In short Article

Hormonal contraception not a cause of depression?


Little research has been done into the association between the use of hormonal contraception and depression. The few studies that have been done have suffered from methodological shortcomings, and have reported conflicting findings. Many women use hormonal contraceptives at a period of their lives in which depressions are common. Hence, people often wonder whether hormonal contraceptives might be a cause of depression. We are not concerned here with mood changes or depressive feelings, but an actual diagnosis of depression. A systematic review found hardly any association between combined hormonal contraceptives and depression. There might be a (minimal) association for hormonal contraceptives that contain only progestogens. However, when applying the Bradford-Hill criteria, a causal relationship appeared unlikely.

  • Too few reliable studies have been done to prove a causal relationship between the use of hormonal contraceptives and depression.
  • Those studies into the association between hormonal contraceptives and depression that have been done have generally suffered from a high risk of bias and have yielded contradictory findings for the various preparations.
  • A weak association between depression and hormonal contraceptives has slightly more often been found for preparations containing only progesterone than for combined hormonal contraceptives.
  • The risk of depression is no reason to stop, or be reticent about, prescribing hormonal contraception.

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The literature refers to the Dutch text

Authors

  • mw S. van der Heijden MSc, prof. dr F.M. Helmerhorst, dr I.M. van Vliet, drs A.D. de Vries