Associations between self-reported mood-related symptoms and early contraceptive method discontinuation

OBJECTIVE: There have been mixed findings regarding the psychological impacts of hormonal contraceptive methods. Some studies suggest negative mood symptoms with hormonal methods, while others report improved mood or no effect. To better inform clinical counseling, this study examines associations between self-reported mood-related symptoms and contraception discontinuation within the first 6 months of use, accounting for self-reported baseline mood symptoms and method type. STUDY DESIGN: This secondary analysis uses data from the HER Salt Lake initiative, a prospective cohort study of 4425 individuals initiating a new contraceptive method between September 2015 and March 2017. Participants were followed for 3 years, with method switching and discontinuation offered at no cost. Surveys were administered at baseline and at months 1, 3, and 6, capturing self-reported mood-related symptoms in the prior 4 weeks, contraceptive use status, and reasons for discontinuation. Chi-square tests examined the self-reported reasons for discontinuation across method types. Mixed effects logistic regression models evaluated the effect of self-reported baseline mood-related symptom burden on discontinuation, stratified by hormone category (ie, progestin-only, combined hormone, and nonhormonal) and controlling for baseline symptom frequency. Given the small sample size of those who discontinued their methods in the first 6 months, no additional covariates were included to avoid overfitting. RESULTS: Among participants who discontinued their method within 6 months (n=880), 28% of progestin-only users (110/389), 21% of combined hormonal users (80/386), and 10% of nonhormonal users (11/105) self-reported mood-related symptoms (ie, moodiness and/or depressive symptoms) as a contributing reason for discontinuation (P=