title: Depressive symptoms in users and non-users of depot medroxyprogesterone acetate.
abstract: To evaluate the possible effects of depot medroxyprogesterone acetate (DMPA) injectable contraception on depressive symptoms, we conducted a population-based prospective study with women aged 18-39 years old enrolled at a health maintenance organization. At baseline, 183 women used DMPA and 274 were non-users. Data on depressive symptoms and on factors potentially related to DMPA use and depression were collected by questionnaire at 6-month intervals for up to 3 years. In multivariate longitudinal analysis, we found an increased likelihood of reporting depressive symptoms among continuous DMPA users (OR = 1.44; 95% CI = 1.00-2.07) and discontinuers (OR = 1.60; 95% CI = 1.03-2.48) when compared to non-users. Women who discontinued DMPA use had elevated depressive symptoms prior to discontinuation (OR = 2.30; 95% CI = 1.42-3.70) and immediately following discontinuation (OR = 2.46; 95% CI = 1. 46-4.14), and depressive symptoms subsided at subsequent visits relative to non-users. Our prospective analyses found an association between DMPA use and depressive symptoms but further research is needed to determine whether the relationship is causal.
authors.affiliation: Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Washington 98101, USA. civic.d@gnc.org
authors.forename: D
authors.initials: D
authors.lastname: Civic
authors.forename: D
authors.initials: D
authors.lastname: Scholes
authors.forename: L
authors.initials: L
authors.lastname: Ichikawa
authors.forename: A Z
authors.initials: AZ
authors.lastname: LaCroix
authors.forename: C K
authors.initials: CK
authors.lastname: Yoshida
authors.forename: S M
authors.initials: SM
authors.lastname: Ott
authors.forename: W E
authors.initials: WE
authors.lastname: Barlow
mesh_terms: D000293:Adolescent; D000328:Adult; D015519:Bone Density; D003271:Contraceptive Agents, Female / Q000008:administration & dosage / Q000009:adverse effects*; D003692:Delayed-Action Preparations; D003863:Depression / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007267:Injections; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects*; D016017:Odds Ratio; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate