Friday, February 5, 2010

birth control pills

So I have an appointment with my gynocologist this morning and I ask her for a prescription for birth control pills. I explain that I had tried them before, twice, but they had made me feel asexual the first time and suicidal the second. So I was hoping she could recommend a low dose kind that wouldn't make me feel either way. She replies, "Unfortunately, all birth control pills make you depressed and lower your sex drive. That's just inherent in how they work. But I can write you a prescription for a low dose one."

I took the prescription, but then I thought wait a second, what??? Why on earth would I take a drug that would make me depressed and asexual? Basically nothing in the world is worth that?! Why do other people take it?

Then I google birth control pills side effects and read:

Side Effects back to top

As the body adjusts to hormonal changes created by The Pill, women often experience some minor side effects, including:

Irregular bleeding or spotting
Breast tenderness
Weight gain and/or water retention
Spotty darkening of the skin
Mood changes

Side effects usually disappear after 2-3 cycles. If your side effects are bothersome after 2-3 cycles or if heavy bleeding occurs, continue taking your pills and call the clinic for an appointment to talk about your prescription.

Again, wtf?? Why are mood changes minor? It is really listed after water retention and spotty darkening of the skin?? What could possibly be more important than your mood? 2-3 cycles is 2-3 months! Imagine even being nauscous for that long.

Then I'm curious what the incidence of depression ("mood changes") is with oral contraceptives. I can't really find that, but I do find this:

However, new research from Australia’s Monash University may change all that. Professor Jayashri Kulkarni from the University’s School of Psychology, Psychiatry and Psychological Medicine conducted a study in March 2005 that compared depression symptom scores between users and non-users of combined oral contraceptives.

Results showed women using the Pill had an average depression rating scale score of 17.6, compared to 9.8 in the non-user group. The women involved in the study were aged over 18, not pregnant or lactating, had no clinical history of depression and had not been on anti-depressant medication in the previous 12 months.

It really seems quite incredible to me that so many people take this drug.

please read the comments


Anonymous said...

"I took the prescription, but then I thought, wtf??? Why on earth would I take a drug that would make me depressed and asexual? Basically nothing in the world is worth that?! Why do other people take it?"

Because it doesn't make THEM feel depressed and asexual. I've had two girlfriends who used birth-control pills and they had no problems. Everyone's different.

Rick Massimo

Anonymous said...

Women are crazy anyway, I bet some are just blaming the pills for them being this way.

Anonymous said...

I think it's fair not to confuse potential side effects with 100% chance of side effect.

Chuck said...

Good thing drugs aren't in the water supp--oh.

Elizabeth Vicary said...

Journal of Psychosomatic Obstetrics & Gynecology
1995, Vol. 16, No. 1, Pages 37-43

University students' subjective experiences of oral contraceptive use
J. T. Condon‌1, J. A. Need‌1, D. Fitzsimmons‌1 and S. Lucy‌1
1Department of Psychiatry, Repatriation General Hospital, Daw Park, SA, 5041, Australia

A substantial proportion of women who commence oral contraceptives discontinue usage due to unwanted side-effects. In investigations of side-effects in current users, such women are excluded, and hence such studies will tend to underestimate the prevalence of side-effects. One hundred and forty-five female university students (both former and current users) completed a questionnaire focusing on their experiences of the impact of oral contraceptives upon their psychological and physical well-being. Although, on average, over half the women reported no effect, the vast majority of those who did report a change in well-being deemed this to be negative. The only exception was pelvic pain which was reported to be improved by oral contraceptive use.

Elizabeth Vicary said...

Br Med J. 1971 August 28; 3(5773): 495–500. PMCID: PMC1800460

Copyright notice
Oral Contraceptives, Depression, and Libido
Brenda N. Herzberg, Katharine C. Draper, Anthony L. Johnson, and Gillian C. Nicol
This article has been cited by other articles in PMC.
Depression, headaches, and libido were rated in 272 women before starting a contraceptive method and at intervals during the first year of use—54 were fitted with an intrauterine device (I.U.D.) and 218 used one of three oral contraceptives. Side effects caused 25% of the oral contraceptive group and 13% of the I.U.D. group to stop the method. Depression, headaches, and loss of libido were the most common reasons for stopping oral contraceptives and breakthrough bleeding was the most common reason for stopping the I.U.D.

Elizabeth Vicary said...

Oral contraceptives and depression*, , **: Impact, prevalence and cause

References and further reading may be available for this article. To view references and further reading you must purchase this article.

M.D.Gail B. Slap

From the Section of General Medicine, Hospital of the University of Pennsylvania and the Section of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

Accepted 20 April 1981. Available online 9 June 2005.

One million American adolescents are currently using oral contraceptives. Sixty percent of those beginning the pill discontinue its use within a year. Concern that mood change might be contributing to the decision to stop the pill prompted a review of the literature on the association between oral contraceptive use and depression.

Trends in adolescent pregnancy, contraceptive use, and compliance are discussed in the first section. In the second, 12 clinical studies are analyzed. Because there are no studies of mood change and oral contraceptive use in adolescents, some data from adults are presented. Biochemical theories to explain an association between oral contraceptive use and depression are discussed in section three.

