Randomised trial, 2017
Does the combined oral contraceptive pill affect mood?
Yes, but effects vary by cycle phase. The pill causes small increases in anxiety and irritability between periods but improves depression in the days before menstruation.
What they did
A randomized, double-blind, placebo-controlled trial with 202 healthy women. Participants took either a combined oral contraceptive (1.5 mg estradiol and 2.5 mg nomegestrol acetate) or placebo for 3 cycles. Mood was measured daily using the Daily Record of Severity of Problems scale.
What they found
During the hormone-free interval, pill users had small but significant increases in anxiety (0.22 points), irritability (0.23 points), and mood swings (0.15 points) compared with placebo. However, in the 5 days before menstruation, pill users had lower depression scores (0.33 points lower) than placebo. Overall, 24.1% of pill users reported clinically relevant mood worsening versus 17.0% on placebo, but this difference was not statistically significant. Women with previous adverse effects from hormonal contraception reported greater mood worsening.
What it means for you
The pill affects mood in different ways at different cycle phases. For most women, changes are small, but some women are sensitive to hormones and can experience significant mood problems, which explains why mood concerns are a major reason women stop using the pill.
202
Healthy women enrolled
0.22-0.23
Point increase in anxiety and irritability
24.1% vs 17.0%
Clinically relevant mood worsening with pill versus placebo
About the study
- Original title
- Combined oral contraceptive use is associated with both improvement and worsening of mood in the different phases of the treatment cycle-A double-blind, placebo-controlled randomized trial
- Authors
- Lundin C, Danielsson KG, Bixo M et al.
- Journal
- Psychoneuroendocrinology
- Year
- 2017
- Study design
- Randomised trial
- Participants
- 202
- What was tested
- Combined oral contraceptive or placebo for 3 cycles
- Read the paper
- doi.org/10.1016/j.psyneuen.2016.11.033
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