Hormonal contraception and depression: another Pill scandal?

Publication of the article by Skovlund et al. ‘Association of hormonal contraception with depression’ [1] has produced a strong media reaction in several countries, with recent headlines like those in the German magazines Gala ‘Finally proven: the Pill causes depression’ and Brigitte ‘Danish scientists show the Pill increases the risk of depression in young women by 80%’. Although the article’s authors refer to association and not causality in the title and in the conclusion, and indicate that ‘further studies are warranted to examine depression as a potential adverse effect of hormonal contraception’, social and other media have seized on the study as proof that the Pill causes depression. After the media storms surrounding thromboembolic risk and sexual dysfunction, we now seem to have another public health issue linked to hormonal contraceptives. No doubt we will soon read about the money we could save if women stopped taking the Pill, by reducing the consumption of antidepressants. First, we should ask the most important question: does this study prove that combined hormonal contraceptives cause depression? The answer, for several reasons, is no.