Hormonal contraception and mental health: a narrative review of screening, monitoring, and patient-centered care for family physicians - Summary - MDSpire
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Hormonal contraception and mental health: a narrative review of screening, monitoring, and patient-centered care for family physicians
To provide a narrative review of current evidence on the association between hormonal contraceptive use and mental health outcomes, and to offer practical, expert-informed recommendations for family physicians.
Approach:
Literature Review: Conducted a narrative review of literature published between 2000 and 2025 in PubMed, Cochrane Library, EMBASE, and PsycINFO, examining studies on hormonal contraceptive methods and mental health outcomes in women of reproductive age.
Key Findings:
Evidence on hormonal contraception and mental health is mixed, with some studies reporting increased depression and anxiety, while others show neutral or protective associations. Most evidence is observational, limiting the ability to establish causation.
Individual variability in mental health outcomes is influenced by age, pre-existing psychiatric history, and contraceptive formulation.
Progestin-only methods and initiation during adolescence are more consistently associated with higher mood-related risks.
Certain combined oral contraceptives, particularly those with anti-androgenic progestins, are associated with better outcomes or mood stabilization.
Interpretation:
Clinicians should prioritize individualized risk assessment, informed counseling, and close monitoring of hormonal contraceptive use in relation to mental health.
Limitations:
The narrative review design may introduce bias due to the heterogeneity of study designs and outcomes.
Most studies are observational, which limits causal inferences.
Conclusion:
Tailoring contraceptive choices to each woman’s mental health history is important for supporting reproductive autonomy.
Systematic review of 8 observational studies found limited evidence on associations between prenatal asthma-medication exposure and neurodevelopmental outcomes, with autism spectrum disorder the only outcome suitable for meta-analysis.
