Psychological symptoms are notoriously difficult to assess, and it is not surprising that the reported incidence of such symptoms in women taking oral contraceptives varies widely. The apparent incidence may further be influenced by what the subjects think they are expected to say. Clinical trials of oral contraceptives where psychological symptoms have been specifically studied provide the most reliable data, but control groups have so far been examined in only a few trials. Data on such symptoms from trials where unwanted effects were merely noted in passing are unreliable. There is however good evidence that synthetic progestagens influence cerebral activity1–3 and intermediary metabolism in the brain4 in both women and animals and that these effects do not mimic those of pregnancy.
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