A Synopsis of The Impact of Oral Contraceptive Pills on Mood – Is the Pill Associated with Depression?

Posted on August 23, 2017

Throughout the history of medicine, thousands of drugs have been developed, but only one has been influential enough to earn the title of simply, the pill. Introduced in May 1950, the oral contraceptive pill is a medical innovation that has dramatically transformed generations. Women have gained incredible freedom and reproductive autonomy. The birth control pill separated sexual practice from conception, forcing re-assessment and reevaluation of social, political, and religious viewpoints.

The first real large-scale trial of the pill was conducted in 1956 in Rio Piédras, a Puerto Rican housing project. The 200-plus women involved in the trial received little information about the safety of the product they were given, as there was none to give, and no one thought that it might be necessary to provide such information. That was the standard of the day. Women who stepped forward to describe side effects of nausea, dizziness, headaches, and blood clots were discounted as “unreliable historians.”Despite the substantial positive effect of the pill, its history is marked by a lack of consent, a lack of full disclosure, a lack of true informed choice, and a lack of clinically relevant research regarding risk. These are the pill’s cautionary tales. [1]

Hormonal contraception is available in oral pills and formulations stored within a device such as a transdermal patch, vaginal ring or a subcutaneous implant. As for contraceptives, they all provide an effective and safe method for the prevention of pregnancy. Regardless of formulation, expected failure rates are <2%. However, typical failure rates are between 3-5% due to accidental non-compliance. [2]

References

1. Half a century of the oral contraceptive pill

Liao, P. V., & Dollin, J. (2012). Half a century of the oral contraceptive pill. Canadian Family Physician, 58(12), e757-e760.

2. An overview of oral contraceptives: mechanism of action and clinical use

Frye C. An overview of oral contraceptives: mechanism of action and clinical use. Neurology. 2006

3.Combined hormonal contraception and its effects on mood

Schaffir J et al., Combined hormonal contraception and its effects on mood: a critical review. The European Journal of Contraception & Reproductive Health Care. 2016.

4.Estrogen actions in the brain

Gillies, G. E., & McArthur, S. (2010). Estrogen actions in the brain and the basis for differential action in men and women: a case for sex-specific medicines. Pharmacological reviews, 62(2), 155-198.

5.Sex hormones affect neurotransmitters

Barth, C., Villringer, A., & Sacher, J. (2015). Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods. Frontiers in neuroscience, 9.

6.Selective estrogen receptor modulators as brain therapeutic agents

Arevalo, M. A., Santos-Galindo, M., Lagunas, N., Azcoitia, I., & Garcia-Segura, L. M. (2011). Selective estrogen receptor modulators as brain therapeutic agents. Journal of molecular endocrinology, 46(1), R1-R9.

7. The role for vitamin B-6 as treatment for depression

William A et al., The role for vitamin B-6 as treatment for depression: a systematic review. Family Practice. 2005.

8.Depressive symptoms and oral contraceptives

Herzberg B et al., Depressive symptoms and oral contraceptives. British Medical Journal. 1970.

9.Depressive symptoms and Norplant contraceptive implants

Westhoff C et al., Depressive symptoms and Norplant contraceptive implants. Contraception. 1998

10.Depressive symptoms and Depo-Provera

Westhoff C et al., Depressive symptoms and Depo-Provera. Contraception. 1998

11.Association of hormonal contraception with depression.

Skovlund C et al., Association of hormonal contraception with depression. JAMA Psychiatry. 2016