Madeeha Syed

Explore the link between taking the contraceptive pill and the risk of depression in women. Meri Sehat provides insights into the potential impact on mental health.

Does Taking The Contraceptive Pill Increase The Risk Of Depression In Women?

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Saad Ullah Siddiqui

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Time For Men To Share The Burden Of Pregnancy

Introduction

A fast-growing population is one of the greatest challenges currently faced by Pakistan. Increasing poverty, food shortage, health challenges, depletion of natural resources, and overcrowding are just some of the problems associated with overpopulation. According to the 2017 Census of Pakistan, with a population of more than 207 million, the country is the fifth most populated country in the world<a href="#accordion">[1]</a>. Therefore, effective birth control methods are a need of the hour to prevent the risks associated with overpopulation.

However, the use of contraception is largely stigmatized in Pakistan due to various reasons. As per the Pakistan Demographic and Health Survey (PDHS), the current contraceptive prevalence rate (CPR) is only 34%<a href="#accordion">[2]</a>. Moreover, the use of contraceptive methods among men is extremely low. Thus, resulting in the burden of pregnancy and contraception lying largely with women. This could probably be due to a lack of awareness among men regarding various contraceptive methods that are readily available. Raising awareness about these methods is the first step in ensuring that the financial and emotional burden of <a href="https://merisehat.pk/article/how-to-practice-safe-sex">safe sex</a> is shared among both partners in a couple.&nbsp;

Almost 200 years ago, humans invented the world&#39;s first condom, and for a long time that was the greatest discovery in the world of contraception. However, scientists soon discovered methods specifically designed for women that could aid further in population control. Several female contraceptive options ranging from hormonal pills to invasive tubal ligation were introduced. However, each of the proposed methods comes with its side effects. Contraception methods have been widely politicized and various speculations exist regarding the reasons behind the disparity among male and female contraceptives. However, it is important to mention that male contraceptive methods are generally safer than their female counterparts, which is why in recent years significant work has been done to search for effective male contraceptive options. This shift in tide is also perpetuated in part by the increasing awareness among men and their willingness to use contraceptives.&nbsp;&nbsp;

&nbsp;

Understanding Male Contraceptives

Currently, two widely acceptable male contraceptive methods exist: condoms and the invasive vasectomy.

&nbsp;

<h5 dir="ltr">Condoms</h5>

These are a form of barrier method and stop the sperm from entering and fertilizing the egg. Along with being an effective and inexpensive birth control, condoms also prevent sexually transmitted infections (STIs). However, incorrect use is associated with a high failure rate, and they can easily break or get damaged. In Pakistan, condoms are the most used form of contraceptive method, with a frequency of 65.5%<a href="#accordion">[3]</a>.&nbsp;

In recent years, the Pakistani government has stepped up its social media campaigns in a bid to educate the public regarding the use of condoms and other effective family planning methods. This is aimed at controlling the growing population by promoting birth spacing and awareness of women&#39;s fertility. Doorstep availability and affordable prices have significantly increased the use of condoms among the general population.&nbsp;

Unfortunately, misconceptions about condoms and other family planning methods still need to be overcome.&nbsp;

&nbsp;

<h5 dir="ltr">Vasectomy</h5>

Also called male sterilization, the surgical procedure has been in use since the 1970s. The procedure involves cutting or blocking the vas deferens that carry sperm to the urethra. As a result, the semen is devoid of sperm and the egg cannot be fertilized. It is not easily reversed; therefore, it is mostly advised to men who are sure of not wanting children or who believe their family is complete.&nbsp;

With a success rate of 99.85%, it is the most reliable contraceptive option. Moreover, compared to tubal ligation in women, it is less invasive, has fewer risks, and has a quicker recovery time. However, only 2.4% of men around the world have undergone the procedure<a href="#accordion">[4]</a>. In Pakistan, the prevalence is only 0.4%<a href="#accordion">[3]</a>.&nbsp;

The lack of knowledge regarding vasectomy plays a major role in its low acceptance. Moreover, a majority of men hold the view that it leads to impotency or reduces sex drive. However, a recent study has found that men in Pakistan are becoming more accepting of vasectomy and recognizing their role in sharing the responsibility of family planning<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

While female birth control pills have been around for more than 50 years, researchers have only recently started looking into pills for men.&nbsp;

