Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;39(9):1013-1022.
doi: 10.1007/s10654-024-01155-z. Epub 2024 Sep 3.

Use of systemic hormonal contraception and risk of attempted suicide: a nested case-control study

Elena Toffol  1 , Timo Partonen  2 , Oskari Heikinheimo  3 , Anna But  4 , Antti Latvala  5 , Jari Haukka  4
Affiliations

Use of systemic hormonal contraception and risk of attempted suicide: a nested case-control study

Elena Toffol et al. Eur J Epidemiol. 2024 Sep.

Abstract

Evidence regarding the role of hormonal contraception (HC) as a risk factor for attempted suicide is inconclusive. Thus, this study aimed to assess the associations of use of different types of systemic HC with the risk of attempted suicide in women aged 15-49 years. Data on a population-based cohort (n = 587,823) of HC users and non-users in 2017 was derived from national registers in Finland. In a nested case-control design we examined the risk of attempted suicide in relation to current HC use (past six months) via multivariable conditional logistic regression models. During the follow-up (from 2018 to 2019) there were 1.174,346 million person-years of which 818 cases of suicide attempts were observed (incidence rate: 0.70 per 1000 person-years). Use of HC, especially combined hormonal contraceptives, was not associated with a higher risk of attempted suicide compared to non-use (OR 0.68, 95% CI 0.45-1.02) after controlling for marital status, socioeconomic status, education, chronic diseases, recent delivery, recent psychiatric hospitalizations, and current use of psychotropic medications. In women without psychiatric history, current HC use (OR 0.73, 95% CI 0.58-0.91), especially ethinylestradiol-containing preparations (OR 0.54, 95% CI 0.40-0.73), was associated with a lower risk of attempted suicide. After adjusting for recent psychiatric hospitalizations and use of psychotropic medications, current use of progestin-only preparations was not associated with attempted suicide. In conclusion, current HC use was not associated with an increased risk of attempted suicide in fertile-aged women.

Keywords: Attempted suicide; Hormonal contraception; Register; Women.

PubMed Disclaimer

Conflict of interest statement

O.H. serves occasionally on advisory boards for Bayer AG and Gedeon Richter, and has designed and lectured at educational events of these companies. The other authors report no financial relationships with commercial interests.

Figures

Fig. 1
Fig. 1
Associations between attempted suicide and current use (in the previous 180 days) of hormonal contraceptives. Results are expressed as Odds Ratios with 95% Confidence Intervals. For each substance the reference category is no use of the same substance in the 180 days before the attempted suicide. Adjusted model is controlled for marital status, socioeconomic status, education, chronic diseases and recent delivery. One substance in model a time. Care Register of Health Care and Register of Primary Health Care visits data together
See this image and copyright information in PMC

References

    1. World Health Organization. Suicide worldwide in 2019: global health estimates. 2021, ISBN 978–92–4–002664–3 (electronic version) ISBN 978–92–4–002665–0 (print version).
    1. World Health Organization. Preventing suicide: a global imperative. World Health Organization. 2014, ISBN 978 92 4 156477 9 (NLM classification: HV 6545).
    1. Baca-Garcia E, Perez-Rodriguez MM, Mann JJ, Oquendo MA. Suicidal behavior in young women. Psychiatr Clin North Am. 2008;31(2):317–31. 10.1016/j.psc.2008.01.002. - PubMed
    1. Bachmann S. Epidemiology of suicide and the psychiatric perspective. Int J Environ Res Public Health. 2018;15(7):1425. 10.3390/ijerph15071425. - PMC - PubMed
    1. Skovlund CW, Mørch LS, Kessing LV, Lange T, Lidegaard Ø. Association of hormonal contraception with suicide attempts and suicides. Am J Psychiatry. 2018;175(4):336–42. 10.1176/appi.ajp.2017.17060616. - PubMed

LinkOut - more resources