![]() 371,372 For this reason, concomitant use of St. ![]() John’s wort, a hepatic enzyme inducer, increased progestin and estrogen metabolism, as well as breakthrough bleeding and the likelihood of ovulation, in women using COCs. 369,370 In contrast, a clinical trial observed that use of the herbal remedy St. 127,368 Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors, the most commonly used antidepressants, do not appear to interact with hormonal contraceptives. 9 There is no evidence that hormonal contraception including DMPA worsens a woman’s mood, regardless of whether or not she has baseline depression. The use of any method of contraception is acceptable for women who suffer from depression, and there are no contraindications (USMEC category 1). ![]() 128 The issues to consider are the impact of hormonal contraceptives on mood and the potential impact of treatments for depression on contraceptive efficacy. Shlomo Melmed MB ChB, MACP, in Williams Textbook of Endocrinology, 2020 Hormonal Contraception in Depressionĭepression and mood disorders are extremely common in women of reproductive age.
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