Ms. Skovlund, your research linking hormonal contraceptive use to depression was conducted over an extended period. Can you tell us about the study and your findings?
I found that use of hormonal contraception both oral and non-oral was associated with an increase in risk in the use of antidepressants, depression diagnoses, suicide attempts and suicide.
Especially among young women and first time users. For the older women, the women that stayed on hormonal contraception for a long period, we found a healthy user effect.
The women who kept taking the contraception were the ones that could tolerate it and those who quit were the ones that couldn’t and there we saw an increasing risk even long after they had quit.
Adolescent users (Age 15-19) of hormonal contraception have a double risk of starting on antidepressants, getting their first depression diagnoses, attempting suicide and committing suicide compared to those who have never been users.
Depression often leads to suicidal thoughts, attempts and even suicides. Can you give us the numbers related to this so that our readers can put it in perspective when we talk about oral contraception?
Assuming a causal relation between hormonal contraception use and the examined depression parameters for 100,000 adolescent women using hormonal contraception in one year, 1,015 will start using antidepressants, 524 will get a diagnoses for depression and 165 will attempt suicide and an unknown amount will be affected on their mood but not enough to be detected in the registers.
Please tell us about your study that associates venous thromboembolism and the use of oral contraception.
Young women have a small risk of venous thromboembolism but when taking oral contraception with estrogen, the risk doubles with the old types of hormonal contraception and if they use the new types with, for example Drospirenone, the risk increases four times. The risk increases with increasing age and if the women have a migraine with an aura.
In addition to depression, suicide attempts, suicides and throboembolism what are the other risks that women should be aware of?
Yes, hormonal contraception can also increase the risk of breast cancer. But on the other hand it lowers the risk of ovarian cancer and endometrial cancer.
Do the producers of hormonal contraception including oral provide clear details of the risks involved?
For most products, side effects are mentioned on the label. But the doctor or medical person that prescribe hormonal contraception should be much more aware of their responsibility of giving the women proper information on the possible side effects.
What would be your message to women on the use of contraception?
Remember that you are using a drug that sets your natural cycle at hold. A drug has benefits as well as side effects so be sure that you need the benefits and be aware of the side effects.
What would be your message to the men out there on their responsibility so far as contraception is concerned?
Men really need to take responsibility for their own sake and not just rely that the women are properly on the P-pill. Therefore we need a change in the attitude around that taking the pill is not a big deal because you change your hormones and they have a lot of influence on your life.
On that topic, do you subscribe to the view that “the pill” empowered women and set them on the path to freedom?
Of course it is evident that for the sake of the women and children, that a woman can control when and how many children she wants. But the Pill is not and should not be the only option for achieving this.
For some women the Pill can be a good option for example if they have heavy menstrual pain or are suffering from PMS in their cycle.
But if women don’t have a medical reason, they should really consider hormone free alternatives such as copper spiral, condom, diaphragm and sterilisation.
Being able to postpone your menstruation to a time where it fits you better is not a medical reason. Today we know more about the pill and its side effects then they did in the ‘60s.
Therefore, women should feel empowered by knowing their natural cycle and making their own choice of prevention.
Please tell us about your self motivation and those who were instrumental in inspiring you.
I found my motivation in the possibilities hidden in the Danish health registers that actually made it possible to answer these relevant research questions about hormonal contraception and the effects on women’s psychological health.
Please also tell us about your formative years.
I grew up in Denmark with my parents and my older sister. We lived close to the sea where I liked to bathe and the forest where I went for walks with my dog. I played outside every day with my sister and our friends that lived close by.
I liked mathematics and biology and later also physics and chemistry while in
primary school I helped my classmates with maths and to develop educational skills. I liked school and education even though I had problems with spelling and languages. Therefore, I just kept educating myself until I, one day, was a civil engineer.
Our readers are mainly youth in different parts of the world, who look up to achievers such as yourself for inspiration. A word of advice for them?
My best advice would be that sometimes you need both tactics and flexibility to achieve what you want. Divide your problems into little pieces and solve them one by one.
Charlotte Wessel Skovlund PhD works with the Danish Cancer Society and Research Center. She was associated with the department of gynaecology at Rigshospitalet which is a highly specialized hospital in Denmark. Ms. Skovlund has important research papers to her credit.
Photos: Shutterstock / From the Archive of Charlotte Wessel Skovlund PhD