The Effect of Hormonal Contraceptive Use on the Risk of Depression in Women of Reproductive Age: Evidence from Gunungkidul, Yogyakarta

Abstract

ABSTRACT Background: Estrogen and progesterone hormones have been hypothesized to play a role in the cause of depressive symptoms in female. Clinical studies have indicated that changes in estrogen levels may trigger depressive episodes among women at risk for depression. A previous study found that use of combined oral contraceptives among women who previously had experienced emotional adverse effects resulted in mood deterioration and changes in emotional brain reactivity. This study aimed to examine the effect of hormonal contraceptive use on the risk of depression in women of reproductive age. Subjects and Method: A cross-sectional study was carried out in Gunungkidul, Yogyakarta. A sample of 200 women of reproductive age was selected by purposive sampling. The dependent variable was depression symptom. The independent variables were age, education, duration of contraceptive use, type of contraceptive use, employment, and family income. Depression symptom was measured by Beck Depression Inventory II (BDI II). The other variables were collected by questionnaire. The data were analyzed by a multiple logistic regression run on Stata 13. Results: Depression symptoms increased with hormonal contraception (OR= 3.74; 95% CI= 1.61 to 8.65; p= 0.001) and duration of contraceptive use ≥36 months (OR= 6.33; 95% CI= 2.36 to 16.97; p <0.001). Depression symptoms decreased with age ≥29 years (OR= 0.12; 95% CI= 0.04 to 0.34; p <0.001), family income ≥Rp 1,571,000 (OR= 0.10; 95% CI= 0.04 to 0.24; p <0.001), education ≥Senior high school (OR= 0.18; 95% CI= 0.07 to 0.45; p<0.001), and working at home (OR= 0.37; 95% CI= 0.16 to 0.83; p= 0.016). Conclusion: Depression symptoms increase with hormonal contraception and duration of contraceptive use ≥36 months. Depression symptoms decrease with age ≥29 years, family income ≥Rp 1,571,000, education ≥Senior high school, and working at home. Keywords: hormonal contraceptive, depression Correspondence: Neta Afriyanti. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: neta.friyanti16@gmail.com DOI: https://doi.org/10.26911/the7thicph.03.121