Impacts of Oral Contraceptive Use on Depressive and Anxious Symptoms: An Integrative Review

Abstract

Aims: This integrative review analyzed the psychological effects of oral contraceptives (OCs), focusing on depressive and anxious symptoms. It examined the influence of age, OC type, psychiatric history, and genetic predisposition, aiming to support individualized prescribing strategies. Study Design: Integrative literature review. Methodology: The review followed PRISMA guidelines. Searches were conducted on November 20, 2024, across PubMed, SciELO, MEDLINE, LILACS, and BVS, targeting studies published from 2014 to 2024. Boolean terms included "oral contraceptives," "depression," and "anxiety." Nineteen primary studies were included, involving diverse populations and methodologies (quantitative, qualitative, mixed). Results: Adolescents using OCs, especially progestin-only types, showed higher risks of depressive and anxious symptoms. Combined OCs were associated with emotional stability, particularly in adults without psychiatric histories. Monophasic formulations induced fewer mood fluctuations than multiphasic ones. Genetic predisposition and mental health history were identified as key risk factors. Some subgroups showed mood stabilization and reduced emotional variability. Conclusion: Emotional impacts of OCs depend on age, formulation, and psychiatric background. Clinicians should assess psychiatric history before prescribing OCs, especially for adolescents and high-risk women. These findings support personalized contraceptive counseling and the integration of mental health screening into clinical practice.