Onset and recovery from depressive mood changes on progestin treatment - a case series reporting the course and type of depressive symptoms in progestin users with different histories and risks

A Muendane, Anne Muendane, Gabriele S. Merki‐Feld, G S Merki-Feld, Merki-Feld GS
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception · 2025 · vol. 30(5) , pp. 272–277 · doi:10.1080/13625187.2025.2525171 · PMID:40643903 · W4412202097
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This case series observed that seven women developed depressive symptoms within three months of starting progestin treatment, with all symptoms resolving soon after discontinuation.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This paper is a case series describing seven women who reported depressive symptoms after initiating synthetic progestin therapies (desogestrel, dienogest, or LNG-IUS 52 mg), with attention to timing of symptom onset, reversibility after discontinuation, and possible risk factors based on their histories. Depressive symptom onset occurred within 3 months for six participants, and one participant reported a family history of depression; three had previously experienced mood problems with another progestin. All users had symptom resolution soon after stopping the progestin, and after resolution two patients were able to tolerate a different progestin method. The study is limited by its small case-series design and the inability to identify clear risk factors in most women prior to prescribing. Relevance to endometriosis: the introduction states that progestin-only contraceptives are important treatment options for conditions like endometriosis, and the paper discusses progestin-associated mood adverse events that could affect endometriosis-related progestin use.

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Abstract

OBJECTIVE: Progestin-only contraceptives are commonly used in women with contraindications for the use of combined hormonal contraception. They are also important treatment options for medical conditions like endometriosis. Although it is well known that progestins may have a negative impact on mood, little is known on how to identify women at risk and the course of such an adverse event after discontinuation. This case series aimed to evaluate the onset and reversibility of depressive symptoms, as well as potential risk factors for the development of mood problems in new-starters of progestins. METHODS: Case series of patients, who reported symptoms of depression after initiating use of a synthetic progestin. RESULTS: Seven women reported depressive symptoms after newstart with desogestrel, dienogest or the LNG-IUS 52 mg. Symptom onset was within 3 months in six cases. One woman reported a family history of depression. In all users symptoms resolved soon after discontinuation. Three patients had experienced mood problems with another progestin in the past. After symptoms had resolved two patients tolerated another progestin method. CONCLUSION: Depressive symptoms after newstart of a progestin came up soon. It is promising that symptoms resolved within few weeks after discontinuation. Close follow-up of all newstarters is recommended.
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Abstract

Objective Progestin-only contraceptives are commonly used in women with contraindications for the use of combined hormonal contraception. They are also important treatment options for medical conditions like endometriosis. Although it is well known that progestins may have a negative impact on mood, little is known on how to identify women at risk and the course of such an adverse event after discontinuation. This case series aimed to evaluate the onset and reversibility of depressive symptoms, as well as potential risk factors for the development of mood problems in new-starters of progestins.

Methods

Case series of patients, who reported symptoms of depression after initiating use of a synthetic progestin.

Results

Seven women reported depressive symptoms after newstart with desogestrel, dienogest or the LNG-IUS 52 mg. Symptom onset was within 3 months in six cases. One woman reported a family history of depression. In all users symptoms resolved soon after discontinuation. Three patients had experienced mood problems with another progestin in the past. After symptoms had resolved two patients tolerated another progestin method.

Conclusion

Depressive symptoms after newstart of a progestin came up soon. It is promising that symptoms resolved within few weeks after discontinuation. Close follow-up of all newstarters is recommended. SHORT CONDENSATION A case series evaluating timing of symptom onset and reversibility of depressive symptoms induced by progestin use. Risk factors could not be identified in the history before prescription for most women. Therefore close follow-up and information of newstarters are relevant. 摘要 目的 单孕激素避孕药常用于联合激素避孕禁忌的女性, 同时在子宫内膜异位症等疾病的治疗中具有重要作用。尽管已有证据提示孕激素可能对情绪产生不良影响, 但关于如何识别高风险人群及停药后症状转归的研究仍然有限。本研究旨在探讨新使用孕激素者抑郁症状的发生时间、可逆性及相关危险因素。 方法 收集并分析使用合成孕激素后出现抑郁症状患者的病例。 结果 共7例女性在新开始使用去氧孕酮、地诺孕酮或52 mg左炔诺孕酮宫内系统后出现抑郁症状, 其中6例在3个月内发病。1例患者有抑郁家族史。所有患者在停药后症状均迅速缓解。另有3例患者既往使用其他孕激素时亦曾出现情绪问题。症状缓解后, 2例能够耐受另一种孕激素方法。 结论 新使用孕激素者的抑郁症状多在早期即出现, 且在停药后可于数周内逆转。建议对孕激素新使用者进行密切监测与随访。 Ethical statement By the regulation of the Cantonal Ethics Committee of Zürich, Switzerland, this research fulfils the criteria of a «practical experience report», where no additional ethical approval besides a written general consent to analyse the medical data obtained during clinical routine is required. This general consent form was obtained from all patients. Disclosure statement No potential conflict of interest was reported by the author(s). Data availability statement The data that support the findings of this study are available from the corresponding author, [am], upon reasonable request.

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Condition tags

endometriosis

MeSH descriptors

Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression Depression

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