Contraceptive use linked to current mood disorder risk in women
MedWire News: The use of progestin-only contraceptives is associated with an increased risk for current mood disorders in women, while the use of combined estrogen and progestin contraceptive agents is associated with a reduced risk, study results suggest.
"Because of the potential adverse effect progestin-only agents have on current mood, caution should be taken when prescribing these agents to women," the researchers comment.
Lana Williams (Deakin University, Geelong, Australia) and team assessed data on 498 women, aged 20-50 years, participating in the Geelong Osteoporosis Study (GOS) - a population-based study designed to investigate the epidemiology of osteoporosis and other health disorders.
All of the participants were assessed for mood disorders, such as bipolar disorder, major and minor depression, and dysthymia, by trained personnel using the Structured Clinical Interview for DSM-IV-TR Research version, Non-patient edition (SCID-I/NP).
The women were also asked whether they currently used hormonal contraceptive agents, and to provide a list of medications or containers to assist with accurate recording of details.
In total, 40 (8%) women were diagnosed with a current mood disorder according to the SCID-I/NP, and 185 (37%) were using hormonal contraceptive agents at the time of assessment.
Of the women using contraceptives, 152 (82%) were using combined estrogen and progestin agents, while 33 (18%) were using progestin-only agents. Of those with mood disorders, six (15%) were taking progestin-only agents, while five (13%) were taking combined contraceptive agents.
After accounting for age, socioeconomic status, and other variables, the researchers found that women taking progestin-only contraceptives were more likely to have a current mood disorder than those who were not taking progestin-only agents, at an odds ratio of 3.0.
By contrast, women taking combined contraceptive agents were less likely to have a mood disorder than those who were not taking such agents, at an OR of 0.3.
The differences in current mood disorder risk associated with single and combined contraceptive agents was not explained by weight, physical activity levels, previous episodes of depression, number of medical conditions, or smoking, the researchers note.
Williams and team conclude in the Journal of Affective Disorders: "If clinically indicated, the combined contraceptive agents appear preferable in terms of mood endpoints."
They add: "Interestingly, less than half of the women with a current mood disorder were taking any contraceptive agent, which is of note, as the relationship between mood and contraception goes beyond hormones, as contraception plays an important role in management of individuals with a mood disorder.
"Replication of these data in other populations would increase confidence in validity and applicability."
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By Mark Cowen