Oral contraceptive use linked to increased risk of suicidal behavior in young women

According to a study published in Psychological medicine. Although the risk of suicide associated with hormonal contraceptives is relatively low, the results indicate that the topic warrants further attention and research.

(If you’re having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-8255 or follow this link to their online chat.)

“I was interested in this topic because of the potential impact of oral contraceptive use on women’s health. Women use birth control pills for a variety of reasons, but relatively few studies have used population-based longitudinal samples to examine associations with suicidal outcomes,” said study author Alexis C. Edwards, Professor associate at Virginia Commonwealth University.

“I think it’s important to be aware of potential risks and contextualize them against other predictors so that women and their healthcare providers can make informed decisions and select appropriate healthcare options. best to an individual.”

The researchers analyzed data from 216,702 women born between 1991 and 1995 who were listed in Swedish national registers. About 45% of these women used only combination pills during the observation period, 11% used only progestin-only pills, and 12% used both combination pills and progestin-only pills. The remaining 32% had no record of hormonal contraceptive use.

Edwards and his colleagues found that suicidal behavior was slightly more common among people using oral contraceptives than among those who did not. The risk of suicidal behavior decreased with increasing duration of oral contraceptive use.

“Overall, the risks of suicide associated with the use of oral contraceptives are relatively low: for women taking combination pills, the risk of suicidal behavior one year after the start of use differed little from women not Not taking the pill. Importantly, the risks associated with the use of birth control pills were overshadowed by those conferred by mood disorders and anxiety,” Edwards told PsyPost.

Using national registries allowed researchers to control for sociodemographic, familial, and psychiatric factors, such as parental suicide history. But the study — like all research — includes some caveats.

“We were only able to follow the women for a limited period of time, and it is possible that the risks associated with the use of oral contraceptives have further diminished over time. We were also unable to compare women who took combination or progestin-only pills with those who used other types of birth control (condoms, IUDs, etc.),” Edwards explained.

“The important questions that remain are whether there are differences in risk based on sexual activity (not everyone taking the pill is not sexually active), whether risks vary depending on the reason of oral contraceptive use and how contraceptive use interacts with behavioral or interpersonal factors to impact the risk of suicidal behavior.

The results are in line with a previous study, which looked at similar data from Danish population registers.

“Studies like ours, and those of Charlotte Skovlund and Katherine Keyes to name a few, can be used to open up discussions between women and their healthcare providers about the use of oral contraceptives. , always keeping in mind that reproductive health decisions and behavioral outcomes are complex issues – different decisions will work for different people,” Edwards said.

The study, “Oral Contraceptive Use and Risk of Suicidal Behavior in Young Women,” was authored by Alexis C. Edwards, Sara Larsson Lönn, Casey Crump, Eve K. Mościcki, Jan Sundquist, Kenneth S. Kendler, and Kristina Sunquist.