Hormonal Contraception Tied to New-Onset Depression

By Amy Orciari Herman

Edited by Susan Sadoughi, MD

Use of hormonal contraception is associated with new-onset depression, according to a prospective study in JAMA Psychiatry.

Using data from Danish registries, researchers followed over a million females (aged 15–34) from 2000 through 2013. Women with prior major psychiatric diagnoses, including depression, were excluded. During follow-up, just over half the women were current or recent users of hormonal contraception. Additionally, there were roughly 133,000 new prescriptions for antidepressants and 23,000 first depression diagnoses.

With former/non-users of hormonal contraception as the reference group, the risk for first use of antidepressants was significantly increased among current/recent users of combined oral contraceptives (rate ratio, 1.2), progestin-only pills, a transdermal patch, a vaginal ring, an implant, an intrauterine device, and depot medroxyprogesterone acetate (RR, 2.7). Findings generally were similar for first depression diagnoses. Associations were strongest among adolescent girls.

Emphasizing the limitations of observational studies such as this, Dr. Andrew Kaunitz, editor-in-chief of NEJM Journal Watch Women's Health, says, "Although mood changes may occur in women using hormonal contraceptives, I feel it would not be evidence-based to counsel women that using such contraception will increase risk for depression."