Academic OB/GYN

This week a study was published in JAMA Psychology drawing a connection between the use of birth control pills and depression.   This was picked up in the popular press, and briefly we were hearing about it in the news and radio.  I first heard about on my way to work listening to NPR.   The message I got was that a study was just published that showed  a link between the use of birth control pills and the development of new depression.

Today I read the actual paper that led to this media frenzy, and not surprisingly the media got it at least partially wrong.

Skovlund et al reported the following

“A total of 1 061 997 women (mean [SD] age, 24.4 [0.001] years; mean [SD] follow-up, 6.4 [0.004] years) were included in the analysis. Compared with nonusers, users of combined oral contraceptives had an RR of first use of an antidepressant of 1.23 (95% CI, 1.22-1.25). Users of progestogen-only pills had an RR for first use of an antidepressant of 1.34 (95% CI, 1.27-1.40); users of a patch (norgestrolmin), 2.0 (95% CI, 1.76-2.18); users of a vaginal ring (etonogestrel), 1.6 (95% CI, 1.55-1.69); and users of a levonorgestrel intrauterine system, 1.4 (95% CI, 1.31-1.42). For depression diagnoses, similar or slightly lower estimates were found. The relative risks generally decreased with increasing age. Adolescents (age range, 15-19 years) using combined oral contraceptives had an RR of a first use of an antidepressant of 1.8 (95% CI, 1.75-1.84) and those using progestin-only pills, 2.2 (95% CI, 1.99-2.52). Six months after starting use of hormonal contraceptives, the RR of antidepressant use peaked at 1.4 (95% CI, 1.34-1.46). When the reference group was changed to those who never used hormonal contraception, the RR estimates for users of combined oral contraceptives increased to 1.7 (95% CI, 1.66-1.71).”

In summary, women who used birth control pills were more likely to also use antidepressants.   They concluded that women who use birth control use antidepressants more often, and thus they may be more likely to be depressed.

Here’s what I think about this.

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