The effect of various oral contraceptive combinations on premenstrual symptoms

Abstract

The influence of different oral contraceptives on premenstrual complaints was examined in 191 randomly selected women from an urban population. Premenstrual depression and abdominal swelling was significantly more common in women taking oral contraceptives containing the progestogen component lynestrenol than those containing norgestrel. The reason for this difference is discussed. A deficiency of pyridoxine which affects tryptophan metabolism can explain the difference in premenstrual depression. However, it should be emphasized that the system which controls neuro-endocrine balance is extremely complicated and does not at the present time permit any definite conclusions regarding the influence of oral contraceptives on mental complaints.

PIP: The frequency and degree of severity of defined premenstrual symptoms in a group of women treated with different oral contraceptives (OCs) was studied through mail questionnaires completed by 913 of 1083 women aged 18-46 randomly selected from the Gothenburg population register. The 6 symptoms studied, irritability, depression, anxiety, swelling of fingers and legs, abdominal swelling, and breast swelling, were defined according to the Comprehensive Psychopathological Rating Scale (CPRS). The Pitman Permutation Test was used in the statistical analysis. Of the 191 women who reported taking OCs, 116 (57.4%) used preparations containing norgestrel, 57 (23.2%) used preparations containing lynestrenol, and 7.9% used preparations containing norethisterone. The premenstrual symptoms of irritability and abdominal swelling had the highest symptom scores irrespective of the OC taken. There was no statistical difference between estrogen and progestogen dominated OCs in the severity of the individual symptoms. Women taking lynestrenol were significantly more depressed and had a greater degree of abdominal swelling than women taking norgestrel, but there was no difference between them in the severity of the other symptoms.