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Oral contraceptives may lower general well-being in healthy women
Swedish women assigned oral contraceptives reported reduced general well-being, but similar burden of depressive symptoms, compared with women assigned placebo, according to findings published in Fertility and Sterility.
“Despite the fact that an estimated 100 million women around the world use contraceptive pills, we know surprisingly little today about the pill’s effect on women’s health,” Angelica Lindén Hirschberg, MD, PhD, of the department of women’s and children’s health at Karolinska Institutet in Sweden, said in a press release. “The scientific base is very limited as regards to the contraceptive pill’s effect on quality of life and depression, and there is a great need for randomized studies where it is compared with placebos.”
Lindén Hirschberg and colleagues evaluated data from 340 women randomly assigned to a combined monophasic pill (Neovletta, Bayer Schering Pharma) containing 150 µg levonorgestrel and 30 µg ethinylestradiol (n = 169) or placebo (n = 171) for 3 months. Participants were instructed to take their assigned medications for 21 days with a 7-day break to define a 28-day treatment cycle.
The psychological General Well-Being Index and Beck Depression Inventory were used to measure general well-being and depressed mood among the participants.
Treatment with the oral contraceptive reduced the global score of the Psychological General Well-Being Index compared with placebo (–4.12; P = .0085). Positive well-being (P = .0492), self-control (P = .0046) and vitality (P = .008) were also negatively affected by oral contraceptives compared with placebo. No difference was found between the oral contraceptive and placebo groups for anxiety, depressed mood or general health. Similarly, researchers observed no significant differences between the two groups for the Beck Depression Inventory.
At baseline, 35% of all participants had moderate to severe distress in general well-being and 7% had moderate to severe depressive symptoms. After treatment, the oral contraceptive group had higher moderate to severe distress in general well-being (44%) compared with the placebo group (38%). No difference was found for moderate to severe depressive symptoms (7% for both).
Adverse events were experienced by more participants in the oral contraceptive group (21%) compared with placebo (12%).
“A first choice combined oral contraceptive could influence general well-being negatively, including vitality and self-control, but not depression in young healthy women,” Lindén Hirschberg told Endocrine Today. “The reductions in well-being were of small to medium size. However, for individual women we believe that even a smaller reduction in general well-being could be of clinical importance and may explain the high discontinuation rate of oral contraceptives. We cannot generalize our finding to other combined oral contraceptives. Therefore, it is highly important to compare the influence of different types of contraception on aspects of life quality.” – by Amber Cox
For more information:
Angelica Lindén Hirschberg, MD, PhD, can be reached at angelica.linden-hirschberg@sll.se.
Disclosure: Lindén Hirschberg reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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