A large study from Denmark found that women using hormonal contraceptives have triple the risk of suicide compared to women who haven’t used this form of birth control. Hormonal contraceptives include the birth control pill as well as the patch, ring, and hormonal IUDs. To investigate the suicide risk, researchers from the University of Copenhagen followed nearly a half million women ages 15 and older for an average of 8.3 years. During that time, they identified 6,999 suicide attempts and 71 actual suicides. The risks were higher in women using hormonal contraceptives as well as in those who had used them in the recent past, compared with women who had never used them. The highest risks seen were among teenagers.
The study found that suicide attempts among women using hormonal contraceptives were nearly double those of women who never used any type of birth control, while the risk of suicide itself was three times that of women who used no birth control. However, the actual number of suicides – 71 – was low considering the number of women being followed. The highest risk of attempted suicide was associated with use of the patch, followed by the IUD, then the vaginal ring and, last, the pill.
Earlier this year, I reported on findings by the same Danish team regarding the extent of depression linked to hormonal birth control methods. Here, the risk was higher with progesterone-only medications and highest among 15 to 19 year-olds, especially those using the ring, patch and IUD. The risks declined as women got older, peaking about six months after they began to use the contraceptives. The study looking at attempted and successful suicides followed up on the depression findings. Here, results showed that the risks of suicide and attempted suicide were highest in the first two months after beginning to use a hormonal contraceptive and plateaued after a year. Even so, the risks remained twice those of women who used no contraceptives. After seven years, the risks were still 30 percent higher among women using hormonal birth control.
This isn’t the only study of the risk of suicide and suicide attempts among women on hormonal contraception. Five other investigations have found higher risks, although in only one case were the increases statistically significant. However, none of the earlier studies included women ages 15 to 25, who were found to be most vulnerable in the latest investigation.
The Danish researchers said their results should prompt doctors to discuss the potential side effects of hormonal contraceptives, especially with women who have a history of depression or other mood disorders. Lead author Charlotte Wessel Skovlund also said doctors should be more reluctant to prescribe hormonal contraceptives to young girls unless there are compelling medical reasons to do so.
If you’re using hormonal birth control and are concerned about the risk of suicide, depression or other serious side effects, be sure to discuss your reservations with your physician. And do consider non-pharmacological, natural birth control options. You can use the calendar method and pay attention to your temperature and the texture of cervical mucus, or you can use a contraceptive sponge, a diaphragm or a cervical cap. Your partner can use condoms, either alone or with spermicidal foam.
Andrew Weil, M.D.
Charlotte Wessel Skovlund et al, “Association of Hormonal Contraception with Suicide Attempts and Suicide.” American Journal of Psychiatry, November 17, 2017, doi.org/10.1176/appi.ajp.2017.17060616