Hormonal contraception on mental health: A warning for mothers of teenage girls?

The effects of hormonal contraception on mental health are complex and vary amongst individuals. While some studies suggest potential negative impacts, others indicate minimal or even positive effects on mood.

Potential negative effects

• Increased risk of depression: Some studies have found an association between hormonal contraceptive use and an increased risk of depression and antidepressant use, particularly among adolescents and users of certain contraceptive types like progestogen-only pills and patches (Skovlund et al., 2016; Brouillard et al., 2022).
• Mood changes in sensitive individuals: Certain women, particularly those with a history of depressive symptoms, may experience mood disturbances or increased psychological distress when using hormonal contraceptives (Lewis et al., 2019; Skovlund, 2018).

Minimal or positive effects

• Lack of negative association: Several studies report no significant negative impact of hormonal contraceptives on mental health. In some cases, current use of oral contraceptives is associated with better mood and fewer depressive symptoms (Toffol et al., 2012; Toffol et al., 2011).
• Improved mental health in specific conditions: Hormonal contraceptives may improve mental health in women with specific psychiatric disorders, such as premenstrual dysphoric disorder (PMDD) (Robakis et al., 2019).

Context-dependent effects

• Variability in response: The effects of hormonal contraceptives on mood can be context-dependent, influenced by factors such as the type of contraceptive, dosage, and individual risk factors (Lewis et al., 2019; Pletzer, 2024).

Conclusion

Overall, the impact of hormonal contraception on mental health is not uniform and can vary widely among individuals. While some women may experience adverse effects, others may benefit or experience no significant changes. Identifying women at risk for negative mood reactions is crucial for informed contraceptive choices. Further research is needed to better understand these effects and guide clinical recommendations.

References

Toffol, E., Heikinheimo, O., Koponen, P., Luoto, R., & Partonen, T. (2012). Further evidence for lack of negative associations between hormonal contraception and mental health.. Contraception, 86 5, 470-80. https://doi.org/10.1016/j.contraception.2012.02.014

Lewis, C., Kimmig, A., Zsido, R., Jank, A., Derntl, B., & Sacher, J. (2019). Effects of Hormonal Contraceptives on Mood: A Focus on Emotion Recognition and Reactivity, Reward Processing, and Stress Response. Current Psychiatry Reports, 21. https://doi.org/10.1007/s11920-019-1095-z

Robakis, T., Williams, K., Nutkiewicz, L., & Rasgon, N. (2019). Hormonal Contraceptives and Mood: Review of the Literature and Implications for Future Research. Current Psychiatry Reports, 21, 1-9. https://doi.org/10.1007/s11920-019-1034-z

Skovlund, C., Mørch, L., Kessing, L., & Lidegaard, Ø. (2016). Association of Hormonal Contraception With Depression.. JAMA psychiatry, 73 11, 1154-1162. https://doi.org/10.1001/jamapsychiatry.2016.2387

Skovlund, C. (2018). Clarifying Methods and Results in Studies of the Association Between Hormonal Contraception and Mental Health Issues: Response to Berlin et al.. The American journal of psychiatry, 175 7, 684. https://doi.org/10.1176/appi.ajp.2018.18010057r

Pletzer, B. (2024). Hormonal contraceptives and women’s mental health – A long-term perspective. Open Access Government. https://doi.org/10.56367/oag-044-11693

Toffol, E., Heikinheimo, O., Koponen, P., Luoto, R., & Partonen, T. (2011). Hormonal contraception and mental health: results of a population-based study.. Human reproduction, 26 11, 3085-93. https://doi.org/10.1093/humrep/der269

Brouillard, A., Davignon, L., Fortin, J., & Marin, M. (2022). A Year Through the COVID-19 Pandemic: Deleterious Impact of Hormonal Contraception on Psychological Distress in Women. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.835857