Contraception Increases Rates of Divorce, Suicide, and Sexual Dysfunction

Dominic Pedulla - Contraception 2


(Second in a four-part series)

The direct and compelling evidence of the strong, arguably causal connection between oral contraceptives (OCPs) and gravely adverse psychosocial outcomes, including suicide, comes from the three largest-ever studies which evaluated OCPs. These were the Royal College of General Practitioners study (47,174 women), the Oxford/FPA study (17,032 women), and the Walnut Creek study (16,638 women). They found strong and clearcut evidence in each case of increased rates of suicide and attempted suicide, as well as violent (intentional and accidental) deaths and mishaps. Pill users were 2.66 times as likely to attempt suicide as nonusers in the Royal college study, 4 times as likely in the Oxford/FPA study, and 2.53 times in the Walnut Creek study. It is fair and accurate to conclude that “the pill” is associated with excesses of suicide, mental illness, and even violent deaths and accidents.

In the Royal College study, divorce also had in interesting and noteworthy interaction with OCPs. The divorce rate of users was found to be double that of nonusers, and while divorce did not by itself explain the association of contraceptives with suicide attempts, it nonetheless strengthened that association. Therefore OCPs were found to have both a robust direct association with increased rates of suicide, accidents and violence unrelated to divorce, as well as an indirect association mediated by an association with increased divorce rates. This association with divorce is something also corroborated by other social science investigations, namely Dr. Robert Michael, Stanford economist, who found that OCPs were very likely responsible for the doubling in the American divorce rate from the 1960s to the 1970s.

The 1974 Royal College report moreover clearly shows that in addition to increased rates of divorce, suicide and suicide attempts, pill users experience a robust increase in the rates of psychosis, neurotic depression, and a nearly 5-fold increase in loss of libido when compared with nonusers. This cluster of bad outcomes is generally altogether referred to as the \”psychosexual effects\” of the pill. These unfavorable outcomes represent an especially striking and powerful indictment of oral contraceptive use when one considers that the study design and patient selection features tended to minimize these outcomes. Absent from the pill using group were the many women who had stopped taking the pill because of psychosexual and other complications before the study began, minimizing from the beginning the psychosexual complication rate by removing a group of particularly susceptible women.

The authors also adjusted the data for the effects of parity and cigarette smoking, but as we have seen at least some of the contraceptive harm may be expressed through parity and it is well-known that smoking is a marker of psychosocial distress, which in turn we suspect is at least partly due to contraceptive behavior. Even more than all of this, the 1974 report even found that OCP users smoked more often and smoked more heavily than nonusers. These and other factors lead us to believe that the report\’s findings, damaging as they are, nonetheless grossly underestimate the psychosexual complications of contraception.

Isn’t suicide important?  Isn’t suicide indicative of more severe depressive episodes? While staring these very unfavorable findings in the face, the authors of the Royal College report nonetheless, unbelievably, concluded that there was “no convincing evidence that oral contraceptive users have more severe depression than non-users”. But we think suicide certainly is a reliable marker of “more severe depression”. What can this unbelievable statement then be, other than a case of massive denial or obfuscation of the clear-cut meaning of the data? This mishandling of data unfortunately robs many innocently-contraceptive Christians of the opportunity to hear and see evidence which might move them to re-visit their convictions. Unfortunately most medical and scientific colleagues also are deprived of this critically relevant and crucial knowledge, and thus is it any surprise at all that they mistakenly accuse us of blindly following faith without evidence?

Ironically the analysis of the Royal College investigators unwittingly lends even more support to our contention that contraceptives cause psychological distress. Keen to avoid attributing these negative outcomes to the purely pharmacologic/hormonal characteristics of oral contraceptives, they instead focus on what they in a strangely noncommittal and nonjudgmental way call the \”psychological effects of being a Pill user\”. They note that the incidence of depression did not perfectly correspond to pill dosages, nor was there any relation to duration of pill use. Neurotic depression and the other psychosexual complications occurred in users regardless of parity, age, and cigarette smoking.

This suggested to them that neurotic depression with pill usage was \”so dominant that it obscures the variations related to the other parameters\”. This contraceptive effect was for the authors far more robust than expected for a purely pharmacological or hormonal effect. Moreover, the text even cites numerous previous studies in support of this notion of a predominantly non-pharmacologic, non-hormonal mechanism. In one contraceptive placebo study significant psychosexual complications occurred even when women merely thought they were taking the contraceptive pill but were merely on a placebo. On the other hand, in situations where pill research succeeded in isolating and testing a purely hormonal effect (excluding a contraceptive/psychological effect), few cases of mild depression occurred, and libido was unaffected.

