Do progesterone-only contraceptives lead to more mood changes than other types?
EVIDENCE-BASED ANSWER:
No. Women taking progesterone-only contraceptives don’t appear to experience more depressive symptoms or mood changes than women on other hormonal contraceptives, and they may experience slightly less depression than women using no contraception (strength of recommendation: B, multiple homogeneous cohorts).
LNG-IUS users reported significantly less anhedonia than nonusers in the previous year (19% vs 22%; P<.05). Moreover, in a partial correlation analysis, LNG-IUS was negatively correlated with anhedonia (r=0.024; P<.05) and symptoms of depression over the previous month (r=0.098; P<.05).
Did relationship satisfaction, rather than contraceptive, influence depression?
A multicenter prospective cohort trial analyzed the effect of the levonorgestrel implant on mood in 267 women followed for 2 years by evaluating depressive symptoms reported from the Mental Health Inventory, a 6-item questionnaire scored 0 to 24.3
The women demonstrated a significant increase in depressive symptom scores from 7.9 at baseline to 8.8 (P=.01). However, the study authors suggested that relationship satisfaction, not method of birth control, was the cause of depressive symptoms. The 62 women who experienced a decrease in relationship satisfaction exhibited a significant increase in depressive symptoms (6.7-10; P=.001) compared with the 156 women who reported an improvement or no change in relationship satisfaction (7.8-8.2; P=.30).
