A recent study published in the journal Frontiers in Psychiatry suggests that hormonal birth control may reduce symptoms of depression among young women. Women taking hormonal birth control had fewer depressive symptoms but higher scores for cannabis use and alcohol use.
Many youth first develop symptoms of depression during early adulthood. Depression is particularly common among women, possibly due to fluctuating sex hormones. Since hormonal birth control inhibits hormonal cycling, there is reason to believe that women who take these contraceptives might experience fewer depressive symptoms, although findings on this topic are mixed.
Researcher Sharlene D. Newman set out to explore the association between the use of hormonal birth control and depressive symptoms among a large sample of college-aged women. At the same time, the study author explored how substance use — which tends to be elevated during the premenstrual phase — might interact with the use of hormonal contraceptives to impact depressive symptoms.
“I am actually interested in the effect of cannabis on brain function and neurochemistry,” explained Newman, a professor and the executive director of the Alabama Life Research Institute at the University of Alabama. “My collaborators and I have found consistent sex differences and preclinical studies have found that estrogens interact with the cannabinoid system. That work led to us proposing a study that focused on female cannabis users. Once we did that it was like opening up pandora’s box. Those initial questions started conversations about the interactions between hormonal birth control, cannabis, and depression.”
A total of 3,320 young women completed surveys that asked them about their current medication, depressive symptoms, alcohol consumption, and cannabis use. Various statistical tests were then applied to the data to determine the relationships and interactions between these variables.
The results revealed that 998 respondents were using some form of hormonal birth control, and these women had significantly lower depression scores compared to those not taking hormonal birth control. According to these scores, 7.6% of women taking hormonal birth control were classified as having major depression symptoms compared to 9.9% of those not taking hormonal birth control. Women taking hormonal contraceptives also had higher scores for problematic cannabis and alcohol use.
The findings further revealed that women with higher scores for cannabis and alcohol use had higher depressive symptoms. Interestingly, there was an interaction between cannabis use and the use of hormonal birth control.
For women who fell within the “safe” category for cannabis use disorder, taking hormonal contraceptives was associated with lower depressive symptoms. But for women who fell within the “hazard” category for cannabis use disorder, taking these contraceptives was associated with increased depressive symptoms. For women with scores within the “disordered” category, depression scores did not differ between users and non-users of hormonal contraceptives. Notably, this same interaction was not found for alcohol use, suggesting that cannabis and alcohol interact differently with sex hormones.
Overall, the findings suggest that hormonal birth control may help lower depressive symptoms among young women — although the author of the study notes that not all studies have found this link. The reason for these inconsistent findings may be that women who experience negative symptoms with hormonal contraceptives — possibly due to a progesterone intolerance — may stop taking the medication. This could mean that the current study sample is biased and mainly includes women who do not experience mood effects with hormonal birth control.
“The main takeaway is that there is a lot of work yet to be done to understand how hormones and hormonal birth control interacts with brain,” Newman told PsyPost. “The second takeaway is that alcohol and cannabis likely act very differently on brain. This study was a feasibility study. Because of its correlational nature I wouldn’t want to make any definitive statements regarding what you should take away.”
Another limitation of the study is that the data did not include detailed information about past contraceptive use or the presence of premenstrual dysphoric disorder — a condition characterized by severe mood disturbance during the premenstrual phase. Nonetheless, the findings pave the way for future research and suggest a need for longitudinal studies to better examine the nuanced relationship between hormonal contraception, substance use, and depression.
“There are likely huge individual differences,” Newman added. “The effect of cannabis varies across individuals. The effect of hormonal birth control varies across individuals. Much more work needs to be done to understand why these differences across people exist.”
The study, “Association Between Hormonal Birth Control, Substance Use, and Depression”, was authored by Sharlene D. Newman.