In other words, there is potential psychological damage from intentional contraceptive practice, no matter which method may be used. And these findings agree with more recent work showing that compared to nonuse, oral contraceptive use adversely affects several measures of psychic well-being independent of measurable change in hormone levels. Users had significantly more difficulties with stress, control, and self-integration, and more often had unfavorable responses to stress which translated directly into negative emotional states such as anger, depression, suicidality, guilt, and resentment.

This data are commented on in a summary statement by a very well-heeled French psychoanalyst commenting on oral contraceptives and their psychosexual effects. Bourgeois says that the psychosexual complications of the pill stem from the unconscious and symbolic implications of sterilization, and from the implications of a purely “hedonic” sexuality with its associated guilt.  He refers to a number of double-blind studies which he said prove that very few cases have purely hormonal causes, not only in line with the foregoing analysis but indicating the need for further study as well. (M. Bourgeois — Le psychiatre et les contr^oles de la procr`eationL`Encephale, 1975, I, 259-263)

Agreeing with Bourgeois, based again on the evidence, the author decided to conduct an exhaustive review of all known relevant “pill” studies, especially with an emphasis on randomized, double-blind studies. This peer-reviewed published analysis concluded that the negative psychosexual and psychosocial complications of the pill are not primarily the result of the pill’s pharmacologic and hormonal properties, but rather the result of the intrinsically harmful and psychologically damaging effects of contraceptive practice itself, since they were in agreement with the foregoing data and since the data allowed for a reasonably probable exclusion of a purely hormonal/pharmacologic effect. This meant that however potent the hormonal activity of oral contraceptives, they are associated with very bad psychosexual sequelae above all because they are contraceptives, and not primarily because they are hormones.  When oral contraceptives are associated with divorce and sexual dissatisfaction, it is mostly because contraceptive behavior has this adverse association. If oral contraceptives cause suicide, it would primarily be due to contraceptive activity causing suicide!

We ourselves in our own research found that women who have had a tubal ligation (studied here because it can be thought of as a form of “surgical contraception” which eliminates the chemical, hormonal, or pharmacological effect) also are 2.1 times as likely to report “stress interfering with sex”, and 1.79 times as likely to report having seen a physician for sexual problems in the previous 12 months. This prompted a special “Note from the Editor-in-Chief” in which Dr. Lawrence D. Devoe considered the findings “…both disturbing and possibly paradoxical since it might be assumed that once reproduction and sexual activity are unlinked, sexual satisfaction would be improved.  Clearly, this study suggests that the opposite is true.” (Devoe, L. A Note from the Editor-in-Chief. J Reprod Med. 2007 Apr;52(4): 257.)

This author also notes, although admittedly with varying strength of the various lines of evidence in each case, that other investigators have also found evidence of links between the various nonhormonal contraceptives and the tendency to suicide or at least adverse psychosocial sequelae with them.  Thus barrier contraceptives, the withdrawal method, and vasectomy have all been suspected by researchers to have a relationship with negative psychosocial sequelae, with varying strength of evidence found to support this suspicion.

Moreover, our 2004 paper on the true genesis of the emotional side effects of oral contraceptives agreed perfectly with these findings, and suggested in agreement with the Royal College investigators that contraception itself, no matter by which method, tends to have negative and even disastrous psychosocial sequelae associated with it. It must also be said that contraceptive psychosocial harm in women had been suspected by numerous well-respected psychiatric authorities, even including Freud, long before the advent of the oral contraceptive pill of the late 1950s.

A very sophisticated objection might be that it is not so much contraception per se but rather childlessness or the lack of parenthood which causes the psychosocial harm, as there has been a well-known interaction between parenthood and decreased suicide levels since the work of the sociologist Emile Durkheim over 100 year ago, and corroborated by other investigators since that time, especially Georg Hoyer. While a somewhat more difficult objection to overcome, this objection also allows us to take special note of the very serious relationship parenthood has with psychological functioning in women.  In these investigations suicide has been shown in Western cultures to have an inverse relationship to parity, the childless woman having for instance six times the suicide risk of the mother of six. But the main instrument Western couples have employed in order to avoid parenthood during the century in which this data has been gathered has been contraceptive practice; i.e. the active sterilization of sexual activity so that fertility which otherwise might have been set into motion is actively frustrated, not merely deferred for the moment.

More importantly in the “big three” pill studies, especially the Royal College study, the association of suicide and other psychosexual sequelae with the pill was found to be far more robust than and independent of the effect of that with parity. This would not be expected if parity were a competitive explanation powerful enough to account for the excess suicides apart from contraceptive practice.  In other words, if it were simply a matter of more children being needed to avert the risk of suicide, controlling for parity in the “big three” would certainly have greatly reduced the pill’s association with excess suicide and other adverse psychosexual sequelae, but it did not. This means the contraceptive-using mother of four was still at higher risk from suicide than the non-using mother of four or even fewer, despite the protection offered her by comparatively high parity. To summarize then, contraceptive practice in and of itself explains not only the pill-suicide relationship of the contraceptive studies, but very likely, in a hidden way, also the low parity-suicide relationship in landmark studies only indirectly studying contraceptive practice.

