Mood...

 

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Although the mental health benefits associated with use of combined hormonal contraceptives (CHCs) outweigh the harms, CHCs might increase risk of dysphoric mood & interact w/ psychiatric meds.

This review & consensus statement based on CDC criteria for contraceptive use addresses the full range of contraceptive choices, including long-acting reversible implants (<1 pregnancy/100 women/year); progestin-only contraceptives or CHCs via injection, pill, patch, or ring; & barrier methods.

Authors discuss PO contraceptives’ variable impact on mood. Some studies of adolescents reported increase depression & suicidal behavior during the 1st few months of PO contraceptive use, but most studies reported little effect on mood or actual benefits, especially premenstrually. 

Among women w/ major depression, CHCs were associated with few ill effects, vs no use of hormone contraceptives. Adherence was problematic in some patients populations. 

Infrequent major drug interactions included higher levels of clozapine w/ CHCs & lower levels of lamotrigine & valproic acid w/ PO CHCs. 
Carbamazepine & oxcarbazepine can decrease contraceptives’ hormone levels & thus effectiveness, possibly leading to unintended pregnancy.