Contraception for Women With Psychiatric Disorders.

Am J Psychiatry

Department of Psychiatry, Asher Center for the Study and Treatment of Depressive Disorders (Wisner; formerly Betcher, Cattan), and Department of Obstetrics and Gynecology (McCloskey, Stika, Kiley), Feinberg School of Medicine, Northwestern University, Chicago; Mayo Clinic, Rochester, Minn. (Betcher); AbbVie, Inc., North Chicago (Cattan).

Published: March 2021

Objective: Mental health care for women includes decision support to prepare for major life events, including preconception planning for treatment during pregnancy and the postpartum period. The authors discuss contraceptive choices and their effectiveness, side effects, and impact on psychiatric symptoms. The Centers for Disease Control and Prevention's recommendations, Medical Eligibility Criteria for Contraceptive Use, provided the structure for review of contraceptive choices.

Methods: A search of PsycINFO, PubMed, Embase, and Scopus was conducted for publications on the management of contraception for women with mental illness. Publications were selected if they included, based on the authors' consensus, data supporting evidence-based care important for psychiatrists who treat women desiring contraceptives.

Results: The majority of women choose combined oral contraceptives. Although long-acting reversible contraceptives (implants, intrauterine devices) are associated with low failure rates, favorable safety profiles, rapid return to fertility after removal, and few contraindications, they are chosen by only 14% of women. All methods are acceptable for women with depression, although medical comorbidities may dictate a specific type. The impact of hormonal contraceptives on the risk for depression is controversial; however, clinical studies and randomized placebo-controlled trials of women with psychiatric disorders have generally reported similar or lower rates of mood symptoms in hormonal contraceptive users compared with nonusers. Although interactions between psychotropic drugs and contraceptives are rare, clozapine, anticonvulsants, and St. John's Wort are exceptions.

Conclusions: Proactive management of mental illness, contraception, and pregnancy improves a woman's capacity to function and optimizes her mental and reproductive health.

Download full-text PDF

Source
http://dx.doi.org/10.1176/appi.ajp.2020.20020154DOI Listing

Publication Analysis

Top Keywords

contraception women
8
women psychiatric
8
psychiatric disorders
8
mental illness
8
women
7
disorders objective
4
mental
4
objective mental
4
mental health
4
health care
4

Similar Publications

Introduction: The intrauterine device (IUD) represents the most cost-effective, long-acting reversible form of contraception, but accounts for only 1% of all contraception methods used in Tanzania.

Objective: This study aims to determine the uptake of IUD use and investigate the perceptions, challenges, and recommendations surrounding the use of intrauterine devices among women of reproductive age in Tanzania.

Method: A cross-sectional study was conducted including 347 women, as well as qualitative semi-structured interviews with 11 women.

View Article and Find Full Text PDF

The intrauterine device (IUD) is a widely utilized contraceptive method. In cases of uterine rupture, an IUD can migrate to the intra-abdominal or pelvic cavity, leading to various complications such as gastrointestinal perforation. The aim of this study was to report a case of a 29-year-old woman presented with acute left lumber pain.

View Article and Find Full Text PDF

The intrauterine device (IUD) is an important and highly effective means of contraception. Migration of the IUD, post implantation, out of the uterus is an infrequent complication, and its subsequent migration into the urinary bladder with formation of secondary bladder calculi, is even more infrequently reported. The authors report a 51 year old woman who had had her last child delivered via cesarean section 16 years ago.

View Article and Find Full Text PDF

Background: Prevention of alcohol-exposed pregnancy (AEP) involves reducing risky alcohol consumption among women at-risk for pregnancy, using effective contraception among women drinking at risky levels to prevent pregnancy, or both. This study presents the outcomes of a randomized controlled trial assessing the efficacy of Native CHOICES, a culturally tailored adaptation of the CHOICES intervention, among American Indian/Alaska Native (AI/AN) women.

Methods: AI/AN women aged 18-44 who were at-risk for an AEP were randomly assigned in a 1:1 ratio to either the Native CHOICES intervention or a waitlist control group.

View Article and Find Full Text PDF

Background: Family planning facilities provide an extensive choice of assistance that is beneficial for women and the society. It may limit the fatality risk for mothers and babies by reducing the rate of pregnancies and abortions. The Government of Pakistan has been continuously trying to persuade the people about the importance of family planning.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!