The relationship between progestin hormonal contraception and depression: a systematic review

Worly, Brett; Gur, Tamar L.; Schaffir, Jonathan

doi:10.1016/j.contraception.2018.01.010

Cited by 83 publications

(46 citation statements)

References 31 publications

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“…With regard to depression as an established effect of LNG exposure, it is worth noting that even this is debated. In a recent narrative review [14] the authors find the evidence from studies with validated measures of depression unconvincing. This judgement conflicts with regulatory assessment despite including a new large observational study [15] that supports the hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice

Slattery¹,

Moralès

Kurz³

2018

Drug Saf

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Section: Discussionmentioning

confidence: 99%

Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice

Slattery¹,

Moralès

Kurz³

2018

Drug Saf

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“…The study on sex-dependent effects of nicotine on developmental brain mainly focus on the nAChR and sex hormones (63). Some studies suggest that sex-based differences in depression may result from alterations in hormonal levels (64). Previous research has demonstrated that females are more sensitive than males to the effects of nicotine (65).…”

Section: Discussionmentioning

confidence: 99%

Prenatal nicotine exposure induces depression‑like behavior in adolescent female rats via modulating neurosteroid in the hippocampus

et al. 2019

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Prenatal nicotine exposure (PNE) is closely related to depression in offspring. However, the underlying mechanism is still unclear. We hypothesized that neurosteroid in the hippocampus may mediate PNE-induced depression-like behaviors. Nicotine was subcutaneously administered (1.0 mg/kg) to pregnant rats twice daily from gestational day (GD) 9 to 20. In adolescent offspring, PNE significantly increased immobility time and decreased the sucrose preference in female rats. The numbers of hippocampal neurons declined in the CA3 and DG regions. Steroidogenic acute regulatory protein (StAR) expression was suppressed in female rats. In fetal offspring, the neuronal numbers of CA3 regions in PNE female fetal hippocampal were significantly decreased, accompanied by the enhanced content of corticosterone and StAR expression. These data indicated that PNE induced depression-like behavior in adolescent female rats via the regulation of neurosteroid levels in the hippocampus.

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“…There are no studies of these methods in women with PMDD. A large population-based study evaluated symptoms of depression in DMPA users over 3 years and found increased likelihood of depressive symptoms with resolution after DMPA was discontinued 87. DMPA package insert states that depression is a side effect of the medication and patients who have a history of depression should be carefully observed and that the drug not be re-administered if the depression persists.…”

Section: Progestin-only Methods Effect On Moodmentioning

confidence: 99%

<p>Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectives</p>

Rapkin¹,

Korotkaya²,

Taylor³

2019

OAJC

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Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) affecting up to 7% of reproductive age women. Women with PMDD are of reproductive age; therefore, contraception and treatment of PMDD are important considerations. The disorder as described in the DSM-V is characterized by moderate to severe psychological, behavioral and physical symptoms beginning up to two weeks prior to menses, resolving soon after the onset of menstruation and significantly interfering with daily functioning. PMDD develops in predisposed individuals after they are exposed to progesterone at the time of ovulation. It has been hypothesized that PMDD is in part attributable to luteal phase abnormalities in serotonergic activity and to altered configuration of ℽ-aminobutyric acid subunit A (GABAA) receptors in the brain triggered by the exposure to the neuroactive steroid progesterone metabolite, allopregnanolone (Allo). A large body of evidence suggests that selective serotonin reuptake inhibitors (SSRIs) can be effective in the treatment of PMDD. Combined hormonal contraceptive (CHC) pills, specifically the 20 mcg ethinyl estradiol/3mg drospirenone in a 24/4 extended cycle regimen has been shown to significantly improve the emotional and physical symptoms of PMDD. Other combined monophasic, extended cycle hormonal contraceptive pills with less androgenic progestins may also be helpful, although not well studied. Copper intrauterine devices (IUDs) are recommended for those not seeking hormonal contraceptives. Progestin-only methods including the progestin-only pill (POP), levonorgestrel (LNG) IUD, etonorgestrel implant or depot medroxyprogesterone acetate (DMPA) have the potential to negatively affect mood symptoms for women with or without baseline mood disorders, including PMDD. Careful counseling and close follow-up is recommended for patients with PMDD seeking these contraceptive methods.

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The relationship between progestin hormonal contraception and depression: a systematic review

Cited by 83 publications

References 31 publications

Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice

Cohort Study of Psychiatric Adverse Events Following Exposure to Levonorgestrel-Containing Intrauterine Devices in UK General Practice

Prenatal nicotine exposure induces depression‑like behavior in adolescent female rats via modulating neurosteroid in the hippocampus

<p>Contraception counseling for women with premenstrual dysphoric disorder (PMDD): current perspectives</p>

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