Identifying psychiatric comorbidities that occur following the introduction of hormonal contraception: A Scoping review

Background Hormonal contraceptives are among the most widely used medications by women of reproductive age yet growing concerns have emerged regarding their potential impact on mental health. While mood-related side effects are frequently reported anecdotally, their prevalence, clinical significance, and relationship to specific contraceptive formulations remain poorly defined. Objective This scoping review aimed to examine the associations between hormonal contraception and psychiatric outcomes, with a focus on depressive symptoms, anxiety, and other mental health disorders. Methods A comprehensive literature search of four major databases was conducted to identify peer-reviewed studies published between 2014 and 2024. Forty-six eligible studies were included, spanning observational cohorts, cross-sectional surveys, and clinical trials. Study quality was appraised using the Joanna Briggs Institute checklist. A meta-analyse were performed with random-effects models and subgroup analyses stratified by hormonal class and psychiatric outcome. Results Pooled data revealed a small but statistically significant association between hormonal contraceptive use (especially progestin-only formulations) and increased risk of depressive symptoms and suicidality. Evidence for associations with anxiety and other psychiatric conditions was less consistent. Methodological heterogeneity, particularly in outcome measurement and control for confounding, was a frequent limitation. Conclusion The findings suggest that hormonal contraception, while highly effective for reproductive health, may contribute to adverse psychiatric outcomes in a subset of users. These results underscore the need for individualized risk assessment, integrated mental health screening in contraceptive care, and future prospective studies using standardized psychiatric endpoints to inform safer, more tailored contraceptive prescribing practices. Clinical trial number: not applicable.