Depression and Its Associated Factor Among Women Using Hormonal Contraceptives: A Cross-Sectional Study in Jimma Town Public Health Facilities, Southwest Ethiopia, 2022.

Abstract

Background: Depression is a significant mental disorder that affects >350 million individuals globally. It is noteworthy that females are approximately twice as likely as males to experience depression, with the incidence of depression in females rising during early adolescence. The fluctuation in levels of gonadal hormones contributes to the increased occurrence of depression in females. The use of hormonal contraceptives suppresses the natural production of these hormones, which, in turn, raises the risk of developing depressive symptoms in women. The complex relationship between fluctuating hormones and depression in women is multifaceted, with both natural hormonal changes and hormonal contraceptive use potentially impacting emotional well-being and susceptibility to affective disorders.

Methods: An institution-based cross-sectional study was conducted on a sample of 423 individuals. A simple random sampling technique was used for participant selection. The Beck Depression Inventory II screening tool, along with pretested structured interview questionnaires, was used to collect sociodemographic information as well as data on the use of hormonal contraceptives and menstrual history. Trained nurses administered the questionnaires and measured the body mass index (BMI) using standard measuring tools. The collected data were entered into Epi-Data Manager version 4.4.1 and then exported to Statistical Package for Social Sciences version 26 for statistical analysis. Bivariate and multivariate logistic regression analyses were performed to determine the association between dependent and independent variables. All explanatory variables with a p-value <0.25 in bivariate analysis were entered into the multivariable logistic regression model. A p-value <0.05 in the multivariate logistic regression analysis was used to determine statistically significant variables.

Results: The prevalence of depression among the study participants was 38.8%. The age category 18-25 years, poor social support, uncomfortable marital relationship, injectable hormonal contraceptives, and BMI status >25 kg/m² were variables that became significantly associated with depression in this study.

Conclusions: This study has shown that the prevalence of depression among contraceptive users was 38.8%. The age-group of 18-25 years, poor social support, an uncomfortable marital relationship, use of injectable hormonal contraceptives, and a BMI status >25 kg/m² have an impact on the prevalence of depression. Based on these findings, it is recommended that women's health initiatives prioritize mental health services. Providing adequate mental health support and counseling can help address the prevalence of depression among contraceptive users. It is also suggested that health care providers carefully evaluate the risks and benefits for women before initiating hormonal contraception. It is important to provide special support to women who have poor social support, conflicts with their husbands, are overweight or obese, and are in their early twenties. To build on this knowledge, further prospective studies are suggested to explore the relationship between hormonal contraception and depression.