risk the potentially long, heavy periods? Diaphragms are considered old school and it's downright time consuming to find someone to fit one. Good luck if you lose weight because then it has to be fitted again. And let's be honest, condoms are not ideal. Did I mention that women with my diagnosis are actually encouraged to be on birth control because hypersexuality is a thing for us. I'm sure you see our predicament.
So yeah, I'm thankful birth control is available for women, but the author is too quick to dismiss the side effects. And I say this as someone who has zero objections to "unnatural" modes of medical treatment. But it's very hard to determine which I value more- sex or sanity.
16
This is one reason to appreciate the ACA, which makes free coverage for IUDs part of insurance. My daughter has bipolar and I experienced both increased anger and increased depression on hormonal contraceptives (not to mention decreased libido), so I have encouraged her to think about the copper IUD rather than hormonal contraception. Until I got my tubes tied, I used a diaphragm with good results, I am sorry to hear it is so hard to get anymore.
6
I don't think the idea is to stop "the Pill", but to find alternatives. I think the doctors who are working with teens and birth control need to monitor closely adjusting the dosage, i.e., lower level... Also, if I'm correct, the IUD concentrates the hormone so there may be a lower risk of mood swings.
Birth control is not just hormones, it is also education and enpowerment.
Birth control is not just hormones, it is also education and enpowerment.
12
And multiple options for both sexes!
8
I agree that BC pills don't cause depression. I think that genetically those who start taking birth control pills for extremely painful, debilitating periods, which young teens often do, sometimes also end up genetically prone to anxiety and/or depression. This is why the type of research quoted here that can't even prove causality, shouldn't even be funded - it tells us nothing. Thankfully the National Institute of Mental Health has changed its funding criteria and is now funding actual medical research on genes and the brain. There are answers to these questions, but psychiatry isn't the medical specialty that's going to find them.
1
mansplaining women's health. many, many, many women say that hormonal birth control hormonally changes how they feel. men say, nope.
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....says a man who has never taken birth control.
40
I suffered two major bouts of depression while on birth control pills and never once did a doctor suggest the pill might be the cause. I figured it out myself, stopped taking them (for good) and never felt better. Women need to be warned and they need to pay close attention to how they are feeling. The benefits do not outweigh the risk when you are depressed. Depression is a serious side effect and women suffering from depression who are on the pill should stop taking it. And don't listen to men who tell you otherwise.
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Sure, just like abortions cause breast cancer. Lies, damn lies, and
" statistics ". Seriously stupid.
" statistics ". Seriously stupid.
14
The right wing loves articles like this. Even it it is true that oral contraceptives can cause depression in some women, it is sad that we have right wing media and websites like Breitbart ready to grab headlines and yell "Birth Control Makes Women Crazy!".
Bottom line: women must be punished for having sex.
Bottom line: women must be punished for having sex.
36
It happened to me, desperate depression after starting a pill. With another pill I stopped being able to metabolize alcohol - I literally would be sick like I'd been poisoned after just a single glass of wine. Stopped the pill and that problem went away, thank goodness. The doctor told me the pill couldn't be the cause. Whatever.
16
We should have more science articles at the NYT and in news outlets in general like this one: teach people the subtleties of interpreting scientific findings
20
It's pretty obvious from reading the comments how scientifically illiterate most of the commenters are. The misandry is terrible too.
10
Moira, calling out misogyny isn't misandry. Women expecting a voice in something that impacts them, and then calling out men who deny, overlook or speak over that voice isn't misandry. Expecting equality isn't misandry. That's because misandry -- in our current social, political and economic system -- isn't real. I'm not saying the idea or possibility isn't real. But misogyny is a systemic, oppressive force that impacts women as a whole in real, measurable ways from birth to death. Sure, you'll find women who genuinely hate men. But those women -- because of institutionalized misogyny! -- have no power to systemically oppress men as a whole because of their hatred.
