Impact of oral contraceptive pill use on premenstrual mood: predictors of improvement and deterioration

Am J Obstet Gynecol. 2003 Dec;189(6):1523-30. doi: 10.1016/s0002-9378(03)00927-x.


Objectives: The purpose of this study was to estimate risk factors for the deterioration and improvement of premenstrual mood disturbance with oral contraceptive pill use.

Study design: Predictors of the deleterious and beneficial effects of oral contraceptive pill use on premenstrual mood were analyzed with the use of logistic regression in a nested case-control study within a community-based cohort of 976 premenopausal women in Massachusetts.

Results: Of 658 women who were using oral contraceptive pills, 16.3% of the women reported oral contraceptive pill-related premenstrual mood deterioration, and 12.3% of the women reported premenstrual mood improvement. In adjusted models, previous depression was the only significant predictor of mood deterioration (odds ratio, 2.0; 95% CI, 1.1-3.8); early-onset premenstrual mood disturbance and dysmenorrhea were significant predictors of oral contraceptive pill-related mood improvement (odds ratio, 3.1 [95% CI, 1.9-5.2] and odds ratio, 2.3 [95% CI, 1.4-3.9], respectively).

Conclusion: Oral contraceptive pills do not influence premenstrual mood in most women. Premenstrual mood is most likely to deteriorate in women with a history of depression and to improve in women with early-onset premenstrual mood disturbance or dysmenorrhea.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Affect / drug effects*
  • Age Factors
  • Case-Control Studies
  • Confidence Intervals
  • Contraceptives, Oral, Combined / administration & dosage*
  • Depression / drug therapy
  • Depression / prevention & control*
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Middle Aged
  • Odds Ratio
  • Patient Satisfaction
  • Predictive Value of Tests
  • Premenstrual Syndrome / diagnosis*
  • Premenstrual Syndrome / drug therapy*
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome


  • Contraceptives, Oral, Combined