(PS7-93) Effects of Health Behaviors on the Relationship between Birth Control and Mental Health

Birth control is widely used for reproductive health, but certain types – particularly oral contraceptive pills (OCPs) – also have been linked to physical and mental side effects. Research in this area remains inconsistent, with some studies finding no difference on variables such as depression or anxiety, but other studies finding some decrement in emotional functioning for individuals on OCPs. One important area that may influence these variables are other health behaviors, such as exercise and reduced substance use, which may positively impact mood and ameliorate the potential negative physical and mental side effects of OCPs. This study examines the relationship between birth control usage and mental health diagnoses (depression, generalized anxiety disorder, panic disorder), as well as how exercise, alcohol use, and drug use may affect these relationships.

Participants included 1075 women between the ages of 18 and 35 surveyed as a part of the National Health and Nutrition Examination Survey. The sample was predominantly White/Non-Hispanic (43%) and unmarried (47.5%) with an average age of 24.9 (SD=5.6). Using a structured interview format, participants were asked about birth control usage, other health behaviors such as exercise and alcohol use, and a comprehensive diagnostic interview for mental health disorders.

There was a trend towards a greater than expected number of individuals with depression in the group who has taken birth control pills, compared to the group who has never taken birth control pills. We did not find a relationship between a history of birth control use and panic disorder or generalized anxiety disorder. Current birth control use and length of birth control usage also were not significantly predictive of mental health diagnosis. Frequency of alcohol use mediated the relationship between current birth control use and depression, although it was not a significant mediator for GAD or panic disorder. A history of drug use also mediated the relationship between current birth control use and mental health problems, but exercise was not found to mediate these relationships.

            Our findings demonstrate some support for the relationship between birth control usage and depression, but not other mental health problems. Similarly, while alcohol and drug use mediate some of these relationships, exercise does not. One challenge of this study was a smaller-than-expected number of individuals with DSM diagnoses within the sample, possibly limiting our ability to detect these relationships. This study adds to the complicated literature on the relationship between birth control usage, mental health, and physical health, and the field will continue to benefit from more clarity on how health behaviors affect the experience of birth control users.