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The findings of a new study suggest that side effects of birth control implants and pills, particularly implants releasing the progestin levonorgestrel, such as the Mirena IUD, may increase the risk of postpartum depression among new mothers.
In a study published this month in the medical journal Nursing Open, researchers from Gifu Pharmaceutical University in Japan found that the use of certain medications were more strongly linked to reports of postpartum depression than others, with levonorgestrel, used in many types of birth control pills and the Mirena intrauterine device, being the one with the highest association.
Researchers looked at reports submitted to the FDA Adverse Event Reporting System (FAERS) database and analyzed them for reported medication use, adverse health events and other factors. They conducted a retrospective analysis of reported cases of postpartum depression from 2004 through 2015.
The study found 253 reported cases of postpartum depression (PPD) from 17 countries, however nearly 73% of those cases were from the U.S. The Mirena IUD, which is coated with levonorgestrel, was associated with more cases than any other drug. There were 34 such incidents reported, compared to the next highest, the Nexplanon implant, containing etonogestrel, which only accounted for 17 such cases.
Other medications linked to reports of postpartum depression included Humira, with 13 cases, the the selective serotonin reuptake inhibitor (SSR) Zoloft, with 10 cases, and drospirenone, one of the active ingredients in birth control pills like Yaz and Yasmin, which as associated with eight reports.
“In this study, we suggest that IUDs, hormonal contraceptives and SSRIs might be associated with an increased risk for PPD,” the researchers concluded. “The suggestion that PPD could be induced by an IUD is particularly important.”
Researchers also noted that their analysis of the FAERS reports also turned up high rates of expulsions, dislocation and vaginal hemorrhage linked to the levonorgestrel-coated IUDs. Only two brands of IUDs sold in the U.S. release levonorgestrel, the Mirena IUD, and the lower-strength Skyla, which was only put on the market in 2013.
The study noted that the postpartum depression effects could be caused by the hormonal effects of the drugs, and noted that the impact of sex steroids on the central nervous system has long been known.
Mirena IUD Health Concerns
The findings come as recent safety concerns have been focused on the side effects of the Mirena IUD.
Mirena is a small, T-shaped device that is placed into the uterus to provide protection against pregnancy for up to five years. Known as an intrauterine device (IUD) or intrauterine system (IUS), the polyethylene frame for Mirena contains a steroid reservoir that release levonorgestrel, which is a second generation progestin used in many forms of birth control.
There are currently hundreds of Mirena IUD lawsuits that have been filed in the federal court system by women diagnosed with pseudotumor cerebri (PTC), which is also commonly referred to as idiopathic intracranial hypertension (IIH). The cases are currently centralized before U.S. District Judge Paul A. Engelmayer in the Southern District of New York, as part of a federal MDL, or multidistrict litigation.