Long-Term Dangers of Birth Control Pills

Dr. Elizabeth Plourde, Clinical Laboratory Scientist, Author, talks, 2011

Dr. Elizabeth Plourde talks about the dangers of using birth control pills for many years and why they are dangerous.

  • Video published on 26 Sep 2011 by iHealthTube.com.

Sweetening the pill : Could some birth-control drugs kill you?

Could some pharmaceutical birth-control methods be having side-effects that are much more dangerous than women realise ?

Featuring interviews with parents and friends of those who’ve died after complications related to some birth control hormones, Abby Epstein and Holly Grigg-Spall question how much the public really know about their medical effects.

  • Find out more about the Sweetening the Pill documentary on Kickstarter.
  • Video published on 22 Jun 2015 by The Guardian.

The Pill : Association of Hormonal Contraception With Depression

Are some side effects of birth control pills being kept secret ?

November 2016, JAMA Psychiatry published a Danish study that found a correlation between the use of hormonal birth control and being diagnosed with clinical depression. The study tracked hormonal birth control use and prescription of antidepressants over six years for over a million women. They found that women who were on hormonal birth control—be it the pill or a hormonal IUD or vaginal ring—were significantly more likely to be prescribed antidepressants.

These findings are only the latest in a long line of battles between women and their doctors over accurate information, broadly.vice reports in The Racist and Sexist History of Keeping Birth Control Side Effects Secret.

In 2018, the popularity of apps like Natural Cycles highlights the serious issues with contraceptives, the conversation reports.

Illustration by Eleanor Doughty, feature image credit broadly-images.vice.

Key Points

  • Question
    Is use of hormonal contraception associated with treatment of depression?
  • Findings
    In a nationwide prospective cohort study of more than 1 million women living in Denmark, an increased risk for first use of an antidepressant and first diagnosis of depression was found among users of different types of hormonal contraception, with the highest rates among adolescents.
  • Meaning
    Health care professionals should be aware of this relatively hitherto unnoticed adverse effect of hormonal contraception.

Abstract

Importance
Millions of women worldwide use hormonal contraception. Despite the clinical evidence of an influence of hormonal contraception on some women’s mood, associations between the use of hormonal contraception and mood disturbances remain inadequately addressed.

Objective
To investigate whether the use of hormonal contraception is positively associated with subsequent use of antidepressants and a diagnosis of depression at a psychiatric hospital.

Design, Setting, and Participants
This nationwide prospective cohort study combined data from the National Prescription Register and the Psychiatric Central Research Register in Denmark. All women and adolescents aged 15 to 34 years who were living in Denmark were followed up from January 1, 2000, to December 2013, if they had no prior depression diagnosis, redeemed prescription for antidepressants, other major psychiatric diagnosis, cancer, venous thrombosis, or infertility treatment. Data were collected from January 1, 1995, to December 31, 2013, and analyzed from January 1, 2015, through April 1, 2016.

Exposures
Use of different types of hormonal contraception.

Main Outcomes and Measures
With time-varying covariates, adjusted incidence rate ratios (RRs) were calculated for first use of an antidepressant and first diagnosis of depression at a psychiatric hospital.

Results
A total of 1 061 997 women (mean [SD] age, 24.4 [0.001] years; mean [SD] follow-up, 6.4 [0.004] years) were included in the analysis. Compared with nonusers, users of combined oral contraceptives had an RR of first use of an antidepressant of 1.23 (95% CI, 1.22-1.25). Users of progestogen-only pills had an RR for first use of an antidepressant of 1.34 (95% CI, 1.27-1.40); users of a patch (norgestrolmin), 2.0 (95% CI, 1.76-2.18); users of a vaginal ring (etonogestrel), 1.6 (95% CI, 1.55-1.69); and users of a levonorgestrel intrauterine system, 1.4 (95% CI, 1.31-1.42). For depression diagnoses, similar or slightly lower estimates were found. The relative risks generally decreased with increasing age. Adolescents (age range, 15-19 years) using combined oral contraceptives had an RR of a first use of an antidepressant of 1.8 (95% CI, 1.75-1.84) and those using progestin-only pills, 2.2 (95% CI, 1.99-2.52). Six months after starting use of hormonal contraceptives, the RR of antidepressant use peaked at 1.4 (95% CI, 1.34-1.46). When the reference group was changed to those who never used hormonal contraception, the RR estimates for users of combined oral contraceptives increased to 1.7 (95% CI, 1.66-1.71).

