The Influence of Hormonal Contraceptive Use on Psychiatric Health

Abstract

Introduction: The use of hormonal contraceptives represents a significant advancement in reproductive health, offering effective contraception and the management of gynecological conditions. However, their effects on psychiatric health remain a subject of debate. This article aims to synthesize current evidence and contribute to individualized clinical counseling, striving for a balance between contraceptive efficacy, safety, and psychiatric well-being. Methodology: This is a literature review based on articles in both Portuguese and English, retrieved from PubMed, Scielo, and Google Scholar. The search included observational studies, cohorts, and meta-analyses published from 1997 to August 2025. Older references were utilized to provide historical context. Results and Discussion: The majority of HC users experience neutral or minimal effects on mood. However, adolescents, young women, and those with a history of psychiatric conditions may be at a higher risk of developing depressive symptoms, anxiety, and, in rare cases, suicidal behavior. Progestin-only methods show a stronger association with mood alterations, whereas some combined formulations may reduce affective symptoms in specific conditions such as premenstrual dysphoric disorder. Neurobiological mechanisms include the modulation of neurotransmitters, the hypothalamic-pituitary-adrenal axis, and emotional processing. Psychosocial factors and the subjective perception of adverse effects influence method adherence and discontinuation. Conclusion: Although psychiatric adverse effects are relatively rare in the general population, a vulnerable subgroup exists that requires individualized clinical monitoring and a careful choice of contraceptive method, considering the hormonal formulation, age, and psychiatric history.