Hormonal Contraceptives And Depression: All Things You Need To Know

Hormonal Contraceptives And Depression

Hormonal Contraceptives And Depression

In this article, we will discuss Hormonal Contraceptives And Depression.

Modern-day medicine and medicinal progress have made it possible for people to procreate safely and without the risk of ending up in pregnancy. These measures taken to prevent conceiving are known as contraception. 

And while the most popular method of contraception is wearable condoms, hormonal contraceptives have too gained popularity for their effectiveness.

Types of Hormonal Contraceptives

Birth Control Pills

They are combination of two pills, each containing estrogen, and progestin. They’re usually consumed regularly, between 21 to 22 days per menstrual cycle. It comes in a monthly pack, and are typically prescribed.

Plan B Pills

This is another form of the birth control pill, but this is taken as an emergency dose within 72 hours of sexual interaction. It contains much higher levels of hormones and hence cannot be consumed daily. As mentioned, it is only for emergencies.

The Contraceptive Skin Patch

It is a small square skin patch that can be attached to the skin anywhere on the upper body, except the breasts. In the first three weeks of a cycle, the patch is placed in the first week. After a gap of one week, another one should be attached within 24 hours.

The Vaginal Ring

Made out of a soft and flexible material, this ring has hormones present in it, and is placed deep within the vagina. It is administered the same way the skin patch is.

While hormonal contraceptives have made it possible to double the security during intercourse, even enabling more pleasure during the act, they have gained negativity quite quickly too. This is fair as these are actual biological compounds being introduced externally to the body. 

Side effects of such contraception include physical ones like sore and swollen breasts, muscle aches, bloating, and weight gain. And on the mental side, it causes mood swings, irritation, and also becomes the root of a severe mental issue, depression.

Depression

It is clinically proven that women are twice as likely to develop depression and other forms of mental issues than men. The female hormones, estrogen, and progesterone have been said to play a probable cause in it. Factors like the treatment women face, moral and ethical problems faced by them, etc. play critical considerations too.

The addition of extra hormones into the body through contraceptive messes up the cognitive functioning of the Central Nervous System (CNS). It has long been established that the introduction of any additional chemical compound into the body would result in side effects that stretch for much longer than the actual reason it has been taken for. But is there definitive proof?

The Link to the Brain

Ovarian hormones have the following effects on the brain:

  1. Estrogen decreases 5-HT reuptake and can increase serotonin levels. Progesterone increases serotonergic neurotransmission through the regulation of expression of serotonin-related genes and proteins. Estrogen and progesterone also modify the serotonergic responses to SSRI administration.
  2. This hormone’s receptors are broadly distributed in the brain, with some of them placed in each, the hippocampus, hypothalamus, amygdala, and brain stem.
  3. Hormonal contraceptives decrease the levels of endogenous testosterone by increasing the sex hormone-binding globulin, which reduces the activity of testosterone and leads to estrogen dominance or a ‘feminizing effect’ on the brain.
  4. Contraceptives are known to reduce the levels of serotonin in mind, which is one of the ‘feel-good’ chemicals of the brain. Alternatively, these have also shown to improve mood-swings in some cases.

Studies Conducted

One of the most significant and recent studies to determine the relationship between these two was conducted in Denmark, between the years 2000 and 2013. 

Who was studied?

Around a million Danish women between the ages of 15 and 34 were tracked simultaneously for years.

The Conditions

The women excluded from the study were on the grounds of:

    1. Pre-existing psychiatric conditions
    2. Women who could not take such hormones due to the danger of blood clots
    3. Those who have already been prescribed this medication for other reasons
    4. Pregnant women, or women who had given birth six months before the study

How was it Conducted?

Denmark’s amazing nationalized information collection systems, including diagnosis and prescribing data, were used for this study. These exist since the country has always had a well-run and organized national health system for decades.

Findings 

Hard data like diagnosis codes and prescription records were used, which strongly suggests that there is an increased risk of depression associated with almost all types of hormonal contraception.

The Vital Connections

Early studies on the first types of hormonal contraceptives showed that oral contraceptives with high progestin content could cause depression in healthy women, and the effects of the same would become more severe in women already diagnosed with it.

When multiple forms of contraceptives came into the market, progestin-only forms were initially favorable because they were longer-acting and required less compliance from the user. Today, newer formulations of progestin-only contraceptives contain synthetic progestins that are similar to progesterone but have higher specificity and fewer reported side effects.

In one study, researchers analyzed the effect of progestin-only contraceptives on the mental health of women. Results showed that 93 of 910 women in the study dropped out due to significant adverse health issues. Analysis of these women six months later, after they had dropped out, showed that they had higher depression scores than those who remained in the study.

The Bigger Picture

While hormonal contraceptives can be directly linked to depression, there are many indirect ways through which this medication could ultimately result in adverse mental health. Some of these ways are:

Mood swings

One of the immediate and widely recognized side effects are mood swings. Irritable behavior, uncalled aggression, extreme sensitivity, etc. are a few of them.

Hair loss

Another well-known side effect is hair thinning and increased hair fall perpetuated by the increase of the synthetic hormones in the body.

Intermenstrual Spotting or Skewed Cycles

Breakthrough bleeding and unexpected variations of the menstrual cycle are enough to impact the daily life of women significantly.

Unstable Weight

Bloating might be temporary, but some women are susceptible to weight gain, with regular consumption of the contraceptives.

Skin Problems

Pimple and acne breakouts, rashes, oily or extremely dry skin, thicker body hair, etc. may affect different women in different ways.

These factors may collectively or individually be responsible for one of the reasons for depression, at least. 

Conclusion

Should doctors stop prescribing hormonal contraceptives to women altogether? No!. Modern research describes many benefits that tweak the working of hormonal contraceptives to reduce side effects. Low-dose oral prescriptions give relative safety and efficacy when compared to higher dose oral contraceptives.

They prevent unwanted pregnancies, exert improvements in the menstrual cycle, reduce mood swings, and may even relieve mental health issues such as anxiety. Although alternative changes to the construction of these contraceptives are welcome, the treatment of women concerning them could be improved, as well.