From the Guidelines
For patients experiencing mood swings on Junel, switching to a pill with a different progestin component, such as drospirenone (like Yaz or Yasmin), desogestrel (like Marvelon), or levonorgestrel (like Levora), may help alleviate symptoms. According to the most recent guidelines, specifically the 2024 U.S. Selected Practice Recommendations for Contraceptive Use 1, these alternatives can be considered. Drospirenone-containing pills, in particular, may be beneficial due to their anti-androgenic properties and mild diuretic effects that can help with mood symptoms.
When switching to a new contraceptive pill, patients should use backup contraception for the first seven days, as recommended in the 2024 guidelines 1. It is also essential to note that it may take 2-3 months to fully adjust to the new hormonal balance. Mood symptoms often relate to how the progestin component interacts with hormone receptors in the brain, and individual responses vary significantly.
Some key points to consider when switching contraceptive methods include:
- Starting a new method at any time, with a follow-up pregnancy test in 2-4 weeks if there is uncertainty about pregnancy 1
- Using backup contraception for a specified period, depending on the method and timing of initiation 1
- Potential benefits and risks associated with each method, including the risk of venous thromboembolism (VTE) and the importance of medical eligibility criteria 1
If mood symptoms persist across multiple pill formulations, non-hormonal methods like copper IUDs or barrier methods might be worth considering, as they do not carry the same risks associated with hormonal contraceptives, such as VTE, as noted in the 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases 1.
From the FDA Drug Label
Drospirenone and ethinyl estradiol tablets may also be taken to treat premenstrual dysphoric disorder (PMDD) if you choose to use the Pill for birth control. PMDD is a mood disorder related to the menstrual cycle. PMDD significantly interferes with work or school, or with usual social activities and relationships with others. Symptoms include markedly depressed mood, anxiety or tension, mood swings, and persistent anger or irritability
For a patient experiencing mood swings on Junel (norethindrone acetate and ethinyl estradiol), a different birth control pill that may be recommended is drospirenone and ethinyl estradiol tablets 2, as it is indicated for the treatment of premenstrual dysphoric disorder (PMDD), which includes symptoms of mood swings. However, it is essential to consult a healthcare provider to determine the best course of treatment, as they will assess the patient's overall health and medical history to make an informed decision.
From the Research
Alternative Birth Control Pills for Mood Swings
If a patient is experiencing mood swings on Junel (norethindrone acetate and ethinyl estradiol), alternative birth control pills can be considered.
- Drospirenone-containing birth control pills, such as those with ethinyl estradiol, may be an option 3, 4, 5, 6.
- These pills have been shown to improve premenstrual symptoms, including mood swings, in women with premenstrual dysphoric disorder (PMDD) 3, 4, 5, 6.
- However, it's essential to note that drospirenone-containing pills may also lead to more adverse effects, such as breast pain, nausea, and intermenstrual bleeding 3, 4.
Considerations for Hormonal Contraception and Mood Disorders
When considering alternative birth control pills, it's crucial to take into account the patient's individual response to hormonal contraception and potential mood disorders.
- Hormonal contraception can precipitate or perpetuate depression in some patients, particularly those with a history of mood disorders 7.
- The type and amount of progestogen in oral contraceptive pills can affect mood, with newer pills containing physiological forms of estrogen potentially being better tolerated 7.
- Clinicians should carefully monitor the patient's mood and adjust the birth control regimen as needed to minimize adverse effects on mental health 7.