In 2019, a team of scientists conducted a clinical trial for a male birth control pill among 82 healthy men<a href="#accordion">[6]</a>.&nbsp;They administered dimethandrolone undecanoate (DMAU) in varying doses over a period of 28 days. The two active hormones, progestin, and modified testosterone, helped suppress levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the study participants. Thus, suppressing sperm production without causing symptoms of low testosterone levels.&nbsp;

Although the study did not measure sperm count, the pill was found to be safe, even in high dosages. The team is currently conducting a longer trial to assess the drug&#39;s effect on sperm production and any long-term effects on the body.&nbsp;

However, men are often hesitant to use hormonal options due to the presence of adverse effects. Therefore, a team at the University of Minnesota have developed a non-hormonal male contraceptive pill. According to early results from a trial in mice, the contraceptive was 99% effective at preventing pregnancy<a href="#accordion">[7]</a>. Moreover, it had no obvious side effects in the mice.

Called YCT529, the non-hormonal pill works by targeting a protein called the retinoic acid receptor alpha (RAR-&alpha;). Through inhibition of this receptor, the retinoic acid in the body is unable to cause cell growth and differentiation, both of which contribute to sperm formation. As a result, the contraceptive helped cause reversible sterility in male mice.&nbsp;

Researchers now plan to conduct human trials for the compound. However, it is too early to tell whether the results in mice will also translate to humans.&nbsp;

&nbsp;

Conclusion

Pakistan faces several challenges to the acceptability of various family planning methods. These range from religious and cultural beliefs, low literacy levels, misconceptions about side effects, lack of knowledge regarding various options for men and women, and reluctance to adopt a method. According to a study from Karachi, fear of side effects was the most common reason for low prevalence among users<a href="#accordion">[8]</a>.&nbsp;

Several trials are currently underway to look for safe and effective male contraceptive pills. However, it can take years till a pill is available in store. Even then, its availability will not matter until there is a change in beliefs regarding family planning.

Despite the safety and availability of male contraception, men are reluctant to use the contraception methods due to various reasons ranging from misconceptions about side effects to a lack of knowledge about safe sexual practices.&nbsp;

Therefore, there is a need for campaigns aimed at educating men about the importance of adopting contraception methods.&nbsp;

&nbsp;

Key Points

<ul>
</ul>

<ul>
	<li>A growing population poses several challenges to a country&#39;s health and economic stability.</li>
	<li>Effective implementation of family planning measures can help control overpopulation.</li>
	<li>In Pakistan, use of contraceptives is highly stigmatized due to various reasons.</li>
	<li>While several advances have been made in the search for female contraception, men have only been presented with two options: condoms and vasectomy.</li>
	<li>Condoms are the most commonly used form of contraception; however, there is a need to raise awareness on its correct usage.</li>
	<li>Vasectomy is the most effective male contraceptive method, but the lack of education and widespread myths regarding its side effects has resulted in a low frequency (0.4%) of the procedure in Pakistan.</li>
	<li>Recently, scientists have begun testing various hormonal and non-hormonal compounds as male contraceptive pills.&nbsp;</li>
	<li>In 2019, a team of scientists tested varying doses of dimethandrolone undecanoate (DMAU) among healthy males and found it was well-tolerated. They are now planning long-term clinical trials to test the compound&#39;s effect on sperm production.</li>
	<li>Recently, a team at the University of Minnesota developed a non-hormonal contraceptive pill. They tested the compound in mice and found it to be 99% effective, with no observable side effects. The team now plans to conduct human trials of the compound.</li>
	<li>The development of male contraceptive pills can help men share some of the burden of contraception and pregnancy.</li>
</ul>

&nbsp;

[1] Statistics, P. B. o., 2021. Brief on Census - 2017. [Online].

[2] Meherali, S., Ali, A., Khaliq, A. & Lassi, Z. S., 2021. Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys (PDHS) dataset from 1990 to 2018. F1000 Research, Volume 10.

[3] Shattuck, D., Perry, B., Packer, C. & Quee, D. C., 2016. A Review of 10 Years of Vasectomy Programming and Research in Low-Resource Settings. Global Health, Science and Practice, 4(4), pp. 647-660.

[4] Siddiqui, M. et al., 2020. Prevalence and Predictors of Contraception Usage in Karachi, Pakistan. Cureus, 12(10).

