{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T20:49:01Z","timestamp":1781038141409,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004441","name":"Styrelsen f\u00f6r Internationellt Utvecklingssamarbete","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004441","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006661","name":"United Nations Population Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the effects of depot medroxyprogesterone acetate (DMPA\u2010IM), levonorgestrel (LNG) implant, and copper intrauterine device (IUD) on mood and sexual function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>At the Effective Care Research Unit in South Africa, women already randomized in the ECHO Trial to the three methods were asked to participate in this study. Participants were interviewed at 3 and 12\u00a0months after enrollment using the Beck Depression Inventory and Arizona Sexual Experiences Scale, and at 12\u00a0months using the WHO\u20105 Wellbeing Index and the Patient Global Impression scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 605 women participated. There was little difference in depression at 3\u00a0months across the three study groups. Contrary to our hypothesis, at 12\u00a0months, depression was lowest among DMPA\u2010IM users (16\/167, 9.6%) and highest among IUD users (28\/158, 17.7%) (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.032). There was little difference in sexual function at any time\u2010point. More women in the DMPA\u2010IM group felt \u201cvery much better\u201d on the PGI scale than in the IUD and LNG implant groups (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Depression may be less likely with DMPA\u2010IM than with the other methods 1\u00a0year after initiation. Major differences in sexual functioning are unlikely. Unhappiness related to not using DMPA\u2010IM, the most popular method in our setting, may have skewed results.<\/jats:p><jats:p>Trial registration number: PACTR201706001651380.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13594","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T21:32:59Z","timestamp":1610746379000},"page":"256-262","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Effects of three contraceptive methods on depression and sexual function: An ancillary study of the ECHO randomized trial"],"prefix":"10.1002","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4193-8786","authenticated-orcid":false,"given":"Mandisa","family":"Singata\u2010Madliki","sequence":"first","affiliation":[{"name":"Effective Care Research Unit Eastern Cape Department of Health\/Universities of the Witwatersrand and Fort Hare East London South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Carayon\u2010Lefebvre d\u2019Hellencourt","sequence":"additional","affiliation":[{"name":"FHI 360 Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa A.","family":"Lawrie","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit Eastern Cape Department of Health\/Universities of the Witwatersrand and Fort Hare East London South Africa"},{"name":"Evidence\u2010based Medicine Consultancy Ltd Bath UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusentha","family":"Balakrishna","sequence":"additional","affiliation":[{"name":"Biostatistics Research Unit South African Medical Research Council Durban South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Justus","family":"Hofmeyr","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit Eastern Cape Department of Health\/Universities of the Witwatersrand and Fort Hare East London South Africa"},{"name":"Department of Obstetrics and Gynecology University of Botswana Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2016.07.008"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-016-0153-9"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(19)31288\u20107"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.2387"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2017.17060616"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt188"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194773"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1998.tb09940.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2015-101334"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743\u20106109.2012.02848.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010019205"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102017\u2010019205"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0272-7358(88)90050-5"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/009262300278623"},{"key":"e_1_2_9_16_1","unstructured":"World Health Organization.The WHO\u2010five well\u2010being Index.https:\/\/www.psykiatri\u2010regionh.dk\/who\u20105\/Documents\/WHO5_English.pdf(Accessed 20\u20104\u20102020)."},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2018.05.006"},{"key":"e_1_2_9_18_1","volume-title":"Stata: Release 15. 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