BACKGROUND:
The use of combined oral contraceptives (COCs) is widespread among young women for various reasons, whereas their association with mental health remains unclear. The aim of study was to assess the emotional well-being of young women aged 20–25 who had been using COCs [low-dose ≤ 20 μg or medium-dose 30–35 μg ethinylestradiol (EE)] ˃ 6 months, compared to those who had never used hormonal contraceptives.

METHODS:
Data were collected using questionnaires, including Emotional State Questionnaire. Four subscales were examined: depression, anxiety, fatigue, and insomnia. Descriptive statistics, t-test or χ² test, and Spearman's correlations were used; p-value of < 0.05 was considered as significant.

RESULTS:
The sample consisted of 45 subjects: 26 COC-users (21.9 ± 1.8 yrs; medium-dose EE n=8, low-dose EE n=18) and 19 non-users (21.6 ± 1.5 yrs). The use of COCs was initiated at 17.2 ± 1.8 yrs and had continued for 4.3 ± 2.0 yrs at the start of study. 69.2% used COCs to prevent pregnancy, 38.5% for irregular menstruation and 26.9% for acne. Symptoms of fatigue were observed in 73.1%, depression 38.5%, anxiety 38.5%, and insomnia 23.1% of COC-users, whereas symptoms` prevalence among non-users were 63.2%, 42.1%, 42.1%, and 26.3%, respectively. There were no differences between the groups. Insomnia was common among low-dose EE users compared to medium-dose users (27.8% vs 12.5%), but there was no statistical difference. Correlation analysis did not reveal a statistically significant association between mental health symptoms score (depression, anxiety, fatigue, and insomnia) and duration of the use of COCs. In the case of anxiety and fatigue, the correlation coefficient was positive, but not statistically significant.

CONCLUSIONS:
The results point to a worrying emotional state among young women; however, due to the small sample size, no definitive conclusions can be drawn regarding the association with COCs use.