[5] Hatesh, H., Maheshwari, B. K., Shah, S. Q. & Kumar, D., 2020. Males’ perception and motivation for Vasectomy. Pakistan Journal of Public Health, 10(4).

[6] Thirumalai, A. et al., 2019. Effects of 28 Days of Oral Dimethandrolone Undecanoate in Healthy Men: A Prototype Male Pill. The Journal of Clinical Endocrinology & Metabolism, 104(2).

[7] Society, A. C., 2022. A non-hormonal pill could soon expand men’s birth control options. [Online].

[8] Bibi, S., Memon, A., Memon, Z. & Bibi, M., 2008. Contraceptive knowledge and practices in two districts of Sindh, Pakistan: A hospital based study. Journal of the Pakistan Medical Associatio, 58(5).

Nimrah H. Sattar

AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

I'm A Heart Patient - Are Oral Contraceptive Pills Safe For Me?

Dialogues concerning sexuality, reproductive health, contraception, and sexually transmitted illnesses (STIs) are limited worldwide. One of the biggest reasons for these decreased dialogues is the fear of spreading indecency among the younger population. Unfortunately, the failure to discuss these topics has had a great impact on public health and led to an increase in the prevalence of abortions and STIs, such as HIV, in the country. The current abortion rate in Pakistan stands at 50 per 1,000 women aged 15-49 years; one of the highest in the world<a href="#accordion">[1]</a>.

The lack of education on such topics also means that both men and women are generally unaware of reproductive health issues. Moreover, the lack of knowledge and awareness of contraception increases the risk of teenage pregnancies, unplanned pregnancies, and unsafe abortions. Thus, resulting in poor health outcomes for both mother and child.&nbsp;

As per estimates, only 35% of married women of reproductive age in Pakistan, use some form of contraception<a href="#accordion">[1]</a>. Condoms are the most common method of contraception, followed by pills and withdrawal methods<a href="#accordion">[2]</a>. Although the use of oral contraceptive pills has increased over the years, there is still poor knowledge of the drug&#39;s effects. This lack of awareness can lead to the misuse of these medications, leading to adverse effects in at-risk individuals for e.g. women with existing cardiovascular disease (CVD) are often at a higher risk of these side effects.&nbsp;

Across Europe and the world, CVD accounts for a majority of deaths in women, while contrastingly in Pakistan, men and women are at an equal risk of coronary artery disease<a href="#accordion">[3]</a>. Due to the high prevalence, it is important that women are aware of the risks associated with using oral contraceptives with pre-existing heart conditions.&nbsp;

&nbsp;

Oral contraceptive pills (OCPs) are often the most popular option among users. They range in effectiveness from 89-99%. They are of two types: combined estrogen-progesterone and the progesterone-only pill. While both are a form of birth control, they can also be used for treating medical conditions such as endometriosis, <a href="https://www.merisehat.pk/disease/polycystic-ovary-syndrome-pcos">polycystic ovary syndrome (PCOS)</a>, and other menstrual disorders.

&nbsp;

1. Combined Oral Contraceptive (COC) - These contain a combination of the hormones, estrogen and progesterone that help prevent ovulation; thus, preventing pregnancy. The pills may contain the same dose of the hormones (monophasic), or varying weekly doses of both or either component (multiphasic). A single packet typically contains 21 pills that are taken over a 28-day period and 7 placebo pills for menstruating days. Although they have a generally safe profile, nausea, vomiting, weight gain, fluid retention, and bloating are common side effects of drug use. However, in some cases, they can also cause other severe side effects, such as:

<ul>
	<li>Increased risk of blood clots</li>
	<li>Hypertension</li>
	<li>Increased risk of stroke and myocardial infarction</li>
</ul>

These drugs are usually contraindicated in smokers and those older than 35 years of age.

&nbsp;

2. Progestin-Only Pill (POP) - Unlike COCs, these only contain a synthetic progestin. The lack of estrogen reduces the risk of adverse side effects such as thromboembolism, stroke, or cardiovascular diseases. However, it can cause breast tenderness, heavy bleeding, mood swings, anxiety, and weight gain among users. POPs are typically prescribed to women who cannot have COCs or estrogen-containing compounds.

