Hormonal contraceptives and psychological health in Swedish women – investigating heterogeneity with quantitative and qualitative methods

This thesis is written against the backdrop of an increasing awareness of possible mental health side effects of hormonal contraceptives, and the tension between different dominant discourses: the medical narrative largely denying any significant adverse outcomes, and the experience based narratives of commonplace detrimental, or, at least unwelcome and unpleasant, mental health effects.

The overarching goal of this interdisciplinary PhD project is to explore possible mental health effects of hormonal contraceptives, conceptualized as a complex interplay of biology and society, grounded in the power-imbued cultural and political contexts, discourses and stories shaping contraceptive experiences in Sweden today. This conceptualization of hormonal effects as irrevocably linked natural-cultural forces, meaning that “real” effects from hormones cannot be reduced to biochemical effects, but that the cultural meaning attributed to them also affect emotions, behaviour and norms, and thus are equally “real”.

This aim entails capturing the complexity of contemporary hormonal contraceptive experience and mental health through a reproductive justice perspective. By studying different central aspects of this field, using diverse methodological approaches, I aim to contribute to a deeper and broader understanding of the current Swedish contraceptive and reproductive landscape, with each study building on the former as well as looking in a new direction.

This is achieved by first epidemiologically investigating a disputed possible causal link between hormonal methods and subsequent depression, then building on these results, question the power structures in play within this field by studying population heterogeneity in depressive response to hormonal contraception based in structural injustice. Thereafter, to situate the knowledge within a broader reproductive conversation and make way for exploring the tension between medical and contraceptive user sensibilities, discourses in medical contraceptive information directed at the public is studied. Finally, drawing on knowledges gained from previous studies, women’s own narratives of navigating hormonal contraceptive communication, choices and experience, centering mental health, is explored through in-depth interviews.

Syftet med projektet är att med en tvärvetenskaplig ansats och integrering av intersektionalitetsteori i kvantitativa och kvalitativa studier, förbättra kunskapen om hormonella preventivmedels roll i den psykiska ohälsan hos unga kvinnor, samt undersöka hur användarna själva navigerar detta fält. Ett övergripande syfte är också att undersöka gapet mellan den biomedicinska förståelsen av hormonella preventivmedels undanskymda roll i den psykiska hälsan, och kvinnors upplevelse av en stor och negativ effekt. Projektet samlar tvärvetenskaplig kompetens från för att undersöka denna fråga med både kvantitativa epidemiologiska studier och kvalitativa media- och intervjustudier.