Onset and recovery from depressive mood changes on progestin treatment - a case series reporting the course and type of depressive symptoms in progestin users with different histories and risks.

OBJECTIVE: Progestin-only contraceptives are commonly used in women with contraindications for the use of combined hormonal contraception. They are also important treatment options for medical conditions like endometriosis. Although it is well known that progestins may have a negative impact on mood, little is known on how to identify women at risk and the course of such an adverse event after discontinuation. This case series aimed to evaluate the onset and reversibility of depressive symptoms, as well as potential risk factors for the development of mood problems in new-starters of progestins.

METHODS: Case series of patients, who reported symptoms of depression after initiating use of a synthetic progestin.

RESULTS: Seven women reported depressive symptoms after newstart with desogestrel, dienogest or the LNG-IUS 52 mg. Symptom onset was within 3 months in six cases. One woman reported a family history of depression. In all users symptoms resolved soon after discontinuation. Three patients had experienced mood problems with another progestin in the past. After symptoms had resolved two patients tolerated another progestin method.

CONCLUSION: Depressive symptoms after newstart of a progestin came up soon. It is promising that symptoms resolved within few weeks after discontinuation. Close follow-up of all newstarters is recommended.