Teen girls on birth control pills more likely to report increased crying, hypersomnia, and eating problems
Teenage girls using birth control pills tend to score higher on a measure of depressive symptoms compared with their nonusing counterparts, according to new research published in JAMA Psychiatry. But these symptoms seem to diminish once
“Data on depressive symptom severity of women currently using oral contraceptives is needed to provide information on the immediate associated risks,” said study author Anouk de Wit, a MD/PhD/MPH trainee in the Department of Psychiatry at University Medical Center Groningen.
“This is one of the more common concerns teens and their parents have when considering taking the pill. Most women first take an oral contraceptive pill as a teen, and teens have lots of challenging emotional issues to deal with so it especially important to monitor how they are doing.”
For their study, the researchers analyzed data from the Tracking Adolescents’ Individual Lives Survey, a longitudinal study of teens and young adults from the Netherlands conducted from
September 1, 2005, to December 31, 2016. The sample included 1,010 female participants ages 16 to 25.
The researchers found an association between oral contraceptive pill use and depressive symptoms among 16-year-old participants — but not older age groups.
“Girls aged 16 years reported 21.2% more depressive symptoms compared with 16-year-old girls not using oral contraceptives. However, this difference in depressive symptoms was not seen at the ages 19, 22, 25,” de Wit told PsyPost.
Sixteen-year-old girls using birth control pills reported more crying, hypersomnia, and eating problems than their counterparts. But rates of anhedonia and sadness were unaffected.
“The magnitude of the association was small, and these depressive symptoms are mild enough that they did not constitute clinical or major depression. However, these mood changes were seen in oral contraceptive-using adolescents, who are a vulnerable population,” said co-author Hadine Joffe in a news release.
“These concerns much be weighed against the bigger risk of lack of contraception leading to unintended pregnancies in teenagers and pregnancy complications including a potential postpartum depression.”
The study — like all research — also includes some limitations.
“Because of the observational design of the study, we can’t say that the examined difference is a cause-effect relationship,” de Wit explained.
“We can’t say that the pill causes mood changes. It is also possible that girls who already had more depressive symptoms were more likely to start oral contraceptive use.”
“Future research should focus on why 16-year-old girls (but not at the older ages) report more depressive symptoms when using oral contraceptives,” de Wit added.
The study, “Association of Use of Oral Contraceptives With Depressive Symptoms Among Adolescents and Young Women“, was authored by Anouk E. de Wit, Sanne H. Booij, Erik J. Giltay, Hadine Joffe, Robert A. Schoevers, and Albertine J. Oldehinkel.
ChaplnGrillSgt on October 29th, 2019 at 13:33 UTC »
I'd be curious to see how this compares to other hormonal birth control such as iud, implants, or nuva rings. Also how it compares with a copper iud.
tensing99 on October 29th, 2019 at 13:03 UTC »
I don't have access to the article so can someone please tell me the study design?
I can see ethical issues from randomized control trial with a control group getting placebos.
But then we run into a heavy self selection bias, where you're looking at how girls who choose to take birth control pills differ from those who don't.
So I'm interested in how they did it.
mvea on October 29th, 2019 at 07:30 UTC »
The title of the post is a copy and paste from the title and first paragraph of the linked academic press release here:
Journal Reference:
Association of Use of Oral Contraceptives With Depressive Symptoms Among Adolescents and Young Women
Anouk E. de Wit, BSc1,2; Sanne H. Booij, PhD1; Erik J. Giltay, MD, PhD3; et al Hadine Joffe, MD, MSc2,4; Robert A. Schoevers, MD, PhD1; Albertine J. Oldehinkel, PhD1
JAMA Psychiatry. Published online October 2, 2019.
Link: https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2751923
doi:10.1001/jamapsychiatry.2019.2838
Key Points
Question What is the association between oral contraceptive use and concurrent depressive symptoms in adolescents and young women?
Findings In this cohort study of 1010 adolescents followed up for 9 years, 16-year-old oral contraceptive users showed higher concurrent depressive symptom scores compared with their counterparts not using oral contraceptives. Oral contraceptive users particularly reported more crying, eating problems, and hypersomnia compared with nonusers.
Meaning It is important to monitor for depressive symptoms in adolescents who are using oral contraceptives, as it may affect their quality of life and put them at risk for nonadherence.
Abstract
Importance Oral contraceptives have been associated with an increased risk of subsequent clinical depression in adolescents. However, the association of oral contraceptive use with concurrent depressive symptoms remains unclear.
Objectives To investigate the association between oral contraceptive use and depressive symptoms and to examine whether this association is affected by age and which specific symptoms are associated with oral contraceptive use.
Design, Setting, and Participants Data from the third to sixth wave of the prospective cohort study Tracking Adolescents’ Individual Lives Survey (TRAILS), conducted from September 1, 2005, to December 31, 2016, among females aged 16 to 25 years who had filled out at least 1 and up to 4 assessments of oral contraceptive use, were used. Data analysis was performed from March 1, 2017, to May 31, 2019.
Exposure Oral contraceptive use at 16, 19, 22, and 25 years of age.
Main Outcomes and Measures Depressive symptoms were assessed by the DSM-IV–oriented affective problems scale of the Youth (aged 16 years) and Adult Self-Report (aged 19, 22, and 25 years).
Results Data from a total of 1010 girls (743-903 girls, depending on the wave) were analyzed (mean [SD] age at the first assessment of oral contraceptive use, 16.3 [0.7]; (mean [SD] age at the final assessment of oral contraceptive use, 25.6 [0.6] years). Oral contraceptive users particularly differed from nonusers at age 16 years, with nonusers having a higher mean (SD) socioeconomic status (0.17 [0.78] vs –0.15 [0.71]) and more often being virgins (424 of 533 [79.5%] vs 74 of 303 [24.4%]). Although all users combined (mean [SD] ages, 16.3 [0.7] to 25.6 [0.6] years) did not show higher depressive symptom scores compared with nonusers, adolescent users (mean [SD] age, 16.5 [0.7] years) reported higher depressive symptom scores compared with their nonusing counterparts (mean [SD] age, 16.1 [0.6] years) (mean [SD] score, 0.40 [0.30] vs 0.33 [0.30]), which persisted after adjustment for age, socioeconomic status and ethnicity (β coefficient for interaction with age, –0.021; 95% CI, –0.038 to –0.005; P = .0096). Adolescent contraceptive users particularly reported more crying (odds ratio, 1.89; 95% CI, 1.38-2.58; P < .001), hypersomnia (odds ratio, 1.68; 95% CI, 1.14-2.48; P = .006), and more eating problems (odds ratio, 1.54; 95% CI, 1.13-2.10; P = .009) than nonusers.
Conclusions and Relevance Although oral contraceptive use showed no association with depressive symptoms when all age groups were combined, 16-year-old girls reported higher depressive symptom scores when using oral contraceptives. Monitoring depressive symptoms in adolescents who are using oral contraceptives is important, as the use of oral contraceptives may affect their quality of life and put them at risk for nonadherence.