Increased Risk of Mental Illness and Suicide in Oral Contraceptive and Hormone Replacement Therapy Studies

Abstract

Epidemiological studies find that takers of contraceptive or menopausal steroid sex hormones are at increased risk of suicide and mental illness. In spite of omitting women from the UK Hormone Replacement Therapy Study who discontinued therapy within the first 12 months, the relative risk (RR) of suicide and suspected suicide was reported as 2.4. In the Royal College of General Practitioners' Oral Contraceptive Study, neurotic depression was the commonest reason for discontinuing hormones, and RRs for attempted suicide for current and former users were 1.42 and 2.12 respectively. In the Oxford/Family Planning Association Contraception Study, first-event hospital admission rates for selfpoisoning were 0.83/1000 women years for oral contraceptive users but only 0.21 for diaphragm users. In the Walnut Creek Contraceptive Drug Study, RRs for current users were 3.2 for depressive neurosis and 2.0 for psychosis. The fact that mood and behaviour changes may be side-effects of taking hormones should be considered much more frequently. These changes may be immediate or occur insidiously over a period of time. Significant 'knock-on' effects for family life and society in general are possible. Hormones can cause changes in mineral and vitamin status which are associated with mental illness.