Ongoing or previous mental disorders predispose to adverse mood reporting during combined oral contraceptive use

Bengtsdotter, Hanna; Lundin, Cecilia; Danielsson, Kristina Gemzell; Bixo, Marie; Baumgart, Juliane; Marions, Lena; Brynhildsen, Jan; Malmborg, Agota; Lindh, Ingela; Poromaa, Inger Sundström

doi:10.1080/13625187.2017.1422239

Cited by 55 publications

(35 citation statements)

References 33 publications

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“…Previous research has reported that most depressions begin during adolescence [27] and that 10-20% of adolescents have had at least one major depressive episode by the age of 18 years [35]. Further, a recently published study concluded that women with ongoing or previous mental disorder had a greater risk of COC-induced mood symptoms [36].…”

Section: Depression and Hormonal Contraceptionmentioning

confidence: 99%

Health-related quality of life in young women starting hormonal contraception: a pilot study

Kristjánsdóttir

Sundelin

Naessén

2018

The European Journal of Contraception & Reproductive Health

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Objectives: Our purpose was to study whether there is a difference in self-rated health-related quality of life (HRQOL) and changes in HRQOL perception after 3 months of hormonal contraceptive use in adolescents. Seasonal variations in symptoms of depression were also studied. Methods: A test group (T1) (n ¼ 193) and a selected control group (n ¼ 238) of women aged 14-20 years who were visiting a young person's clinic completed the 36-item short-form health survey (SF-36) and answered additional questions on menstrual history and pattern, need for menstrual pain relief medication, and other regular medication. The test group was reassessed after 3 months of hormonal contraception (T2). Seasonal variations in reported SF-36 scores were studied for the whole group. Results: The selected control group and test group at T1 were similar with regard to age at menarche and menstrual pattern. The duration of bleeding and use of painkillers were significantly reduced and the impact on everyday life was significantly improved after 3 months of hormonal contraception (p ¼ .000, two-tailed). No changes in HRQOL or symptoms of possible depression were found after 3 months of hormonal contraception. The highest prevalence odds ratio for possible depression (SF-36 mental health scale score 48), adjusted for group, season and age, for spring vs winter, was 2.15 (95% confidence interval 0.95, 4.85). Conclusions: After 3 months of hormonal contraception both the number of days of menstrual bleeding and the use of medication to relieve menstrual pain were reduced, but there were no significant changes in self-rated HRQOL perception. Seasonal effects on HRQOL were reported. ARTICLE HISTORY

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Section: Depression and Hormonal Contraceptionmentioning

confidence: 99%

Health-related quality of life in young women starting hormonal contraception: a pilot study

Kristjánsdóttir

Sundelin

Naessén

2018

The European Journal of Contraception & Reproductive Health

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“…7 8 Other studies have reported that women with previous or ongoing psychological symptoms, mental disorders or impulsive or antisocial behaviours typically exhibit an inconsistent use of contraception. [9][10][11] According to other studies, the risk of unintended pregnancy is also elevated in women with eating disorders. 12 However, systematic data on their HC use are still lacking, and the subject needs to be further studied.…”

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confidence: 93%

Associations between hormonal contraception use, sociodemographic factors and mental health: a nationwide, register-based, matched case–control study

et al. 2020

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ObjectivesSociodemographic and mental health characteristics are associated with contraceptive choices. We aimed to describe the sociodemographic, reproductive and mental health characteristics of all fertile-aged women in Finland who used hormonal contraception (HC) in 2017.DesignA nationwide, register-based study.SettingAll women living in Finland in 2017; data from the Care Register of Health Care, Medical Birth Register, Population Register Centre, Prescription Centre, Register of Induced Abortions.ParticipantsAll women aged 15–49 with one redeemed HC prescription in 2017 (n=294 356), and a same-sized, age-matched and residence-matched, control group of non-users.OutcomesRates of HC use; associations between HC use and mental disorders, sociodemographic and reproductive characteristics.Results25.8% of women aged 15–49 years used HC. Women with the lowest socioeconomic levels had lower odds of using HC than women with upper-level statuses (OR, 95% CI students: 0.97, 0.94 to 0.99; entitled to pension: 0.66, 0.63 to 0.69; other: 0.87, 0.85 to 0.89; unknown: 0.90, 0.85 to 0.90). Women with the highest education (secondary: 1.46, 1.43 to 1.48; tertiary: 1.64, 1.58 to 1.70; academic: 1.60, 1.56 to 1.63) and income (second quarter: 1.57, 1.54 to 1.60; third quarter: 1.85, 1.82 to 1.89; fourth quarter: 2.01, 1.97 to 2.06), and unmarried women had higher odds of using HC than women with the lowest education and income levels, and married (0.61, 0.60 to 0.62), divorced (0.86, 0.84 to 0.88), widowed (0.73, 0.65 to 0.83) or other marital status women (0.26, 0.22 to 0.30).Parous women (0.70, 0.69 to 0.71), those with previous induced abortion(s) (0.91, 0.89 to 0.92) or recent eating (0.68, 0.62 to 0.75) or personality (0.89, 0.79 to 0.97) disorders had lower odds of HC use. Absolute risk differences between women with and without mental disorders ranged from 3.1% (anxiety disorders) to 10.1% (eating disorders).ConclusionsA quarter of the fertile-aged women use HC in Finland. Sociodemographic disparities persist in relation to HC use, although of small effect size. HC use is less common among women suffering from severe to moderate psychiatric disorders, especially eating disorders.

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“…The review also reported that women with underlying mood disorders might have a predisposition to mood effects with CHC [12]. This conclusion was supported by the findings of a recent study by Bengtsdotter et al [20] The authors went further to suggest that women with no psychiatric history have little risk of developing mood symptoms with use of CHC [20].…”

Section: Risk Of Mood Symptoms and Hormonal Contraceptionmentioning

confidence: 74%

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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Ongoing or previous mental disorders predispose to adverse mood reporting during combined oral contraceptive use

Abstract: Women with ongoing or previous mental disorders or risk use of alcohol have greater risk of COC-induced mood symptoms. This may be worth noting during family planning and contraceptive counselling.

Cited by 55 publications

References 33 publications

Health-related quality of life in young women starting hormonal contraception: a pilot study

Health-related quality of life in young women starting hormonal contraception: a pilot study

Associations between hormonal contraception use, sociodemographic factors and mental health: a nationwide, register-based, matched case–control study

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

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