Hormonal Contraceptives Tied to Lower Suicide Attempt Risk

Finnish women taking hormonal birth control have fewer suicide attempts than women not taking hormonal contraceptives (HC), according to a study presented at the annual European Congress of Psychiatry, held virtually from June 3 to 7.

Elena Toffol, M.D., Ph.D., of the University of Helsinki in Finland, and colleagues examined the association between the use of HC and the risk for attempted suicide. The analysis included 587,823 women (aged 15 to 49 years) in the initial incidence study in 2017. Then, all incident attempted suicide cases (818; 2018 to 2019) were matched (1:4) with controls.

The researchers found that during follow-up, the incidence rate was 0.70/1,000 person-years, with an incident rate ratio of 0.73 for HC versus no-HC use. Current estradiol- or ethinylestradiol-containing HC use (within 180 days before the event) was associated with a lower risk for attempted suicide (hazard ratios, 0.53 and 0.49, respectively) compared with nonuse of HC. When controlling for marital and socioeconomic status, education level, and use of psychotropic medications, only the association with current use of HC containing ethinylestradiol remained significant (hazard ratio, 0.39).

“This striking finding deserves a careful evaluation and needs to be replicated in different cohorts of women and controlled for the impact of several psychosocial stressors, such as economic upheavals, social insecurity and uncertainty due to the COVID pandemic,” Andrea Fiorillo, M.D., Ph.D., from the University of Campania in Naples, Italy, said in a statement. “The clinical implications of the study are obvious and may help to destigmatize the use of hormonal contraceptives.” Fiorillo is treasurer of the European Psychiatric Association and was not involved in the study.

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