Researchers have suggested that women who are taking the oral contraceptive pill are less likely to report depression, according to their analysis of data from more than 6 000 American women, aged between 18 and 55.
The team found that the prevalence of major depression among users of the oral contraceptive pill (OCP) was significantly lower, at 4.6%, compared with former OCP users (11.4%).
The study was led by researchers at Anglia Ruskin University (ARU), with experts from the Dana-Farber Cancer Institute in Boston and University of California, Davis.
The researchers suggest two possible explanations for their findings, which are contrary to a commonly held belief that OCP can cause depression.
One is that taking the pill can remove concerns about unwanted pregnancy, therefore helping to improve the mental health of OCP users. It is also possible the results could be influenced by “survivor bias”, where women who experience signs of depression while using OCP stop taking it, moving them into the category of former users.
The cross-sectional study, which used data collected by the US Centre for Disease Control and Prevention (CDC), controlled for demographic characteristics, chronic conditions, and the use of antidepressants.
In both users and former users, widowed, divorced or separated women, obese women or those with a history of cancer, were more likely to report depression. In addition, in former users, depression was more commonly reported in women who were black or Hispanic, were smokers, had lower levels of education, or were experiencing poverty.
The findings were published in the Journal of Affective Disorders.
Lead author Dr Julia Gawronska, a Postdoctoral Research Fellow at Anglia Ruskin University (ARU), said: “Contraception is a crucial component of preventive healthcare. Most women tolerate taking the oral contraceptive pill without experiencing depressive symptoms but there is a subset of women who may suffer adverse mood side effects and even develop depression, and the reasons are not entirely clear.
“Unlike some previous studies, we found that women currently taking the oral contraceptive pill were much less likely to report clinically relevant depression compared with women who previously took the pill.
“Taking the pill could provide positive mental health benefits for some women, simply by removing their concerns about becoming pregnant. The ‘survivor effect’ could also play a part, with women who undergoing symptoms of depression more likely to discontinue taking it, placing them into the group of former users.
“However, stopping taking the pill without a suitable alternative increases the risk of unintended pregnancy. It is important that women are fully supported, provided with full information, and offered alternative forms of contraception if necessary.”
Study details
Association of oral contraceptive pill use and depression among US women.
Julia Gawronska, Catherine Meads, Lee Smith, Chao Cao, Nan Wang, Susan Walker.
Published in the Journal of Affective Disorders in January 2024
Abstract
Background
The link between oral contraceptive pill (OCP) and depression is still unclear. This work analyses the prevalence and correlates of major depression in US women using OCP.
Methods
This study used the National Health and Nutrition Examination Survey (NHANES) 2005–2012 data to provide the prevalence and correlates of major depression in women using OCP. Major depression was defined as a score of ≥10 using the Patient Health Questionnaire-9 (PHQ-9).
Results
A total of 6239 women aged 18–55 years were included in the present analysis. Current OCP users had a lower prevalence of major depression (4.6 %; 95 % CI, 3.2 to 6.6) compared to former users of OCP (11.4 %; 95 % CI, 10.1 to 12.9) and never users of OCP (10 %; 95 % CI, 8.3 to 12.1). Current users of OCP were significantly less likely to report major depression compared to former users of OCP (OR 0.59; 95CI%, 0.39 to 0.90) after adjusting for potential confounders. The prevalence of major depression was higher in women who were: black or Hispanic, widowed/divorced/separated, those with a low and middle income, current smokers, current users of antidepressants, and with history of cancer and thyroid problems.
Limitations
This is a cross-sectional study.
Conclusion
The prevalence of major depression among women using OCP may be lower than in former users of OCP, however, the burden of depression remains high. Further research with longitudinal follow-up for depression in women using OCP is needed to understand real world effect of the OCP on depression.
See more from MedicalBrief archives:
Contraceptive pills tied to depression – large Swedish study
Contraceptive pill link to stress responses – Danish study
No link between hormonal birth control and depression