Stress and Depression May Halt Contraception Use

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SAN FRANCISCO – Depression and stress can cause lapses in proper use of contraception, a new study suggests.

In the study, women with moderate to severe depression and stress symptoms were less likely to use contraception consistently — that is, use it each time they had sex — compared to women with mild or no symptoms. Women with depression or stress were also more likely to say they did not use contraception at all in the past week compared to women with less severe symptoms.

The findings, presented here yesterday (Oct. 29) at the annual meeting of the America Public Health Association, are concerning because, although preventing unplanned pregnancies is important for all women, it may be especially important for women with mental health issues, said study researcher Kelli Stidham Hall.

"Perhaps an unintended pregnancy for these women could make things even worse," said Hall, of the University of Michigan's Population Studies Center.

Family planning providers should consider mental health symptoms when they council their patients, Hall said.

Best method?

In addition, women with depression and stress who do not want to become pregnant in the near future may be good candidates for long-acting reversible contraception, such as an IUD — highly effective methods of birth control that women do not need to remember to use everyday or each time they have sex, which may be burdensome for some, Hall said.

Hall and colleagues analyzed information 689 non-pregnant women ages 18 and 19 living in Michigan. Participants first answered questions about their mental health. Then, for the next year, they filled out weekly journal entries that included the number of times they had sex in the past week, and whether they used contraception when they had sex.

About 25 percent of women had moderate to severe depression, and 25 percent had moderate to severe stress.

Overall, women used contraception consistently 72 percent of the time. The most common forms of contraception were oral birth control or condoms. For women with depression, the odds of using contraception consistently each week was 47 percent lower than for women with less severe symptoms. For those with stress, the odds of using contraception consistently were 69 percent lower.

Women with depression and stress may have social circumstances, such as unemployment, that interfere with their ability to effectively use contraception, Hall said. In addition, mental health issues may impair a person's ability to make decisions, Hall said.

Pass it on: Women with depression or stress may be at increased risk for lapses in contraception use.

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