Many women take birth control pills to relieve the physical and mental symptoms of premenstrual stress and menstruation. However, scientists have found that the commonly recommended method for taking these pills may result in adverse mental health outcomes.
About 407 million women and people who menstruate use hormonal birth control worldwide, the United Nations says, but the mental health implications of taking these pills is hotly debated. For example, a study from Uppsala University in June found that women who began taking the pill as a teenager had a 130 percent higher incidence of depression symptoms than their peers, with an increase of 92 percent in adult users.
Other studies have suggested that taking hormonal contraceptives can actually reduce rates of panic disorder and depression. That may be particularly true for the roughly 5 percent to 8 percent of people menstruating who experience an extreme and often crippling form of premenstrual stress called premenstrual dysphoric disorder.
These conflicting results depend on many factors, including how the pill is taken. While some people take hormonal contraception continuously, many women choose to take short "pill free breaks" between packs. This may be to reduce breakthrough bleeding and spotting or simply to reassure themselves that they aren't pregnant.
However, research published on September 27 in the journal JAMA Network Open by the Universities of Salzburg and Copenhagen found that the hormonal withdrawal that occurs during these breaks may be linked with negative mood, anxiety and depression akin to that experienced during a natural period.
The study involved 181 women between the ages of 18 and 35. Two-thirds of the women had been using combined oral contraceptives for at least six months, while the other third had not. Over the course of a month, each pill-taking participant was asked to take two identical mood questionnaires—one during the active pill-taking phase of their "cycle" and once during their pill-free break. Those without hormonal contraception performed the questionnaires at three different phases of their monthly cycle.
At the end of the study, pill users showed a 12.7 percent increase in negative affect, 7.4 percent increase in anxiety and a 23.6 percent rise in mental health symptoms during their pill-free break, compared to their active intake phase, which was comparable to the monthly mood changes experienced by women who hadn't been using hormonal contraception.
"These results question the use of the pill pause from a mental health perspective," the study's authors say. "Long-term combined oral contraceptive users may benefit more from the mood-stabilizing effects of combined oral contraceptive in cases of
continuous intake."
To ensure safe and effective use of oral contraceptives, you should always speak to your doctor.
Uncommon Knowledge
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Newsweek is committed to challenging conventional wisdom and finding connections in the search for common ground.
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Pandora Dewan is a Senior Science Reporter at Newsweek based in London, UK. Her focus is reporting on science, health ... Read more
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