3. Emergency Contraception Pill (ECP) - Also called the morning-after pill, it may contain higher doses of the hormone estrogen, progestin, or both. They help delay ovulation or fertilization and are commonly used following unprotected sexual intercourse or a condom breakage. However, they are not meant for regular birth control.

Understanding The Correct OCP For Heart Patients

Doctors usually prescribe contraceptive methods based on a patient&#39;s health and preference. As per current guidelines, doctors must weigh the risks and benefits for each patient prior to selection of contraception.&nbsp;

Women with cardiac disease are not only at a higher risk of maternal death during pregnancy, but also complications such as stillbirth, preterm delivery, or intrauterine growth restriction. Due to the high incidence of unplanned pregnancies, it is important that these women are counselled on effective and safe contraceptive options. Moreover, they are more likely to develop adverse effects to oral contraceptives. Therefore, caution is practiced when prescribing them pills or other contraceptive options.&nbsp;

OCP use among smokers older than 35 years of age is associated with a significantly higher risk of cardiovascular side effects such as deep vein thrombosis. As per estimates, such women have a ten-fold increased risk of myocardial infarction<a href="#accordion">[4]</a>. Therefore, women older than 35 are typically assessed for risk factors such as CVD, hypertension, diabetes, and kidney disease prior to use.&nbsp;

Compared to non-users, combined oral contraceptive users have a much higher risk of myocardial infarction and stroke. Moreover, women with pre-existing hypertension have a 9-16% chance of exacerbation when using OCPs<a href="#accordion">[4]</a>.

&nbsp;

Ideally, contraception is meant to be safe, effective, and protect against sexually transmitted infections. However, no one method can guarantee all three.&nbsp;

&nbsp;

<ul>
	<li>Barrier Methods - These methods are all safe for cardiac patients; however, they have a high failure rate. Therefore, should not be prescribed in cardiac patients to avoid pregnancies.&nbsp;</li>
	<li>Combined Oral Contraceptive Pill - Due to the estrogen component, COCs are associated with multiple risks to women with cardiovascular disease. Therefore, women with CVD risk factors and existing heart disease are not prescribed COCs.</li>
	<li>Progestin-Only Pill - In women with an increased risk of thromboembolism, POPs are usually the preferred option. They are generally considered safe for all CVD patients. However, they can interfere with warfarin metabolism and decrease its therapeutic role. Therefore, careful monitoring of INR is required in such patients.&nbsp;</li>
	<li>Depo-Provera Injection - These injectable contraceptives last 12 weeks and are very effective. However, discontinuation causes a rapid return to fertility. Moreover, it can put patients at risk of ischemic heart disease.</li>
	<li>Mirena Intra-uterine Device (IUD) - Although extremely effective, its insertion can induce a vasovagal reaction in 5% of patients, and lead to a cardiovascular collapse<a href="#accordion">[5]</a>. It is contraindicated in women with pulmonary vascular disease and those at high risk of endocarditis.&nbsp;</li>
	<li>Hormonal Implants - Subcutaneous progestogen implants are highly effective and work as a form of sterilization. Moreover, they have no cardiac contraindications.</li>
</ul>

&nbsp;

According to the Pakistan Demographic and Health Survey (PDHS), the current contraceptive prevalence rate (CPR) is only 34%<a href="#accordion">[6]</a>. There are several barriers to contraceptive use among Pakistani women of reproductive age. These range from religious factors, and lack of access to low socioeconomic status. Although oral contraceptive pills are commonly used as a form of birth control, there are a lot of misconceptions regarding infertility and weight gain that further limits their use.&nbsp;

The lack of dialogue around sexual and reproductive health has left a huge majority of Pakistani women unaware of their health condition and the best health options for their bodies. Moreover, in Pakistan, there is a high prevalence of cardiovascular diseases among women. This puts them at an even higher risk of pregnancy complications; thus, emphasizing the need for better contraceptive methods for these individuals.&nbsp;

Currently, progestin-only pills and hormonal implants are considered the most effective and safe contraceptive options for women with CVD. However, newer formulations of oral contraceptive pills with lower overall risk are being developed. These are expected to help lower blood pressure in users and prevent weight gain.&nbsp;

For now, the best method is to weigh all benefits and risks associated with a particular method before use. Moreover, women should be counseled on the various options available to them and the adverse effects associated with these options.&nbsp;

&nbsp;

