Suicide Risk Increased By Hormonal Contraception Use

Hormonal contraception was associated with increased risk for suicide and suicide attempts, according to the findings of a recent study.

For their study, the researchers examined the incidence of suicide and suicide attempts among women involved in a nationwide prospective cohort study in Denmark who had no psychiatric diagnosis, antidepressant use, or hormonal contraceptive use before the age of 15 and turned 15 within the study period. They used nationwide registers to collect data on hormonal contraception use, suicide attempt, suicide, and potential confounding variables. In addition, the researchers estimated adjusted hazard ratios for suicide and suicide attempts for current compared with never users and considered psychiatric diagnoses and antidepressant use as potential mediators in this relationship. 
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During the 8.3 years of follow-up, 6999 first suicide attempts and 71 suicides occurred.

Overall, the relative risks for suicide attempt and suicide for current and recent hormonal contraceptive users were 1.97 and 3.08, respectively, compared with never users. Among those receiving hormonal contraception, the risk estimates for suicide attempt was 1.91 for oral combined products, 2.29 for oral progestin-only products, 2.68 for vaginal rings, and 3.28 for the patch.

In addition, the association between first suicide attempt and hormonal contraceptive use peaked after 2 months of use.

“Use of hormonal contraception was positively associated with subsequent suicide attempt and suicide,” the researchers concluded. “Adolescent women experienced the highest relative risk.”

—Melissa Weiss

Reference:

Skovlund CW, Mørch LS, Kessing LV, Lange T, Lidegaard O, et al. Association of Hormonal Contraception With Suicide Attempts and Suicides [published online November 17, 2017]. Am J Psychiatry. https://doi.org/10.1176/appi.ajp.2017.17060616.