Association between Oral Contraceptive Usage and Symptoms of General Anxiety Disorder in Korean Women

Background Oral contraceptives are widely used by women for reproductive and non-reproductive purposes, such as regulating menstrual cycles and managing mood. However, the mental health side effects, particularly related to anxiety and mood disorders, remain poorly understood and often underreported. Previous research has shown inconsistent findings regarding the association between oral contraceptive use and mental health symptoms, including anxiety. Despite their widespread use, the impact of oral contraceptives on anxiety is not well-documented, and gaps in health education contribute to continued use despite potential side effects. Given that anxiety disorders disproportionately affect women, this study aims to explore the correlation between oral contraceptive use and anxiety symptoms in South Korea, addressing a critical gap in research and informing healthcare decisions for women globally. Methods This study used data from 2021 and 2022 of the Korea National Health and Nutrition Examination Survey (KNHANES). Focusing on female respondents aged 18 and older, the final analysis included 5,686 women. Symptoms of anxiety were measured using the GAD-7 Scale. The main independent variable was oral contraceptive use for longer than one month. A multiple regression model assessed the association between contraceptive usage and anxiety symptoms, presenting results as adjusted odds ratios (aORs) and a significance threshold of p < 0.05. All analyses were conducted using SAS version 9.4. Results Analysis of survey data from 5,686 women revealed that 943 women who had used oral contraceptives for over a month were more likely to report significant anxiety symptoms (7.6%) compared to those who did not use oral contraceptives (5.7%). Logistic regression showed that women using oral contraceptives for longer than a month had 1.45 times higher odds (95% CI 1.04–2.03) of experiencing significant anxiety symptoms. Subgroup analysis indicated that women with higher stress levels, those who were unemployed, and physically inactive women had greater odds of developing anxiety symptoms (aOR 1.50, 1.71, and 1.47, respectively). Multiple regression revealed that the odds of developing greater severity levels of anxiety were higher in women using oral contraceptives, though the results for severity levels of anxiety were not statistically significant. Conclusion This study found that prolonged oral contraceptive use is associated with higher odds of anxiety symptoms in South Korean women, especially among those with higher stress, unemployment, and physical inactivity. Although the severity of anxiety did not reach statistical significance, the findings highlight the need for further research on the mental health effects of oral contraceptives and the importance of providing women with detailed information on potential side effects.