The first large, randomized study on how birth control impacts well-being—conducted by the the Karolinska Institutet in Stockholm, Sweden and published in the journal Fertility and Sterility this month—adds to the growing literature on the long-ignored side effects of birth control. The study found that birth control pills negatively impact women's quality of life.
Anecdotal evidence for this phenomenon hasn't been hard to come by. According to the CDC, about 62 percent of women use some form of birth control. But some women have found that birth control pills just aren't for them—they get moody, easily irritated, and even clinically depressed—and opt for non-hormonal alternatives.
Kate Sloan, a woman who was prescribed Aviane, a hormonal contraceptive method known as the combination pill, previously told Broadly about her productivity decrease on the pill. "Prior to being on birth control, I used to write two to three songs a month," she said. "I only wrote about four to five songs during the entire three and a half years I was on birth control." After two months on birth control, she claimed could barely get out of bed to shower or eat because she felt so bad.
Research has been slow to affirm the negative aspects of what women experience on oral contraceptives. Last year, a cohort study published in JAMA Psychiatry discovered a link between hormonal birth control and being prescribed anti-depressants for the first time.
While the researchers at the Karolinska Institutet found no increase in depressive symptoms for women on birth control, they did find that women who were given contraceptive pills estimated their quality of life to be lower than those who were given placebos.
For the double-blind study, 340 women between the ages of 18 and 35 were either placed on birth control pills containing ethinyl estradiol and levonorgestrelor, one of the most common combination pills, or a placebo for three months. (Aviane, which Sloan was prescribed, is the brand name.)
To gather baseline information, participants filled out two surveys on general well-being and depressive symptoms before the study began. And after the three months were up, the participants took the surveys again. The survey that measured general well-being assessed "anxiety, depressed mood, positive well-being, self-control, general health, and vitality." The survey on depression measured 21 depressive symptoms, including sadness, sense of failure, dissatisfaction, guilt, crying, social withdrawal, and weight loss. Three hundred and thirty-two women ultimately completed the data collection.
The researchers found that both general quality of life—along with certain aspects like well-being, self control, and energy levels—were negatively affected by birth control. However, they did not see any significant increase in depressive symptoms.
"We found that 35 percent of the OC [oral contraceptive] and placebo groups had moderate to severe distress in general well-being at baseline, whereas seven percent in the OC and placebo group had moderate to severe depressive symptoms, the researchers write in the study. "After treatment, 44 percent in the OC group and 38 percent in the placebo group had moderate to severe distress in general well-being, whereas seven percent in the OC group and seven percent in the placebo group had moderate to severe depressive symptoms."
The researchers note that the changes to well-being are small and a study with a longer timeframe could see different results, as it's documented that adverse effects dissipate over time. But these burdens that women experience when trying to manage their reproductive health are important. Research has shown, the study notes, that up to 60 percent of women on birth control discontinue use or use it irregularly. The negative side effects could play a role, according to the researchers.
"This might, in some cases, be a contributing cause of low compliance and irregular use of contraceptive pills," said Niklas Zethraeus, an associate professor who worked on the study. "This possible degradation of quality of life should be paid attention to and taken into account in conjunction with prescribing of contraceptive pills and when choosing a method of contraception."