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The relationship between progestin hormonal contraception and depression: a systematic review
Brett L Worly1, Tamar L Gur2, Jonathan Schaffir3
1Department of Obstetrics & Gynecology, The Ohio State University, Columbus, OH; Dept of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH.
Contraception
|March 3, 2018
Summary
This systematic review found minimal evidence linking progestin-only contraception to depression. The majority of studies, using validated measures, do not support a causal association between these contraceptives and depressive symptoms.
Area of Science:
- Reproductive Health
- Mental Health
- Clinical Epidemiology
Background:
- Progestin-only contraceptives are widely used globally.
- Concerns persist regarding potential mood-related side effects, specifically depression.
- Existing evidence requires synthesis to clarify the association.
Purpose of the Study:
- To systematically review and assess the association between progestin-only contraception and depression.
- To evaluate the quality of evidence from relevant studies.
Main Methods:
- Systematic literature search of PubMed, Ovid, and Web of Science (inception–September 2016).
- Inclusion of English-language studies on progestin-only contraception and depression with validated measures.
- Study quality assessed using USPSTF and Cochrane Risk of Bias tools.
Main Results:
- Twenty-six studies were included (5 RCTs, 11 cohort, 10 cross-sectional).
- Overall, minimal association was found between progestin-only methods and depression.
- Most studies, including high-quality ones, did not demonstrate a significant link, though one study suggested an association.
Conclusions:
- The preponderance of evidence does not support a link between progestin-only contraceptives and depression.
- Findings are based on moderate-quality evidence (mostly Level II-1) with low risk of bias.
- Community perceptions of increased depression are not supported by current validated research.
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