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Objectives
To evaluate whether levonorgestrel intrauterine devices (LNG-IUD) or oral contraceptive
pills (OCPs) users are more likely to have a positive depression screen after 12 months
of use compared to copper IUD users.
Methods
We conducted a secondary analysis of the Contraceptive CHOICE Project of LNG-IUD,
OCP, and copper IUD users. Participants completed the Center for Epidemiologic Studies
Depression Scale (CESD-10) at baseline and at 12 months. We examined differences in
participant characteristics, depression/anxiety history, and CESD-10 scores between
method groups using chi-square test, and used Poisson regression to assess factors
associated with a positive depression screen (CESD-10 score ≥10) at 12 months.
Results
At enrollment, 5,217 initiated an IUD or OCPs. At 12 months, 3,882 participants were
still using their method and were included in this analysis. LNG-IUD users were more
likely to have a positive depression screen at baseline, followed by copper IUD and
OCP users (22.1% vs. 20.1% vs. 17.1%, p=0.04). After adjusting for positive depression
screen at baseline, history of depression or anxiety, and parity, LNG-IUD and OCP
users were no more likely to have a positive depression screen at 12 months compared
with copper IUD users (Rradj 1.02; 95% CI, 0.87–1.18; Rradj 0.93, 0.72–1.19, respectively).
The proportion of patients discontinuing their method prior to 12 months due to worsening
mood did not differ between method groups (range, 2.2–4.9%; p=0.31).
Conclusions
Among individuals using contraception for 12 months, those initiating a LNG-IUD or
OCPs were no more likely to screen positive for depression at 12 months compared to
copper IUD users.
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Copyright
© 2022 Published by Elsevier Inc.
