Elon Musk wrong about ‘scientific consensus’ on birth control's depression, suicide risks

Samantha Putterman
·8 min read
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Elon Musk

Statement: There is “clear scientific consensus” that “hormonal birth control makes you fat, doubles risk of depression & triples risk of suicide.”

Elon Musk says people in developed countries should have more babies. The Tesla CEO, who has fathered 11 children, is now warning women about what he says are birth control’s dangerous side effects.

"Hormonal birth control makes you fat, doubles risk of depression & triples risk of suicide," Musk wrote Feb. 16 on his social media platform, X. "This is the clear scientific consensus, but very few people seem to know it."

To support his claim, Musk shared two links about a 2017 study from Denmark that said hormonal birth control could be tied to higher suicide risk.

But experts in reproductive health and contraception research criticized Musk’s conclusion and said that the study, which has noted limitations, is far from "consensus."

Using hormonal contraception, such as birth control pills and intrauterine devices, can come with psychological side effects. But experts said the overall risk of severe side effects is low. Musk’s post ignores that many women take birth control to treat painful periods and health conditions, such as endometriosis and polycystic ovary syndrome.

The Denmark paper showed an increase in suicide risk in people who used hormonal contraception, "but in no way can it definitively claim the birth control was the cause; rather, it is a correlation," said Dr. Jennifer Lincoln, a board-certified OB-GYN and social media educator based in Portland, Ore. "This study was a registry review, not a blinded randomized control trial, so this can only tell us association, which is interesting, but in no way should broad sweeping conclusions a la Elon be made."

Registry studies use databases to evaluate specified outcomes in certain populations and are often considered observational.

We emailed the X press account for additional evidence and received an automatic reply: "Busy now, please check back later."

What is hormonal birth control?

Hormonal contraception refers to birth control methods that contain estrogen and progesterone, or progesterone only, to prevent pregnancy. These methods can block the release of eggs from the ovaries, thin the uterus’s lining, or thicken mucus in the cervix to keep sperm from reaching the egg.

Hormonal birth control methods (pill, ring, patch, shot, intrauterine device and implant) are considered more effective — 90% to 99%, depending on correct and consistent usage — than almost all nonhormonal methods that prevent pregnancy without affecting a person’s natural hormone production or period cycle. Nonhormonal methods include condoms, diaphragms and contraceptive gels.

Hormonal birth control, like many other medicines, has beneficial effects and potential risks that affect people differently. The most common side effects are nausea, headaches, breast tenderness and irregular periods. These usually subside within a few months after hormone levels balance out, doctors say.

What the study and other research say about birth control and depression, suicide risks

The 2017 study referred to by Musk was published in the American Journal of Psychiatry by researchers in Denmark who used a national registry that tracked women ages 15 and older living in the country from 1996 to 2013.

The paper analyzed prescriptions along with deaths and medical records with "suicide attempt" coding. It found that women who had used hormonal contraceptives had up to triple the risk of suicide compared with women who hadn't. In a 2017 Time article to which Musk linked, the researchers noted that the absolute risk of suicide "was still extremely low."

The study’s lead author, Charlotte Wessel Skovlund, told PolitiFact that Musk had a short post that summed up her findings in a "very unnuanced matter" but affirmed that her studies found those risks for depression and suicide.

Skovlund said the studies were observational and thus could "only see if there is an association between hormonal contraception and the different depression parameters, not a causal link."

Other researchers and reproductive health experts said the results warrant further study but aren’t conclusive and don’t represent scientific consensus.

"When looking directly at that data, we are talking about an extremely small number of people," said Dr. Michael Belmonte, an OB-GYN and complex family planning subspecialist based in Washington.

The data shows that among the 475,802 women in the sample, there were 6,999 suicide attempts (1.47%) and 71 suicides (0.01%).

"While this study has found an association, it is unable to say that hormonal birth control is the cause," Belmonte said.

The study focused solely on suicide and suicide attempts, not depression or weight gain. A separate study by the same authors found an increased prevalence of depression among hormonal birth control users. Belmonte said other studies that have examined this are mixed, "without consistent evidence of mood effects."

Two contemporaneous reports cited the study’s limitations, including a November 2018 paper to which Musk linked. The paper said the analysis lacked information on "risk factors" that might influence the link between contraception and suicidal behavior, such as relationship status, domestic abuse exposure and family history of mental health diagnoses.

In a July 2018 letter, biomedical experts in psychiatry and psychology noted other concerns.  The suicide risk seemed to be higher for former hormonal birth control users, compared with recent or current users, they said, suggesting that "factors other than hormonal contraception medications are at work." The study also didn't specify which psychiatric diagnoses were controlled for, including substance use disorders and mood disorders.

The letter’s authors said the study doesn’t allow for attributing an association specifically to hormonal contraception because it didn’t compare hormonal birth control users with people who used nonhormonal methods. It cited a 2013 study that found a lower suicide risk among hormonal contraception users than for those using nonhormonal methods or no contraception.Nearly all forms of birth control involving estrogen can increase the risk of serious health problems, but researchers and medical experts say risks are rare. Some research suggests that birth control might increase the risk of some forms of cancer while decreasing the risk of others.

Research shows the pill, patch, ring and IUD are unlikely to cause any weight changes, while the birth control shot and implant might cause some people, but not all, to gain weight.

Dr. Jenni Villavicencio is an OB-GYN and senior director of public affairs at the Society of Family Planning, a nonprofit organization specializing in abortion and contraception science. She said decades of rigorous research show that "any method of birth control is safe for use in individuals with depressive disorder."

"It’s advisable for people experiencing mental health or mood challenges to seek care from an expert as well as ongoing monitoring when starting any new medication," Villavicencio said.

Besides preventing pregnancy, hormonal birth control can offer different health benefits, such as lightening periods, easing cramps and treating polycystic ovary syndrome.

Lincoln, the Oregon-based OB-GYN, said the Denmark study didn’t address how many birth control users deal with painful and heavy periods, painful sex and other debilitating health issues.

"All things that alone can increase risk for undiagnosed mental health disorders and — you guessed it — suicide risk," she said.

The study’s researchers said women should be informed about these "little-recognized potential side effects." Lincoln said doctors routinely do this already and discuss with patients concerns about depression, anxiety or thoughts of self-harm.

PolitiFact's ruling

Musk said there is "clear scientific consensus" that hormonal birth control makes people gain weight, doubles the risk of depression and triples the risk of suicide.

Musk referred to a single 2017 study that experts said is limited and does not prove a causal relationship.

Research shows that most types of hormonal birth control do not affect weight, though some can. Medical experts and contraceptive researchers said there is mixed data on hormonal birth control’s side effects, including depression, and that the overall risk of suicide is low.

Musk’s claim ignores that many women use birth control to treat painful periods and other disorders, as well as the negative mental health outcomes that can arise from unplanned pregnancy.

We rate his claim False.

Our sources

This article originally appeared on Austin American-Statesman: Musk misses mark on birth control's depression, suicide risks