Symptoms of mental disorders and oral contraception use: A systematic review and meta-analysis

Mathilda Z Kraft; Philine Rojczyk; Thomas Weiss; Birgit Derntl; Zora Kikinis; Ilona Croy; Carina Heller

doi:10.1016/j.yfrne.2023.101111

Symptoms of mental disorders and oral contraception use: A systematic review and meta-analysis

Front Neuroendocrinol. 2024 Jan:72:101111. doi: 10.1016/j.yfrne.2023.101111. Epub 2023 Nov 14.

Authors

Mathilda Z Kraft¹, Philine Rojczyk², Thomas Weiss¹, Birgit Derntl³, Zora Kikinis⁴, Ilona Croy⁵, Carina Heller⁶

Affiliations

¹ Department of Clinical Psychology, Friedrich Schiller University Jena, Germany.
² Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.
³ Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; Lead Graduate School, University of Tübingen, Tübingen, Germany.
⁴ Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁵ Department of Clinical Psychology, Friedrich Schiller University Jena, Germany; German Center for Mental Health (DZPG), Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany.
⁶ Department of Clinical Psychology, Friedrich Schiller University Jena, Germany; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany; German Center for Mental Health (DZPG), Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany. Electronic address: [email protected].

PMID: 37967755
DOI: 10.1016/j.yfrne.2023.101111

Abstract

Worldwide, over 150 million adolescent and adult women use oral contraceptives (OC). An association between OC-use and the emergence of symptoms of mental disorders has been suggested. This systematic review and meta-analysis provide an overview of published research regarding symptoms of mental disorders in association with OC-use, factoring the influence of OC types, age of first-use, duration of OC-intake, and previous diagnoses of mental disorders. A systematic literature search was conducted between June-July 2022. 22 studies were included. While most found no significant OC-use effects on mental symptoms, some hinted at OCs as a potential risk. The existing evidence regarding the potential link between progestin-only OC-use and an elevated risk of mental symptoms in comparison to combined OC-use remains inconclusive. However, due to emerging indications suggesting that the formulation of OC might play a role in mental health outcomes, this topic warrants further investigation. Moreover, indications of an increased risk for depressive symptoms in adolescent OC-users should be noted. Hence, while general population effects seem unlikely, they cannot be completely disregarded. The decision on OC-use should depend on the patient's medical history and should be re-evaluated regularly.

Keywords: Adolescent OC-use; Combined oral contraceptive; Mental disorder; Mental health; Meta-analysis; Mood disorder; OC-use; Progestin-only oral contraceptive; Systematic review.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Adolescent
Adult
Contraceptives, Oral* / adverse effects
Female
Humans
Mental Disorders* / epidemiology
Young Adult

Substances

Contraceptives, Oral