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August 8, 2001

Depression and Hormonal Contraception—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(6):671-672. doi:10.1001/jama.286.6.671

In Reply: Dr Freeman raises a very important issue for clinicians who care for women: that depression is a serious health problem and is often overlooked. The relationship between hormonal patterns and depression, however, is not simple. Mood disorders and depression are reported in studies as reasons for contraceptive discontinuation by some women, and admonishing women to report symptoms of depression has been a commonly accepted clinical practice in providing progestin-only contraceptive methods. Depression and postpartum depression are common irrespective of contraceptive status, however, and a review of 400 peer-reviewed, published clinical studies involving 55 000 users of implantable levonorgestrel (Norplant, Wyeth-Ayerst) concluded that reports of mood disturbances, anxiety, and depression were similar to those reported by women using hormonal methods containing estrogen.1