A study reveals that oral contraception containing synthetic progesterone may increase the risk of suicidal behavior in women with depression. The research sheds light on the mechanisms behind this link and highlights the importance of screening patients for depression and suicidal risk before prescribing contraceptive options.
Understanding the Link Between Synthetic Progesterone and Increased Suicide Risk in Women with Depression
( Credit to: Medicalxpress )
Oral contraception containing synthetic progesterone has been found to potentially increase the risk of suicidal behavior in women with depression, according to a study conducted by researchers at the Netherlands Institute for Neuroscience. This finding sheds light on an important link and emphasizes the need for healthcare professionals to screen patients for depression and suicidal risk before prescribing contraceptive options.
( Credit to: Medicalxpress )
Dr. Lin Zhang, under the supervision of Prof. Dr. Dick Swaab, led the study to delve into the mechanisms behind this phenomenon. Progesterone, primarily known for its role in women's reproductive systems, also acts as a stress hormone. This aspect is often overlooked, but all stress-related substances can contribute to suicide risk. Dr. Zhang focused on understanding how progesterone affects the brain and its connection to stress, depression, and suicide.
Through examining brain samples obtained from the Netherlands Brain Bank, Dr. Zhang discovered that the infundibular nucleus, located in the lower part of the hypothalamus, is particularly sensitive to progesterone and became the focal point of her investigation. In individuals with depression who died by suicide, Dr. Zhang observed an increased number of cells producing an opiate-like substance, due to the co-expression of the progesterone receptor. Opiate use is known to heighten the risk of suicide, as the brain is sensitive to opiate-like substances and can produce them naturally. Therefore, progesterone likely enhances the activation of the opioid system, ultimately increasing the risk of suicide.
Another intriguing finding by Dr. Zhang was the presence of signs of cell division in the infundibular nucleus of older individuals. The generation of new neurons in the adult human brain, especially in the elderly, is a topic of debate among neuroscientists.
While progestogen-containing drugs are commonly prescribed as contraception or for the treatment of menopausal symptoms, clinical research indicates that the risk of suicide is negligible in drugs containing natural progesterone. However, this may not be the case for synthetic progesterone, as it is more potent.
Gynecologists have already incorporated this knowledge into their standard practice by screening patients for depression and suicidal risk before prescribing contraceptive options. However, general practitioners have yet to adopt this approach. The hope is that this new finding will encourage doctors to explicitly inquire about signs of depression or suicidal thoughts and, if necessary, suggest alternative contraceptive options.
The study's findings have been published in the journal Acta Neuropathologica Communications. This research sheds light on the potential link between synthetic progesterone and an increased risk of suicide, particularly in women with depression and suicidal ideations. By understanding the mechanisms involved, healthcare professionals can make more informed decisions when prescribing oral contraceptives and better identify individuals who may be at a higher risk for suicide.