Meta-analysis: Do Combined Oral Contraceptives Relieve Premenstrual Depressive Symptoms?
BACKGROUND AND PURPOSE:
Combined oral contraceptives are often used as treatment for women with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) but data on efficacy is limited
In a review and meta-analysis, de Wit et al. (AJOG, 2021) assessed the efficacy of combined oral contraceptives in managing premenstrual depressive symptoms
Systematic review and meta-analysis
Studies that evaluated the efficacy of combined oral contraceptives in women with PMS or PMDD
Random effect Bayesian pairwise and network meta-analysis
Certainty of evidence was assessed using GRADE criteria
Change in premenstrual depressive symptoms and overall premenstrual symptomatology between baseline and 3 cycles
9 trials | 1205 women
Mean age: 24.6 to 36.5 years
Combined oral contraceptives were more efficacious than placebo in treating overall premenstrual symptomatology
Standardized mean difference 0.41 (95% CI, 0.17 to 0.67)
Combined oral contraceptives did not have a significant effect on premenstrual depressive symptoms specifically
Standardized mean difference 0.22 (95% CI, -0.06 to 0.47)
None of the combined oral contraceptives were more effective than others in reducing premenstrual depressive symptoms and overall premenstrual symptomatology
The use of combined oral contraceptives may improve overall premenstrual symptoms for those with PMS or PMDD, but not premenstrual depressive symptoms
No one type of combined oral contraceptive was superior to another for symptom reduction
The authors state
In women who predominantly complain about depressive symptoms, other commonly used treatment options for women with PMDD, such as selective serotonin reuptake inhibitors and cognitive-behavioral therapy, might be a more effective approach
In contrast to what is often thought, there was no evidence for a difference in efficacy among formulations containing drospirenone and other formulations or a 24-day regimen vs other regimens
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan