Greco T, Graham CA, Bancroft J, Tanner A, Doll HA. The effects of oral contraceptives on androgen levels and their relevance to premenstrual mood and sexual interest: a comparison of two triphasic formulations containing norgestimate and either 35 or 25 μg of ethinyl estradiol. Contraception. 2007;76:8–17.
Andrea J. Rapkin, MD Professor of Obstetrics and Gynecology, David Geffen School of Medicine, UCLA, Los Angeles, Calif.
The study by Greco and colleagues adds to evidence that an OC containing a lower dose of ethinyl estradiol is better for premenstrual mood, although this effect is unlikely to be related to its effect on androgens. It remains unclear how a lower estrogen dose affects mood in women who have a history of premenstrual syndrome and whether mood improvement with a lower estrogen dose is related to a lower degree of androgen suppression.
When there is concern about a patient’s mood or depression, prescribe a low-dose OC, such as one containing 20 μg of ethinyl estradiol and 3 mg of drospirenone in a 24/4-day regimen (Yaz). Most women experience no adverse effects of OCs on mood. Those with a history of depression should be aware that there may be a deterioration of mood on the OC.