9
Once again the anti choice (and anti birth control) gang has a grenade to throw into the birth control system. Back in 1988, Patrick Robertson promised, if elected president, to stop All funding for birth control because "we need more babies." Same old, same old.
23
Mary Jane, don't forget my generation's admonition to their fellow guys, "to keep women in their place, they should be kept barefoot and pregnant." (I'm 84). I sincerely hoped this generation would be different, but I worry that this may not be true.
7
If Dr. Carroll's mother or daughter, let alone he, had suffered depression, psychotic depression or dramatic mood changes as a result of birth control pills, he might not have written this article. The mood effect may not apply to the majority of users of the pill, but for those of us whom is does affect, the consequences can be devastating. It has been hard enough to get physicians to understand and accept this significant risk: the Danish research was finally a validation and confirmation of what many of us have known all along. Side effects can kill. I wish my daughters' very lovely gynecologists were more sensitive to this issue, as they continue to prescribe "low hormone" pills and disregard significant family history.
24
So many anecdotal stories of "took hormonal BC, went crazy" shared here.
Where can these adverse events be reported and tracked?
Or is the sudden onset of crying jags, loss of memory, and inability to concentrate not significant enough to merit recognition as severe side effects?
My doctor brushed aside my concerns when I had a negative experience with BC. I am positive that negative reaction was not recorded anywhere and will not cause any systematic change, research, or more careful choice for others regarding which drug is appropriate for each person. The current model of "try another one until you can tolerate the side effects" is broken.
Where can these adverse events be reported and tracked?
Or is the sudden onset of crying jags, loss of memory, and inability to concentrate not significant enough to merit recognition as severe side effects?
My doctor brushed aside my concerns when I had a negative experience with BC. I am positive that negative reaction was not recorded anywhere and will not cause any systematic change, research, or more careful choice for others regarding which drug is appropriate for each person. The current model of "try another one until you can tolerate the side effects" is broken.
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Where can these adverse events be reported and tracked?>>
Somewhere at the FDA, in the regulatory binders. (Possibly in a remote basement office like Mulder's desk on the X-Files?) Adverse events that take place during clinical trials are reported and filed with the FDA. Depression is listed as a side effect in the prescription insert, which means that during clinical trials a significant number of subjects reported experiencing depression as a side effect. I'm sure someone could dig this up...
Somewhere at the FDA, in the regulatory binders. (Possibly in a remote basement office like Mulder's desk on the X-Files?) Adverse events that take place during clinical trials are reported and filed with the FDA. Depression is listed as a side effect in the prescription insert, which means that during clinical trials a significant number of subjects reported experiencing depression as a side effect. I'm sure someone could dig this up...
1
The author is missing so much about women's health, as is true with the patriarchal medical establishment:
While the list of negative side-effects on women's health is growing longer, we, arguably, still don't have the evidence we need to conclude if hormonal birth control is "good" or "bad" for women. (Read the book Sweetening The Pill for full download of the studies that are available!)
WHY?
The underlying truth is this: we don't put enough money and research into women's health.
The author is operating under the assumption that women's reproduction is where her value lays. Is it "worth it" for women to experience crushing depression so that her reproduction can be easily controlled?
Maybe we should finally put real money into developing a pill for men. That would make this question a non-issue.
While the list of negative side-effects on women's health is growing longer, we, arguably, still don't have the evidence we need to conclude if hormonal birth control is "good" or "bad" for women. (Read the book Sweetening The Pill for full download of the studies that are available!)
WHY?
The underlying truth is this: we don't put enough money and research into women's health.
The author is operating under the assumption that women's reproduction is where her value lays. Is it "worth it" for women to experience crushing depression so that her reproduction can be easily controlled?
Maybe we should finally put real money into developing a pill for men. That would make this question a non-issue.
46
I've used the pill in four different periods of my life and undoubtedly it caused mood changes. The easiest time to handle was the last, because I was taking Accutane (which causes birth defects); I was prepared for the low, dull mood and knew it was temporary. The hardest time to handle was the first time I took the pill -- for six years! I initially had a severe bought of depression and then a pretty low sex drive. I assumed this was caused by my relationship being more established and the sort of boringness of adulthood. I was soooo surprised when I went off the pill and things changed.
