Use of systemic hormonal contraception and depression: a nested case-control study
Introduction Depression is twice as common in women as in men, especially in the young age group. Multiple factors may contribute to this gender difference. Growing attention is being focused on the role of sex hormones, including those of hormonal contraception (HC). Some recent studies have indi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-03-01
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| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823002572/type/journal_article |
| _version_ | 1797616185378865152 |
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| author | E. Toffol T. Partonen O. Heikinheimo A. Latvala A. But J. Haukka |
| author_facet | E. Toffol T. Partonen O. Heikinheimo A. Latvala A. But J. Haukka |
| author_sort | E. Toffol |
| collection | DOAJ |
| description |
Introduction
Depression is twice as common in women as in men, especially in the young age group. Multiple factors may contribute to this gender difference. Growing attention is being focused on the role of sex hormones, including those of hormonal contraception
(HC). Some recent studies have indicated a higher risk of depression among women using HC, although the results are inconclusive.
Objectives
The aim of this study is to examine the associations between the use of hormonal contraception and the risk of depression in childbearing age women.
Methods
The original cohorts for the study included all women aged 15-49 years with at least one redeemed prescriptions for HC in Finland in 2017 (n=294,356), and a 1:1 age-matched cohort of non-users. After exclusion of prevalent cases (n=35,102), all incident cases of depression (as recorded in the Care Register of Health Care and Register of Primary Health Care Visits) in 2018-2019 were identified (n=23,480), and a 4:1 age-matched control group (n=93,920) was selected from the above cohorts. Current use of HC in the 180 days before the event was compared in cases and controls, and associations with risk of depression were tested via conditional multivariate logistic regression models.
Results
During the follow-up, 23,480 incident cases of depression were identified. Current use (in the 180 days before the event) of HC (OR 0.82, 95% CI 0.79-0.85), in particular of estradiol- or
ethinylestradiol-containing combined HC was associated with a lower risk of depression (OR 0.83, 95% CI 0.76–0.89; OR 0.74, 95% CI 0.71–0.78, respectively) compared to non-use of HC. The results remained significant (OR 0.87, 95% CI 0.81-0.95; and OR 0.77, 95% CI 0.73-0.81, respectively) after controlling for covariates (marital and socioeconomic status, education level, chronic diseases). Use of progestin-only contraception was not associated with altered risk of depression.
Conclusions
Use of HC in childbearing age women is not associated with increased risk of depression. Rather, the use of estradiol- or ethinylestradiol-containing HC is associated with a lower risk of depression.
Disclosure of InterestNone Declared |
| first_indexed | 2024-03-11T07:37:48Z |
| format | Article |
| id | doaj.art-2a69fb9a4d4c48048f3b5d466d1327f9 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:37:48Z |
| publishDate | 2023-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-2a69fb9a4d4c48048f3b5d466d1327f92023-11-17T05:09:13ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S82S8210.1192/j.eurpsy.2023.257Use of systemic hormonal contraception and depression: a nested case-control studyE. Toffol0T. Partonen1O. Heikinheimo2A. Latvala3A. But4J. Haukka5Department of Public Health, University of HelsinkiFinnish Institute for Health and WelfareUniversity of Helsinki, Helsinki, FinlandUniversity of Helsinki, Helsinki, FinlandDepartment of Public Health, University of HelsinkiDepartment of Public Health, University of Helsinki Introduction Depression is twice as common in women as in men, especially in the young age group. Multiple factors may contribute to this gender difference. Growing attention is being focused on the role of sex hormones, including those of hormonal contraception (HC). Some recent studies have indicated a higher risk of depression among women using HC, although the results are inconclusive. Objectives The aim of this study is to examine the associations between the use of hormonal contraception and the risk of depression in childbearing age women. Methods The original cohorts for the study included all women aged 15-49 years with at least one redeemed prescriptions for HC in Finland in 2017 (n=294,356), and a 1:1 age-matched cohort of non-users. After exclusion of prevalent cases (n=35,102), all incident cases of depression (as recorded in the Care Register of Health Care and Register of Primary Health Care Visits) in 2018-2019 were identified (n=23,480), and a 4:1 age-matched control group (n=93,920) was selected from the above cohorts. Current use of HC in the 180 days before the event was compared in cases and controls, and associations with risk of depression were tested via conditional multivariate logistic regression models. Results During the follow-up, 23,480 incident cases of depression were identified. Current use (in the 180 days before the event) of HC (OR 0.82, 95% CI 0.79-0.85), in particular of estradiol- or ethinylestradiol-containing combined HC was associated with a lower risk of depression (OR 0.83, 95% CI 0.76–0.89; OR 0.74, 95% CI 0.71–0.78, respectively) compared to non-use of HC. The results remained significant (OR 0.87, 95% CI 0.81-0.95; and OR 0.77, 95% CI 0.73-0.81, respectively) after controlling for covariates (marital and socioeconomic status, education level, chronic diseases). Use of progestin-only contraception was not associated with altered risk of depression. Conclusions Use of HC in childbearing age women is not associated with increased risk of depression. Rather, the use of estradiol- or ethinylestradiol-containing HC is associated with a lower risk of depression. Disclosure of InterestNone Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823002572/type/journal_article |
| spellingShingle | E. Toffol T. Partonen O. Heikinheimo A. Latvala A. But J. Haukka Use of systemic hormonal contraception and depression: a nested case-control study European Psychiatry |
| title | Use of systemic hormonal contraception and depression: a nested case-control study |
| title_full | Use of systemic hormonal contraception and depression: a nested case-control study |
| title_fullStr | Use of systemic hormonal contraception and depression: a nested case-control study |
| title_full_unstemmed | Use of systemic hormonal contraception and depression: a nested case-control study |
| title_short | Use of systemic hormonal contraception and depression: a nested case-control study |
| title_sort | use of systemic hormonal contraception and depression a nested case control study |
| url | https://www.cambridge.org/core/product/identifier/S0924933823002572/type/journal_article |
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