My focus in this article critique
is to understand and determine whether or not hormonal birth control can
actually be linked to a higher risk of suicide. In the article written by Alice
Park with the New York Times, it is mentioned that although the data connecting
“The absolute risk of suicide associated with hormonal contraceptives is still
extremely low … the data suggests it’s worth studying and understanding
further.” Studies have revealed that birth control use has lead to higher
chances of women developing depression which, in turn, can result in the
possibility of its users committing suicide, the reason why remains unknown but
may have to do with the effects of hormonal contraceptives on the brain. Women,
by today’s standards, are expected to be on or take some form of birth control
when they are sexually active. While there are non-hormonal options, the ones
that are the most effective are hormonal contraceptives. According to the
Planned Parenthood website and Stöppler at MedicineNet, hormonal contraceptives
are those that act on the endocrine system. These methods are composed of
either both estrogen and progestin or only progestin. They deliver a dosage of
hormones to the body that prevents the release of eggs from the ovaries,
prevent sperm from entering the uterus by thickening the mucus found in the
cervix, and prevent implantation of sperm in the uterus by thinning its lining.
Options for Hormonal birth control are birth control pills, the patch, the
ring, and hormonal IUDs. The side effects of birth control, according to
Stöppler, can be useful to women in many ways. Not only is it helpful in
preventing unwanted pregnancies, it can also reduce acne, alleviate symptoms of
PMS, lighten heavy or painful periods, alleviate menstrual migraines, and
reduce the risk of ovarian cancer. Birth control is also known to lower the
possibility of endometrial cancer, polycystic ovarian syndrome, pelvic
inflammatory disease, and ectopic pregnancies. Although there are many upsides
to using birth control, there are always individuals who unfortunately
experience the unpleasant side effects. Nausea, headaches, weight gain,
decreased libido, mood changes, and depression are also on the list of side
effects for birth control. In the article, the author developed a comprehensive
understanding of the connection between birth control and depression. She
introduced data from the first study which compared the development of
depression and risk for suicide in women who had either just started or have
been on some form of hormonal contraceptive and women who were either no longer
on hormonal contraceptives or had never been on any form of hormonal
contraceptives. She also included the outcome of when the study compared the
results of depression and suicide to women who have never used contraceptives
before. When the initial study was altered to no longer include women who had
previously been on hormonal contraceptives, the researchers noticed a
difference. There weren’t differing results when compared to the women who had
previously used a form of contraception. This discovery can mean that there is
a possibility that depression and risk of suicide caused by birth control will
remain even after stopping use. One focus in the article was on the risk of
suicide among the younger population. This risk peaked in the first two months
after starting a hormonal contraceptive but plateaued after a year of continued
use. The Planned Parenthood website says that all side effects upon the first
month of starting a new birth control regimen will be more prominent and fade
as the use is continued. Meaning that these initial signs of depression are
normal but should fade as the user continues. However, the study found that
prolonged use of hormonal contraceptives was more likely to raise the risk of
suicide up to “30%” even after seven years. With an increased risk of
developing depression, the article also mentions the possibility of an
individual committing suicide raising as the use of hormonal contraception is
prolonged. When the factors that affected the risk of suicide such as “mental
illness and the initiation of sexual relationships” were adjusted or removed,
the results were still the same. Although the results remained the same, they
do not include the possibility of other emotional challenges and their
influence on women. The author understood this and points out the fact that the
study did not factor in the possibility of younger women being more insecure,
going through more breakups, and other unsettling events. On the other hand,
the article did not mention if the study included or compared the number of
suicides of women who were taking hormonal contraceptives and the number of
suicides in the Denmark region. Meaning that although there were women who
committed suicide while on hormonal contraception, the possibility of
environmental factors having an impact is ruled out by not including a total
suicide rate (men and women) in Denmark. The article ultimately concludes that
it is “not clear how contraceptives may be affecting suicide risk” but, it
mentions that “it’s possible that some of the risk is occurring through the way
that hormones can affect mood and depression.” Meaning that there is a
possibility that the hormones used in this form of contraception can affect the
brain. It is not expanded upon but merely said. A statement that is
undetermined and not fully studied meaning that it is important for there to be
more research on the subject. When signing up for a new birth control regimen,
individuals may unknowingly be putting their mental health at risk. The
possibility of developing depression from birth control is higher than
anticipated and it is undetermined how long after stopping a regimen until the
side effects subside. The article does not mention whether side effects of the
birth control will completely dissipate after stopping use which is concerning.