If I had fully understood the risks of the pill, I would have been better able to cope with what was happening. Eventually my husband and I made the choice to use condoms -- but it is a little scary because I have irregular periods. We're in a position to handle an accidental pregnancy, though. But choices about birth control are so fraught. Is it worth a dull mood, or worse, just to have sex? But then, do you have the self-control to abstain if you're a young, unmarried woman, say? What is the risk of an unplanned baby -- would it be risky or is it God's plan to tuck an extra in if you're married? Mother Nature certainly extracts a heavy toll for the fun she gives us!
Yeah, birth control is one of the hardest choices to manage. And, yeah, I agree with the commentator who said she'd rather deal with her daughter's having an abortion than risk her suicide again.
If I had fully understood the risks of the pill, I would have been better able to cope with what was happening. Eventually my husband and I made the choice to use condoms -- but it is a little scary because I have irregular periods. We're in a position to handle an accidental pregnancy, though. But choices about birth control are so fraught. Is it worth a dull mood, or worse, just to have sex? But then, do you have the self-control to abstain if you're a young, unmarried woman, say? What is the risk of an unplanned baby -- would it be risky or is it God's plan to tuck an extra in if you're married? Mother Nature certainly extracts a heavy toll for the fun she gives us!
Yeah, birth control is one of the hardest choices to manage. And, yeah, I agree with the commentator who said she'd rather deal with her daughter's having an abortion than risk her suicide again.
17
Teenagers aren't usually great at carefully researching studies, or even instagram posts. The news that hormone controlling birth control methods can cause depression is precisely why my step daughter refuses to use them. At the age of 20, she and her boyfriend have two babies and still can't always afford condoms, which aren't great at preventing pregnancy anyway. She has a loving boyfriend who supports her decision, but who, being only 19, won't have a vasectomy. There are IUDs that don't contain hormones, but she has read about the "dangers" of those, too.
I guess my point is that being informed and making decisions based on our own research won't always prevent unplanned pregnancy.
I guess my point is that being informed and making decisions based on our own research won't always prevent unplanned pregnancy.
8
So, if they can't afford condoms, how can they afford to have any more children than the two they already do?
38
She should think about a diaphragm. Old-fashioned, but they work.
3
This is insane. Birth control hormones cause depression--which has a non-negligible risk of fatality--and women are urged to "consider the pros and cons".
Seriously!?!? What, exactly, is the upside to suicidal depression?
And I don't know why this is just coming out now.
Back in the 1980s, as an emancipated young woman, I carefully read the (long) list of side effects from the Pill... and realized that in addition to clots, strokes, and heart attacks, depression was one. And, since I was currently battling depression, it was ludicrous to take a drug whose side effect was... depression.
I switched to the diaphragm, charting my fertility, and augmenting with condoms during a fertile period.
The cloud lifted.
And I've never had an unintended pregnancy.
Women: Stop drugging yourself to death for the sake of convenience.
Seriously!?!? What, exactly, is the upside to suicidal depression?
And I don't know why this is just coming out now.
Back in the 1980s, as an emancipated young woman, I carefully read the (long) list of side effects from the Pill... and realized that in addition to clots, strokes, and heart attacks, depression was one. And, since I was currently battling depression, it was ludicrous to take a drug whose side effect was... depression.
I switched to the diaphragm, charting my fertility, and augmenting with condoms during a fertile period.
The cloud lifted.
And I've never had an unintended pregnancy.
Women: Stop drugging yourself to death for the sake of convenience.
22
Why do US women suffer from depression in substantial numbers? It couldn't possibly be due to stereotyping, being underpaid, undervalued, overworked, and then blamed for the difficulties these situations lead to; no. It must be due to those birth control drugs they're taking.
119
But what about Danish women? Because that's who the study looked at.
