Studies have shown associations between levonorgestrel intrauterine systems and depression, antidepressant use, or anxiolytic use. A 19.5-mg levonorgestrel intrauterine system, indicated for contraceptive use, has been marketed in France since 2018 and its lower dosage may lead to fewer adverse mental health effects.
We conducted a nationwide matched-cohort study using data from the French National Health Insurance database (SNDS). We identified females aged 13 to 40 years who did not use a levonorgestrel intrauterine system in the 6 years before 2019 or psychotropic drugs in the previous year. In total, 45 736 females who received a 52-mg levonorgestrel intrauterine system and 45 736 who received a 19.5-mg levonorgestrel intrauterine system (mean age, 32.3 [SD, 5.4] and 31.8 [SD, 5.4] years, respectively) were well matched on most characteristics
This nationwide study in France found a low but statistically significant increased risk of antidepressant use associated with a 52-mg vs a 19.5-mg levonorgestrel intrauterine system; associations with the use of anxiolytics and hypnotics did not reach statistical significance. The difference in absolute percentages of antidepressant use were small and unlikely to be clinically important at an individual level. However, this result could be important on a population level.
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