Nine of the 12 clinical studies reported depression in 16–56% of women using oral contraceptives. Three studies found no association between oral contraceptive use and depression. The major problems found in the clinical trials were selection bias, poor assessment of pre-therapeutic mood state and unclear definition or measurement of depression. Current biochemical research suggests that oral contraceptives induce tryptophan oxygenase, which leads to pyridoxine deficiency in some women. However, the use of pyridoxine to prevent or treat depression in women taking oral contraceptives requires further study.

Key words: Adolescence; Contraceptives, oral; Depression; Monoamine oxidase; Pyridoxine; Serotonin; Tryptophan

Direct reprint requests to: Gail B. Slap, M.D., Section of General Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.

Journal of Adolescent Health Care
Volume 2, Issue 1, September 1981, Pages 53-64

**Nine of the 12 clinical studies reported depression in 16–56% of women using oral contraceptives.**

Elizabeth Vicary said...

A prospective study of the effects of oral contraceptives on sexuality and well-being and their relationship to discontinuation

References and further reading may be available for this article. To view references and further reading you must purchase this article.

Stephanie A. Sanders, , a, b, Cynthia A. Grahamc, Jennifer L. Bassa and John Bancrofta

a The Kinsey Institute for Research in Sex, Gender & Reproduction, Indiana University, Bloomington, IN, USA

b Gender Studies, Indiana University, Bloomington, IN, USA

c Department of Psychology, Indiana University, Bloomington, IN, USA

Available online 29 August 2001.

The purpose of the study was to explore predictors of discontinuation of oral contraceptives (OC) including pre-OC use characteristics and adverse physical, emotional, and sexual effects of OCs. Women aged 18+ years in committed, sexually active relationships were assessed before starting OC and reassessed at 3, 6, and 12 months or shortly after discontinuation. Assessment included pre-OC use attitudes and expectations about the pill; self-reported side effects and perimenstrual symptoms including premenstrual syndrome (PMS); physical and emotional well-being; and sexual interest, enjoyment, and frequency of sexual activity. Seventy-nine women completed the study, 38% continued OCs, 47% discontinued, and 14% switched to another OC. Emotional side effects, worsening of PMS, decreased frequency of sexual thoughts, and decreased psychosexual arousability correctly categorized 87% of cases by using logistic regression. Emotional and sexual side effects were the best predictors of discontinuation/switching, yet such OC effects have been largely ignored in the research literature.

Author Keywords: Contraceptives; Oral; Sex; Sexuality; Affect; Mood; Hormones


Anonymous said...

I once tried the pill for a while, and it made me impotent.

I noticed one change after my wife went off the pill. She stopped having sex with me.

I once asked a lesbian friend what she thought of the pill, and she said "I dunno."

Temposchlucker said...

Let's start with the first premise to begin with. So you look at a child as an unwanted side effect of sex? :P

Elizabeth Vicary said...

at the moment, yes. what's your point?

Unknown said...

I suggest condoms.

Anonymous said...

Depo Provera made me completely loose my libido, and as if that wasn't bad enough, it made me always dry.

i bet a lot of women don't realize it's the drug that's causing it. it's not immediately obvious.

Mark Howitt said...

If you just don't take it and don't moan about it you'll feel better :).

Gurdonark said...

To add a bit more data to the mix, here is a summary from the CDC about the various birth control methods and their effectiveness.

Gurdonark said...

Here is an interesting article which quotes the study authors you cite as well as other prominent Australian researchers in this field for some additional nuance on the issue:

interesting article.

Anonymous said...

i am very concerned about any lack of sexuality on your part. please keep us posted.

Anonymous said...

Seriously, don't touch the stuff. Anything that allows total unprotected pleasure has to have a hidden drawback. Bottom line is your libido is higher OFF the pill. Why would you mess with that?

Anonymous said...

Anytime you consume artificial substances, there are going to be "side effects." Our bodies create all the pharmaceuticals we need. End of conversation!

Unknown said...

One site you should consider:

an ordinary chessplayer said...

In hockey they have an expression "sacrifice the body". In sports men do it and consider themselves heros. In relationships men won't do it, but women will...

Maybe that is why there are so many birth control options for women and so few for men.

I'm with you on this one Elizabeth. The pill is *not good*. Maybe your boyfriend can step up. Otherwise, you might consider a diaphragm, which seems your safest option (although not totally safe).

Anonymous said...

I suggest you look into studies regarding the success rate of withdrawal, which is almost comparable to condoms (in committed relationships where couples know each other's responses and sexual histories) and has no side-effects at all. Just do not have intercourse twice in one night due to the presence of live sperm in the urethra (there are other things you can do, after all). In two long-term committed relationships, that was our method of choice and no pregnancies resulted. In both cases, we both first got tested for HIV. STDs are the only issue -- though, if you are choosing the pill, you obviously are not concerned about that. Anyway, condoms are not much use against HPV, which is now the most prevalent STD -- and you should probably get vaccinated for that.