My focus in this article critique is to understand and determine whether or not hormonal birth control can actually be linked to a higher risk of suicide. In the article written by Alice Park with the New York Times, it is mentioned that although the data connecting “The absolute risk of suicide associated with hormonal contraceptives is still extremely low … the data suggests it’s worth studying and understanding further.” Studies have revealed that birth control use has lead to higher chances of women developing depression which, in turn, can result in the possibility of its users committing suicide, the reason why remains unknown but may have to do with the effects of hormonal contraceptives on the brain.
Women, by today’s standards are expected to be on or take some form of birth control when they are sexually active. While there are non-hormonal options, the ones that are the most effective are hormonal contraceptives. According to the Planned Parenthood website and Stöppler at MedicineNet, hormonal contraceptives are those that act on the endocrine system. These methods are composed of either both estrogen and progestin or only progestin. They deliver a dosage of hormones to the body that prevent the release of eggs from the ovaries, prevent sperm from entering the uterus by thickening the mucus found in the cervix, and prevent implantation of sperm in the uterus by thinning its lining. Options for Hormonal birth control are birth control pills, the patch, the ring, and hormonal IUDs.
The side effects of birth control, according to Stöppler, can be useful to women in many ways. Not only is it helpful in preventing unwanted pregnancies, it can also reduce acne, alleviate symptoms of PMS, lighten heavy or painful periods, alleviate menstrual migraines, and reduce the risk of ovarian cancer. Birth control is also known to lower the possibility of endometrial cancer, polycystic ovarian syndrome, pelvic inflammatory disease, and ectopic pregnancies. Although there are many upsides to using birth control, there are always individuals who unfortunately experience the unpleasant side effects. Nausea, headaches, weight gain, decreased libido, mood changes, and depression are also among the list of side effects for birth control.
In the article, the author developed a comprehensive understanding of the connection between birth control and depression. She introduced data from the first study which compared the development of depression and risk for suicide in women who had either just started or have been on some form of hormonal contraceptive and women who were either no longer on hormonal contraceptives or had never been on any form of hormonal contraceptives. She also included the outcome of when the study compared the results of depression and suicide to women who have never used contraceptives before. When the initial study was altered to no longer include women who had previously been on hormonal contraceptives, the researchers noticed a difference. There weren’t differing results when compared to the women who had previously used a form of contraception. This discovery can mean that there is a possibility that depression and risk of suicide caused by birth control will remain even after stopping use.
One focus in the article was on the risk of suicide among the younger population. This risk peaked in the first two months after starting a hormonal contraceptive but plateaued after a year of continued use. The Planned Parenthood website says that all side effects upon the first month of starting a new birth control regimen will be more prominent and fade as use is continued. Meaning that these initial signs of depression are normal but should fade as the user continues. However, the study found that prolonged use of hormonal contraceptives was more likely to raise the risk of suicide up to “30%” even after seven years. With an increased risk of developing depression, the article also mentions the possibility of an individual committing suicide raising as the use of hormonal contraception is prolonged.
When the factors that affected the risk of suicide such as “mental illness and the initiation of sexual relationships” were adjusted or removed, the results were still the same. Although the results remained the same, they do not include the possibility of other emotional challenges and their influence on women. The author understood this and points out the fact that the study did not factor in the possibility of younger women being more insecure, going through more breakups, and other unsettling events. On the other hand, the article did not mention if the study included or compared the amount of suicides of women who were taking hormonal contraceptives and the amount of suicides in the Denmark region. Meaning that although there were women who committed suicide while on hormonal contraception, the possibility of environmental factors having an impact is ruled out by not including a total suicide rate (men and women) in Denmark. The article ultimately concludes that it is “not clear how contraceptives may be affecting suicide risk” but, it mentions that “it’s possible that some of the risk is occurring through the way that hormones can affect mood and depression.” Meaning that there is a possibility that the hormones used in this form of contraception can affect the brain. It is not expanded upon but merely said. A statement that is undetermined and not fully studied meaning that it is important for there to be more research on the subject.
When signing up for a new birth control regimen, individuals may unknowingly be putting their mental health at risk. The possibility of developing depression from birth control is higher than anticipated and it is undetermined how long after stopping a regimen until the side effects subside. The article does not mention whether side effects of the birth control will completely dissipate after stopping use which is concerning. The lead author in the paper from the university of Copenhagen in Denmark, Charlotte Wessel Skovlund stands by her belief that “hormonal contraception can also have a direct effect on the brain”. To which extent remains undetermined and leaves individuals uninformed on the subject. There are no known articles mentioned by the author that expand on the idea that birth control directly affects the brain meaning this area of study is either currently being researched or unknown to others.
Every individual is different and on a genetic level, everyone varies drastically. From the very beginning of a sperm-egg-fusion, there is a distinct combination of 46 chromosomes that result in the formation of a child. Humans are all different and complex which makes each and every individual unique. Some people are allergic to penicillin and others aren’t allergic to anything at all which makes it understandable that all medications can affect every individual in a different way. Some women who are on birth control do not experience any kind of change while others can experience great benefits and others, unpleasant side effects. According to Planned Parenthood, there are many different types of hormonal birth control methods and the difference between them all are the types of hormones used, how much of the hormone is delivered, and the way the hormone enters the body. This means that since there are different options for women to choose from.
The relationship between a patient and a doctor is crucial, any medications a patient takes can react and lead to complications. In the conclusion of the article, it is mentioned that although the data found is not discouraging enough to completely stop medical providers from prescribing hormonal contraceptives, it would be best if they carefully considered the possibilities with each individual and worked with them to find what works best. It is necessary for women to have an open relationship with their medical providers in order to adequately prescribe contraceptive medications which will result in the least amount of side effects. Women should be more cautious. While one form of contraception works amazing for a friend or family member, the same medication can result in another individual developing depression or having intense mood swings. It is important for women to know about the mental side effects in order for them to understand when it is necessary to halt use when there is a noticeable difference in their mood.
Furthermore the article mentions that “The patch was linked to the highest risk of suicide attempts, followed by IUD, the vaginal ring and then pills.” If it is true that the hormones delivered alter the brain in a negative way, it would be best to understand how each form of hormonal contraception works. According to MedicineNet, the pill is taken orally and comes in two forms, a combination pill which includes both estrogen and progestin hormones and a mini pill which only contains the progestin hormones. The patch is similar to the combination pill since they both contain estrogen and progestin hormones but the patch differs because the hormones aren’t delivered orally but through transdermal process. The IUD can be implanted in the arm and provides a continuous delivery of progestin hormones over the course of three years. The main difference found between these forms of contraception is how the hormones are delivered. My personal conclusion for why the patch and the IUD lead to higher risks of suicide attempts among women may be because the release of hormones is ineffective. While a pill is a specific dosage every day at a specific time, the patch and the IUD deliver a continuous administration of hormones throughout a day. Since there are no sources that have information on why the patch and IUD have higher risks of suicide I had to come up with an explanation.
Although hormonal contraceptives can be helpful to women in many ways, there are still concerns among women as to why there are so many negative side effects. Unfortunately, it is common for women to feel depressed while on some form of hormonal contraceptive. The article written by Alice Park brings this issue to light. Although this field of research remains underdeveloped, hopefully this article enlightens others and enables them to acknowledge that birth control is linked to higher rates of depression. The need for an understanding is crucial because women everywhere may unknowingly be hurting themselves by developing higher risks of depression and suicide.