By Joy Stephenson-Laws, JD, Founder

Nowadays, there is a variety of contraceptives to choose from (reportedly around 15 different methods). And for young women who want to avoid pregnancy, all of these options may be overwhelming.

So let’s breakdown contraceptive options.

There are barrier contraceptives, which are exactly what they sound like. They prevent the sperm from reaching the egg. Barrier contraceptives include male and female condoms, diaphragm, cervical cap, contraceptive sponge and spermicide (which contains chemicals that kill sperm). Pretty simple.

And then there are hormonal contraceptives, and this is where it gets a bit tricky. Hormonal contraceptives deliver manufactured forms of the hormones estrogen and or progesterone, two female sex hormones.

Combinations of estrogen and progesterone work by preventing ovulation (the release of eggs from the ovaries). They also change the lining of the uterus (womb) to prevent pregnancy from developing and change the mucus at the cervix (opening of the uterus) to prevent sperm (male reproductive cells) from entering, according to the National Institutes for Health (NIH).

The hormonal contraceptive you are most likely familiar with is oral birth control pills. Other forms of hormonal contraceptive include:

• Injections, like the Depo-Provera shot (which may prevent pregnancy for three months). Lunelle is another shot that may prevent pregnancy for one month.
• Vaginal Ring, also called Nuva-Ring. A ring that is inserted into the vagina and releases hormones. It may remain inserted for three weeks, removed for one week and then replaced with a new ring.
• Birth control patch. An adhesive bandage that sticks to the skin, just like a nicotine patch, and delivers hormones through the skin. The hormones are built into the sticky side of the patch.
• Intrauterine Device (IUD). An IUD is a small device (kind of resembles a wishbone or a small letter T) that is implanted into the uterus. There are five different brands of IUDs, which are FDA-approved for use in the United States. Within these brands there are two different types of IUDs: copper and hormonal.

• The copper IUD has a copper wire coiled around the stem of the device, and two copper sleeves are placed on the arms of the device. Copper is released to bathe the lining of the uterus and essentially create a toxic environment for sperm. Apparently, sperm do not like copper.

• The hormonal IUD releases progestin, a synthetic hormone very similar to progesterone (which the human body naturally makes). The hormones in the hormonal IUDs thicken cervical mucus, which helps block and trap sperm. The hormones may also prevent ovulation.

So as you can see, a girl has her options!

Side effects of hormonal contraceptives may include weight gain, decreased libido, breast tenderness, headaches, irregular periods and mood changes. If you experience any of these side effects, they may go away as your body adjusts. Some women tolerate hormonal birth control better than others. I was personally not one of them.

At one point in my life, I gave various types of hormonal contraception a try but I was not a fan. It made me retain water and feel depressed.

And in a recent study involving nearly half a million Danish women, researchers found an association between the use of hormonal contraceptives and suicide.

The study followed the women (aged 15 and older, average age 21) for an average of about 8 years, to assess daily use of hormonal contraception and risk for first suicide attempt or an actual suicide.

Women who had prior suicide attempts, current antidepressant use, psychiatric diagnosis, cancer diagnosis, or venous thrombosis (a blood clot in the deep vein) diagnosis were excluded from the study, “because these factors could influence both use of hormonal contraception and risk for suicide,” according to a report on the study.

At the end of the study, researchers identified 6,999 first suicide attempts and 71 suicides which were more commonly seen in the women who used hormonal contraceptives, compared to the women who had never used them.

Adolescents were more prone to first suicide attempts when it came to being influenced by hormonal birth control, compared to older women. The type of hormonal birth control also mattered.

“Risk estimates for suicide attempt were 1.91 (95% CI=1.79–2.03) for oral combined products, 2.29 (95% CI=1.77–2.95) for oral progestin-only products, 2.58 (95% CI=2.06–3.22) for vaginal ring, and 3.28 (95% CI=2.08–5.16) for patch. The association between hormonal contraceptive use and a first suicide attempt peaked after 2 months of use,” the study reports.

The study found that progestin-only forms of hormonal birth control, like the IUD, had more of a risk.

Another report says that “it is not uncommon for patients to report a worsening of depressive symptoms after starting treatment with oral contraceptive pills (OCPs).”

"Healthcare professionals need to keep in mind the possible unmasking or causation of suicidality in women started on OCPs," according to one doctor. "These are hormones and are not to be prescribed lightly.”

Given the results of these studies, it is perhaps a good idea for doctors to assess the mental health status of a patient before they prescribe hormonal birth control. It should be relevant whether the patient has been depressed before, currently experiencing symptoms of depression or attempted or had thoughts of suicide.

So how can we be proactive?

It has been shown that oral contraceptives may deplete the body of key nutrients such as magnesium, selenium, zinc, folic acid, vitamin B2, B6, B12, C and E. Adequate levels of these nutrients are vital for our physical and mental health, and any reduction in the body should not be taken lightly.  

“In particular, a report from the World Health Organization (WHO) points out that the influence of OCs on nutrient requirements is a topic of high clinical relevance and should, therefore, receive great attention.”  

For example, it should come as no surprise that depression is one of the side effects of OCPs because many credible studies associate reduced levels of magnesium, selenium, zinc and vitamins B, C and E with depression.  

As a result, it is critical to maintain a healthy diet with all of the essential nutrients when taking OCPs. This will not only help keep your body in its best physical state, but it may also do a lot for your mental health. It may also help if you routinely request a nutrient test to ensure that your body is absorbing these nutrients from the foods you eat. Stress and other factors may affect your nutrient levels even if you eat the right foods. For more information on depression, read here.

Antidepressants may also affect levels of estrogen and progesterone in women. So if you are on antidepressants and interested in taking hormonal contraceptives, it is imperative that you discuss these issues with a competent physician.   

Remember, a big part of being proactive about your health is knowing exactly what you are putting in your body and the effects this may have on you. Just because “everyone is doing it” does not mean that it is the best method for you.

Enjoy your healthy life!

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.