[On some psychiatric complications of oral contraception].

After a summary of the types of oral contraceptives available their mechanism and side effects the authors critically review the psychological literature up to 1970 on systematic studies of the pill case reports of worsening or improvement of psychiatric symptoms during pill use the effect of the pill on epilepsy its use in mental patients for contraception and the predominant theories of pathogenesis. The authors conclude that the pill probably relieves dysmenorrhea but may cause chronic irritability depression and premenstrual tension-like symptoms especially in those with a history of premenstrual syndrome. Most cases of psychiatric symptoms appearing or worsening during oral contraception are in women with psychiatric history particularly postpartum psychosis. There are reports of mentally ill patients who improved with the pill for example women who were being successfully treated for endometriosis. Oral contraceptives will probably help epileptics if the dose of medication is adjusted since progesterone is a depressant. The pill should be offered to patients resuming a normal social life but failure rate is reportedly higher than for normal women. The chief theories of the pathogenic action of the pill concern metabolism of tryptophane monoamines catecholamines and the steroid hormones themselves. The authors suggest that temporary sterility or the new responsibilities associated with new sex roles may also be important etiologic factors in psychologic problems associated with oral contraception.