Relationship between Hormonal Contraception and Mental Health: A Cross-sectional Study in Ecuador

Abstract

Millions of women worldwide use hormonal contraceptives as an effective form of contraception. However, the focus on their side effects to date has mainly been on the physical aspects, although the most common reason for discontinuation is depression. The main objective of our research is to assess the impact hormonal contraceptives have on mood in women of childbearing age. Surprisingly, there are few studies investigating depression related to hormonal contraceptive use. More research is needed to better inform women and physicians about contraceptive-related depression, as well as clinical guidelines on the different types of oral contraceptives and their possible depressogenic properties. A nationally representative sample of women aged 12 years and older from the 2018 National Health and Nutrition Survey (ENSANUT) was used. We used multicollinearity tests to rule out possible statistical modeling problems and a binary logistic linear regression model where Odds Ratio (OR) with their 95% confidence intervals (95% CI) were estimated for each of the independent variables. In addition, we used specificity tests to test the fit between our dependent and independent variables. That is, our results reveal that the use of hormonal contraceptives increased 3.12-fold (OR=3.12; CI=3.046-3.321) the likelihood of chronic mental illnesses such as depression. This result is statistically significant (p<0.05). It was also demonstrated that women in rural areas with lower income and low schooling are more susceptible to mental disorders compared to the rest of the population. We also showed that variables such as age, a greater number of children, obesity, low schooling, unemployment, being a migrant and greater urban density have a positive influence on the probability of suffering from chronic mental disorders. The results of this study showed that, although poor mental health is correlated with the type of family planning, fear of depression should not be an obstacle to choosing between these methods. It became evident that depression is a multifactorial issue. This study showed that the type of family planning method itself cannot be the cause of depression and should be considered by family planners and counselors.