Now we have the largest epidemiologic study of its kind, published in JAMA, out of Denmark, entitled Association of Hormonal Contraception with Depression. One million women ages 15-34 were followed for 13 years.
Here’s what they found:
Women who were prescribed the combined pill were 23 percent more likely to be treated with antidepressants
Progestin-only treated women (sometimes called the “mini pill”) were 34 percent more likely to be treated with antidepressants
Teens were 80 percent more likely if prescribed the combined pill and two-fold more likely with the progestin-only pill to be treated with antidepressants
Epidemiologic data is rife with potential confounders and certainly doesn’t demonstrate a clear causal signal, so this is merely food for thought. But what thought? What should we be thinking about as prescribers, mothers, and women?
I believe in informed consent and free choice.
Because oral contraceptives are poorly studied drugs given to healthy women, prescribers are morally obligated to thoroughly explore the known risks. If you still want to take a pill daily knowing you could develop everything from weight gain to migraines to an unhealthy relationship with your moods, all the way to your very life, then that is your choice.