The purpose of this study was to assess the relative risk of suicide attempt and suicide in users of hormonal contraception.

The authors assessed associations between hormonal contraceptive use and suicide attempt and suicide in a nationwide prospective cohort study of all women in Denmark who had no psychiatric diagnoses, antidepressant use, or hormonal contraceptive use before age 15 and who turned 15 during the study period, which extended from 1996 through 2013. Nationwide registers provided individually updated information about use of hormonal contraception, suicide attempt, suicide, and potential confounding variables. Psychiatric diagnoses or antidepressant use during the study period were considered potential mediators between hormonal contraceptive use and risk of suicide attempt. Adjusted hazard ratios for suicide attempt and suicide were estimated for users of hormonal contraception as compared with those who never used hormonal contraception.

Among nearly half a million women followed on average for 8.3 years (3.9 million person-years) with a mean age of 21 years, 6,999 first suicide attempts and 71 suicides were identified. Compared with women who never used hormonal contraceptives, the relative risk among current and recent users was 1.97 (95% CI=1.85–2.10) for suicide attempt and 3.08 (95% CI=1.34–7.08) for suicide. Risk estimates for suicide attempt were 1.91 (95% CI=1.79–2.03) for oral combined products, 2.29 (95% CI=1.77–2.95) for oral progestin-only products, 2.58 (95% CI=2.06–3.22) for vaginal ring, and 3.28 (95% CI=2.08–5.16) for patch. The association between hormonal contraceptive use and a first suicide attempt peaked after 2 months of use.

Use of hormonal contraception was positively associated with subsequent suicide attempt and suicide. Adolescent women experienced the highest relative risk.

这项研究的目的是评估激素避孕药使用者自杀未遂和自杀的相对风险。

作者在一项全国性的前瞻性队列研究中评估了激素避孕药使用与自杀未遂和自杀之间的关联，该研究对丹麦所有在15岁之前没有精神病诊断，抗抑郁药或激素避孕药且在研究期间年满15岁的女性进行了研究。范围从1996年延长至2013年。全国注册簿提供了有关激素避孕药使用，自杀未遂，自杀和潜在混淆变量的个别更新信息。在研究期间，精神病学诊断或抗抑郁药被认为是激素避孕药使用与自杀未遂风险之间的潜在媒介。与从未使用过激素避孕药的使用者相比，估计使用激素避孕药的使用者自杀未遂和自杀的调整后的危险比。

在将近50万名女性平均随访8.3年（390万人年），平均年龄为21岁的女性中，有6999名首次自杀未遂，其中71名自杀。与从未使用过激素避孕药的妇女相比，目前和近期使用者自杀未遂的相对风险为1.97（95％CI = 1.85–2.10），自杀的相对风险为3.08（95％CI = 1.34–7.08）。口服联合产品自杀未遂的风险估计为1.91（95％CI = 1.79–2.03），仅口服孕激素产品为2.29（95％CI = 1.77–2.95），阴道用药为2.58（95％CI = 2.06-3.22）。环和3.28（95％CI = 2.08–5.16）进行修补。使用激素避孕药与首次自杀尝试之间的关联在使用2个月后达到峰值。

使用激素避孕与随后的自杀未遂和自杀呈正相关。青春期妇女的相对风险最高。