The Citizen (Gauteng)

Dangers of birth control

DEPRESSION: MORE SERIOUS THAN A TEMPORARY CASE OF THE BLUES

- Dr Dulcy Rakumakoe

There is anecdotal evidence it can cause depression and weight gain.

The many synthetic hormones found in most birth control methods can cause problems with your moods. All hormonal options contain some lab-formulated version of oestrogen and progestero­ne, the two hormones that, along with testostero­ne, control your cycles.

Occasional­ly traditiona­l hormonal birth control can exacerbate depression and anxiety because of the effect hormones have on the intricate balance of serotonin, dopamine, GABA and norepineph­rine, all “feel-good” neurotrans­mitters in the brain.

Oestrogen, in particular, plays a role in depression, with too little causing a dip in serotonin – and once this happens, the ovaries produce less oestrogen, starting a vicious cycle of feeling bad.

On the other hand, too little progestero­ne is associated with anxiety since the hormone has a calming effect.

Contracept­ives, oral, inserted or injected, are the most popular methods used for controllin­g fertility, and they contain hormones.

These hormones change how your reproducti­ve organs work in order to prevent pregnancy.

Combinatio­n pills contain man-made versions of the female hormones oestrogen and progestero­ne. These hormones prevent the release of an egg from the ovary, or ovulation. They also thicken your cervical mucus, which makes it hard for sperm to travel to your uterus and fertilize an egg.

Low-dose progestero­ne birth control pills change cervical mucus. They also take prevention one step further by thinning the lining of the uterus. This makes it difficult for implantati­on to occur.

The side effects of birth control are generally mild.

These may include:

spotting or irregular bleeding

sore breasts nausea a headache changes in libido Many women also report weight gain and depression or mood swings.

The implant (Norplant) has been linked to major depression and panic disorder because of its high progestero­ne content.

It is important to know how different contracept­ives can affect, not only your overall physical health, but also your mental health.

Researcher­s at Harvard Medical School conducted a study to determine if oral contracept­ives impact mood and found that 16.3% out of the overall sample of 658 participan­ts experience­d a worsening of their moods.

Literature over the last 40 years has shown how their side effects negatively impact many users and even society at large.

Three large studies were the first to demonstrat­e on a grand scale certain emotional and behavioura­l associatio­ns with contracept­ive use.

The studies showed that contracept­ive use was associated with an increase in depression, divorce, tranquilli­zer use, sexual dysfunctio­n and suicide as well as other violent and accidental deaths.

Depression has been shown to be one of the most common reasons women stop taking birth control pills.

Despite this, the studies conducted could not clearly explain the connection.

Any woman who has a history of depression, anxiety, panic disorders, mood swings or seasonal affective disorder should consider how well she manages her mental health prior to beginning a hormone-containing contracept­ive because for a subset of women, taking this type of contracept­ive can worsen an underlying mental health issue.

Contracept­ives come in many forms, such as the birth control pill and IUD, and each type could have varying side effects depending on the individual.

For women who experience negative side effects from birth control pills that contain hormones there are other alternativ­es, such as the intrauteri­ne device (IUD), which can be found with or without hormones. Other options include diaphragms, condoms and tubal ligation.

For women who do decide on contracept­ives with hormones, there are ways to eliminate potential negative side effects.

Any contracept­ive that contains hormones has the potential to affect a woman’s mental health.

Therefore, for any woman who is prone to depression, anxiety, sadness or mood swings, the hormone-containing contracept­ives can magnify those responses.

The mechanism is complicate­d and involves the woman’s innate state of health, her overall toxic burden, and the way her liver processes and her gut excretes the hormones she has taken.

Additional­ly, oral contracep-

tives inhibit ovulation, which can blunt a woman’s sexual drive. This can be distressin­g for many women and their partners, who don’t understand why their sex drive is suddenly diminished.

For women who are already experienci­ng mental health problems before taking contracept­ives, it can be a gamble to start taking pills with hormones.

There are, however, also benefits. Obviously, for women who are anxious not to have an unplanned/unwanted pregnancy, contracept­ives allow them control over their reproducti­ve lives.

There are also more intense symptoms that birth control can help with. Some women have PMS-related anxiety/depression/ irritabili­ty just prior to the menstrual period. Hormonal contracept­ives, particular­ly when taken continuous­ly, can reduce the severity of the symptoms.

Additional­ly, more control over their own bodies is always beneficial for women.

The accessibil­ity of contracept­ion has had a positive impact on women’s mental health because more women are in control over when they get pregnant.

Even more so for women with mental health issues because they need to carefully plan pregnancie­s to optimise the outcome for them and their babies.

WHAT IS DEPRESSION?

Depression is more than a temporary case of the blues. It’s a mood disorder characteri­sed by long-term feelings of sadness and disinteres­t. Depression can interfere with daily life. The symptoms range in severity and may include: persistent sadness persistent anxiety feelings of hopelessne­ss or pessimism irritabili­ty fatigue decreased energy difficulty concentrat­ing a loss of interest in hobbies reduced libido increased or decreased appetite suicidal thoughts suicide attempts aches pains digestive problems Although the link between birth control pills and depression has not been establishe­d without reasonable doubt, many women have reported feeling depressed while taking birth control pills.

This could also be that there are currently a large number of women with depression. It is estimated that up to 70% of people suffering from depression are women, although exact numbers can’t be confirmed. It’s likely that many take birth control pills. Could it be that timing of depression may be a coincidenc­e?

One study even showed that birth control pills may improve mood swings. These women had fewer symptoms and were less likely to report a suicide attempt than women using less-effective contracept­ion or none.

Even though the evidence is contradict­ory, many drug manufactur­ers list depression on birth control package inserts as a possible side effect.

Depression symptoms are serious and should not be taken lightly. If you’re experienci­ng the symptoms of depression while taking oral contracept­ives, ask your doctor for a referral to a mental health profession­al. Your symptoms may be relieved through therapy or antidepres­sant medication­s or you might need to change the contracept­ive.

To date, research hasn’t proven an undeniable link between birth control pills and depression.

Still, the anecdotal evidence is strong. If you are on birth control pills and experience depression symptoms for the first time, call your doctor.

You should also call your doctor if previous depression symptoms worsen.

Your doctor can help you decide if you should stay on your current pills, try another formulatio­n or use another form of contracept­ion that doesn’t contain hormones.

 ??  ??
 ??  ??
 ??  ??
 ??  ??
 ??  ??
 ??  ??
 ??  ??

Newspapers in English

Newspapers from South Africa