Oral contraceptives reduce general well-being in healthy women

Side view portrait of a happy woman taking contraceptive pill in the bed at home

Media Release
One of the most common
combined oral contraceptive pills has a negative impact on women’s quality of
life but does not increase depressive symptoms. This is shown by a major
randomised, placebo-controlled study conducted by researchers at Karolinska
Institutet in Sweden in collaboration with the Stockholm School of Economics.
The results have been published in the scientific journal Fertility and
“Despite the fact that an
estimated 100 million women around the world use contraceptive pills we know
surprisingly little today about the pill’s effect on women’s health. The
scientific base is very limited as regards the contraceptive pill’s effect on
quality of life and depression and there is a great need for randomised studies
where it is compared with placebos,” says professor Angelica Lindén
Hirschberg at the Department of Women’s and Children’s Health at Karolinska
She has led just such a study
together with Niklas Zethraeus, associate professor at the Department of
Learning, Informatics, Management and Ethics, Anna Dreber Almenberg from the
Stockholm School of Economics, and Eva Ranehill of the University of Zürich.
340 healthy women aged between 18 and 35 were treated randomly over the course
of three months with either pills with no effect (placebos) or contraceptive
pills containing ethinylestradiol and levonorgestrel, the most common form of
combined contraceptive pill in Sweden and many other countries. Neither the
leaders of the experiment nor the subjects knew which treatment was given to
which women.
The women who were given
contraceptive pills estimated their quality of life to be significantly lower
than those who were given placebos. Both general quality of life and specific
aspects like mood/well-being, self-control and energy level were affected
negatively by the contraceptives. On the other hand, no significant increase in
depressive symptoms was observed.
Since the changes were
relatively small, the results must be interpreted with a certain amount of
caution, the researchers emphasise. In the case of individual women, however,
the negative effect on quality of life may be of clinical importance.
“This might in some cases
be a contributing cause of low compliance and irregular use of contraceptive
pills. This possible degradation of quality of life should be paid attention to
and taken into account in conjunction with prescribing of contraceptive pills
and when choosing a method of contraception,” says Niklas Zethraeus.
The type of combined
contraceptive pill that was used in the study (etinylestradiol +
levonorgestrel) is recommended in many countries as the first choice since it
is considered to entail the least risk of thrombosis among the combined
contraceptive pills. The findings from the study cannot be generalised to other
kinds of combined contraceptive pills because they may have a different risk
profile and side-effects.
The study was supported by
research grants from Jan Wallander and Tom Hedelius Foundation, Knut and Alice
Wallenberg Foundation, Swedish Council for Working Life and Social Research,
the Swiss National Science Foundation, the Swedish Research Council, Karolinska
Institutet, and the regional agreement on medical training and clinical
research (ALF) between Stockholm County Council and Karolinska Institutet.
Article: A first choice
combined oral contraceptive influences general well-being in healthy women – a
double-blind, randomized, placebo-controlled trial, Niklas Zethraeus, Anna
Dreber, Eva Ranehill, Liselott Blomberg, Fernand Labrie, Bo von Schoultz,
Magnus Johannesson, Angelica Lindén Hirschberg, Fertility and Sterility,
doi:10.1016/j.fertnstert.2017.02.120, published online 18 April 2017.
Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.