Contraception in individuals with depression

The effect of hormonal contraceptives on depression has not been determined in clinical trials. While an association between a first prescription of an antidepressant and hormonal contraception has been found (particularly in adolescents), a causal link has not been proven. Advise users of hormonal contraception to report new or worsening mood-related symptoms.

Combined oral contraceptives (COCs) are of benefit in premenstrual dysphoric disorder, but data on their effect on other mood symptoms (including premenstrual syndrome) is limited; tailored regimens that avoid or minimise hormone-free intervals may help reduce premenstrual mood symptoms.