Which birth control is safe for women with depression at 26?
Patient's Query
Hello doctor,
I am a 26-year-old female with a history of depression. I have been stable on an SSRI, but I am considering starting contraception. I have heard that some hormonal contraceptives can impact mood.
Which birth control methods are least likely to worsen depression?
Please advise.
Hello,
Welcome to icliniq.com.
I understand your concerns and appreciate you sharing the details.
Based on your situation, Mirena (hormonal intrauterine device) may be the best contraceptive option for you, though the final choice also depends on how long you wish to continue family planning. Mirena is a hormonal intrauterine device (IUD) used for both contraception and the treatment of heavy menstrual bleeding. It is a T-shaped plastic device that releases levonorgestrel (LNG) directly into the uterus.
This not only prevents pregnancy but also often reduces menstrual bleeding. Mirena can be used for up to eight years for contraception and up to five years for managing heavy bleeding. It contains 52 milligrams of Levonorgestrel and releases approximately 20 µg/day into the uterine cavity. It offers effective contraception, typically resulting in shorter, lighter, and less painful periods.
Other LNG-IUS options include:
- Jaydess: Contains 13.5 milligrams of Levonorgestrel. Releases 6 to 10 µg/day. Smaller in size and suitable for women who have not given birth.
- Kyleena: Contains 19.5 milligrams of Levonorgestrel. Releases 17.5 µg/day.
- Liletta: Releases approximately 18.6 µg/day.
Mechanism of action:
- Thickens cervical mucus, making it difficult for sperm to enter the uterus.
- Inhibits fertilization and ovulation.
- Thins the endometrial lining (causing endometrial atrophy), making implantation unlikely.
Indications:
- Long-term contraception (up to five years).
- Heavy menstrual bleeding.
- Dysmenorrhea (painful periods).
- Premenstrual syndrome (PMS).
Contraindications:
- Known or suspected pregnancy.
- Current or recurrent pelvic inflammatory disease (PID).
- Active genital tract infections (cervicitis or endometritis).
- Cervical or endometrial cancer.
- Cervical polyps.
Based on your history and needs, I recommend considering Mirena, but please consult with your gynecologist to discuss the best option tailored to your personal and medical history.
I hope this helps you.
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