Am J Obstet Gynecol. 2003 Dec;189(6):1523-30.

Impact of oral contraceptive pill use on premenstrual mood: predictors of improvement and deterioration.

Joffe H,Cohen LS,Harlow BL.

Perinatal and Reproductive Psychiatry Clinical Research Program, Massachusetts General Hospital, 15 Parkman Street, WACC, Boston, MA 02114, USA. hjoffe@partners.org

Objectives:

The purpose of this study was to estimate risk factors for the deterioration and improvement of premenstrual mood disturbance with oral contraceptive pill use.

Study Design:

Predictors of the deleterious and beneficial effects of oral contraceptive pill use on premenstrual mood were analyzed with the use of logistic regression in a nested case-control study within a community-based cohort of 976 premenopausal women in Massachusetts.

Results:

Of 658 women who were using oral contraceptive pills, 16.3% of the women reported oral contraceptive pill-related premenstrual mood deterioration, and 12.3% of the women reported premenstrual mood improvement. In adjusted models, previous depression was the only significant predictor of mood deterioration (odds ratio, 2.0; 95% CI, 1.1-3.8); early-onset premenstrual mood disturbance and dysmenorrhea were significant predictors of oral contraceptive pill-related mood improvement (odds ratio, 3.1 [95% CI, 1.9-5.2] and odds ratio, 2.3 [95% CI, 1.4-3.9], respectively).

Conclusion:

Oral contraceptive pills do not influence premenstrual mood in most women. Premenstrual mood is most likely to deteriorate in women with a history of depression and to improve in women with early-onset premenstrual mood disturbance or dysmenorrhea.

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