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Towards individualised contraceptive counselling: Clinical and reproductive factors associated with self-reported hormonal contraceptive-induced adverse mood symptoms
Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14 B, Uppsala, Sweden.
Department of Women's and Children's Health, Uppsala University, Dag Hammarskjölds väg 14 B, Uppsala, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.ORCID iD: 0000-0002-4988-1967
Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
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2021 (English)In: BMJ Sexual & Reproductive Health, ISSN 2515-1991, E-ISSN 2515-2009, Vol. 47, no 3, article id e8Article in journal (Refereed) Published
Abstract [en]

Objective: The study aim was to establish which demographic, clinical, reproductive and psychiatric factors are associated with self-reported hormonal contraceptive (HC)-induced adverse mood symptoms.

Study design: We compiled baseline data from two Swedish studies: one cross-sectional study on combined oral contraceptive (COC)-induced adverse mood symptoms (n=118) and one randomised controlled trial on adverse mood symptoms on COC (n=184). Both included women eligible for COC use, aged over 18 years. All women answered a questionnaire on HC use and associated mood problems. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was used to capture mood and anxiety disorders. Women who acknowledged HC-induced adverse mood symptoms, ongoing or previously (n=145), were compared with women without any such experience (n=157).

Results: Compared with women without self-reported HC-induced adverse mood symptoms, women with these symptoms were younger at HC start (adjusted odds ratio (aOR) 0.83, 95% CI 0.72 to 0.95), had more often undergone induced abortion (OR 3.36, 95% CI 1.57 to 7.23), more often suffered from an ongoing minor depressive disorder (n=12 vs n=0) and had more often experienced any previous mental health problem (aOR 1.90, 95% CI 1.01 to 3.59).

Conclusions: In line with previous research, this study suggests that women with previous or ongoing mental health problems and women who are younger at HC start are more likely to experience HC-induced adverse mood symptoms. Former and current mental health should be addressed at contraceptive counselling, and ongoing mental health disorders should be adequately treated.

Implications: This study adds valuable knowledge for identification of women susceptible to HC-induced adverse mood symptoms. It should facilitate the assessment of whether or not a woman has an increased risk of such symptoms, and thus enable clinicians to adopt a more personalised approach to contraceptive counselling.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021. Vol. 47, no 3, article id e8
Keywords [en]
contraception behavior, counseling, hormonal contraception, reproductive health
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-186202DOI: 10.1136/bmjsrh-2020-200658ISI: 000675428400006PubMedID: 33452056Scopus ID: 2-s2.0-85099702958OAI: oai:DiVA.org:umu-186202DiVA, id: diva2:1581090
Available from: 2021-07-19 Created: 2021-07-19 Last updated: 2024-02-28Bibliographically approved

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Bixo, Marie

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