{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:28:30Z","timestamp":1790875710670,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate whether users of hormonal contraceptives (HCs) are at increased risk of depression compared with non\u2010users.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Register\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Sweden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Women aged 15\u201325 years between 2010 and 2017 with no prior antidepressant treatment, psychiatric diagnose or contraindication for HCs (<jats:italic>n<\/jats:italic>\u2009=\u2009739\u2009585).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women with a prescription of HC were identified via the Swedish Prescribed Drug Register (SPDR). Relative risks (RRs) for first depression diagnosis in current HC\u2010users compared with non\u2010users were modelled by Poisson regression. Adjustments included age, medical indication for HC\u2010use and parental history of mental disorders, among others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Depression, captured by a redeemed prescription of antidepressant treatment, or a first depression diagnosis in the SPDR and the National Patient Register.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with non\u2010users, women on combined oral contraceptives (COCs) and oral progestogen\u2010only products had lower or no increased risk of depression, relative risk (RR) 0.89 (95% CI 0.87\u20130.91) and 1.03 (95% CI 0.99\u20131.06) after adjustments, respectively. Age\u2010stratified analyses demonstrated that COC use in adolescents conferred no increase in risk (RR 0.96, 95% CI 0.93\u20130.98), whereas use of progestogen\u2010only pills (RR 1.13, 95% CI 1.07\u20131.19), contraceptive patch\/vaginal ring (RR 1.43, 95% CI 1.30\u20131.58), implant (RR 1.38, 95% CI 1.30\u20131.45) or a levonorgestrel intrauterine device (RR 1.59, 95% CI 1.46\u20131.73) were associated with increased risks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study did not find any association between use of COCs, which is the dominating HC in first time users, and depression. Non\u2010oral products were associated with increased risks. Residual confounding must be addressed in the interpretation of the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>There is no association between combined hormonal contraceptives and depression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17028","type":"journal-article","created":{"date-parts":[[2021,11,27]],"date-time":"2021-11-27T09:30:03Z","timestamp":1638005403000},"page":"917-925","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["There is no association between combined oral hormonal contraceptives and depression: a Swedish register\u2010based cohort study"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5013-2680","authenticated-orcid":false,"given":"C","family":"Lundin","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Wikman","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Lampa","sequence":"additional","affiliation":[{"name":"Uppsala Clinical Research Center Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Bixo","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Obstetrics and Gynaecology Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-1444","authenticated-orcid":false,"given":"K","family":"Gemzell\u2010Danielsson","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health Karolinska Institutet, and Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Wikman","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Ljung","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology Institute of Environmental Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Sundstr\u00f6m Poromaa","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2012.11.004"},{"key":"e_1_2_7_3_1","unstructured":"United Nations Department of Economic and Social Affairs.Contraceptive use by method 2019 [Data Booklet].2019[cited 2020 Oct 12]. 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