Oral Contraceptives Reduce Risks for Anxiety, Depression, Panic Disorder, Study Finds
Compared to American men, American women are considerably more likely to develop issues related to the presence of a range of mental health concerns, including major depression and several anxiety disorders. In a study published in February 2015 in the Archives of Women’s Mental Health, researchers from Columbia University’s Mailman School of Public Health used several years of nationally representative survey information to compare the mental health risks of younger women who use oral contraceptives to the risks of women in the same age range who don’t use these pregnancy-preventing substances.
Women’s Mental Health Risks
Women in the U.S. and across the world develop major depression and other depressive illnesses more often than men. Women also have a gender-specific elevated risk for several diagnosable anxiety disorders, including panic attacks and panic disorder, generalized anxiety disorder and social anxiety disorder (a phobia related to social exposure). Other mental health conditions that women experience substantially more often than men include obsessive-compulsive disorder or OCD (an illness once classified as an anxiety disorder), post-traumatic stress disorder or PTSD (another illness once classified as an anxiety disorder), an illness called somatic symptom disorder and the eating disorders bulimia nervosa, anorexia nervosa and binge eating disorder.
Some of women’s elevated risk for certain mental health problems is hormonal. This fact largely holds true because women can develop a range of gender-specific illnesses linked to predictable short- and long-term fluctuations in the hormones (primarily estrogen and progesterone) responsible for controlling changes in fertility. The World Health Organization cites a number of additional, non-biological influences on women’s mental health risks. These influences include a widespread lack of socioeconomic resources relative to men, the combination of workplace and home stresses that commonly affects women who hold jobs and the widespread adoption of social roles that unduly restrict women’s range of acceptable behaviors.
Oral contraceptives are pharmaceutically produced combinations of hormones (typically estrogen and a progesterone equivalent called progestin) that prevent pregnancy by doing such things as halting the release of viable eggs during ovulation, preventing eggs from attaching to the surface of the uterus and preventing sperm from passing through the cervix into the uterus. When taken according to instructions, these hormone products are effective more than 99 percent of the time in new users. Some oral contraceptives, called monophasic contraceptives, deliver the same balanced dose of estrogen and progestin with each use. Other contraceptives, called multiphasic contraceptives, rely on varying estrogen/progestin mixtures during different phases of the menstrual cycle.
Oral Contraceptives and Mental Health Risks
In the study published in the Archives of Women’s Mental Health, the Columbia University researchers used data from six years of a project called the National Health and Nutrition Exam Survey or NHANES (1998-2004) to help determine if oral contraceptive use has any impact on younger women’s susceptibility to three mental illnesses: major depression, panic disorder and generalized anxiety disorder. All told, the researchers included information from 1,105 young women between the ages of 20 and 39 (the heart of childbearing years). The gathered information included all forms of oral contraceptive use in the year prior to NHANES enrollment; diagnosable symptoms of generalized anxiety disorder, panic disorder and major depression; and the presence of generalized anxiety, panic or major depression not severe enough to trigger an official diagnosis.
The researchers concluded that the women who had used oral contraceptives in the year prior to NHANES enrollment had a significantly lower rate of diagnosable generalized anxiety disorder, panic disorder and major depression, as well as a significantly lower rate of generalized anxiety disorder symptoms and panic disorder symptoms not severe enough for official diagnosis.
The study’s authors found that monophasic contraceptives are associated with a steeper drop in mental illness risks than multiphasic contraceptives. While they tentatively confirm the mental health benefits of recent oral contraceptive use, they defer to a need for additional studies that further analyze the longer-term mental health implications of contraceptive intake.