Finally some, whose prejudice in favor of contraception makes them unable to react to this “surprising” data with the calm acceptance shown by JRM editor Dr. Devoe, might consider the idea that contraception causes psychosocial harm to women intrinsically unacceptable.  The root of this refusal to accept the data or more precisely its implications is very likely rooted in an invincible intellectual attachment to the idea that contraception and sterilization are a boon for women.  But shouldn’t those thus attached ask themselves why it is that they so uncritically welcome the dissolution of the natural bond between sexual activity and reproduction, two things which after all in normal reproductive biology are united together?  Would it really be so surprising that the pro-conceptive design concepts clearly recognizable from reproductive biology might have their counterpart in a designed reproductive “psycho-biology”, with the disruption at the physical level predicting a further and perhaps even more serious disruption at the psychological level?

© 2013. Dominic M. Pedulla MD. All Rights Reserved.

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11 thoughts on “Contraception Increases Rates of Divorce, Suicide, and Sexual Dysfunction”

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  3. If you are going to cite medical studies, please cite them fully. Don’t just take what you can use you your advantage. Once again, it completely devalues your article. Just accept that people will use what they are going to use, and your religious beliefs will never influence that.

    For everyone curious as to where he got this information, and those who want to see the studies themselves, here are links to the studies and facts taken directly from the studies. I will readily admit that there are some averse effects to using contraceptives, it has been proven by these studies, but like they all conclude, there are really not any significant risks. Thank you.
    (unfortunately, I could not find a site that provided the walnut study free of charge, therefore I cannot refer to that study in my argument with confidence, though I am confident that the findings of that study would be very similar to the other two referenced in both this article and my own response. the link Dr. Pedulla provides leads to the title of the study, not the study itself. I am sorry for the inconvenience, thank you!)

    Oxford/FPA study:
    * The overall relative risk of death in the oral contraceptive users was 0.9 (95% confidence interval 0.7 to 1.2). Though the numbers of deaths were small in most individual disease categories, the trends observed were generally consistent with findings in other reports. Thus the relative risk of death in the oral contraceptive users was 4.9 (95% confidence interval 0.7 to 230) for cancer of the cervix, 3.3 (95% confidence interval 0.9 to 17.9) for ischaemic heart disease, and 0.4 (95% confidence interval 0.1 to 1.2) for ovarian cancer. There was a linear trend in the death rates from cervical cancer and ovarian cancer (in opposite directions) with total duration of oral contraceptive use.

    *This was found in the conclusion of the study; These findings contain no significant evidence of any overall effect of oral contraceptive use on mortality.

    Royal College of General Practitioners study:
    *In the full dataset, all cause mortality among ever users of oral contraception was 12% lower than that of never users (adjusted relative risk 0.88, 95% confidence interval 0.82 to 0.93). We found significantly lower rates among ever users of deaths from all cancers; cancer of the large bowel/rectum, uterine body, or ovaries; main gynaecological cancers combined; all circulatory disease; ischaemic heart disease; and all other diseases. The all other diseases category included 445 respiratory conditions, 72 nervous system and sense organ conditions, 68 infective and parasitic disorders, 55 symptoms and ill defined conditions, 51 mental disorders, 47 genitourinary disorders, and 41 endocrine and metabolic disorders
    *In all categories of smoking, social class, and parity, ever users of oral contraception had lower all cause mortality than did never users, although not all of the relative risk estimates were statistically significant.
    *The pattern of relative risks was different when we used the smaller general practice observation subset. In this subset, the adjusted relative risk for any death between ever users and never users was very close to unity (0.98, 0.88 to 1.10). Compared with never users, ever users had a significantly lower rate of death from ovarian cancer, main gynaecological cancers combined, and all other diseases and a higher rate of death from all circulatory disease, cerebrovascular disease, other circulatory disease, and violence.
    *The rate of death from any cause among current and recent users (<5 years since last use) was similar to that of never users (adjusted relative risk 1.08, 0.83 to 1.40). Thus, although current and recent users had a statistically significant doubling of the rate of circulatory death, this was offset by reductions in the rate of death from non-circulatory causes.
    *In the full dataset, all cause mortality among ever users of oral contraception was 12% lower than that of never users (adjusted relative risk 0.88, 95% confidence interval 0.82 to 0.93). We found significantly lower rates among ever users of deaths from all cancers; cancer of the large bowel/rectum, uterine body, or ovaries; main gynaecological cancers combined; all circulatory disease; ischaemic heart disease; and all other diseases
    *The balance of risks and benefits, however, may vary around the world, depending on patterns of oral contraception usage and the prevalence of different diseases
    *Oral contraception was not associated with an increased long term risk of death in this UK cohort and may even produce a net benefit (absolute risk reduction among ever users 52 per 100 000 woman years)

