The Relationship of Oral Contraception to Depressive Symptoms

Summary: A double‐blind cross‐over trial involving 45 patients was carried out to determine the relationship between oral contraception and pharmacologically‐induced depressive symptoms. Oral contraception produced pharmacological symptoms in 15% of women from a selected group, of whom half had previously experienced adverse side‐effects from the contraceptive pill. This depression occurred in 2 forms. Three women had endogenous depression which increased on oral contraception, becoming worse during the second month of therapy. A fourth woman had reactive depression due to associated nausea and vomiting which improved during the second month of therapy. “Scapegoat” depressive symptoms were at least as common as pharmacological effects when taking oral contraception. About half the number of women with a history of depressive ill‐nessness experienced an increase in depression on oral contraception. Oestrogen‐progesterone balance was not important in the development of depressive side‐effects; the latter bore no relationship to the cytohormonal status of the patient, either before treatment or during oral contraceptive therapy.