<ul>
</ul>

<ul>
	<li>In Pakistan, only 35% of married women of reproductive age practice some form of contraception.</li>
	<li>The stigma surrounding sexual health has placed several barriers for women to access safe contraception methods in the country.</li>
	<li>The lack of awareness of various contraceptive methods has led to an increase in abortions and sexually transmitted infections among the younger population.</li>
	<li>Due to their overall safety profile, easy availability, and high effectiveness oral contraceptive pills are mostly prescribed to women. The two common oral contraceptives include the progestin-only pill and the combined oral pill.</li>
	<li>Despite the overall safety profile, OCPs can increase the risk of several side effects, especially among women with a cardiovascular disorder.</li>
	<li>Women with existing cardiac disease are at a higher risk of maternal death during pregnancy, and complications such as preterm birth, growth restriction, and stillbirth. Therefore, there is a greater need for safe and effective contraceptive methods for these high-risk individuals.&nbsp;</li>
	<li>COCs increase the risk of stroke, thromboembolism, and myocardial infarctions. Therefore, they are contraindicated in smokers above 35 years of age and women with CVD risk factors or existing cardiac disease.</li>
	<li>POPs and hormonal implants are generally considered safe and effective in cardiac patients.</li>
	<li>Newer contraceptive pills are being developed that are expected to have a lower overall risk for cardiac patients.</li>
</ul>

&nbsp;

[1] Siddiqui, M. et al., 2020. Prevalence and Predictors of Contraception Usage in Karachi, Pakistan. Cureus, 12(10).

[2] Mushtaq, K., Ashraf, M. & Thaver, I. H., 2020. Who are the women wishing to opt for contraception?. Journal of the Pakistan Medical Association, 70(12).

[3] Jafar, T. H., Jafary, F. H., Jessani, S. & Chaturvedi, N., 2005. Heart disease epidemic in Pakistan: women and men at equal risk. American Heart Journal.

[4] Cooper, D. B., Patel, P. & Mahdy, H., 2022. Oral Contraceptive Pills. s.l.:StatPearls Publishing.

[5] Kaminski, P., Szpotanska-Sikorska, M. & Wielgos, M., 2013. Cardiovascular risk and the use of oral contraceptives. Neuro Endicrinology Letters.

[6] Hudsmith, L. & Thorne, S., 2007. Contraception in women with cardiac disease. Women's Health, 3(6), pp. 711-717.

[7] Meherali, S., Ali, A., Khaliq, A. & Lassi, Z. S., 2021. Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys (PDHS) dataset from 1990 to 2018. F1000 Research, Volume 10.

Iqra Mazhar

Impact Of OCP On Mental Health

Oral contraceptive pills (OCPs) are popular among women of reproductive age due to their ease of use and high efficacy. However, sociodemographic disparities in its use persist around the world. Those with greater awareness and education, who are unmarried and from the upper class, are more likely to use it than others. In Pakistan, this figure is close to 8% of girls and women<a href="#accordion">[4]</a>. 
&nbsp;

Understanding OCP's Influence on Mental Health

The effects of OCPs vary depending on individual factors, the specific formulation of the pill, and how it is used. 
&nbsp;

<ul>
	<li>
	<h5>Mood Swings</h5>
	</li>
</ul>

OCPs change your body&#39;s hormone levels by preventing ovulation and thickening cervical mucus. These hormonal changes may have an impact on your brain&#39;s neurotransmitters and hormonal signaling pathways, which may have an impact on your mood and cognitive function. As a result, you go through emotional changes, such as increased feelings of irritability, sadness, or anxiety.

Some studies have pointed out a possible connection between OCP and depression. This might be brought on by pill-induced bloating, decreased sex desire, and weight gain. Headaches, fatigue, and nausea may also have an impact on mental health. 
&nbsp;

These fluctuations in mood and an increase in symptoms of depression are the most common reasons girls and women discontinue OCPs. In general, adolescent girls who use OCPs are more likely to experience hypersomnia, eating problems, and increased crying than their counterparts who do not use OCPs. According to one study, it may be related to the type and amount of progestin in these pills<a href="#accordion">[1]</a>.

Many older OCPs that contain ethinyl estradiol are linked to severe mood problems. In contrast, newer OCPs with physiological forms of estrogen are usually easier to tolerate and have a weak link to mood problems<a href="#accordion">[1]</a>.

