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Reproductive endocrinology

The emotional cost of contraception

The link between mood disorders and hormonal fluctuations has long been known, but the direction of this correlation has been questioned. New research suggests that initiation of hormonal contraception leads to increased risk of first-time diagnosis of or treatment for depression over a short time frame, particularly for adolescents.

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  1. Skovlund, C. W., Mørch, L. S., Kessing, L. V. & Lidegaard, Ø . Association of hormonal contraception with depression. JAMA Psychiatry 73, 1154–1162 (2016).

    Article  Google Scholar 

  2. Kessler, R. C., McGonagle, K. A., Swartz, M., Blazer, D. G. & Nelson, C. B. Sex and depression in the National Comorbidity Survey. I: lifetime prevalence, chronicity and recurrence. J. Affect. Disord. 29, 85–96 (1993).

    CAS  Article  Google Scholar 

  3. Yonkers, K. A. et al. Symptom-onset dosing of sertraline for the treatment of premenstrual dysphoric disorder: a randomized clinical trial. JAMA Psychiatry 72, 1037–1044 (2015).

    Article  Google Scholar 

  4. Yonkers, K. A. et al. Efficacy of a new low-dose oral contraceptive with drospirenone in premenstrual dysphoric disorder. Obstet. Gynecol. 106, 492–501 (2005).

    CAS  Article  Google Scholar 

  5. Schaffir, J., Worly, B. L. & Gur, T. L. Combined hormonal contraception and its effects on mood: a critical review. Eur. J. Contracept. Reprod. Health Care 21, 347–355 (2016).

    CAS  Article  Google Scholar 

  6. Svendal, G. et al. The use of hormonal contraceptive agents and mood disorders in women. J. Affect. Disord. 140, 92–96 (2012).

    CAS  Article  Google Scholar 

  7. Andréen, L. et al. Sex steroid induced negative mood may be explained by the paradoxical effect mediated by GABAA modulators. Psychoneuroendocrinology 34, 1121–1132 (2009).

    Article  Google Scholar 

  8. Jane Costello, E., Erkanli, A. & Angold, A. Is there an epidemic of child or adolescent depression? J. Child Psychol. Psychiatry 47, 1263–1271 (2006).

    CAS  PubMed  Google Scholar 

  9. Young, E. A. et al. Influences of hormone-based contraception on depressive symptoms in premenopausal women with major depression. Psychoneuroendocrinology 32, 843–853 (2007).

    CAS  Article  Google Scholar 

  10. Francis, J., Presser, L., Malbon, K., Braun-Courville, D. & Linares, L. O. An exploratory analysis of contraceptive method choice and symptoms of depression in adolescent females initiating prescription contraception. Contraception 91, 336–343 (2015).

    Article  Google Scholar 

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The authors thank S. Hoeppner, Center for Anxiety and Traumatic Stress Disorders, Department of Psychiatry, Massachusetts General Hospital, Massachusetts, USA, for her assistance with statistical analyses. This work was supported by NIH (National Heart, Lung, and Blood Institute (NHLBI)) T32HL007374 and a Beth Israel Deaconess Medical Center (BIDMC) Psychiatry Junior Faculty fund (R.A.R.), and by NIH (Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)) R01 HD019938, R01 HD082314 and K12 HD051959 (U.B.K.).

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Correspondence to Ursula B. Kaiser.

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Ross, R., Kaiser, U. The emotional cost of contraception. Nat Rev Endocrinol 13, 7–9 (2017).

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