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When it comes to taking hormonal contraceptives, the FDA has issued warnings that it could be putting women’s health at risk. A new study shows that women’s mental health is on the line, too.

The Journal of the American Medical Association recently published a comprehensive investigation on the association between hormonal birth control and depression. The study conducted nationwide in Denmark included more than one million women ages 15 to 34 whose data was collected and analyzed over a period of fourteen years.

Until now, research data linking depression as a potential adverse effect of hormonal contraception has been varied. The authors say this may be because users who begin to experience mood swings often choose to stop using hormonal birth control. An article in American Family Physician reports, “Despite the transient course of these effects, a population-based survey found that 64.6 percent of women who discontinued oral contraceptives did so because of adverse effects.” The Danish study is unique because of the large, nationally representative sample size and because it was controlled to include users who had stopped using hormonal birth control within six months.

The investigation concludes that using hormonal contraceptives “was associated with subsequent use of antidepressants and a first diagnosis of depression.” The authors also note that “all types of hormonal contraceptives” were associated with these risks.

Compared to nonusers, women using combination birth control pills containing estrogen and progestin were up to 25 percent more likely to be prescribed an antidepressant. The risk for progestin-only pill users was up to 40 percent. For other types of hormonal birth control, the risks were higher. Compared to nonusers, the rate of antidepressant prescriptions were up to 42 percent for those using a progestin-only IUD; up to 69 percent for those using a vaginal ring; and 100 percent for those using a patch. And the risks were two to three times higher for adolescent users.

The Danish study reports, “A total of 133,178 first prescriptions of antidepressants and 23,077 first diagnoses of depression were detected during follow-up.” The authors also note that not all women who are depressed are diagnosed or prescribed antidepressants. In light of this, concerns about hormonal birth control’s associated risks with depression and its influence on women’s mood are seriously warranted.

Dr. Marguerite Duane, family physician and executive director of Fertility Appreciation Collaborative to Teach the Science, tells Verily, “The Pill is the most widely used drug given to healthy people to suppress a normal physiologic function. [Yet] it exposes women to a myriad of side effects including blood clots, bleeding irregularities, breast tenderness, mood changes, and many others.”

Dr. Duane points out that hormonal contraception introduces synthetic hormones, which modulates hormone production already occurring in the body. As noted in the JAMA article, “External progestins, probably more than natural progesterone, increase levels of monoamine oxidase, which degrades serotonin concentrations and thus potentially produces depression and irritability.” Serotonin is a major neurotransmitter involved in the control of pain perception, the sleep cycle, and mood. It should come as no surprise, then, that hormonal contraceptives impact aspects of the body beyond the reproductive cycle.

VICE recently published a piece titled “Women Talk About How the Pill Has Completely Fucked Them Over.” The stories of exploding cells, eternal menstruation, and abnormal breast growth are unsettling, but what’s even more disturbing is how some of these women seem resigned to the risks. One woman named Georgia shares, “I enjoy sex, and I enjoy being happy. It looks like, for me, as long as I’m taking hormonal contraception, the two may never be mutually exclusive.”

But family planning doesn’t have to be this way. In fact, taking good care of one’s feminine health means it shouldn’t be this way. Dr. Duane asks, “Why would we want to expose healthy women to serious or a substantial number of side effects under the guise of preventing pregnancy when there are other effective options available that pose no health risk?”

Fertility Awareness-Based Methods, or FABMs, for instance, are “a very effective method of family planning and are comparable to most artificial methods of birth control when it comes to avoiding pregnancy,” Dr. Duane says. And FABMs are natural, hormone-free, and free of side effects.

FABMs are not grandma’s rhythm method. Rather, they are based on decades of solid scientific research of a woman’s reproductive physiology. Dr. Duane shares that FABMs “allow a woman to work with her body rather than suppress her normal physiology.” In fact, Dr. Duane calls FABMs “the only true methods of family planning because couples can use them to both avoid and achieve pregnancy.”

Unfortunately, few women (and men) know about FABMs or their effectiveness because they have such a low mainstream presence. Dr. Duane says, “The reality is good marketing costs a lot of money, and there is very little money to be made ‘selling’ FABMs as opposed to the billions of dollars pharmaceutical companies make from the sale of birth control.”

While more research on the connection between hormonal contraceptives and their influence on women’s mood and bodies should be done, the results of this investigation make a convincing case. If women’s health and happiness are to be valued and protected, giving FABMS a try is the most empowering alternative to hormonal birth control.

Photo Credit: Ashley Crawford