Psychological effect of the oral contraceptive formulation containing 3 mg of drospirenone plus 30 μg of ethinyl estradiol (original) (raw)
Related papers
Contraception, 2007
Purpose: This study compared two oral contraceptives (OCs) with the same triphasic regimen of progestin (norgestimate 0.18, 0.215 and 0.25 mg) but differing doses of ethinyl estradiol (EE) -25 and 35 μg EEin their effects on androgens, mood and sexual interest in women starting on OCs. Methods: Total testosterone (T), free testosterone (FT), sex-hormone-binding globulin (SHBG) and dehydroepiandrosterone sulphate (DHEA-S), together with measures of mood [Beck Depression Inventory (BDI)], sexual interest [Dyadic and Solitary subscales of the Sexual Desire Inventory (SDI)] and self-reported side effects were assessed before starting on the OC and again after 3 months of use. Results: Sixty women, all university students, were randomized to receive either the 25 μg EE (N/EE25) or the 35 μg EE (N/EE35) pill; 12 women discontinued, leaving 48 who completed the 3-month study. Their mean age was 19.7 years (18-30) and they were predominantly white and single. Both OCs produced reductions in mean T [N/EE35: from 1.33 to 0.60 nmol/L, pb.001; N/EE25: from 1.12 to 1.02 nmol/L; nonsignificant (NS)] and FT (N/EE35: from 41.3 to 4.4 pmol/L, pb.001; N/EE25: from 25.4 to 7.9 pmol/L, pb.01), but the reduction in both T and FT was significantly greater with the higher EE dose (N/EE35) (p=.05 and p=.03, respectively). DHEA-S was also reduced with both formulations (N/EE35: from 7.26 to 5.22 μmol/L); N/EE25: from 7.50 to 5.39 μmol/L), although the reduction was only significant in the N/EE35 group (pb.02). Considerable variability in changes in mood was evident with both OCs, with some women showing predominantly negative effects (10 in N/EE35, 5 in N/EE25); others, positive effects (9 in N/EE35, 17 in N/EE25) and some, no change (four in each group). Women using N/EE25 were significantly more likely to show improvement in premenstrual mood than those in the N/EE35 group (pb.02), although there was no correlation between changes in BDI and FT or DHEA-S. Sexual interest scores did not change significantly from baseline to posttreatment with either OC (N/EE35: dyadic, from 40.5 to 39.6, NS; solitary, from 5.9 to 6.4, NS; N/EE25: dyadic, from 36.7 to 37.0, NS; solitary, from 5.0 to 4.2, NS). Conclusion: The lower EE pill reduced FT less and was associated with greater improvement in premenstrual mood. A causal relation between these two effects is uncertain.
Psychological effects associated with oral contraceptives
BULLETIN OF INTEGRATIVE PSYCHIATRY, 2020
Combined oral contraceptives (COC) are used by millions of women worldwide. Although findings are not entirely consistent, COC have been found to impact on brain function and, thus, to modulate affective processes. Even though conflicting, the data already published should make aware every prescriber that women on oral contraceptive (OC) can develop psychological problems. In this situation, physicians have to focus their attention on those cases that at risk, like adolescents, women with depression or with previous history of hormonal contraceptive-induced adverse mood. The current study highlights the effects of OC on fear, depression and suicidal behaviour and it is intended to be a useful tool for the medical practice of both psychiatrists and those who prescribe sexual hormones therapies.
International Journal of Gynecology & Obstetrics, 2011
Objective: To determine the effects of ethinyl estradiol (EE)/drospirenone in a 24/4 regimen (24 days of active and 4 days of inactive pills) on functional impairment (affecting work, partnership, and social activities) in women with premenstrual dysphoric disorder (PMDD). Methods: The present study was a secondary analysis of a double-blind, randomized, parallel-design multicenter trial. Women received EE 20 μg/drospirenone 3 mg (n = 232) or placebo (n = 218) and completed the Daily Record of Severity of Problems (DRSP) scale daily. Results: The decrease in mean scores for all 3 DRSP functional impairment items (work, partnership, and social activities) from baseline to cycle 3 mirrored changes in the total DRSP symptom score; the greatest decreases were observed in cycle 1 with further small reductions through to cycle 3. The proportional mean decreases from baseline to cycle 1 for the 3 functional items ranged from 47% to 48%. For all 3 functional items, the mean reductions from baseline to cycle 1 (but not from cycle 1 to cycles 2 and 3) were significantly greater with EE/drospirenone than with placebo (P b 0.05). Conclusion: Ethinyl estradiol 20 μg/drospirenone 3 mg in a 24/4 regimen significantly improved functional impairment in women with PMDD. Symptoms improved in parallel.
