In the tumultuous aftermath of last November’s election, urgent calls to action echoed across the internet and social media-scapes, imploring readers to do everything from donating to the ACLU to demanding that Congress overturn the election results.
One in particular stands out in my memory:
Ladies, go get your IUDs.
With uncertainty regarding the Affordable Care Act and overall healthcare, young women across the country—myself included—have been scrambling to obtain long-lasting contraception, most commonly via an intrauterine device (IUD).
Why the push for IUDs? For starters, it means never having to take the pill again. In contrast to the more traditional oral contraceptives, IUDs are implanted directly into the uterus to prevent pregnancy—and once an IUD is there, you’re protected for anywhere from three to twelve years.
IUDs are also even more effective at preventing pregnancy than the Pill, and are currently considered the most effective method of birth control available. The insertion process is quick and (relatively) painless, and the IUD can be easily removed whenever you decide. Finally and perhaps most appealingly, the hormonal IUD options can make periods lighter and reduce cramping—which seals the deal for many women like me who have battled painful cramping and a heavy flow for years.
Life with a hormonal IUD isn’t always sunshine and roses, however. Recently, there has been a lot of anecdotal evidence emerging about the IUDs effect on mental health and anxiety. Dozens of women have taken to their blogs to share their painful experiences, citing everything from panic attacks to insomnia:
“Most everyday about mid-afternoon I would have to go lay in my bed and cover up my head because my anxiety levels had risen too high for me to cope anymore. I was living in a dark box that I just couldn’t get out of,” one woman wrote.
“I found myself immersed in full-blown insomnia. I couldn’t fall asleep at night without ingesting huge, unholy amounts of Benadryl and, even at that point, I could only sleep for an hour or two at most,” revealed another.
Hormonal birth control and mood disorders
It’s long been known that hormonal birth control and mood disorders are somehow linked. Reports of depression and other psychological side effects were present as early as the 1960s when the Pill was first developed, but most of these complaints were dismissed as simply “the price that women had to pay.”
In more recent years, multiple research studies were conducted in an attempt to correlate mood changes with hormone-based contraceptives including IUDs, but most of the findings were inconclusive and led to little enlightenment. In fact, according to a 2015 critical review of such studies, “inconsistent research methods and lack of uniform assessments make it difficult to make strong conclusions” from the research on the subject. Though personal horror stories abounded, hard science backing them up was simply non-existent—until now.
A breakthrough study
This past September, JAMA Psychiatry published a Danish study that examined the incidence of depression diagnoses in hormonal birth control users. The breakthrough study followed over one million Danish women aged 15 to 35 over the course of six years to determine whether use of hormonal contraceptives led to an increased risk of a depression diagnosis and antidepressant use—and for the first time, the answer was yes.
Women who were using any form of hormonal birth control—be it the Pill, a hormonal IUD, or a vaginal ring—had an increased risk of developing depression, with the highest rates among adolescents. These results are gratifying to many women who feel that science is finally validating their lived experiences with hormonal birth control.
Should we still use hormonal birth control?
So does this mean that we shouldn’t use IUDs and other hormonal birth control forms? Not quite. While the Danish study does suggest that hormonal contraception leads to an increased risk of depression, the overall number of women affected is still quite small. More than anything else, the study demonstrates that “healthcare professionals should be aware of this relatively hitherto unnoticed adverse effect of hormonal contraception” and that they should inform patients of this potential risk before prescribing any kind of hormone-based birth control.
Every woman is different, and while many women, like me, have had great experiences with their IUDs after the initial adjustment period, others may not have such a positive experience. It’s most important to have all the information necessary to make informed decisions about your body and your health. After all, you know your body best—it’s only fitting that you should be empowered to make the right choices for yourself.