Hormonal Contraceptive Use and Affective Disorders: An Updated Review.

IF 1.8 Q3 OBSTETRICS & GYNECOLOGY
Open access journal of contraception Pub Date : 2025-02-11 eCollection Date: 2025-01-01 DOI:10.2147/OAJC.S431365
Summer Mengelkoch, Kimya Afshar, George M Slavich
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Abstract

Hormonal contraceptives have given women historic freedoms and control over their fertility. At the same time, the potential side effects and unintended consequences of hormonal contraceptive use remain unclear due to a severe lack of funding and research. In this review, we summarize what is currently known about the impact of hormonal contraceptive use on mood symptoms, depression, and premenstrual disorders, and propose using the Social Signal Transduction Theory of Depression as a framework to generate predictions about the mechanistic pathways through which contraceptive use is associated with depression risk. The highest-quality evidence suggests that some types of contraceptives increase depression risk for some women. However, some contraceptives also appear to decrease depression risk in some instances. Key risk factors that predict depression following hormonal contraceptive use include age/age at onset of contraceptive use and mental health history/susceptibility. Hormonal contraceptives differ in ways that influence mood-related outcomes and can be used to treat depression in some women, especially those whose depression symptoms fluctuate across the cycle, indicating the potential presence of a premenstrual disorder. Looking forward, research, and funding for this research, is needed to elucidate the mechanistic pathways through which the use of different contraceptives impacts mood in different women to allow for a precision medicine approach to contraceptive treatment. In the meantime, health care providers should adopt patient-centered, "mindful prescribing" approaches to contraceptive counseling.

激素避孕药的使用和情感性障碍:最新综述。
荷尔蒙避孕药给了女性历史性的自由和生育控制。与此同时,由于严重缺乏资金和研究,使用激素避孕药的潜在副作用和意想不到的后果仍不清楚。在这篇综述中,我们总结了目前已知的激素避孕药使用对情绪症状、抑郁和经前障碍的影响,并建议使用抑郁症的社会信号转导理论作为框架来预测避孕药使用与抑郁风险相关的机制途径。最高质量的证据表明,某些类型的避孕药会增加某些女性患抑郁症的风险。然而,在某些情况下,一些避孕药似乎也能降低患抑郁症的风险。预测使用激素避孕药后抑郁的关键风险因素包括年龄/开始使用避孕药的年龄和精神健康史/易感性。激素避孕药在影响情绪相关结果的方式上有所不同,可用于治疗一些女性的抑郁症,特别是那些抑郁症状在月经周期中波动的女性,这表明可能存在经前紊乱。展望未来,需要研究和资助这项研究,以阐明使用不同避孕药影响不同女性情绪的机制途径,从而允许精准医学方法来避孕治疗。与此同时,卫生保健提供者应采取以病人为中心的“谨慎处方”方法进行避孕咨询。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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