Conclusions and Relevance
Use of hormonal contraception, especially among adolescents, was associated with subsequent use of antidepressants and a first diagnosis of depression, suggesting depression as a potential adverse effect of hormonal contraceptive use.

Behavioral effects of birth control pills

Developmental estrogen exposures and disruptions to maternal behavior and brain: Effects of ethinyl estradiol, a common positive control

2018 Study Highlights

  • Developmental EE2 exposure increases time spent on maternal self-care.
  • Pups born to EE2-treated females were less likely to initiate nursing on LD14.
  • Exposure to EE2 altered ERα expression in the MPOA both early and late in lactation.
  • Developmental EE2 exposure decreased dopaminergic cells in the VTA on LD2.
  • Effects of EDCs on maternal behavior depend on chemical and period of exposure.

Abstract

Due of its structural similarity to the endogenous estrogen 17β-estradiol (E2), the synthetic estrogen 17α-ethinyl estradiol (EE2) is widely used to study the effects of estrogenic substances on sensitive organs at multiple stages of development.

Here, we investigated the effects of EE2 on maternal behavior and the maternal brain in females exposed during gestation and the perinatal period.

We assessed several components of maternal behavior including nesting behavior and pup retrieval; characterized the expression of estrogen receptor (ER)α in the medial preoptic area (MPOA), a brain region critical for the display of maternal behavior; and measured expression of tyrosine hydroxylase, a marker for dopaminergic cells, in the ventral tegmental area (VTA), a brain region important in maternal motivation.

We found that developmental exposure to EE2 induces subtle effects on several aspects of maternal behavior including time building the nest and time spent engaged in self-care. Developmental exposure to EE2 also altered ERα expression in the central MPOA during both early and late lactation and led to significantly reduced tyrosine hydroxylase immunoreactivity in the VTA.

ur results demonstrate both dose- and postpartum stage-related effects of developmental exposure to EE2 on behavior and brain that manifest later in adulthood, during the maternal period. These findings provide further evidence for effects of exposure to exogenous estrogenic compounds during the critical periods of fetal and perinatal development.

En médecine, la longue temporalité est cliniquement et scientifiquement très difficile à prouver

Enthousiasme à court et long terme

Publié par Luc Perino, médecin généraliste, humeur du 28/03/2018

Les plus grands succès de la médecine se sont établis dans le court-terme. La chirurgie de guerre a stoppé la gangrène et les hémorragies. Les césariennes ont sauvé des millions de femmes et de nouveau-nés. L’héparine a empêché la mort immédiate par embolie. La vitamine C a guéri le scorbut en quelques jours. Les antibiotiques ont rayé de la carte en quelques mois les morts par syphilis, pneumonie, choléra, méningite ou septicémie. L’insuline a empêché les diabétiques de type 1 de mourir avant l’âge de 20 ans. Les neuroleptiques ont calmé les délires en quelques minutes. La morphine a neutralisé les agonies terminales. Dans cette liste incomplète des triomphes du XX° siècle, la seule exception concerne les vaccins qui ont donné l’audace du long-terme.

Alors, la médecine, forte de tous ces incontestables succès, a osé aborder plus résolument le long-terme. Elle a opté pour les maladies tumorales, neurodégénératives ou cardio-vasculaires, celles qui nous tuent inévitablement un jour.

Mais, en médecine, la longue temporalité est cliniquement et scientifiquement ingrate, car la preuve y est très difficile. Comment prouver, (hors les règles immuables d’hygiène de vie), que ce que nous faisons aujourd’hui sera bénéfique dans 20, 30 ou 40 ans ? Pour ces maladies multifactorielles de la sénescence, la méthode consiste à mettre en lumière un facteur et à en montrer la variation par action médicale. Ce réductionnisme scientifique est peu satisfaisant, mais l’opinion publique, éblouie par les succès médicaux passés, ne voit pas la forêt de facteurs qui se cache derrière le facteur unique ainsi mis en lumière. En évinçant la science, cet enthousiasme populaire ouvre la porte aux excès.

