Q. Does the dosage of estradiol in OCs affect mood and sexual interest?

The study by Greco and colleagues adds to evidence that an OC containing a lower dose of ethinyl estradiol is better for premenstrual mood, although this effect is unlikely to be related to its effect on androgens. It remains unclear how a lower estrogen dose affects mood in women who have a history of premenstrual syndrome and whether mood improvement with a lower estrogen dose is related to a lower degree of androgen suppression.

When there is concern about a patient’s mood or depression, prescribe a low-dose OC, such as one containing 20 μg of ethinyl estradiol and 3 mg of drospirenone in a 24/4-day regimen (Yaz). Most women experience no adverse effects of OCs on mood. Those with a history of depression should be aware that there may be a deterioration of mood on the OC.