Rationale:
There is considerable heterogeneity in the findings on use of progesterone only contraceptives and mental health in premenopausal women. Most of the available evidence on the association between progesterone and mental health exists as part of adverse event information from clinical trials focusing on menopausal hormone therapy or treatments for gynecological illnesses. This study was therefore, conceptualized with the main objective of evaluating whether consumption of progesterone or analogs is associated with depression, anxiety or mood dysphoria in premenopausal females.
Aim: In this large-scale longitudinal cohort study, we plan to investigate whether exposure to progesterone or synthetic analogs is associated with mental health outcomes.
Research questions:
1) Is the occurrence of diagnosis of depression similar in pre-menopausal women with exposure to progesterone only compared to those who use combination of progesterone + estrogen versus those who do not use either hormones any exposure?
2) Is the occurrence of diagnosis of anxiety similar in pre-menopausal women with exposure to progesterone only compared to those who use combination of progesterone + estrogen versus those who do not use either hormones compared to those who do not have any exposure?
3) Is the occurrence of diagnosis of mood dysphoria similar in pre-menopausal women with exposure to progesterone only compared to those who use combination of progesterone + estrogen versus those who do not use either hormones compared to those who do not have any exposure?
4) Is the length of exposure to progesterone associated with depression or anxiety or mood dysphoria?
5) Does any association between long-term exposure to progesterone and depression, anxiety, ! exist after adjustment for age, ethnicity, socioeconomic status, education level, prior mental health illness, BMI and polycystic ovarian syndrome (PCOS).