Oral contraceptive use and psychiatric disorders in a nationally representative sample of women
- 927 Downloads
The purpose of this study is to examine the association between oral contraceptive use (any current use, duration, and type) and major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) in a nationally representative sample of women in the USA. Data were drawn from 1,105 women aged 20–39 in the National Health and Nutrition Examination Surveys from 1999 to 2004. The associations between self-reported use of oral contraceptives in the past year and DSM-IV diagnosed and subthreshold MDD, GAD, and PD in the past year were assessed comparing oral contraceptive users to all non-users, former users, and former long-term users. Women using oral contraceptives had a lower past-year prevalence of all disorders assessed, other than subthreshold MDD. When adjusted for confounders, women using oral contraceptives in the past year had significantly lower odds of subthreshold PD, compared to former users (odds ratio (OR) = 0.34, 95 % CI 0.14–0.84). Effects estimates were strongest for monophasic (versus multiphasic) oral contraceptive users. Hormonal contraceptive use was associated with reduced risk of subthreshold PD. A potential mental health benefit of hormonal contraceptives has substantial public health implications; prospective longitudinal studies are needed to confirm whether hormonal contraceptive use improves mental health.
KeywordsGeneralized anxiety disorder Hormonal contraceptives Major depressive disorder Oral contraceptives Panic disorder
The authors would like to acknowledge Michelle Haloossim for the literature review and writing assistance and Kirstin H. Heinrich for the assistance with literature review and figure preparation. At the time of manuscript preparation, Ms. Haloossim was a student in the Department of Sociomedical Sciences and Ms. Heinrich was a student in the Department of Epidemiology at the Columbia University Mailman School of Public Health. Funding for this study was provided by the National Institute of Mental Health (2-T32-MH-13043 to KCP and SRL and K01-AA021511 to KMK).
Conflict of interest
The authors declare that they have no conflicts of interest.
- Greco T, Graham CA, Bancroft J, Tanner A, Doll HA (2007) The effects of oral contraceptives on androgen levels and their relevance to premenstrual mood and sexual interest: a comparison of two triphasic formulations containing norgestimate and either 35 or 25 microg of ethinyl estradiol. Contraception 76(1):8–17PubMedCrossRefGoogle Scholar
- Mosher WD, Jones J (2010) Use of contraception in the United States: 1982–2008. Center for Disease Control and Prevention, Washington, DCGoogle Scholar
- National Center for Health Statistics (a). National Health and Nutrition Examination Survey, 2013–2014 overview. http://www.cdc.gov/nchs/data/nhanes/nhanes_13_14/2013-14_overview_brochure.pdf. Accessed 04/05/13
- National Center for Health Statistics (b). NHANES response rates and population totals. http://www.cdc.gov/nchs/nhanes/response_rates_cps.htm. Accessed November 6, 2013
- National Comorbidity Study. Table 2. 12-month prevalence of DSM-IV/WMH-CIDI disorders by sex and cohort (n = 9282). http://www.hcp.med.harvard.edu/ncs/ftpdir/NCS-R_12-month_Prevalence_Estimates.pdf. Accessed 05/01/2013
- Payne JL, Roy PS, Murphy-Eberenz K, Weismann MM, Swartz KL, McInnis MG, Nwulia E, Mondimore FM, MacKinnon DF, Miller EB, Nurnberger JI, Levinson DF, DePaulo JR Jr, Potash JB (2007) Reproductive cycle-associated mood symptoms in women with major depression and bipolar disorder. J Affect Disord 99(1–3):221–229PubMedCrossRefGoogle Scholar
- WHO (1997) CIDI-Auto version 2.1: Administrator’s guide and reference. Training and Reference Centre for WHO CIDI, SydneyGoogle Scholar