A Comparison of Second and Third Generations Combined Oral Contraceptive Pills’ Effect on Mood

Abstract

Background:Most women taking combined oral contraceptives (COCs) are satisfied with their contraceptive method. However, one of the most common reasons reported for discontinuation of combined oral contraceptives (COCs) is mood deterioration.Objectives:This study aimed to compare effects of the second and third generation oral contraceptive pills on the mood of reproductive women.Materials and Methods:This randomized, double-blind, controlled clinical trial was conducted in reproductive women at health centers in Tehran, Iran. Participants were randomized into the second and third generation oral contraceptive groups. Positive and negative moods were recorded using positive affect, negative affect scale (PANAS) tools at the end the second and fourth months of the study. Data analysis was carried out using ANOVA and P Values < 0.05 was considered significant.Results:Statistically significant difference was seen in positive and negative mood changes in women receiving contraceptive pills. The second generation oral contraceptive pills resulted in a decrease in positive mood (95% CI: 43.39 to 38.32 in second month and 43.39 to 26.05 in four month) and increase in negative mood (95% CI: 14.23 to 22.04 in second month and 14.23 to 32.26 in four month - P < 0.001), but the third generation led to an increase in positive mood (95% CI: 22.42 to 25.60 in second month and 22.42 to 33.87 in four month) and decrease in negative mood (95% CI: 36.78 to 31.97 in second month and 36.78 to 22.65 in four month - P < 0.001).Conclusions:Third generation combined oral contraceptive pills have a better effect on mood in women in reproductive ages than the second generation pills. It can be recommended as a proper combined oral contraceptive in Iran.

Comparison of Adverse Drug Reactions of Second- And Third-Generation Oral Contraceptives

“…This suggests that EE-LNG is more likely to cause mood swings and vaginal dryness compared to EE-DSG. These findings are consistent with those of previous studies that state that third-generation contraceptive pills have better effects on women's mood swings compared to secondgeneration ones [26].…”

Hormonal contraceptive use is associated with neural and affective changes in healthy young women

“…Longitudinal and cross-sectional studies assessing contraceptionrelated mood changes have yielded inconsistent results. The use of hormonal contraceptives was found to be associated with increases, decreases or no overall change in negative affect (Gingnell et al, 2013;Jarva and Oinonen, 2007;O'Connell et al, 2007;Oinonen and Mazmanian, 2002;Ott et al, 2008;Rosenberg and Waugh, 1998;Shahnazi et al, 2014;Svendal et al, 2012). It is unclear whether the inconsistency of findings reflects actual differences between women in their mood-related responses to hormonal contraceptives, or whether they are due to differences in study design or pill types (Pletzer and Kerschbaum, 2014).…”

FSRH Guideline (January 2019, amended October 2023) Combined Hormonal Contraception

“…While some studies have suggested differences in the incidence of mood change between COC formulations (EE dose316, progestogen type336) no consistent trends have been reported. It is possible that formulations containing an anti-androgenic progestogen such as drospirenone337,338 could have a more beneficial effect on mood than preparations containing other progestogens.…”