July 1, 2024
New Mechanism Reveals Increased Risk of Suicidal Behavior Among Some Contraceptive Users

New Mechanism Reveals Increased Risk of Suicidal Behavior Among Some Contraceptive Users

A recent study conducted by researchers at the Netherlands Institute for Neuroscience has shed light on the heightened risk of suicidal behavior among women who use contraceptive pills containing synthetic progesterone (progestogen) and suffer from depression and suicidal thoughts. By unraveling the underlying mechanism behind this process, the researchers aim to raise awareness about this serious issue.

Suicide continues to be a taboo topic and a poorly understood health problem, with approximately 700,000 people dying by suicide worldwide each year. Dr. Lin Zhang, under the supervision of Prof. Dr. Dick Swaab, focused her research on understanding the mechanisms that contribute to suicide, with a particular emphasis on the connection to progesterone.

While progesterone is known for its role in women’s reproductive systems, it can also act as a stress hormone, a fact often overlooked. According to Swaab, all stress-related substances can contribute to an increased risk of suicide. Therefore, given its link to stress, depression, and suicide, further investigation was warranted to understand how progesterone affects the brain.

Zhang analyzed brain samples obtained from the Netherlands Brain Bank, taking into account various factors such as age, sex, diagnoses, and causes of death. Her research focused on the lower part of the hypothalamus, known as the infundibular nucleus, which was found to be the most sensitive to progesterone.

In individuals with depression who died by suicide, Zhang discovered an elevated number of cells producing a substance similar to opiates. This increase was attributed to the co-expression of the progesterone receptor. Swaab explains, “It is known that taking opiates increases the risk for suicide. The brain is sensitive to opiate-like substances because it also produces them. Therefore, progesterone likely enhances the activation of the opioid system, ultimately leading to a heightened risk of suicide.”

Moreover, Zhang made an additional significant observation. In the infundibular nucleus of the elderly population, signs of cell division were identified. The generation of newborn neurons in the adult human brain, especially in the elderly, has been a topic of debate among neuroscientists.

Progestogen-containing drugs are commonly prescribed as contraceptives or for the treatment of menopausal symptoms. Clinical research indicates that while drugs containing natural progesterone have a negligible risk of suicide, the same may not hold true for their synthetic form, as it is more potent.

Gynecologists have already incorporated this knowledge into their practice by screening patients for depression and suicidal tendencies before prescribing a particular contraceptive. However, general practitioners have yet to follow suit. The hope is that this research finding will prompt doctors to inquire explicitly about signs of depression or suicidal ideations and, if necessary, consider alternative options for their patients.

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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it