The lead author in the paper from the University
of Copenhagen in Denmark, Charlotte Wessel Skovlund stands by her belief that
“hormonal contraception can also have a direct effect on the brain”. To which
extent remains undetermined and leaves individuals uninformed on the subject.
There are no known articles mentioned by the author that expand on the idea
that birth control directly affects the brain meaning this area of study is
either currently being researched or unknown to others. Every individual is
different and on a genetic level, everyone varies drastically. From the very
beginning of a sperm-egg-fusion, there is a distinct combination of 46
chromosomes that result in the formation of a child. Humans are all different
and complex which makes each and every individual unique. Some people are
allergic to penicillin and others aren’t allergic to anything at all which
makes it understandable that all medications can affect every individual in a
different way. Some women who are on birth control do not experience any kind
of change while others can experience great benefits and others, unpleasant
side effects.  According to Planned
Parenthood, there are many different types of hormonal birth control methods
and the difference between them all are the types of hormones used, how much of
the hormone is delivered, and the way the hormone enters the body. This means
that since there are different options for women to choose from. The
relationship between a patient and a doctor is crucial, any medications a
patient takes can react and lead to complications. In the conclusion of the
article, it is mentioned that although the data found is not discouraging
enough to completely stop medical providers from prescribing hormonal
contraceptives, it would be best if they carefully considered the possibilities
with each individual and worked with them to find what works best. It is
necessary for women to have an open relationship with their medical providers
in order to adequately prescribe contraceptive medications which will result in
the least amount of side effects. Women should be more cautious. While one form
of contraception works amazing for a friend or family member, the same
medication can result in another individual developing depression or intense
mood swings. It is important for women to know about the mental side effects in
order for them to understand when it is necessary to halt use when there is a
noticeable difference in their mood. The study conducted by Charlotte Wessel
Skovlund found that the form of birth control connected to the highest risk of
suicide attempts was the patch. The IUD and vaginal ring held the second
highest risks while pills resulted in the lowest risk of contraception. If it
is true that the hormones delivered alter the brain in a negative way, it would
be best to understand how each form of hormonal contraception works. According
to MedicineNet, the pill is taken orally and comes in two forms, a combination
pill which includes both estrogen and progestin hormones and a mini pill which
only contains the progestin hormones. The patch is similar to the combination
pill since they both contain estrogen and progestin hormones but the patch
differs because the hormones aren’t delivered orally but through a transdermal
process. The IUD can be implanted in the arm and provides a continuous delivery
of progestin hormones over the course of three years. The main difference found
between these forms of contraception is how the hormones are delivered. My
personal conclusion for why the patch and the IUD lead to higher risks of
suicide attempts among women may be because the release of hormones is
ineffective. While a pill is a specific dosage every day at a specific time,
the patch and the IUD deliver a continuous administration of hormones
throughout a day. Since there are no sources that have information on why the
patch and IUD have higher risks of suicide I had to come up with an
explanation. Although hormonal contraceptives can be helpful to women in many
ways, there are still concerns among women as to why there are so many negative
side effects. Unfortunately, it is common for women to feel depressed while on
some form of hormonal contraceptive. The article written by Alice Park brings
this issue to light. Although this field of research remains underdeveloped,
hopefully, this article enlightens others and enables them to acknowledge that
birth control is linked to higher rates of depression. The need for an
understanding is crucial because women everywhere may unknowingly be hurting
themselves by developing higher risks of depression and suicide.


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