Therapeutics and Clinical Risk Management
Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS). Pharmacologic options studied for treating severe PMS and PMDD may include selective serotonin reuptake inhibitors, anxiolytic agents, gonadotropin-releasing hormone agonists and the diuretic spironolactone. However, the use of combined oral contraceptives (COC) may be a therapeutic option in treating PMS and PMDD. The combination of drospirenone with ethinylestradiol (EE/drospirenone) was approved for marketing as an oral contraceptive in Europe and the United States. The preparation is characterized by a high contraceptive efficacy in combination with excellent cycle control, good tolerability, and a favourable impact on lipid and glucose metabolism. Recently, some placebo-controlled, randomized studies have tested clinical efficacy and tolerability of this COC in the treatment of PMDD. The aim of the present review was to elucidate the possible benefits or disadvantages of PMDD treatment with ...
Fertility and Sterility, 2006
Objective: To evaluate the effects of a low-dose combined oral contraceptive pill (OCP) on peripheral neuroactive steroid concentrations, precursors for neuroactive steroid synthesis, and mood in healthy women desiring contraception. These neuroactive steroids are ␥-aminobutyric acid receptor agonists and are important in the modulation of affect and adaptation to stress. Design: Prospective observational study. Setting: Human ambulatory patient study. Patient(s): Healthy OCP-naive women without current or history of affective disorder. Intervention(s): A 0.020-mg ethinyl E 2 -0.1-mg levonorgestrel containing OCP for 3 months. Main Outcome Measure(s): Serum neuroactive steroids allopregnanolone, allotetrahydrodeoxycorticosterone, and DHEA; neuroactive steroid precursors P and pregnenolone; E 2 ; and mood and anxiety as assessed by the Premenstrual Syndrome Daily Ratings Form, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Profile of Mood States.
The Journal of Sexual Medicine, 2011
Women may use new oral contraceptives (OC) having flexible extended-cycle regimens with a reduced hormone-free interval. Aim. To study the changes of the quality of sexual life in users of the traditional 21/7 or extended-cycle 24/4 OC regimens both containing 3 mg drospirenone and 20 mg ethinyl estradiol. Methods. One hundred fifteen women (age range 18-37 years) were enrolled. Fifty-four women were randomly placed on traditional OC standard regimen, administered for 21 days, followed by a 7-day hormone-free interval (group A); and 61 women were placed on extended-cycle OC regimen covering 24 days of the cycle with a 4-day hormone-free interval (group B).
Contraception, 2015
Combined oral contraceptives (COCs) decrease androgen levels, including testosterone (T), which may be associated with sexual dysfunction and mood complaints in some women. We have shown that 'co-administration' of dehydroepiandrosterone (DHEA) to a drospirenone (DRSP)-containing COC restored total T levels to baseline and free T levels by 47%. Here we describe the effects on sexual function, mood and quality of life of such an intervention. This was a randomized, double-blind, placebo-controlled study in 99 healthy COC starters. A COC containing 30mcg ethinylestradiol (EE) and 3mg DRSP was used for three cycles, followed by six cycles of the same COC combined with 50mg/day DHEA or placebo. Subjects completed the Moos Menstrual Distress Questionnaire (MDQ), the McCoy Female Sexuality Questionnaire and the short form of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Safety and tolerability, including effects on skin, were evaluated. The addition of DH...
Further evidence for lack of negative associations between hormonal contraception and mental health
Contraception, 2012
Background: There is limited and inconsistent information concerning the effects of hormonal contraception [oral contraceptives (OCs) and the levonorgestrel-releasing intrauterine system (LNG-IUS)] on mental health. The aim of this work was to further study the association(s) between the use of OCs and the LNG-IUS and psychopathology. Study design: Data concerning adult women who participated in the national FINRISK Study Surveys in Finland in 1997Finland in , 2002Finland in and 2007 were analyzed. The associations between the current use, as well as the duration of use of OCs and the LNG-IUS vs. mood symptoms, psychological and physical symptoms and recent psychiatric diagnoses were tested. Results: A negative association between the current use of OCs and Beck Depression Inventory-13 (BDI-13) score was found. Some other negative associations, all characterized by a small effect size, were detected between current use of OCs and the BDI items feelings of dissatisfaction, feelings of uselessness, irritability, lost interest in people and lost appetite. Additionally, only weak positive associations were found between the duration of OC use and irregular heart rate, insomnia and recent anhedonia. No noteworthy associations emerged between current use of the LNG-IUS, or its duration, and any of the inquired items. Conclusion: The use of hormonal contraception is not associated with negative influence on mental health. Current OC use seems to be associated with better mood, whereas the associations between duration of use of hormonal contraception and mental health effects are not clear.