--- title: Do birth control pills help with depression and other symptoms of PMS? description: Birth control pills help reduce overall PMS symptoms but not depression specifically. No particular pill is more effective than others. url: https://niyora.com/research/papers/efficacy-of-combined-oral-contraceptives-for-depressive-symptoms-and-overall-2021/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Do birth control pills help with depression and other symptoms of PMS? Systematic review, 2021 # Do birth control pills help with depression and other symptoms of PMS? Birth control pills help reduce overall PMS symptoms but not depression specifically. No particular pill is more effective than others. Strong study design Women with PMS or PMDD (1,205 total, aged 24.6 to 36.5 per study). ## What they did Researchers searched medical databases for randomized trials comparing birth control pills to placebo in women with PMS or PMDD. They found 9 trials involving 1,205 women. Mean age per study ranged from 24.6 to 36.5 years. ## What they found Compared to placebo, birth control pills improved overall PMS symptoms. However, they did not significantly reduce depressive symptoms. When different pills were compared to each other, none was more effective than the others at reducing symptoms. ## What it means for you Birth control pills can reduce PMS physical symptoms like bloating and mood swings, but don't specifically treat depression. They may be reasonable if you also want contraception, but SSRIs might work better for depression. The evidence is from good-quality studies but some differences were modest. 9 Randomized trials included 1205 Total women studied 0.41 Effect size for overall symptom improvement ## About the study Original title Efficacy of combined oral contraceptives for depressive symptoms and overall symptomatology in premenstrual syndrome: pairwise and network meta-analysis of randomized trials Authors de Wit AE, de Vries YA, de Boer MK et al. Journal American journal of obstetrics and gynecology Year 2021 Study design Systematic review What was tested Combined oral contraceptive pills versus placebo. Open access Yes Read the paper [doi.org/10.1016/j.ajog.2021.06.090](https://doi.org/10.1016/j.ajog.2021.06.090) Original abstract Objective: Combined oral contraceptives are often considered a treatment option for women with premenstrual syndrome or premenstrual dysphoric disorder also seeking contraception, but evidence for this treatment is scarce. We aimed to determine (1) the level of evidence for the efficacy of combined oral contraceptives in managing premenstrual depressive symptoms and overall premenstrual symptomatology and (2) the comparative efficacy of combined oral contraceptives (the International Prospective Register of Systematic Reviews registration number CRD42020205510). Data sources: We searched Cochrane Central Register of Controlled Trials, PubMed, Web of Science, PsycINFO, EMCare, and Embase from inception to June 3, 2021. Study eligibility criteria: All randomized clinical trials that evaluated the efficacy of combined oral contraceptives in women with premenstrual syndrome or premenstrual dysphoric disorder were considered eligible for inclusion in this meta-analysis. Study appraisal and synthesis methods: A random effect Bayesian pairwise and network meta-analysis was conducted with change in premenstrual depressive symptoms and overall premenstrual symptomatology between baseline and 3 cycles as outcome. Certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Results: Of 3664 records, 9 eligible trials were included that studied 1205 women with premenstrual syndrome or premenstrual dysphoric disorder (mean age per study range, 24.6-36.5 years). The pairwise meta-analysis revealed that combined oral contraceptives were more efficacious than placebo in treating overall premenstrual symptomatology (standardized mean difference, 0.41; 95% credible interval, 0.17-0.67), but not premenstrual depressive symptoms specifically (standardized mean difference, 0.22; 95% credible interval, -0.06 to 0.47). However, none of the combined oral contraceptives were more effective than each other in reducing premenstrual depressive symptoms and overall premenstrual symptomatology. Conclusion: Combined oral contraceptives may improve overall premenstrual symptomatology in women with premenstrual syndrome or premenstrual dysphoric disorder, but not premenstrual depressive symptoms. There is no evidence for one combined oral contraceptive being more efficacious than any other. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Systematic review, 2024 What are the best treatments for PMDD and PMS? 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