4
I took birth control pills for seven years in the early 1970s, when the hormone doses were much, much higher than they are now. I was also depressed--what I used to refer to as "the big sleep," because it's all I wanted or had the energy to do. It has never occurred to me (I came from a family with a history of depression) or to my doctors then that birth control pills might have played a role. Later I got an IUD (Copper-7), and still later, a diaphragm.
Another lesson in why we should be cautious with medications--and hormones.
Another lesson in why we should be cautious with medications--and hormones.
13
The author first points out the dearth of birth control clinical studies, then asks women to weigh the pros and cons of taking the pill. If the side effects aren't widely studied, how can one make a good decision? Presumably, the risks associated with the author's medication were studied in full.
Also, the author does not consider the implications of the JAMA study. Many women with worsening depression presumably stop taking the pill, so the percentage of women who experience depression because of birth control pills is probably higher than reported.
Also, the author does not consider the implications of the JAMA study. Many women with worsening depression presumably stop taking the pill, so the percentage of women who experience depression because of birth control pills is probably higher than reported.
22
Of course, the piece is written by a man who has never had to take birth control pills or deal with the side effects. There is no question that hormone-based birth control pills increase the likelihood of depression, and yet here he is still questioning a large JAMA study, with the weak, nonsensical argument that women should thank their lucky stars that they have the "benefit of family planning" with mood-altering drugs, further compounded by being forced to take *yet another* drug to alleviate the effects of the first. Right. How about developing a birth control pill for men and study the side effects of that and then get back to us. Until then, ladies, you have other choices and options for birth control.
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If this author is a straight man, I wonder how many of his partners struggled with the decision whether to continue taking birth control and suffer, or go off birth control and suffer potentially far worse consequences. And I wonder if he even knew about it, or whether he just thought she was being "emotional".
This study should be read while bearing in mind that women's pain is taken less seriously than men in a medical context. This also goes for emotional pain. The emotional pain caused by birth control is diminished, as if women should simply be grateful that male science has gifted us a half finished product that was only tested on men to begin with.
This article is, essentially, one long micro-aggression from a man who has no idea.
This study should be read while bearing in mind that women's pain is taken less seriously than men in a medical context. This also goes for emotional pain. The emotional pain caused by birth control is diminished, as if women should simply be grateful that male science has gifted us a half finished product that was only tested on men to begin with.
This article is, essentially, one long micro-aggression from a man who has no idea.
95
I'm not surprised a man wrote this; it's not his body or psychological well being at risk.
I felt suicidal after taking birth control all three times I tried it at different phases of my life, not to mention no sexual desire at all as another side effect. I rather abstain than have to use a method with those risks.
I felt suicidal after taking birth control all three times I tried it at different phases of my life, not to mention no sexual desire at all as another side effect. I rather abstain than have to use a method with those risks.
76
This is too facile. Women suffer disproportionately from depression. Women suffer disproportionately the burden of contraception. A major study linking the two should not just be swept away with the "explanation" that all drugs carry risks and unintended pregnancy is . . . unintended.
Over 10 million women in the US are on the pill. Mr. Carroll considers that if the pill causes "only" 1 in 200 users to take antidepressants, that risk is acceptable. In the US alone that would mean an additional 50,000 women would be taking antidepressants. Given that more than half of depression sufferers do not seek treatment that might mean 100,000 cases of needless depression.
When a widely used drug is found to potentially have serious side effects the proper response is
1--to repeat and verify or debunk the study
2--to intensify research into new, improved, safer treatments.
Over 40 years ago I contemplated suicide just weeks after going on the pill. I stopped taking the pill and my depression disappeared. Depression is not a minor side effect. Contraception has changed little over the last 50 years. My daughters have the same poor options I had. I doubt very much that if male medical researchers started each day taking a hormone pill we would know so little about the side effects and have so few choices. I doubt too that if Mr Carroll started each day taking his pill he would be so cavalier in dismissing the obvious effects it has on every aspect of a woman's body.
