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Birth Control and Depression: What You Need to Know

A new study suggests a link between hormonal contraceptives and depression.  Which methods were more likely to cause these mood changes? And what do you need to know before you make any decisions about your contraceptive health?

By
Sanaz Majd, MD
4-minute read
Episode #224

Here are some essential take home points to remember:

1.  Estrogen-containing methods seem to be more protective against depression.  

2. The progesterone component seems to be the main mood-changing culprit—therefore even changing the progesterone component from one type to another may be a worthwhile effort before throwing in the towel.

3.  It is not a perfect study (no study is). This was a "cohort study," which is really an observational study where patients are simply observed passively through time.  And although still useful information, cohort studies do have their drawbacks. Studies that are "double-blind" (meaning neither the patients nor the physicians know which patient is taking what medication) and "placebo-controlled" studies (those with the administration of a placebo without knowing they are taking a placebo) are features of more well-accepted studies.  

4.  The study also measured the use of prescribed antidepressants. But not everyone taking an antidepressant is being treated for depression. Examples of other uses of medications in the antidepressant category include:  Anxiety disorders, PMSsmoking cessationhot flashes, and ADHD.  

5.  It's important to make certain your mood changes aren't due to numerous other causes as well.

6.  Lastly, adolescents already have mood swings—that’s almost a defining feature of this age group in the first place. This population is already more vulnerable to depression, so it makes sense that they are the most susceptible towards anything that can impose on their mood.

As a physician, will this change the way I practice? Well, for patients whom i know have suffered from significant depression, the combined pill may be a more preferable option, but this is only taking the patient's preferences into consideration and only if there are no contraindication to estrogen use. And for others who initiate hormonal contraception and then report mood changes, the pros and cons of all other available methods may be worthwhile to revisit. Overall, the study has caused me to keep my antennas up and simply be more aware.

The wonderful thing about birth control nowadays is this: there are numerous options. If one doesn't work well for you, it doesn't mean something else won't.

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Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.

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Medical Disclaimer
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.

About the Author

Sanaz Majd, MD

Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women's health and patient education.