All those women are also x

November 19, 2012 7:41 PM

Are there things we can say about women who do not do well with hormonal birth control as a group?

I attempted some pubmed research on this, but while I'm a crack legal researcher.....nada.
There's a group of women for whom any kind of hormonal birth control makes them "crazy", sad, or otherwise baaad. Is there anything we can say about these women in other health-ways? Do they die of X more? Menopause is some specific experience for these women? I'm interested if there is any research in this vein and, if so, what it says. Help?

posted by atomicstone to Science & Nature (9 answers total)

One study from 2008 drew some broad conclusions:

...women who reported PMS and severe menstrual pain as a teenager were more likely to experience premenstrual mood improvement on the pill than those without these symptoms. Women with a history of depression were more likely to experience premenstrual mood worsening on the pill than those with no history of depression. However, most women with a history of depression experienced either no change in their mood (61%) or mood improvement (14%); only a small number (25%) experienced premenstrual mood worsening on the pill.

I only have access to the abstract so I haven't analyzed the study deeply.
posted by muddgirl at 7:55 PM on November 19, 2012 [2 favorites]

Are you looking for only research on women who experience psychiatric side effects with hormonal birth control and what that might mean for them? I'm just not sure what "otherwise baaad" / "not doing well" includes, and there are numerous non-psychiatric side effects of hormonal birth control. Obviously women who have blood clots on hormonal birth control are a different group than those who experience moodiness on it.
posted by treehorn+bunny at 8:21 PM on November 19, 2012

Not entirely sure what you mean by "otherwise bad," but: many women with migraines find that hormonal birth control makes their migraines worse. And women with migraines who take birth control pills are at increased risk of stroke.

(Migraine trouble is why I personally eventually stopped using hormonal birth control -- even though I have a second health condition that is actually improved by hormonal birth control use. Kinda stuck between a rock and a hard place there.)
posted by BlueJae at 8:44 PM on November 19, 2012

You may have a problem with a large categorization because many women who have a problem with hormonal birth control only have an issue with one type or even one brand, whereas another version doesn't bother them. The specifics vary so much from woman to woman that I'd be surprised if there's a larger correlation that hasn't been noted already.
posted by peanut_mcgillicuty at 9:06 PM on November 19, 2012

And some of the issues aren't really reported accurately. I stopped using it because it seemed to make me very much more susceptible to yeast and other undiagnosable vaginal infections. I used to joke that the methodology of the pill was to make sex so painful that you never wanted to have it, thereby reducing the risk of pregnancy. Once I stopped, no more infections. But I don't think any of that was reported as a side effect of the pill. If it was recorded at all, the reason was probably listed as "patient choice" to discontinue. I don't think my doctor ever agreed that my issues were related to hormonal birth control.
posted by CathyG at 7:42 AM on November 20, 2012

I used to joke that the methodology of the pill was to make sex so painful that you never wanted to have it, thereby reducing the risk of pregnancy.

My version was that it prevented pregnancy by making you hate all people so much that you never took anybody to bed. Dosage and maker didn't seem to matter; just a HUGE DARK CLOUD. Also wouldn't show up in research, as dropped mid-cycle of last attempt...
posted by acm at 8:31 AM on November 20, 2012 [1 favorite]

So, I unfortunately do not have a lot of time to look into this, because it is a super interesting question (I'm heading out the door), but copy/paste this into the PubMed search bar and see if anything of interest pops up:

("Contraceptives, Oral/adverse effects"[Mesh]) AND "Emotions/drug effects"[Mesh]

A group that might have information on this topic is the American Congress of Obstetricians and Gynecologists.

I'm going to check back in on this thread and see if you guys come up with anything else, because as I said this is a really fun question.
posted by zoetrope at 11:17 AM on November 20, 2012

In case it helps, Dr. Jayashri Kulkarni of Australia's Alfred and Monash University is one of the people doing research in this area.
posted by Lexica at 7:38 PM on November 20, 2012

It seems like there is some research regarding whether bipolar disorder in women (particularly rapid cycling) is influenced by menstrual cycles, but nothing conclusive one way or another. Anecdata (personal and friends) suggests that hormonal birth control can be a goddamn waking nightmare (technical term) for some women with bipolar disorder.

What I've found that might interest you:
Menstrual dysfunction prior to onset of psychiatric illness is reported more commonly by women with bipolar disorder than by women with unipolar depression and healthy controls.

Onset of unipolar depression or bipolar disorder prior or close to menarche.

Specifically on rapid cycling in women with bipolar disorder

Premenstrual Mood Changes Predictive Of Greater Bipolar Disorder Severity

Menstrual psychosis:
on Wikipedia
Menstrual psychosis: a bipolar disorder with a link to the hypothalamus.

It seems like if worsening of bipolar disorder can be connected to menstruation, it would have something to do with hormonal birth control as well. It has for me, anyhow.
posted by fiercecupcake at 3:49 PM on November 21, 2012