Over 10 million women in the US are on the pill. Mr. Carroll considers that if the pill causes "only" 1 in 200 users to take antidepressants, that risk is acceptable. In the US alone that would mean an additional 50,000 women would be taking antidepressants. Given that more than half of depression sufferers do not seek treatment that might mean 100,000 cases of needless depression.
When a widely used drug is found to potentially have serious side effects the proper response is
1--to repeat and verify or debunk the study
2--to intensify research into new, improved, safer treatments.
Over 40 years ago I contemplated suicide just weeks after going on the pill. I stopped taking the pill and my depression disappeared. Depression is not a minor side effect. Contraception has changed little over the last 50 years. My daughters have the same poor options I had. I doubt very much that if male medical researchers started each day taking a hormone pill we would know so little about the side effects and have so few choices. I doubt too that if Mr Carroll started each day taking his pill he would be so cavalier in dismissing the obvious effects it has on every aspect of a woman's body.
73
"Women who choose to have sex could also be more likely to consider antidepressant use" is an actual quote from this article, which is symptomatic of the bias presented: that the collective benefit derived from fewer unwanted births is more important than the consequences of this broadly used type of medication for specific individuals. This is, by the way, precisely the opposite discussion that male birth control options have received. Women negatively effected by birth control pills are not saying that they want not to "receive the benefit of... family planning." What they are saying is that they would like effective family planning options for themselves and their partners with fewer side-effects on their bodies and minds.
108
Your conclusion is spot on. After having my three beloved children, the peace of mind that came with reliable birth control was a real mood lifter for me. By all means we should study the link between hormonal contraception and depression and work towards alleviating that risk, but meanwhile let's also remember the days of yore and be grateful for the freedom of choice brought to us by the pill. What were the prior depression rates due to unwanted pregnancies, when women "had" to get married, give babies up for adoption, or obtain (illegal) abortions? Women often had more children than they really wanted and stayed unhappily married "for the sake of the children."
Hormonal contraception has brought us a long way, baby!
Hormonal contraception has brought us a long way, baby!
81
I wonder what both depression and hormonal contraception use rates are among women living in the very few places where abortion is fully legal, easily obtainable without stigma, and pillowed by social and psychologial supports for any reproductive choice a woman makes.
In my clinical counseling practice, the great majority of women who presented as depressed were also using a form of hormonal birth control.
But it took witnessing major depression in both my daughters - one with sudden onsets unmistakeably linked to new contraceptive use, the other suffering chronic, slowly worsening symptoms - for me to recognize these drugs are truly dangerous. Their depressions lifted when they stopped the medications. Rejecting hormonal drugs required them to make challenging adjustments in
their sexual relationships, but each says she'll never use hormones again. They also realize their choice is made easier, even possible, because they live in New York where (for now) they know they can choose an abortion if their careful planning fails.
As a mother, I'd much rather have to support a daughter through an abortion than a mental illness as cruel and terrifying as major depression.
In my clinical counseling practice, the great majority of women who presented as depressed were also using a form of hormonal birth control.
But it took witnessing major depression in both my daughters - one with sudden onsets unmistakeably linked to new contraceptive use, the other suffering chronic, slowly worsening symptoms - for me to recognize these drugs are truly dangerous. Their depressions lifted when they stopped the medications. Rejecting hormonal drugs required them to make challenging adjustments in
their sexual relationships, but each says she'll never use hormones again. They also realize their choice is made easier, even possible, because they live in New York where (for now) they know they can choose an abortion if their careful planning fails.
As a mother, I'd much rather have to support a daughter through an abortion than a mental illness as cruel and terrifying as major depression.
29
The simple truth is that messing with hormones in any way will have some side effects.
And that women can make their own decisions--or in the case of teens, with the help of adults--about whether the trade-off is worth it for them. Just as men make those decisions about their bodies and medications.
And that women can make their own decisions--or in the case of teens, with the help of adults--about whether the trade-off is worth it for them. Just as men make those decisions about their bodies and medications.
29