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Contraceptive choices for behaviorally disordered women

L D Hankoff¹, P D Darney

¹Department of Psychiatry, Elizabeth General Medical Center, N.J.

American Journal of Obstetrics and Gynecology

|June 1, 1993

Summary

Contraception for mentally disturbed women requires diverse options. Oral contraceptives are preferred if compliance is high, but progestin implants or injections may be necessary when compliance is uncertain.

Keywords:

Barrier Methods Behavior Condom Contraception Contraceptive Agents Contraceptive Agents, Female Contraceptive Agents, Progestin Contraceptive Implants Contraceptive Methods Contraceptive Usage Decision Making Demographic Factors Diseases Drug Usage Family Planning Female Sterilization Fertility Infections Iud Literature Review Mental Disorders Obstacles Oral Contraceptives Organization And Administration Population Population Dynamics Pregnancy, Unwanted Recommendations Reproductive Behavior Reproductive Tract Infections Sexually Transmitted Diseases Sterilization, Sexual User Compliance

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Area of Science:

Reproductive Health
Psychiatry
Pharmacology

Background:

Mentally disturbed women, including those with depression, anxiety, or thought disorders, present unique challenges for contraception.
Co-occurring drug abuse in this population further complicates management.
Ensuring safe and effective contraception requires a comprehensive approach and a wide range of options.

Purpose of the Study:

To review contraceptive management strategies for women with psychological disturbances.
To highlight the importance of considering compliance and potential side effects.
To emphasize the need for sexually transmitted disease protection.

Main Methods:

Review of existing literature and clinical guidelines on contraception for women with mental health conditions.
Discussion of various contraceptive methods and their suitability for this population.
Consideration of factors influencing method selection, such as compliance and side effect profiles.

Main Results:

Oral contraceptives are the preferred method when patient compliance can be reliably ensured.
Progestin implants or injections are viable alternatives when compliance is questionable.
Progestin-only contraceptives may exacerbate mood symptoms in some patients, particularly those with depression.

Conclusions:

A broad spectrum of contraceptive methods is essential for managing behaviorally disturbed women.
Method selection must balance efficacy, safety, compliance, and potential psychiatric side effects.
Integrated care addressing both mental health and reproductive health needs is crucial.