Evidence regarding the role of hormonal contraception (HC) as a risk factor for attempted suicide is inconclusive. Thus, this study aimed to assess the associations of use of different types of systemic HC with the risk of attempted suicide in women aged 15–49 years. Data on a population-based cohort (n = 587,823) of HC users and non-users in 2017 was derived from national registers in Finland. In a nested case–control design we examined the risk of attempted suicide in relation to current HC use (past six months) via multivariable conditional logistic regression models. During the follow-up (from 2018 to 2019) there were 1.174,346 million person-years of which 818 cases of suicide attempts were observed (incidence rate: 0.70 per 1000 person-years). Use of HC, especially combined hormonal contraceptives, was not associated with a higher risk of attempted suicide compared to non-use (OR 0.68, 95% CI 0.45–1.02) after controlling for marital status, socioeconomic status, education, chronic diseases, recent delivery, recent psychiatric hospitalizations, and current use of psychotropic medications. In women without psychiatric history, current HC use (OR 0.73, 95% CI 0.58–0.91), especially ethinylestradiol-containing preparations (OR 0.54, 95% CI 0.40–0.73), was associated with a lower risk of attempted suicide. After adjusting for recent psychiatric hospitalizations and use of psychotropic medications, current use of progestin-only preparations was not associated with attempted suicide. In conclusion, current HC use was not associated with an increased risk of attempted suicide in fertile-aged women.

关于激素避孕 （HC） 作为自杀未遂危险因素的证据尚无定论。因此，本研究旨在评估使用不同类型的全身性 HC 与 15-49 岁女性自杀未遂风险的关联。2017 年 HC 用户和非用户的基于人群的队列 （n = 587,823） 的数据来自芬兰的国家登记册。在嵌套病例对照设计中，我们通过多变量条件 logistic 回归模型检查了与当前 HC 使用（过去 6 个月）相关的自杀未遂风险。随访期间（2018 年至 2019 年），共计 117.4346 万人年，其中观察到 818 例自杀未遂（发生率：每 1000 人年 0.70 例）。在控制婚姻状况、社会经济地位、教育程度、慢性病、近期分娩、近期精神病住院和当前使用精神药物后，与不使用相比，使用 HC，尤其是复方激素避孕药与较高的自杀未遂风险无关 （OR 0.68,95% CI 0.45–1.02）。在无精神病史的妇女中，当前使用 HC （OR 0.73， 95% CI 0.58-0.91），尤其是含炔雌醇的制剂 （OR 0.54， 95% CI 0.40-0.73），与自杀未遂风险较低相关。在调整了最近的精神病住院和精神药物的使用后，目前使用纯孕激素制剂与自杀未遂无关。总之，目前的 HC 使用与生育年龄女性自杀未遂的风险增加无关。