Many women accept concerns almost the side furnishings of oral contraceptives (birth control pills). Potential side effects include bloating, breast tenderness, and weight gain. In addition, some women may experience depression or mood swings, side effects that may influence a woman's determination to commencement taking an oral contraceptive (OC), particularly if she has a history of depression.  Despite the prevalence of OC usage, few studies accept explored the association betwixt hormonal contraceptive use and mood disturbance.

Clinically nosotros find that some women written report depression or mood swings with oral contraceptive.  In our group, nosotros refer to this every bit "OC dysphoria".  Women with OC dysphoria typically develop moderate to severe depressive symptoms shortly after starting oral contraceptives, and they usually end taking it before finishing the first pack.  While this is what we observe clinically, information technology is not a common side effect just is severe enough to lead to discontinuation.   The few research studies we do accept show that oral contraceptives are well-tolerated by virtually women.

The Harvard Study of Moods and Cycles examined the outcome of oral contraceptives on mood. In this study, data from 658 women were analyzed to determine the proportion of women whose mood either improved or worsened while taking an oral contraceptive. In the overall sample, 107 women (16.3%) noted worsening of their mood on oral contraceptive, 81 (12.three%) experienced mood improvement, and 470 (71.four%) had no change in their mood. They noted that women with a history of depression were more than likely to experience mood worsening on the pill than those with no history of depression. However, most women with a history of depression experienced either no modify in their mood (61%) or mood improvement (14%); only a pocket-size number (25%) experienced mood worsening on the pill.

Ane of the largest studies included 6,654 sexually active non-significant women participating in the National Longitudinal Study of Adolescent Health.  In a cohort of women aged 25–34 years, the researchers compared contraceptive users with other sexually active women who were using either non-hormonal contraception or no contraception. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale.

What they institute was that users of hormonal contraceptives had lower mean levels of depressive symptoms and were less likely to accept attempted suicide in the previous year (odds ratio = 0.37, 95% confidence interval: 0.xiv, 0.95) than women using other forms of contraception or no contraception.

While this written report may provide some reassurance to women concerned about the impact of oral contraceptives on their mood, many questions remain.  This was a cantankerous-sectional study, where women were evaluated at a single fourth dimension bespeak.  One might hypothesize that women who developed mood symptoms later treatment with an oral contraceptive nearly likely stopped taking OCs, so that in this report the hormonal contraceptive users as a grouping consisted primarily of women who tolerated OCs whereas the non-user group contained a higher number of women who were unable to tolerate OCs.

Of particular concern is the touch on of hormonal contraceptives on mood in women with histories of depression.  In the Harvard Report of Moods and Cycles, information technology was found that women with histories of depression were more likely to experience premenstrual mood worsening on OCs than women with no history of low. However, near women with a history of depression experienced either no modify in their mood (61%) or mood comeback (14%); only a small number (25%) experienced premenstrual mood worsening on the pill.

Before starting a nativity control pill, women should talk to their clinicians almost their history of low. Those with a history of depression should be attentive to potential mood changes after starting an oral contraceptive; nonetheless, these studies taken together indicate that oral contraceptives may be a viable selection for contraception for all women, including those with a history of depression.

Ruta Nonacs, Doc PHD

Keys KM, Cheslack-Postava K, Westhoff C, et al. Association of Hormonal Contraceptive Apply With Reduced Levels of Depressive Symptoms: A National Study of Sexually Active Women in the United states of america.  Am J Eidemiol 2013.

Joffe H, Cohen LS, Harlow BL. Touch of oral contraceptive pill use on premenstrual mood: Predictors of improvement and deterioration. Am J Obstet Gynecol 2003;189:1523-30.

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