Improvement of quality of life in women using a low-dose desogestrel-containing contraceptive: results of an observational clinical evaluation

Ernst, U; Baumgartner, Leona; Bauer, Ulrike; Janßen, Gisela

doi:10.1080/ejc.7.4.238.243

Cited by 37 publications

(11 citation statements)

References 16 publications

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“…Data from prospective trials suggest that the vast majority of women report improved mood while on COC. For instance, among 3679 never‐users, who were treated with ethinylestradiol (EE) 20μg and desogestrel for three months, 61.5% reported reduced nervousness and 70.6% improved depressive mood on the Quality of Life Enjoyment and Satisfaction Questionnaire (Q‐LES‐Q), whereas 10% reported worsening of depressive mood, and 6.7% increased nervousness (8). Similarly, using a seven‐score assessment of overall improvement of emotional well‐being, 61 and 51% of EE 30μg/drospirenone and EE 30μg/levonorgestrel users reported improvement, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The assessment of adverse mood symptoms during COC use represents a scientific challenge and various study designs have been used to elucidate this issue. In prospective trials the frequency of women who report deteriorated mood or deteriorated emotional well‐being has varied between 4 and 10%, but these figures are substantially higher in retrospective studies (8,9). However, it can be assumed that not all adverse mood symptoms experienced by COC users are drug‐related.…”

Section: Discussionmentioning

confidence: 99%

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Adverse mood symptoms with oral contraceptives

Sundström‐Poromaa

Segebladh

2012

Acta Obstet Gynecol Scand

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In spite of combined oral contraceptives (COCs) having been available for more than 50 years, surprisingly little is known about the prevalence of truly COC-related adverse mood symptoms and about the underlying biological mechanisms of proposed changes in mood and affect. Precise estimates of COC-related adverse mood symptoms are not available due to the lack of placebo-controlled trials. In prospective trials the frequency of women who report deteriorated mood or deteriorated emotional well-being varies between 4 and 10%, but it can be assumed that the causal relation in these prevalence rates is overestimated. Adverse mood symptoms and somatic symptoms are most pronounced during the pill-free interval of the treatment cycles, but whether extended COC regimens would be more favorable in this respect is not known. COCs with anti-androgenic progestagens, such as drospirenone and desogestrel, appear more favorable in terms of mood symptoms than progestagens with a more androgenic profile. Available data suggest that lower doses of ethinylestradiol could be beneficial.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adverse mood symptoms with oral contraceptives

Sundström‐Poromaa

Segebladh

2012

Acta Obstet Gynecol Scand

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“…Initial exacerbation in the early cycles of use appears to resolve with continued use. Of 3679 women starting COCs for the first time, using 20 mcg of ethinylestradiol and 150 mcg of desogestrel (20EE/150DSG), 36% reported headache at baseline . After 3 cycles, 14% reported that headache had worsened, 57% reported improvement, and 28% reported no change.…”

Section: Effect Of Contraceptive Methods On Headachementioning

confidence: 99%

Contraception and Headache

MacGregor

2013

Headache

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Most women have used at least 1 method of contraception during their reproductive years, with the majority favoring combined oral contraceptives. Women are often concerned about the safety of their method of choice and also ask about likely effects on their pre-existing headache or migraine and restrictions on using their headache medication. While there should be no restriction to the use of combined hormonal contraceptives by women with migraine without aura, the balance of risks vs benefits for women with aura are debatable. Migraine with aura, but not migraine without aura, is associated with a twofold increased risk of ischemic stroke, although the absolute risk is very low in healthy, nonsmoking women. Although ethinylestradiol has been associated with increased risk of ischemic stroke, the risk is dose-dependent. Low-dose pills currently used are considerably safer than pills containing higher doses of ethinylestradiol but they are not risk-free. This review examines the evidence available regarding the effect that different methods of contraception have on headache and migraine and identifies strategies available to minimize risk and to manage specific triggers such as estrogen "withdrawal" headache and migraine associated with combined hormonal contraceptives. The independent risks of ischemic stroke associated with migraine and with hormonal contraceptives are reviewed, and guidelines for use of contraception by women with migraine are discussed in light of the current evidence.

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“…Whilst some prospective and retrospective studies suggest that between 4 and 17% of women using combined hormonal contraception (CHC) report increased anxiety and depressed mood. [13][14][15]. others suggest that CHC may reduce variability in mood across the menstrual cycle [16] or ameliorate the severity of symptoms [17].…”

Section: Risk Of Mood Symptoms and Hormonal Contraceptionmentioning

confidence: 99%

Managing the risks of mood symptoms with LNG-IUS: a clinical perspective

Bitzer

Rapkin

Soares

2018

The European Journal of Contraception & Reproductive Health

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Introduction: Lack of awareness of reproductive hormone-related mood changes in the general population or limited acknowledgement of their existence by health care providers regularly contribute to fears or misconceptions about the link between hormonal contraception and potential mood changes. Recent media discussion linked the levonorgestrel intrauterine system (LNG-IUS 20 mg/d) to elevated cortisol levels and the possibility of panic attacks, anxiety, mood changes, sleep disturbance and restlessness. Efficacy of the LNG-IUS is based primarily on local effects but systemic effects, including a potential increase in mood symptoms, are a known risk and reflected in the product labelling for all LNG-IUS products. Objective: There is a need to improve communication to the public and health care providers around potential risk of mood disorders in order to facilitate 'informed choice' amongst women considering an LNG-IUS as their contraceptive method and directly address the fears of women currently using an LNG-IUS. Results: We propose a simple and brief, step-by-step process that can be embedded within current counselling that explores and clarifies the potential risk of developing mood symptoms prior to placement of LNG-IUS. It also addresses concerns from women using an LNG-IUS who either present with mood symptoms or are concerned about potential onset. Conclusion: Mood symptoms with use of LNG-IUS are uncommon; however, all women, including those who may experience an increased sensitivity to certain progestins, should be counselled appropriately to raise awareness of the potential risk within an informed discussion around effectiveness, benefits and possible adverse events.

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Improvement of quality of life in women using a low-dose desogestrel-containing contraceptive: results of an observational clinical evaluation

Abstract: The OC containing ethinylestradiol and desogestrel significantly improved the quality of life and subjective symptoms. The OC was well tolerated by first-time users.

Cited by 37 publications

References 16 publications

Adverse mood symptoms with oral contraceptives

Adverse mood symptoms with oral contraceptives

Contraception and Headache

Managing the risks of mood symptoms with LNG-IUS: a clinical perspective

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