A Danish study found an increased risk of the first diagnosis of depression and the first use of an antidepressant among users of various types of OCPs. They were highest among adolescents. However, more research is needed to fully understand this relationship.

On the plus side, studies show that OCPs improve mood and mental health while alleviating premenstrual symptoms. 
&nbsp;

<ul>
	<li>
	<h5>Cognitive Function</h5>
	</li>
</ul>

The impact of OCPs on cognitive function and brain health is complicated.

Estrogen, for example, is thought to be neuroprotective in the hippocampus, hypothalamus, amygdala, and brainstem. It helps to protect the brain from cognitive decline, neurodegenerative disease, and affective disorders. 
&nbsp;

Furthermore, estrogen can influence brain regions involved in emotional processing, such as the dorsolateral prefrontal cortex.

Progesterone, on the other hand, is not thought to be neuroprotective. It can also aggravate mood symptoms.

The clinical significance of these findings is still under investigation. 
&nbsp;

Note: It should be noted that scientific research on this topic is still ongoing, and the long-term effects of OCPs on brain health are not fully understood.

Any changes in mood or brain function associated with OCP use are likely to be temporary and reversible in many cases. When you stop using OCPs, your hormone levels will return to normal, and any negative effects on brain health will fade.

Some girls, however, may have specific sensitivities or reactions to the hormones in OCPs. In rare cases, stopping the use of OCPs may not immediately reverse certain effects on mood or brain function.

Decisions about the use of OCPs should be made in consultation with a healthcare professional who can take into account individual health needs and medical history. 
&nbsp;

This includes:

<ul>
	<li>
	<h5>Pre-Existing Mental Health Conditions</h5>
	</li>
</ul>

If you already have a mental health condition, such as depression or anxiety, OCPs may exacerbate your symptoms. Furthermore, OCPs may interact with your current medications.

Inform your doctor so that he or she can tailor your treatment to your specific needs, medical history, and potential risks and benefits of OCPs. 
&nbsp;

<ul>
	<li>
	<h5>Individual Response</h5>
	</li>
</ul>

Individual reactions to OCP use can differ greatly. Some girls tolerate OCPs well and experience no adverse effects on brain health.

At the same time, some girls may be more sensitive to the hormonal changes caused by OCPs, resulting in emotional or mental health issues. Or they may be predisposed to side effects due to risk factors. 
&nbsp;

Note: Please consult a professional doctor if you have any concerns about the effects of OCPs on your brain health or mood. They can offer personalized advice, consider alternative contraceptive options, or modify the prescription to reduce side effects. 
&nbsp;

Few studies have looked into the relationship between oral contraceptives and mental health, such as mood swings and cognitive function.

According to the Harvard Study of Moods and Cycles, 16.3% of people reported a decline in their mood, while 12.3% reported an improvement. However, the vast majority of people reported no change in their mood<a href="#accordion">[2]</a>. 
&nbsp;

32-60% of women discontinue the pill within 6 months for a variety of reasons, the most common of which are mood changes<a href="#accordion">[3]</a>.

It&rsquo;s important to talk to a doctor before starting a contraceptive pill, especially if you have known potential risks, like a history of depression.

It&rsquo;s also important for healthcare providers and adult supervisors to monitor depressive symptoms in adolescents using OCPs because it may put them at risk for nonadherence if the pill affects their quality of life. 
&nbsp;

Key Takeaways

<ul>
	<li>OCPs may have significant benefits, such as providing contraceptive protection, regulating menstrual cycles, and managing certain medical conditions like PCOS.</li>
	<li>The potential effects of OCPs on brain health in girls vary depending on the individual.</li>
	<li>According to the limited research available, it&#39;s been observed that not all girls will experience these symptoms, and those who do may have different degrees of severity.</li>
	<li>Some possible symptoms include mood swings, depression, anxiety, and changes in cognitive function like memory or concentration issues.</li>
	<li>Symptoms such as headaches, nausea, fatigue, and decreased libido can also have an impact on the overall well-being and brain health of girls who use OCPs.</li>
	<li>In most cases, these symptoms are transient and disappear once the pill is discontinued.</li>
	<li>It&#39;s crucial to weigh the potential benefits of OCP use (such as contraceptive protection, regulation of menstrual cycles, and management of certain medical conditions like PCOS) against potential risks. 
	&nbsp;</li>
</ul>

[1] Mu E, Kulkarni J. Hormonal contraception and mood disorders. Australian prescriber.

