If you follow the news, you will have heard about this study linking hormonal contraception to an increased risk of being diagnosed with depression.
Did you dismiss it? “Old news, we’ve known about that forever”, “It was an association, not a causal link. Nothing needs to change here.”
Or did you feel relieved, and maybe angry? At last some research to confirm what you or yours have been going through?
I welcome the research. Hurrah for Scandinavian record keeping and universal healthcare! Who knows what research treasure might be lurking in the NHS records system?
I also welcome, in a slightly more reserved way, this powerful piece by Holly Grigg-Spall who is understandably frustrated by all the “pillsplaining” that followed the publication of the research. Her article has been shared over 200k times, which is some indication of how uneasy many women are with hormonal contraception.
Holly Grigg-Spall had a bad experience with the pill herself and shares many stories. These are important, evidence is about more than big randomised controlled trials, or what gets published in medical journals. Women who do not get on with hormonal contraception should not simply be told to "persevere" by their doctors. We need options not lectures.
But we also need to remember the women who get on fine with the pill, the women whose mood is improved by the pill, and those who are stuck in an abusive relationship where a secret stash might be a lifeline. Overstating risks could mean that women feel they have fewer options, and we need all the choices we can get when it comes to contraception.
Holly Grigg-Spall is doing great work, her book is a rollicking read, but I'd love it if she could turn it down a notich and give us a bit more context. We need to know that the 80 per cent increase in depression meant the numbers increased from 1 per cent to 1.8 per cent – from one in a hundred women to nearly two in a hundred.
Maybe I'm being naive - that isn't how journalism works. Maybe the pendulum needs to swing a bit more against the pill, it's not as if Big Pharma don't indulge in a few dirty tricks, but I think the research and stories are strong enough to handle a more careful approach. More importantly it might make it harder for the "pillsplainers" to dismiss Holly Grigg-Spall's arguments.
Anyway, back to the main point. Does the pill cause depression? Yes it can, for some women. Here are some ideas for what to do do if you think you have depression or anxiety, whether you are on the pill or not:
1. Believe yourself. There are 101 things that can affect your mood. It can be hard to tell, but don’t rule out the pill as either a cause or a treatment. The study found that the risk of being diagnosed with depression peaks at approximately two to three months after starting to use hormonal contraception.
2. Know your options. If you think the pill is causing problems, try switching your brand or using non-hormonal contraception. Your options include:
- Condoms – use them well
- The diaphragm or the cap
- Caya - a streamlined mixture of the diaphragm and the cap which fits 80 per cent of women.
- IUD (copper coil)
- Vasectomy – quicker, easier and more effective than female sterilisation
- Withdrawal – more effective than you might think
And of course Fertility awareness (natural family planning) which can be highly effective, so long as you know what you're doing, and can handle your fertile days.