{"id":1211,"date":"2021-01-20T16:25:11","date_gmt":"2021-01-20T15:25:11","guid":{"rendered":"https:\/\/svjmedia.nl\/internationaljournalism\/?p=1211"},"modified":"2021-01-20T16:25:11","modified_gmt":"2021-01-20T15:25:11","slug":"dutch-women-ditch-contraceptive-pill-1-in-10-experience-psychological-side-effects-such-as-depression","status":"publish","type":"post","link":"https:\/\/svjmedia.nl\/internationaljournalism\/1211\/dutch-women-ditch-contraceptive-pill-1-in-10-experience-psychological-side-effects-such-as-depression\/","title":{"rendered":"Dutch women ditch contraceptive pill: 1 in 10 experience psychological side-effects such as depression"},"content":{"rendered":"
Contraceptive pill use has decreased by 11% amongst Dutch women in the past five years. Side-effects of hormone-based birth control methods are known, though women still feel they lack concrete evidence that health problems, such as mental instability and mood swings, can be linked to contraceptives.<\/span><\/b><\/div>\n
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Side-effects of hormonal contraceptives, including the oral contraceptive pill, the Intrauterine Device (IUD) and the implant, are common. One in ten women experiences mood swings, headaches, a decreased sexual libido, weight gain, acne and a different stress reaction, according to the prescription provided with the contraceptives. Doctor Lilian van Raalte sees this reflected in the consults made in her doctor\u2019s office. \u201cMany women feel they experience these consequences of their contraceptive use,\u201d she says.<\/p>\n

Though a lot of research has been done to expose the physical health effects of pill use \u2013 since the pill is older and more known than the IUD and implant \u2013, not a lot is known about the mental health effects. Worldwide, 151 million women use the pill. In 2016, Danish researcher Charlotte Skovlund completed a study about depression and the contraceptive pill amongst one million Danish women. She concluded that a correlation was evident: a greater number of women taking the pill also experienced depressed feelings, especially amongst adolescents. However, it was not studied whether depression caused pill use, or vice versa. Sometimes when a woman is depressed, a contraceptive pill is prescribed to calm the hormones and stabilise the mood. This effect is different on everyone.<\/p>\n

\u201cThe psychological effects of the contraceptive pill are highly understudied. Something we are just now learning more about is the impact it has on mood,\u201d says assistant professor Estrella Montoya of Utrecht University, who has written her dissertation on the effects of contraceptive hormones on the body. \u201cThe pill can cause both negative and positive feelings, leading to depressed feelings on the one hand, or an increased positive feeling on the other hand. It differs per user, but this effect occurs amongst one in ten women,\u201d she says. Other effects are an alteration in feelings of attraction, stress, emotion regulation, friendships and changed hunger patterns, says Montoya.<\/p>\n

67% of women between ages 15 and 49 use contraceptives, over half of which use the oral contraceptive pill. In the past years, many women have switched to the Intrauterine Device (IUD). This long-acting birth control method is impossible to forget, since it is placed in the uterus and doesn\u2019t need to be swallowed daily like the pill. It is less expensive and excretes less hormones than the standard contraceptive pill. However, placement is painful and cysts can occur. And though there are less hormones excreted, the hormones still impact the way the woman is feeling, says Montoya.<\/p>\n

\"\"

Figure 1. Percentage of contraceptive use and teen pregnancies in the Netherlands and Europe, 2017<\/p><\/div>\n

Student Camille van den Boorn (24) was a mere twelve years old when doctors prescribed her a contraceptive pill due to heavy menstrual bleeding. Recently, she began to question what effect these synthetic hormones had on her mental well-being, as she had suffered through turbulent puberty years including a depression. At 24, she quit using the pill, and noticed she feels better. \u201cI have stopped having migraines around my menstruation. I don\u2019t feel bloated anymore. And I am now able to distinguish where my emotions come from, and how I can deal with them,\u201d says Van den Boorn. \u201cAround me, I heard more and more women starting to question the pill, and I was wondering to what extent it was impacting me. The annoying thing is that you don\u2019t know what the effect it until you have stopped using it,\u201d she says.<\/p>\n

Montoya has also researched what the pill does to the stress reaction. \u201cNormally we produce cortisol, a hormone that enables us to deal with stressful situations. But we see that this cortisol production is lower amongst women who take the pill,\u201d the psychologist says. She states that this lowered stress reaction is also something which is evident amongst people with a depression. However, a difference is found with the IUD, which only excretes progesterone. \u201cProgesterone-only birth control methods actually increases cortisol production, leading to an increased reaction to stress,\u201d says Montoya.<\/p>\n

Also, Contraceptive pills can decrease the level of testosterone by 70% in the female body. \u201cTestosterone is extremely important for sexual libido and mood,\u201d says Montoya. Now new contraceptive pills are being developed which include testosterone, to fill in the shortage.<\/p>\n

