Effect of the Monthly Injectable Combined Contraceptives versus Oral Contraceptive Pills on Mood
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Background: Contraceptive agents are widely used by women of reproductive age, and resulting depression is the most common side effect of this usage. This study aimed to study the effect of monthly injectable combined contra-ceptives versus that of combined oral contraceptive pills (COC) on patients’ mood.Methods: A prospective cohort study was conducted on 124 females aged 18–45 years attending the Kom-Ashfeen Family Medicine Unit, El-Kalyubia, Egypt. Participants were divided into three groups according to their choice: group A included 44 participants who received monthly combined injectable contraceptives (CIC); group B includ-ed 40 participants who took COC; and group C included 40 participants who used the copper intrauterine device (IUD). The Patient Health Questionnaire-9 (PHQ-9) score was assessed at the beginning of the study and after 6 months of follow-up.Results: After 6 months of follow-up, there were mild but statistically significant increases in the PHQ-9 score in groups A and B, with group A (CIC users) showing the highest increase. Approximately 34.1%, 27.5%, and 15% of CIC, COC, and IUD users, respectively, moved from the non-depression stage to mild depression after 6 months; this change was statistically significant in groups A and B only.Conclusion: Monthly injectable combined contraceptives and oral contraceptive pills were associated with an in-creased risk of developing mild depression; this risk was higher in users of CICs, although the difference was not statistically significant. Thus, it is crucial to counsel patients about this possible risk and to follow them up. Howev-er, further studies are required to confirm our results.
Abstract
Background: Contraceptive agents are widely used by women of reproductive age, and resulting depression is the most common side effect of this usage. This study aimed to study the effect of monthly injectable combined contra-ceptives versus that of combined oral contraceptive pills (COC) on patients’ mood.Methods: A prospective cohort study was conducted on 124 females aged 18–45 years attending the Kom-Ashfeen Family Medicine Unit, El-Kalyubia, Egypt. Participants were divided into three groups according to their choice: group A included 44 participants who received monthly combined injectable contraceptives (CIC); group B includ-ed 40 participants who took COC; and group C included 40 participants who used the copper intrauterine device (IUD). The Patient Health Questionnaire-9 (PHQ-9) score was assessed at the beginning of the study and after 6 months of follow-up.Results: After 6 months of follow-up, there were mild but statistically significant increases in the PHQ-9 score in groups A and B, with group A (CIC users) showing the highest increase. Approximately 34.1%, 27.5%, and 15% of CIC, COC, and IUD users, respectively, moved from the non-depression stage to mild depression after 6 months; this change was statistically significant in groups A and B only.Conclusion: Monthly injectable combined contraceptives and oral contraceptive pills were associated with an in-creased risk of developing mild depression; this risk was higher in users of CICs, although the difference was not statistically significant. Thus, it is crucial to counsel patients about this possible risk and to follow them up. Howev-er, further studies are required to confirm our results.
참고문헌 (20)
- World Health Organization, "Selected practice recommendations for contraceptive use" (2016), World Health Organization
- Mansour D, "International survey to assess women’s attitudes regarding choice of daily versus nondaily female hormonal contraception", Int J Womens Health, 6, pp.367~375 (2014)
- Halpern V, "Towards the development of a longer-acting injectable contraceptive : past research and current trends", Contraception, 92, pp.3~9 (2015)
- Dimkpa OJ, "Experience with combined injectable contraceptive(Norigynon)in Port Harcourt", J Adv Med Med Res, 19, pp.1~6 (2017)
- World Health Organization, "Medical eligibility criteria for contraceptive use" (2015), World Health Organization
- Lundin C, "Combined oral contraceptive use is associated with both improvement and worsening of mood in the different phases of the treatment cycle: a double-blind, placebo-controlled randomized trial", Psychoneuroendocrinology, 76, pp.135~143 (2017)
- "Depression fact sheet" (2020)[URL]
- Smith K, "Do progestin-only contraceptives contribute to the risk of developing depression as implied by beta-arrestin 1 levels in leukocytes? : a pilot study", Int J Environ Res Public Health, 15, pp.1966~ (2018)
- El-Gilany A, "Updating and validation of the socioeconomic status scale for health research in Egypt", East Mediterr Health J, 18, pp.962~968 (2012)
- AlHadi AN, "An Arabic translation, reliability, and validation of Patient Health Questionnaire in a Saudi sample", Ann Gen Psychiatry, 16, pp.32~ (2017)
- Kroenke K, "The PHQ-9 : a new depression diagnostic and severity measure", Psychiatr Ann 2002;, 32, pp.509~515 (2002)
- Kroenke K, "The PHQ-9 : validity of a brief depression severity measure", J Gen Intern Med, 16, pp.606~613 (2001)
- Toffoletto S, "Emotional and cognitive functional imaging of estrogen and progesterone effects in the female human brain : a systematic review", Psychoneuroendocrinology, 50, pp.28~52 (2014)
- Pluchino N, "Progestogens and brain : an update", Maturitas, 62, pp.349~355 (2009)
- Rohleder N, "Impact of oral contraceptive use on glucocorticoid sensitivity of pro-inflammatory cytokine production after psychosocial stress", Psychoneuroendocrinology, 28, pp.261~273 (2003)
- Anderl C, "Oral contraceptive use in adolescence predicts lasting vulnerability to depression in adulthood", J Child Psychol Psychiatry, 61, pp.148~156 (2020)
- De Wit AE, "Association of use of oral contraceptives with depressive symptoms among adolescents and young women", JAMA Psychiatry, 77, pp.52~59 (2020)
- Zethraeus N, "A first-choice combined oral contraceptive influences general well-being in healthy women: a double-blind, randomized, placebocontrolled trial", Fertil Steril, 107, pp.1238~1245 (2017)
- Hall KS, "Contraception and mental health : a commentary on the evidence and principles for practice", Am J Obstet Gynecol, 212, pp.740~746 (2015)
- Skovlund CW, "Association of hormonal contraception with depression", JAMA Psychiatry, 73, pp.1154~1162 (2016)