The Influence of Hormonal Contraception on Mood and Sexual Interest among Adolescents

Abstract

Mood and sexual interest changes are commonly cited reasons for discontinuing hormonal contraceptives. Data, however, are inconsistent and limited to adult users. We examined associations of hormonal contraceptive use with mood and sexual interest among adolescents. We recruited 14-17 year old women primary care clinics and followed them longitudinally for up to 41 months. Participants completed face-to-face interviews quarterly and two 12 week periods of daily diary collection per year. On daily diaries, participants recorded positive mood, negative mood, and sexual interest. We classified 12 week diary periods as "stable OCP use," "non-use," "initiated use," "stopped use," and "DMPA use" based on self-report of oral contraceptive pill (OCP) use and depot medroxyprogesterone acetate (DMPA) use from medical charts. Diary periods were the unit of analysis. Participants could contribute more than one diary period. We analyzed data using linear models with a random intercept and slope across weeks in a diary period, an effect for contraceptive group, and an adjustment for age at the start of a diary period. Mean weekly positive mood was higher in diary periods characterized by stable OCP use, compared to other groups. Mean weekly negative mood was lower in diary periods characterized by stable OCP use and higher in periods characterized by DMPA use. Periods characterized by stable OCP use additionally showed less mood variation than other groups. Changes in mood among adolescent hormonal contraceptive users differed from those anticipated for adult users. Attention to adolescent-specific changes in mood and sexual interest may improve contraceptive adherence.

Adolescents’ cortisol responses to awakening and social stress; Effects of gender, menstrual phase and oral contraceptives. The TRAILS study

“…The discrepancy in findings between adult women and adolescent girls might be related to the duration period of OC use and the time to adjust to the effects of OC intake. Longitudinal research is needed to elucidate the effects of oral contraceptive use on HPA-axis functioning in adolescence, since especially longterm effects of OC use are still unknown (Ott et al, 2008).…”

Adolescents’ Experiences Using the Contraceptive Patch versus Pills

“…4 Although much larger, Urdl's study did not include adolescents younger than 18 years, did not measure baseline mood, and did not use a validated tool to measure mood, limitations shared by other studies which have reported on mood in patch users. 5,24,42 Given the frequency with which women attribute mood changes to hormonal contraception, 43 this remains an area where significant further study is warranted.…”

Contraception for Adolescents

“…Neither weight gain nor mood changes have been reliably linked to use of combined hormonal contraception. [118][119][120] Recommendations for managing adverse effects have been published elsewhere 121 or can be found online (http:// www.managingcontraception.com/qa/ index.php). COCs have few contraindications in healthy female adolescents.…”