New medicinesAn investigation has been launched into a potential link between hormonal contraceptives and mental health issues.

Digital media brand The Debrief has partnered with BBC Radio 4 programme Woman’s Hour to launch the investigation, called Mad About the Pill, after the former obtained exclusive, and previously unpublished data, on the suspected link between hormonal contraceptives and mental health issues. The investigation also aims to raise awareness, encourage debate around the topic and call for better care for women. 

The Debrief want to encourage the NHS to take action by putting processes in place and conducting the necessary research to ensure that women can make a more informed decision about their contraception. Furthermore, the initiative is calling on the NHS to provide support for young women suffering from mental health concerns as a result of their contraception. 

Mad About the Pill has thus far uncovered further evidence of the suspected correlation between women suffering from anxiety, depression, panic attacks and even suicidal thoughts as a result of their hormonal contraception. After submitting several Freedom of Information requests, The Debrief discovered that the NHS does not currently have a record of women simultaneously being prescribed the contraceptive pill and medication for depression and anxiety. This makes it difficult to prove or disprove a link between the two. Several expert doctors have told The Debrief that the issue is known in the medical community. 

The Debrief’s editor, Rebecca Holman, said: “As the data isn’t available we simply don’t know how widespread a problem this is. But the evidence we do have suggests the link between hormonal contraception and mental health is far more widespread than anyone is admitting, and that young women simply aren’t being given the information they need to make an informed decision about their contraception. We need more research, more information, better communication and more support for young women.”

Hormonal contraception comes in the form of the combined and the progesterone-only pill depending on the type and brand of contraception. The Debrief discovered that a significant number of reports flagged to the Medicines and Healthcare products Regulatory Agency raised concerns about synthetic hormones in contraception. Two hormones were flagged the most. There were 839 reports of psychiatric reactions to Desogestrel between 2002-2016. This is found in six types of contraception. In addition, there were 1377 reports of psychiatric reactions to Levonorgestrel, which is found in 8 types of hormonal contraception, including the Mirena coil, since 1999.

These reports demonstrate that significant numbers of women are raising concerns about the link between their hormonal contraception and their mental health, yet proper guidelines or processes are not in place to efficiently monitor the correlation. 

The Debrief also asked its 1,022 of its readers about their experience taking the contraceptive pill. Of those surveyed, 46% were currently taking the pill and 47% had taken it in the past. Of these, 45% said they had experienced anxiety, 45% said they had experienced depression and 20% reported experiencing panic attacks, which they attributed to their hormonal contraception.

Anne MacGregor, Honorary Professor, Centre for Neuroscience and Trauma, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, said: “Prospective studies to address a causal link should not be difficult - it only needs an anxiety and depression rating questionnaire before and after starting/switching contraception and hopefully this campaign will push this forward.

“There is a very clear need to try and make pills as safe as we possibly can to consider whether actually having them in a pill form is the most appropriate route.

“Our understanding of anxiety and depression still needs work – the difficulty is trying to recreate or mimic naturalness as much as possible. Clearly synthetic hormones are going to affect different people in different ways. The problem is that we can only look at what side effects people report, and then look at them as a statistical group. But within that group you may have individuals who respond very well or very badly to synthetic hormones.”

Professor Ojvind Lidegaard, gynecologist at the University of Copenhagen, said: “The first step is that the scientific community should accept and recognise that there is a causal relationship between depression and hormonal contraception. When the scientific community has accepted this correlation then the next step is to inform doctors that there is this link so that they can inform the women who get these products that one of the possible adverse effects of these products is that they could get depression. And then women should, thirdly, with this information reconsider whether the best contraception method for them is hormonal contraception or whether they should find others which influence their mood and mental health less. This is relevant, especially, for women with a previous history of depression.”

Mad About The Pill and the corresponding program on Woman’s Hour are part of a week-long series of content on thedebrief.co.uk looking at the contraceptive pill and how it’s prescribed.