Dr. Charlotte Wessel Skovlund and associates conducted a nationwide prospective cohort study in Denmark to assess the relative risk of suicide attempt and suicide in users of hormonal contraception and found that Use of hormonal contraception was positively associated with subsequent suicide attempt and suicide. The study was published in American Journal of Psychiatry.
In the study, the authors assessed associations between hormonal contraceptive use and suicide attempt and suicide in all women in Denmark who had no psychiatric diagnoses, antidepressant use, or hormonal contraceptive use before age 15 and who turned 15 during the study period, which extended from 1996 through 2013. Nationwide registers provided individually updated information about use of hormonal contraception, suicide attempt, suicide, and potential confounding variables. Psychiatric diagnoses or antidepressant use during the study period were considered potential mediators between hormonal contraceptive use and risk of suicide attempt. Adjusted hazard ratios for suicide attempt and suicide were estimated for users of hormonal contraception as compared with those who never used hormonal contraception.
In the final assessment among nearly half a million women followed on average for 8.3 years (3.9 million person-years) with a mean age of 21 years, 6,999 first suicide attempts and 71 suicides were identified. Compared with women who never used hormonal contraceptives, the relative risk among current and recent users was 1.97 (95% CI=1.85–2.10) for suicide attempt and 3.08 (95% CI=1.34–7.08) for suicide. Risk estimates for suicide attempt were 1.91 (95% CI=1.79–2.03) for oral combined products, 2.29 (95% CI=1.77–2.95) for oral progestin-only products, 2.58 (95% CI=2.06–3.22) for vaginal ring, and 3.28 (95% CI=2.08–5.16) for patch.
It was found that among women who used hormonal contraceptives currently or recently, the risk of attempting suicide was nearly double that of women who had never used contraceptives.The association between hormonal contraceptive use and a first suicide attempt peaked after 2 months of use.
The researchers concluded that use of hormonal contraception was positively associated with subsequent suicide attempt and suicide. Adolescent women experienced the highest relative risk.The absolute risk of suicide associated with hormonal contraceptives is still extremely low, say the researchers, but the data suggest it’s worth studying and understanding further.
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