Physiologic and psychologic symptoms associated with use of injectable contraception and 20 microg oral contraceptive pills

Abstract

Objective: The objective of the study was to compare menstrual, physiologic, and psychologic symptoms over 2 years among women initiating use of depot medroxyprogesterone acetate or an oral contraceptive pill with a reduced pill-free interval and those not using hormonal contraception.

Study design: A total of 608 women reported their experience regarding 17 symptoms prior to initiating contraception and every 6 months thereafter for 24 months. Longitudinal relationships between symptoms and contraceptives were assessed after adjusting for age, visits, and baseline status of symptoms.

Results: Oral contraceptive pills were protective against mastalgia (odds ratio [OR], 0.7), cramping (OR, 0.5), hair loss (OR, 0.6), acne (OR, 0.4), nervousness (OR, 0.5), and mood swings (OR, 0.7). Depot medroxyprogesterone acetate (DMPA) was protective against bloating (OR, 0.5) and mood swings (OR, 0.7) but caused weight gain (OR, 2.3), bleeding episodes more than 20 days (OR, 13.4), and missed periods (OR, 96.9). Both methods caused intermenstrual bleeding.

Conclusion: Evidence-based data regarding beneficial and adverse symptoms associated with these methods may help clinicians counsel patients appropriately prior to contraceptive initiation.

Figure 1

Flow of recruitment and retention across the study.

Figure 2

Prevalence of menstrual symptoms across 24 months by contraceptive method. Data presented are for women who completed all 24 months of the study (n = 253) for ease of interpretation (ie, without dropouts included at each time point).

Figure 3

Prevalence of physiologic symptoms across 24 months by contraceptive method. Data presented are for women who completed all 24 months of the study (n = 253) for ease of interpretation (ie, without dropouts included at each time point).

Figure 4

Prevalence of psychologic symptoms across 24 months by contraceptive method. Data presented are for women who completed all 24 months of the study (n = 253) for ease of interpretation (ie, without dropouts included at each time point).