Changes in Psychological Symptoms in Women Taking Oral Contraceptives

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Abstract
Oestrogens have been used for some years to treat dysmenorrhoea (Lyon, R. A., 1942; Sturgis, S. H., 1943). Our results agree with other authors (Nilsson and Sölvell) that the Pill relieves dysmenorrhoea in the majority of cases. In our series there was marked diminution of premenstrual depression and irritability, although premenstrual headaches and swelling were not altered. The difference in the response of these two sets of symptoms suggests that the psychological and somatic components of the premenstrual syndrome may be produced by different mechanisms. Support for this view comes from a recent double blind trial of norethisterone and diuretic in the premenstrual syndrome (Coppen et al., 1969). This reported that the psychological symptoms were relieved by a diuretic, but not by norethisterone, which, however, improved premenstrual swelling. A certain number of women developed psychological side effects, including depression. The numbers are too small, at this stage, to say whether this is a statistically significant effect, but a 5 to 10 per cent. incidence of depression is of importance when the very great number of women taking the Pill is considered. The women who developed depression and irritability as side effects had higher Neuroticism and Extraversion scores than the Pill group as a whole, and they also had an increased incidence of moderate or severe premenstrual depression before starting the Pill. In conclusion, we have demonstrated that dysmenorrhoea and certain premenstrual symptoms are relieved by the Pill, and that it produces certain side effects in a small percentage of women.

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