An estimated 80% of sexually active young women in the United States use hormonal or oral contraceptives (OCs). Clinically it is found that some women report depression or mood swings with oral contraceptives; however, many women seem to tolerate hormonal contraceptive without any effects on mood. Despite the prevalence of OC usage, few studies have explored the association between hormonal contraceptive use and mood disturbance.
About 75% of women with regular menstrual cycles report unpleasant physical or psychological symptoms premenstrually. For the majority of women, these symptoms are mild and tolerable. However, some women have more severe and disabling symptoms, or premenstrual dysphoric disorder (PMDD). Several years ago, a large, multicenter trial of calcium supplementation found that calcium (600 mg twice a day) significantly reduced both the physical and emotional symptoms of PMS; however, it has not been clear whether calcium supplementation might be effective for more severe premenstrual symptoms or PMDD.
Women with premenstrual symptoms (PMS) and premenstrual dysphoric disorder experience symptoms during the premenstrual phase of their cycles. Because levels of estrogen and progesterone do not differ significantly between women with PMS and those without, it has long been hypothesized that PMS/PMDD represents an abnormal response to normal hormonal fluctuations (Schmidt et al, 1998).
Many women with PMS and PMDD ask about herbal remedies for the treatment of their symptoms. WebMD recently reviewed this topic. The supplements most commonly mentioned for the treatment of PMS include chasteberry, evening primrose oil, Gingko biloba, St. John’s wort, and dandelion leaf. Some important things to remember:
The American Psychiatric Association is now considering the possibility of including premenstrual dysphoric disorder (PMDD) in the DSM-V as a new category, rather than listing a set of criteria for PMDD in the appendix (as in DSM-IV). The diagnostic criteria remain relatively unchanged. Many feel that the Inclusion of PMDD as a distinct diagnostic category will lead to greater legitimacy for the disorder and will encourage the growth of evidence-based research in this area.
The FDA will require Yaz, Yasmin and several other newer oral contraceptives to carry new warning labels that detail the potential risk of venous thromboembolism (VTE or blood clots). All oral contraceptives increase the risk of blood clots; however, recent studies have suggested that birth control pills containing drospirenone, a synthetic form of the hormone progesterone, may carry a slightly increased risk of VTE, compared with older birth control pills. The FDA estimates that over a one year period, 10 in 10,000 women taking an oral contraceptive with drospirenone would develop a blood clot , as compared to about 6 in 10,000 women taking older contraceptives.
Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) affect a large number of women of childbearing age. 30-80% of reproductive age women experience premenstrual symptoms. PMS refers to a pattern of physical, emotional, and behavioral symptoms occurring 1-2 weeks before menses and remitting with the onset of menses. Common symptoms include fatigue, poor concentration, mild mood changes, headaches, abdominal bloating, and breast tenderness.
Significant numbers of reproductive-aged women experience premenstrual syndromes characterized by depressed mood, irritability, mood swings, anxiety or tension, sleep disruption, and other physical symptoms, including bloating and breast tenderness. Typically these symptoms emerge during the week preceding menstruation, improve with the onset of menses, and are not present during the week after menstruation.
Many women have concerns about the side effects of oral contraceptives (birth control pills). Potential side effects include bloating, breast tenderness, and weight gain. In addition, some women may experience depression or mood swings, side effects that may influence a woman’s decision to start taking a birth control pill, particularly if she has a history of depression.
Seeking women between 18-45 with PMS who have been diagnosed with depression. If you are between 18 and 45 and:
