# Anxiety, depression and perseverative cognition in women cycling naturally or taking oral contraceptives – a diary study

## TL;DR

This study compares anxiety, depression, and stress in women using oral contraceptives versus those cycling naturally.

## Contribution

It identifies differences in depression and self-esteem between types of oral contraceptive users and naturally cycling women.

## Key findings

- Anti-androgenic OC users had higher daily depression than NC women across all three cycle phases.
- Both OC groups had lower daily self-esteem than NC women in all phases.
- Androgenic OC users showed higher life satisfaction than anti-androgenic users in one phase.

## Abstract

While the literature is inconsistent about the link between anxiety and oral contraceptives (OC), the link between depression and OC is recognized in women who started OC during adolescence. Perseverative cognition is a stress-coping mechanism present both in anxiety and depression. Our study aimed to understand the differences between women taking OC and naturally cycling (NC) women regarding their daily levels of anxiety, depression, related negative factors (perseverative cognition and stress), and protective factors (self-esteem and life satisfaction).

The study was conducted on 89 adult women (M age = 26.60, SD = 4.65) (48 – OC; 41 – NC) who participated in a 15-day online diary study divided into 3 phases throughout one menstrual cycle. The women using OC were further classified according to the androgenicity of their OC (androgenic and anti-androgenic). The participants were sent an email in the evening with questionnaires they had to complete on the same day. The daily measures were taken from existing trait-level scales and adapted for daily administration. The analyses were conducted using hierarchical linear modeling, with a significance level of p < 0.05.

There were no differences between groups in daily levels of anxiety, perseverative cognition, and stress. However, anti-androgenic OC users had higher levels of daily depression than NC women in the three menstrual cycle phases tested for, while androgenic OC users had higher levels of daily depression than NC women in two phases. Both groups of women taking OC had lower levels of daily self-esteem than NC women in all three phases. Androgenic OC users had higher daily satisfaction with life than anti-androgenic OC users in one testing phase.

OC users had higher daily levels of depression and lower daily levels of self-esteem than NC women. Future studies could explore the link between depression and the different types of OC in adult women, especially with longitudinal methods.