Does the pill cause depression?
Johannes Bitzer (CH)
[Bitzer] .
Does the pill cause depression? Prof Johannes Bitzer Introduction: There is a longstanding controversy regarding the impact of combined hormonal contraceptives on mood. In a recent large registry data based study the risk of depression was significantly higher in COC users. Objective: Compare studies with contradictory results and analise reasons for differences Results: Several studies show improvement of mood in women with depression or premenstrual dysphoric disorders while using COCs with different progestogens. Other studies show deterioration of mood in COC users with associations to preexisting depression. To understand these differences research on PMS and PMDD shows a large individual responsiveness of the serotonin pathways and the GABA receptor to ovarian hormones pointing into the direction of individual vulnerability. In addition psychosocial factors like negative life events, loss of sense in life, separation and personal losses have been described as having an important impact on depression. Conclusion: Women reporting mood deterioration while using CHC should be taken care of in a comprehensive way taking into account hormonal vulnerability to specific steroid hormones and the individual life context. Solutions should be searched including change of steroids, non hormonal contraception and psychological counselling