A significant number of women in th...

A significant number of women in the United States use oral contraceptives (OCs) during their reproductive years. However, there are regards that OCs may cause temper disturbances in some patients. This belong to is a common reason for the discontinuation of OC therapy. However, several studies have produc conflicting inferences regarding the impact of OC in succession mood. Some risk factors have been shown to be associated with OC-related premenstrual temper deterioration. They include history of depression, dysmenorrhea, premenstrual depression, higher dosages of estrogen and progestin, and use of triphasic preparations, as well as a family history of OC-related temper changes and younger age at first OC use. Despite the fact that studies have assessed the negative impact of OC forward mood, only a few studies examined the potential benefit of OC onward mood in certain patients. Joffe and colleagues assessed the risk factors for the deterioration and improvement of premenstrual temper symptoms in women who use OCs

The thought was a nested case-control studious mood of women 36 to 45 years of age who were pre-menopausal. The sample population came from a metropolitan community. Screening questionnaires were mailed to 6228 women to determine their eligibility for the application of mind A structured psychiatric interview was con-duct with 976 women who agreed to participate in this phase of the consideration Diagnosis of current or previous major depressive disorder was established during the interview.

The original questionnaire included information concerning OC use, premenstrual symptoms before first OC use, and the impact of OC forward premenstrual mood symptoms in women who had used them for at least three months

The 10 items that were examined during the contemplation included (1) the presence of a depression episode before first OC use, (2) the proceeding of early-onset premenstrual mood symptoms, (3) the early attack of dysmenorrhea, (4) the early attack of hypermenorrhea, (5) the early storm of heaviness of menstruation, (6) the regularity of menstrual period during adolescence, (7) the age of first OC use, (8) the young adult dead body mass index, (9) cigarette smoking status before first OC use, and (10) the casualty of at least one pregnancy that cessationed in a live birth before first OC use. temper response to OCs was assemblageed into three categories: deterioration, improvement, and absence of change.

The research involved 658 women who had used OC for at least three month Of these women 163 percent reported frame of mind deterioration with OC use while 123 percent reported temper improvement. No change in temper was reported by 71.4 percent of women during OC use. Women with a history of depression before the use of OC were twice as likely to have premenstrual temper deterioration while taking OCs compared with women who did not have this history. Women who had a history of early-onset premenstrual humor disturbances and dysmenorrhea were more likely to have improved premenstrual temper when taking OCs. The remainder of the items did not predict improvement in or deterioration of mood

The authors close that the majority of women will have no change in premenstrual temper when using OCs. They note that women who have a history of depression are at higher risk for premenstrual vein deterioration with the use of OC In addition, women who have a history of early-onset premenstrual disposition disturbances and dysmenorrhea are more likely to experience an improvement in their premenstrual mood

KARL E MILLER, MD Joffe H et al. Impact of oral contraceptive pill use upon pre-menstrual mood: predictors of improvement and deterioration. Am J Obstet Gynecol December 2003;189:1523-30

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