[2] MGH Center for Women’s Mental Health. Do oral contraceptives cause mood swings or depression? MGH Center for Women’s Mental Health.

[3] Anouk E. de Wit Bs. Association of use of oral contraceptives with depressive symptoms among adolescents and young women. JAMA Psychiatry.

[4] Meherali S, Ali A, Khaliq A, Lassi ZS. Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys (PDHS) dataset from 1990 to 2018. F1000Res. 2021;10:790. Published 2021 Aug 11. doi:10.12688/f1000research.55204.1

Shermeen Zuberi

Overview

The contraceptive pill, hailed as a revolutionary advancement in reproductive health, has been a cornerstone of family planning for millions of women worldwide. However, questions persist about its potential impact on mental health, particularly whether it increases the risk of depression. In this article, we delve into the subject, examining the existing research and exploring the complex relationship between birth control pills and mood disorders. 
&nbsp;

Contraceptive Pill and  Risk of Depression

Before delving into the potential connection with depression, let&#39;s establish a basic understanding of contraceptive pills. These pills contain synthetic hormones, usually a combination of estrogen and progestin (or a progestin-only formulation), which work to prevent pregnancy by inhibiting ovulation, thickening cervical mucus, and altering the uterine lining. Their effectiveness in preventing pregnancy is well-established, but what about their impact on mental health? 
&nbsp;

<h5>Early&nbsp;Concerns</h5>

<ul>
	<li>A Historical Perspective</li>
	<li>Initial Reports and Anecdotal Evidence 
	&nbsp;</li>
</ul>

Historically, some early contraceptive pills had high hormone doses, leading to mood swings and other emotional disturbances in some users. These side effects sparked concerns about the pill&#39;s impact on mental health. However, advancements in formulation have led to lower hormone doses, reducing the severity of such side effects. 
&nbsp;

<h5>Contemporary&nbsp;Studies</h5>

<ul>
	<li>A Closer Look at Recent Research</li>
	<li>Mixed Findings</li>
	<li>Potential Moderating Factors 
	&nbsp;</li>
</ul>

Recent studies on the relationship between contraceptive pills and depression have yielded mixed results. Some research suggests a modest increase in the risk of depression among users, while others find no significant association. Factors like the specific formulation of the pill, a woman&#39;s individual hormonal response, and pre-existing mental health conditions can influence these outcomes. 
&nbsp;

<h5>Potential&nbsp;Mechanisms</h5>

<ul>
	<li>Hormonal Fluctuations</li>
	<li>Neurotransmitter Regulation</li>
	<li>Psychosocial Factors 
	&nbsp;</li>
</ul>

Researchers have proposed several mechanisms by which birth control pills could potentially impact mood. These mechanisms include hormonal fluctuations, alterations in neurotransmitter regulation, and psychosocial factors related to contraceptive use. However, the exact mechanisms remain the subject of ongoing investigation. 
&nbsp;

While the research on the relationship between contraceptive pills and depression continues to evolve, it&#39;s essential for women to make informed decisions about their reproductive health. Here are some key takeaways:

<ul>
	<li>Individual Variation: Responses to birth control pills vary widely among women. What works well for one may not work the same for another. Consult with a healthcare provider to find the best option for your unique circumstances. 
	&nbsp;</li>
	<li>Monitoring Your Mental Health: If you suspect that your birth control is affecting your mood, it&#39;s crucial to discuss your concerns with a healthcare professional. They can help you explore alternative contraceptive options or recommend strategies to manage any mood-related issues. 
	&nbsp;</li>
	<li>Holistic Approach: Mental health is influenced by a multitude of factors, including genetics, lifestyle, and life circumstances. Addressing these broader aspects of well-being can also play a crucial role in managing mood disorders. 
	&nbsp;</li>
</ul>

Bottom Line

The question of whether taking the contraceptive pill increases the risk of depression in women is a complex one with no definitive answer. While some research suggests a potential link, the overall evidence remains inconclusive, with many factors at play. It&#39;s essential for women to have open and informed discussions with healthcare providers to make choices that align with their individual needs and health concerns. As research continues to evolve, a deeper understanding of the relationship between birth control pills and mental health will emerge, offering greater clarity to those making contraceptive decisions.