Impact of oral contraceptive pill use on premenstrual mood: Predictors of improvement and deterioration☆
Section snippets
Methods
This investigation is a nested case-control study within a cohort of 36- to 45-year-old premenopausal women from the greater metropolitan Boston area (Harvard Study of Moods and Cycles).11 Written informed consent was obtained from each subject, and the research study was approved by the Brigham and Women's Hospital Institutional Review Board. The primary goal of the Harvard Study of Moods and Cycles was to determine the association between a lifetime history of depression and an earlier
Results
Of the 658 women who had used an OCP, 107 women (16.3%) reported premenstrual mood deterioration, and 81 women (12.3%) reported premenstrual mood improvement with OCP use. OCP use therefore had no deleterious or advantageous impact on premenstrual mood in 470 of women (71.4%) who had used an OCP.
The mean age of the subjects was 40.4±2.5 years, and the study population was comprised predominately of white, educated, married, working, Catholic women with children (Table I). There were no
Comment
This analysis highlights clinical risk-benefit decisions about the potential impact of OCP use on premenstrual mood symptoms. Our findings suggest that most women do not have a change in premenstrual mood symptoms after starting an OCP. The population in whom premenstrual mood is most likely to worsen with OCP use appears to be restricted to those with a history of depression. In contrast, the women who are most likely to benefit from a positive influence of an OCP on premenstrual mood symptoms
Acknowledgements
We thank Jonathan Orav, PhD, for his biostatistical consultation and Ms Allison Vitonis for her assistance with database management.
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Supported by National Institutes of Health grants No. T32 MH17119 (H. J.) and No. R01-MH50013 (B. L. H., L. S. C.).