Only recently have mental side-effects received more attention. In the summer of 2020, the Dutch Doctor Society (NHG) altered the guidelines for the prescription of contraceptives, so that psychological side-effects are included in the information given to women wanting to start using them. Ineke van der Vlugt is programme leader at the Dutch Knowledge Centre of Sexual Health Rutgers. She says: \u201cPsychological wellbeing is considered more important now. Previously, most attention had been given to the effect of the pill on for example thrombosis or cancer, but not on the mental wellbeing.\u201d Montoya agrees with this: \u201cPsychological effects are seen as secondary effects. There is a significant knowledge gap between physical effects and psychological effects.\u201d<\/p>\n

Link to interactive infographic: https:\/\/localfocuswidgets.net\/5ff86f83b4689<\/a><\/p>\n

Some people disagree with the recent augment in careful attention being paid to the effect of hormones on the body. Gynaecologist Jelle Stekelenburg, professor at Groningen University in the north of the Netherlands, compares it to \u201ca hype\u201d that women are \u201ctired of hormones\u201d. Stekelenburg says: \u201cThe hormones used in the pill and the IUD are very similar to the hormones present in the female body.\u201d A lot of women come to his office and state they don\u2019t want to take any more hormones. Stekelenburg: \u201cI\u2019m afraid many women blame differing complaints on their hormonal cycle, though there isn\u2019t always sufficient ground for that.\u201d<\/p>\n

The lack of concrete knowledge and evidence is something women are struggling with. Van den Boorn sees women around her hesitant in stopping their pill intake. \u201cThey are wondering what the effect is on their body. But the downpart is that stopping means you need to find a different way to protect yourself against pregnancy,\u201d she says.<\/p>\n

Is the awareness about the effects of hormonal birth control a recent phenomenon? Stekelenburg thinks back to the 1960s, when the pill was celebrated as the emancipation of females. \u201cWomen had fought for decades for contraceptives. Now it almost seems as if hormones oppressing women,\u201d he says.<\/p>\n

In society, Van der Vlugt witnesses a collective aim to be a perfect, most natural version of oneself. \u201cEspecially amongst higher educated women, a wish to be \u2018pure\u2019 is popular. Synthetic hormones don\u2019t fit into this image of natural perfection,\u201d she says. Stekelenburg agrees. \u201cIt is no longer all right to feel bad anymore. One must be pretty, social and always have enough energy to do sports. But sometimes, this just isn\u2019t the case. Whether you do or don\u2019t take hormones,\u201d he says.<\/p>\n

American psychologist Sarah Hill, known for her book This Is Your Brain on Birth Control: The Surprising Science of Women, Hormones and the Law of Unintended Consequences <\/em>(2019), was one of the first to openly address the consequences of hormones crossing the membrane barrier into the brain. \u201cThis means women are a different version of themselves when they are on birth control,\u201d the psychologist writes in her book. The idea that IUDs only excrete hormones affecting the uterus, is a myth, says Montoya. \u201cHormones enter your blood. It\u2019s not just your uterus, not just your brain: it\u2019s your whole body that is affected,\u201d says Montoya. However, little research has been done about the psychological effect of an IUD.<\/p>\n

Steps can be taken to increase awareness for the psychological effects when girls and women speak to their doctors, right before starting birth control. \u201cResearch I am conducting now is showing many women want more information about mental consequences when starting hormonal birth control,\u201d says Montoya. She feels doctors should be clear about these consequences, especially about the impact on mood. Doctor Van Raalte sees the benefit in this also, though she notes that time is scarce in doctors\u2019 offices. \u201cWomen should be more aware of the side-effects of these medicine. If you are doubting what effect it has on you, stop for two months and examine carefully how you feel,\u201d says van Raalte.<\/p>\n

Montoya has a clear view on it. \u201cDoctors ought to call back the women two months after starting contraception, to check how it is going. Hormonal changes are very drastic, and this is something that should be communicated well,\u201d she says.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Contraceptive pill use has decreased by 11% amongst Dutch women in the past five years. Side-effects of hormone-based birth control methods are known, though women still feel they lack concrete evidence that health problems, such as mental instability and mood swings, can be linked to contraceptives. Side-effects of hormonal contraceptives, including the oral contraceptive pill, […]<\/p>\n","protected":false},"author":852,"featured_media":1214,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-1211","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cbj","et-has-post-format-content","et_post_format-et-post-format-standard"],"acf":[],"yoast_head":"\nDutch women ditch contraceptive pill: 1 in 10 experience psychological side-effects such as depression - International Journalism<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dutch women ditch contraceptive pill: 1 in 10 experience psychological side-effects such as depression - International Journalism\" \/>\n<meta property=\"og:description\" content=\"Contraceptive pill use has decreased by 11% amongst Dutch women in the past five years. 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