Oral Contraceptives and Psychiatric Disturbance: Evidence from Research

Abstract

There is a commonly held conviction among physicians and the lay public that oral contraceptive agents are associated with a high incidence of adverse psychological effects, particularly depressive symptoms. This belief is enhanced by a body of literature which includes case reports, studies of small samples, and overall side effect incidence rates (1–22). Careful, adequately controlled, objective studies of emotional reactions are, however, lacking, and this can be ascribed to the serious problems inherent in the design of such studies. For example, adequate control groups are difficult to establish, and contraceptives cannot easily be randomly assigned. Studies using a placebo must also introduce other contraceptives; nonrandom processes operate in the selection of women for study. Suggestibility secondary to use of medication requires placebo double-blind studies in order to differentiate the psychological from the pharmacological effects.