Clinical Report: Contraceptive Use Among Women With Bipolar Disorder

Overview

This investigation used data from the 2010–2011 French MONTRA survey to examine effective contraceptive use among women aged 50 years or younger with bipolar disorder (BD). The supplied article excerpt describes the study rationale, design, and eligibility criteria but does not provide the prevalence results or factors associated with contraceptive use.

Background

BD is a chronic psychiatric condition characterized by depressive, manic, and hypomanic episodes, and the source reports associations with sexual risk behaviors and unplanned pregnancy. Pregnancy and the postpartum period can complicate BD treatment because discontinuing pharmacological treatment is associated with increased risk of illness recurrence, while some medications may carry teratogenic risks or compromise contraceptive efficacy. The source notes that evidence on contraceptive-use patterns and associated characteristics among women with BD remains sparse. It identifies shared decision-making as a patient-centered approach to weighing treatment risks and benefits during the perinatal period.

Data Highlights

Key Findings

• The study aimed to estimate effective contraceptive use and describe sociodemographic, clinical, and pharmacological characteristics associated with use among women with BD.
• The MONTRA survey captured routine-care information from patients already known to and managed by participating psychiatrists.
• The source reports that women with BD may have higher rates of unplanned or inadequately planned pregnancy than people without psychiatric conditions.
• The source states that discontinuation of pharmacological treatment during pregnancy or postpartum is associated with increased risk of illness recurrence.
• It identifies anticonvulsant mood stabilizers and lithium among treatments that may present teratogenic risks or compromise contraceptive efficacy.
• The 2024 U.S. Medical Eligibility Criteria classifies depressive disorders as Category 1 for listed contraceptive methods; its cited evidence includes BD cohorts and a small BD study, as summarized in the supplied web research context.

Clinical Implications

The source identifies shared decision-making as a patient-centered strategy for considering treatment risks and benefits during the perinatal period. The supplied U.S. guidance context also notes that medication–contraceptive interactions are relevant in BD, including reduced effectiveness of some methods with enzyme-inducing anticonvulsants and reduced lamotrigine levels with combined hormonal contraceptives.

Conclusion

The MONTRA analysis was designed to address limited evidence on effective contraceptive use among reproductive-age women with BD. The supplied excerpt does not report its outcome estimates or the variables found to be associated with contraceptive use.

Related Resources & Content

1. MONTRA survey investigators, MONTRA survey, 2010–2011 -- Contraceptive Use Among Women of Reproductive Age Living With Bipolar Disorder (article excerpt supplied)
2. U.S. Centers for Disease Control and Prevention, MMWR, 2024 -- Appendices for U.S. Medical Eligibility Criteria for Contraceptive Use, 2024
3. Frontiers in Psychiatry — Identifying psychiatric comorbidities that occur following the introduction of hormonal contraception: a scoping review
4. Frontiers in Psychiatry — Hormonal contraception and mental health: a narrative review of screening, monitoring, and patient-centered care for family physicians
5. BMC Psychiatry (Springer) — Neuroendocrine abnormalities as predictors of suicidal ideation in bipolar disorder patients during depressive episodes: a cross-sectional study
6. Journal of Crohn's and Colitis — Knowledge, Values, and Preferences Regarding Contraceptive Choices Among Women Living With Inflammatory Bowel Disease
7. Appendices for U.S. Medical Eligibility Criteria for Contraceptive Use, 2024
8. DailyMed - DEPAKOTE- divalproex sodium tablet, delayed release