    1. I seem to have made a grammatical error. My finger brushed over the D key instead of pushing it down when i was typing the word ‘adverse’. Sorry, my mistake

  4. This is absurd. Your foundation is a catholic based foundation, you are a catholic yourself, and your religion completely prohibits the use of contraceptives. Coincidence? I think not. This whole article is a perfect example of science misused to further the ‘scientist’s’ agenda. You may have done some form of research, I’ll give you that much, but you did not do it correctly. If you had done it correctly, you would have taken your religious bias out of the study. Removing deliberate bias is necessary if you want educated people to believe you. Your study is obviously based in your religious beliefs, which takes away any credibility you could have had. And, while Sigmund Freud did think that contraception caused all of those things, he lived in the late nineteen century to the early twentieth century. he did not have all of the technology we have today to be able to figure out what causes mental illness and suicidal thoughts. Also, this is the same Sigmund Freud who also believed that, for society to function, people had to repress primal needs and desires. While I agree with that to a point, he states that dreams were the place in which these urges and desires would be released. So, basically, he thought that everybody was perverted, they just had enough will to repress their perverse thoughts, and that dreams were all about sex. Now, don’t get me wrong, the man made many contributions to psychology, but there are things that he may not have been right about. I also consider it ironic that you chose to include Freud in part of your argument. Do you know how Freud saw religion? He had this to say about it; “Religion is an illusion and it derives its strength from the fact that it falls in with our instinctual desires,” and this; “Religion is comparable to a childhood neurosis,” and this; “Religion is an attempt to get control over the sensory world, in which we are placed, by means of the wish-world, which we have developed inside us as a result of biological and psychological necessities. […] If one attempts to assign to religion its place in man’s evolution, it seems not so much to be a lasting acquisition, as a parallel to the neurosis which the civilized individual must pass through on his way from childhood to maturity.” and this; “The whole thing is so patently infantile, so foreign to reality, that to anyone with a friendly attitude to humanity it is painful to think that the great majority of mortals will never be able to rise above this view of life. It is still more humiliating to discover how a large number of people living today, who cannot but see that this religion is not tenable, nevertheless try to defend it piece by piece in a series of pitiful rearguard actions.” Freud thought Religion was an infantile institution, something that needed to be grown out of. Do not take one aspect of Freud and completely leave out the rest of what he said and did. This is another example of how you failed to rid the ‘study’ of deliberate bias, thus losing any credibility it could have had. Next time, take your religion out of your study and post the honest results. Thank you.

    1. Thanks Austin! You obviously found the studies so there was no problem in not fully citing things right? I fully agree we should never force science to conform to religion, and in my case even more actually I am STRICTLY OBLIGED not to do that by the 8th commandment which I take seriously. I am also obliged never to unnecessarily disturb the peace of conscience of another, by the 5th commandment. I only mention these things because you have correctly identified my religious commitment, and I think it’s only fair you fully understand the true and full nature of that commitment.

      Some findings are very hard to accept, especially in the presence of a powerful bias or prejudice against seeing them. I have no such prejudice, and make no bones about admitting that my religious beliefs offer a source of wisdom I might otherwise not have had. The passages you cited from the studies are interesting — no one can deny it — but they don’t speak directly to the points I made, about the doubling of the divorce rate, the rate of induced abortions, and that of various cancers deadly to women. Surely you noticed the interposition of various strange adjectives like “overall”, and “longterm”that someone as shrewd as you could not miss? As if, it doesn’t matter that some die unnecessarily, as long as “overall” there’s no harm. Or, some die unnecessarily in the short term, but that’ OK, as long as there’s no “longterm” effect? I mean really, come on now!

      I think you would really profit from reading the books by Dr. Ellen Grant, an epidemiologist in England who is herself not opposed to contraception from a religious or moral standpoint, and whose observations are based strictly on science and data. Her books are titled Sexual Chemistry and The Bitter Pill. She was intimately familiar with the original pill studies, knew the researchers, and proved herself a perceptive and keen analyst of the data. She reached conclusions very different from you.

      I’d be happy to continue the discussion. Where are you from and how did you get interested in this subject?


      Dr. Pedulla

  5. Obviously, someone needs to study the link between the effects of contraception use or non-use on those doing the studies themselves.

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