Hormonal contraception is linked to heightened risk of postpartum depression, study finds

New research has found that depression associated with hormonal contraception use may be a risk factor for developing postpartum depression later on in life.

Published in JAMA Psychiatry, the study included 188,648 first-time mothers who had used hormonal contraception before their child was born, and found that those who previously reported a link between their depression and hormonal contraception had an increased chance of developing postpartum depression compared to women with a history of depression that was not associated with hormonal contraception.

Hormonal contraception and postpartum depression

To better understand the findings of the study, and the risks posed to those taking hormonal contraception, we spoke to Dr Deborah Lee at Dr Fox Online Pharmacy.

"Women who experience depression on hormonal contraceptives may have a specific hormone sensitivity that makes them more susceptible to depression," Dr Lee explains. "For example, women with postpartum depression (PPD) are more likely to have had premenstrual dysphoric disorder (PMDD)." To that end, Dr Lee notes that those with perimenopausal depression are also more likely to have suffered from PMDD and PPD.

hormonal contraception linked to risk of postpartum depression
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Commenting on the study, Dr Lee says it "adds weight to the belief that some women are hormone sensitive and are more susceptible to mood disorders such as depression after taking hormonal contraception." But, that's not to say that we should all be concerned.

"It’s always important to consider new research findings carefully," she stresses. "However, studies are also always open to criticism due to flaws in research design and methodology." As such, people taking hormonal contraception "should not panic and are strongly advised to continue with their current method of contraception and see their GP if they are concerned."

"Hormonal contraception has numerous advantages and health benefits, so [those taking it] should think very carefully before making any decisions," Dr Lee adds.

What causes postpartum depression?

"Postpartum depression occurs within six weeks of childbirth," explains Dr Lee, noting that it affects up to 20% of new parents. Although the cause of postpartum depression is not known, Dr Lee says: "Pregnancy is a time of major hormonal changes – at the end of pregnancy, estrogen levels are very high, but after childbirth, they drop precipitously. This steep fall in estrogen may cause postpartum depression."

As well as potentially being linked to hormonal contraception, Dr Lee points out that there are a number of risk factors associated with postpartum depression. These include:

  • A personal past history of depression, anxiety and/or premenstrual syndrome (PMS)

  • A high-risk pregnancy, an emergency Caesarean-section, umbilical cord prolapse and/or low haemoglobin

  • Lack of social support

  • Domestic, physical or sexual violence

  • Lifestyle factors such as poor sleep, smoking and lack of exercise

hormonal contraception linked to risk of postpartum depression
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What are the symptoms of postpartum depression?

According to the NHS, signs that you or someone you know might be experiencing postpartum depression include:

  • A persistent feeling of sadness and low mood

  • Lack of enjoyment and loss of interest in the wider world

  • Lack of energy and feeling tired all the time

  • Trouble sleeping at night and feeling sleepy during the day

  • Finding it difficult to look after yourself and your baby

  • Withdrawing from contact with other people

  • Problems concentrating and making decisions

  • Frightening thoughts – for example, about hurting your baby

Although these symptoms may appear obvious, the NHS notes that "many women do not realise they have postnatal depression because it can develop gradually."

If you're worried that you or someone else might be suffering with postpartum depression, Dr Lee says: "Don’t suffer in silence."

"Reach out to friends and family [and] stay connected," she says, emphasising that it is important to see your GP and discuss the options available to you.

For information, support and advice about mental health and where to get support, visit Mind’s website at www.mind.org.uk or call Mind’s Infoline on 0300 123 3393 (Monday to Friday, 9.00am to 6.00pm).

This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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