Is your progestin-only birth control making you depressed? Probably not, suggests research published online today in the journal Contraception.
After conducting a review of past studies, researchers from The Ohio State University found that most data didn’t support a link between progestin-only contraception and depression.
“There’s lots of reasons why people will sometimes get depression, but progestin-only contraception is not likely the cause for most people,” Dr. Brett Worly, lead author of the study and assistant professor of obstetrics and gynecology at The Ohio State University Wexner Medical Center, told Healthline.
“It’s hard to say from person to person,” he added, “but when looking at bigger populations, based on the best scientific evidence, it seems like these medicines are safe and most people should do really well with them.”
Previously, Worly was involved in a literature review that found no consistent link between combined hormonal contraception and depression.
Most studies have found no link
To conduct their latest literature review, Worly and colleagues used several research databases to search for past studies on progestin-only contraception and depression.
They found 26 studies that met their inclusion criteria. They included studies on progestin-only birth control pills, intrauterine devices (IUDs), implants, and injections.
Across these studies, some patients reported increased symptoms of depression after they began to use progestin-only contraception.
However, the most robust studies found no link between depressive symptoms and progestin-only contraception use.
This was true even when the research team focused on patients at higher risk of depression, including postpartum patients, adolescent patients, and those with a history of depression.
“Unfortunately, a lot of people have depression,” Worly said, including some women who use progestin-only contraception.
“But just because they’re both simultaneously there doesn’t mean that one necessarily causes the other,” he added, “and I feel safe at this point saying, for most women, progestin-only contraception should not cause them to have depression.”
Women face an array of choices
In recent decades, many new contraceptive methods have hit the market, including a growing number of hormonal contraceptives that contain progestin but not estrogen.
They also include the birth control shot, which is commonly marketed under the brand name Depo-Provera.
Compared to birth control pills, the Mirena IUD, Nexplanon implant, and Depo-Provera injections are more effective for preventing pregnancy and more convenient for many people.
But some women might be reluctant to try these methods of birth control due to concerns over potential side effects.
“One of the problems that a lot of people have is that they hear that their friend or family member has experienced some sort of depression,” Worly said.
“So I wanted to go and look through the literature from a scientific perspective and really assess the question: Is there a link between depression and progestin-only contraception and is it something that my patients need to worry about?” he explained.
He said his findings might help reassure people about the safety of these progestin-only options, including the Mirena IUD, Nexplanon implant, and Depo-Provera shot.
“Most women should feel safe and reassured that they can use that long-acting contraception,” Worly said, “and they shouldn’t have trouble as far as depression.”
More research is needed
While Worly and his associates found some high-quality studies on progestin-only contraception and depression, he noted that more research is needed.
“The best would be well-done randomized control trials that look at these different issues,” he said.
“Those are hard studies to do because they take a lot of time, a lot of resources, and a lot of money,” he noted, “but those are the type of studies that really need to be done.”
In the meantime, people should work closely with their doctors or other healthcare providers to find a contraceptive method that meets their needs.
“Contraception is not a one-size-fits-all decision,” Dr. Holly Bullock, MPH, a fellow in the Long-Acting Reversible Contraceptive Program of the American College of Obstetricians and Gynecologists, told Healthline.
“Reviewing each method, with its benefits and risks, is an important step before starting any new contraceptive method,” she said.
Although progestin-only and combined hormonal contraceptives pose some risks of side effects, they’re generally considered safe.
In rare cases, they may contribute to the formation of blood clots, stroke, and heart attack.
Bullock noted the risk of these adverse events is greater with pregnancy.
Similarly, an “unplanned pregnancy may have more of an impact on mood and mental health than any method of contraception,” she said.
“For women with a history of medical illness or on medications,” she advised, “consult your doctor when starting a method of birth control, as some methods may be safer than others, or drug-drug interactions may make your medications or the contraceptive method less effective.”
If you suspect that you’re experiencing depression or side effects from contraceptives, make an appointment with your doctor.