Hormonal contraception and depression: a survey of the present state of knowledge

Depressive symptoms often occur among women of reproductive age. In this article we perform an analysis of existing studies to examine a possible correlation between depression and the use of hormone-based contraceptives. The computerized databases MEDLINE/PubMed were searched for studies examining the relation between depressive disorders and hormonal contraception of the years 1976-2010. Data on this topic are limited. At least two confounding variables influence the analysis of the available data and make it difficult to draw firm conclusions: the inconsistent use of the term "depression" and the large number of combined contraceptives which vary in their composition. The association between the use of oral contraceptives and depression is not clear. We found that depression is not a common side effect of hormone-based contraceptives. Individual, patient-based decisions with consideration of the individual history and predispositions are recommended when starting oral contraceptives. If depressive symptoms or mood changes occur, decisions regarding discontinuation or medication change need to be made on an individual basis.