February 15, 2023
The risk of depression associated with the use of a hormonal IUD is well known. A recent study reveals that reducing the dose of levonorgestrel may lower the risk.
Developing depressive symptoms, suffering from sleep disturbances following the insertion of a hormonal intrauterine device (IUD). Many women have experienced these well-documented side effects of IUDs containing levonorgestrel. According to recent work by the GIS Epi-Phare, opting for IUDs that are less loaded with hormones would reduce the risk of using antidepressants.
The epidemiological study conducted on health insurance reimbursement data concerns “girls and women aged 13-40, with no prior use of a hormonal IUD and no prior use of psychotropic drugs, who received a 52 mg IUD in 2019 and a control group who received a 19-mg IUD, 5mg”.
Risk increase “weak but significant”
Result, “a small but significant increased risk of antidepressant use within 2 years following insertion of an IUD containing 52 mg of levonorgestrel compared to a lower dose IUD”, note the authors. The increased risk was precisely 4% in the 52 mg group once morest 3.6% in the 19.5 mg group.
This difference is “weak, but significant”, say the authors. As a result “This result is important to take into account at the population level and requires additional studies”. Especially since the existence of less dosed IUDs offers an alternative to devices more loaded with hormones. In France, these are Kyleena and Jaydess, which contain 19.5mg and 13.5mg of levonorgestrel respectively, unlike Mirena and Donasert which contain 52mg.
Follow-up and prevention of adverse effects
The ANSM recalls that“a medical check-up must be carried out 4 to 6 weeks following installation, then once a year, or more frequently if necessary”. Without forgetting that to allow a better follow-up, a “Patient card given at the time of insertion makes it possible to note the date of insertion and the deadline for removal of the IUD”.
Finally, “in the event of mood changes and the occurrence of depressive symptoms, including at the start of treatment, women are advised to contact their doctor”, concludes the agency.