Dans le même temps, les objectifs à court-terme de la médecine ont changé de nature. La pilule répond à une exigence immédiate, mais elle laisse les femmes atteindre dangereusement l’âge de l’infécondité. Les césariennes et déclenchements d’accouchement atteignent un nombre qui outrepasse les nécessités de court-terme et induisent de multiples pathologies à long terme pour la mère et l’enfant. La réussite d’une FIV est un succès immédiat qui néglige les pathologies qui en découlent. Les succès à court-terme sur les très grandes prématurités sont pourvoyeurs de pathologies à long terme. La pharmacologie préventive apparaît souvent plus nuisible qu’utile à long terme, sans compter ses risques à court-terme. Le dépistage généralisé fait difficilement la preuve de son efficacité à long terme, tout en induisant une morbidité vécue à court terme. La liste est longue de ces nouvelles actions médicales où la preuve à court-terme, souvent illusoire, perturbe l’analyse des preuves à long terme.

Nous pouvons encore espérer que la médecine améliore un peu notre quantité-qualité de vie, mais pour la sérénité que la preuve exige, il faudrait pouvoir contenir l’enthousiasme naïf des patients pour le long terme et l’obsession structurelle des médecins pour le court-terme.

En Savoir Plus

MPs Call for Public Inquiry into Hormone Pregnancy Tests

Judge-led inquiry into pregnancy drug Primodos not “off the table”, the Government confirmed

There have been growing calls for a public inquiry into the “Report of the Commission on Human Medicines’ Expert Working Group on Hormone Pregnancy Tests” scandal, after MPs debated the Primodos drug’s legacy.

Severals MPs have joined the Primodos campaigners to say that the Expert Working Group review was a complete whitewash.

House of Commons and House of Lords Debates

  • House of Commons’ talks ref “Hormone pregnancy tests“, 14 December 2017 – 15:20:54 parliamentlive.tv.
  • House of Commons’ talks ref “Hormone pregnancy tests“, 16 November 2017 – 10:40:26 parliamentlive.tv.
  • House of Lords’ talks ref “Hormone pregnancy tests“, 16 November 2017 – 17:53:45 parliamentlive.tv.
  • House of Commons’ talks ref “Hormone pregnancy tests“, 13 October 2016 – 15:05:52 parliamentlive.tv.
  • House of Lords’ talks ref “Hormone pregnancy tests“, 21 January 2016 – 11:06:20 parliamentlive.tv.

More About Primodos

Lower-Dose Primodos-like Contraceptives are Still being used Today : is it Safe ?

Primodos EWG Report : Marie Lyon Comments

Marie Lyon, Chair of the Association for Children Damaged by Hormone Pregnancy Tests, speaks live to Jason Farrell, Senior Political Correspondent for Sky News, about the growing anger among MPs over last month’s Government-commissioned report on the pregnancy drug Primodos.

Severals MPs have joined the Primodos campaigners to say that the Expert Working Group review was a complete whitewash.

  • To download the Report of the Commission on Human Medicines’ Expert Working Group on Hormone Pregnancy Testsgov.uk.

House of Commons and House of Lords Debates

  • House of Commons’ talks ref “Hormone pregnancy tests“, 14 December 2017 – 15:20:54 parliamentlive.tv.
  • House of Commons’ talks ref “Hormone pregnancy tests“, 16 November 2017 – 10:40:26 parliamentlive.tv.
  • House of Lords’ talks ref “Hormone pregnancy tests“, 16 November 2017 – 17:53:45 parliamentlive.tv.
  • House of Commons’ talks ref “Hormone pregnancy tests“, 13 October 2016 – 15:05:52 parliamentlive.tv.
  • House of Lords’ talks ref “Hormone pregnancy tests“, 21 January 2016 – 11:06:20 parliamentlive.tv.

More About Primodos