Weyand AC, Fitzgerald KD, McGrath M, et al. - According to this retrospective cohort study, heavy menstrual bleeding (HMB) is linked to depression in adolescent females. In a multivariable analysis that included HMB, age, BMI, anxiety, sexual activity, and substance use, the use of hormonal contraception was not associated with depression diagnosis. Because hormonal contraception is frequently used to treat HMB, it is possible that HMB is contributing to previous reports of increased depression risk in those using hormonal contraception.

• The sample consisted of 1,168 females, aged 9 to 18 years, presenting to general pediatricians for HMB or well visits.

• There were 581 adolescents with HMB and 587 without.

• Depression diagnoses were more common in youth with HMB compared with those without HMB, but there was no significant difference between those using vs not using hormonal contraception.

• The majority of patients with depression and HMB developed depression after or concurrent with HMB.

• Of these, 199/261 (76%) were given hormonal contraception, but the majority (168/199 (84%)) had been diagnosed with depression prior to starting.