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Thurley J, Buades-Rotger M, Serfling G, Howaldt T, Reisch N, Krämer UM. Reduced threat avoidance but increased stress induced approach bias in women taking oral contraceptives. Psychoneuroendocrinology 2024; 167:107111. [PMID: 38943719 DOI: 10.1016/j.psyneuen.2024.107111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/15/2024] [Accepted: 06/21/2024] [Indexed: 07/01/2024]
Abstract
Recent research has increasingly acknowledged the impact of oral contraceptives on affective behavior and stress responses; however, the underlying mechanisms are still not well understood. Studies have previously shown that steroid hormones modulate automatic approach and avoidance behavior. Here, we thus investigated the effects of oral contraceptives on approach and avoidance behavior and whether these effects are modulated by stress. The study comprised 130 female participants, half of whom were using oral contraceptives, while the other half were not using any hormonal contraception (NC). The participants completed the Approach Avoidance Task (AAT), which measures automatic approach and avoidance behavior to socio-affective signals. The AAT was run once before and once after a stress manipulation using the Socially Evaluated Cold Pressor Test. OC users showed absent avoidance behavior to social threat signals and a stress-induced increase in approach behavior to positive social signals. The latter was found in particular in women taking androgenic acting OC, demonstrating that different OC preparations need to be taken into account in research on OC effects. However, OC and NC group did not differ in their cortisol stress response. Overall, the results suggest that OC usage impacts on approach and avoidance behavior to social signals, which might also contribute to the development of affective side effects.
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Affiliation(s)
| | - Macià Buades-Rotger
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Georg Serfling
- Medizinische Klinik I und Institut für Endokrinologie und Diabetes, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Lübeck, Germany
| | | | - Nicole Reisch
- Medizinische Klinik und Poliklinik IV, LMU Klinikum München, Munich, Germany
| | - Ulrike M Krämer
- Institute of Medical Psychology, Center of Brain, Behavior and Metabolism (CBBM), University of Lübeck, Lübeck, Germany.
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2
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Mengelkoch S, Slavich GM. Sex Differences in Stress Susceptibility as a Key Mechanism Underlying Depression Risk. Curr Psychiatry Rep 2024; 26:157-165. [PMID: 38470558 PMCID: PMC10978685 DOI: 10.1007/s11920-024-01490-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE OF REVIEW Although females are at relatively greater risk for a variety of disorders, including depression, the biological mechanisms underlying this striking health disparity remain unclear. To address this issue, we highlight sex differences in stress susceptibility as a key mechanism potentially driving this effect and describe the interacting inflammatory, hormonal, epigenomic, and social-environmental mechanisms involved. RECENT FINDINGS Using the Social Signal Transduction Theory of Depression as a theoretical framework, women's elevated risk for depression may stem from a tight link between life stress, inflammation, and depression in women. Further, research finds hormonal contraceptive use alters cortisol and inflammatory reactivity to acute stress in ways that may increase depression risk in females. Finally, beyond established epigenetic mechanisms, mothers may transfer risk for depression to their female offspring through stressful family environments, which influence stress generation and stress-related gene expression. Together, these findings provide initial, biologically plausible clues that may help explain the relatively greater risk for depression in females vs. males. Looking forward, much more research is needed to address the longstanding underrepresentation of females in biomedical research on the biology of stress and depression.
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Affiliation(s)
- Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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3
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Mengelkoch S, Gassen J, Slavich GM, Hill SE. Hormonal contraceptive use is associated with differences in women's inflammatory and psychological reactivity to an acute social stressor. Brain Behav Immun 2024; 115:747-757. [PMID: 37914104 PMCID: PMC11216059 DOI: 10.1016/j.bbi.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/06/2023] [Accepted: 10/29/2023] [Indexed: 11/03/2023] Open
Abstract
Women using hormonal contraceptives (HCs) exhibit numerous signs of chronic inflammation, including elevated C-reactive protein levels and greater risk of developing mood and autoimmune disorders. However, users and non-users of HCs often have similar circulating proinflammatory cytokine levels, making the mechanism of association unclear. One possible explanation for this paradox is that HC users exhibit differences in their inflammatory responses to psychosocial stress that, over time, could contribute to chronic inflammation and its pathologies. Here, we tested this possibility by examining women's glucocorticoid, inflammatory, and psychological responses to the Trier Social Stress Test (TSST) in 67 naturally cycling (NC) and 60 oral HC-using women (Mage = 19.31, SDage = 1.95). As hypothesized, HC users and NC women exhibited different glucocorticoid and proinflammatory cytokine responses to the TSST. For NC women, TSST-induced increases in glucocorticoids were uncommon, and increases in glucocorticoids were accompanied by elevations in IL-6. In contrast, for women using HCs, increases in glucocorticoids in response to the TSST were common, and increases in glucocorticoids were accompanied by increases in TNF-α. HC users and NC women also differed in their psychological responses to the TSST, with HC users reporting elevated stress levels compared to NC women. Together, these results suggest that HC use impacts women's glucocorticoid, inflammatory, and psychological responses to psychosocial stress, potentially contributing to observed differences in these women's mental and physical health.
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Affiliation(s)
- Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, United States; Department of Psychology, Texas Christian University, 2955 South University Drive, Fort Worth TX 76129, United States.
| | - Jeffrey Gassen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, United States
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, United States
| | - Sarah E Hill
- Department of Psychology, Texas Christian University, 2955 South University Drive, Fort Worth TX 76129, United States
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Kraft MZ, Rojczyk P, Weiss T, Derntl B, Kikinis Z, Croy I, Heller C. Symptoms of mental disorders and oral contraception use: A systematic review and meta-analysis. Front Neuroendocrinol 2024; 72:101111. [PMID: 37967755 DOI: 10.1016/j.yfrne.2023.101111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/22/2023] [Accepted: 11/12/2023] [Indexed: 11/17/2023]
Abstract
Worldwide, over 150 million adolescent and adult women use oral contraceptives (OC). An association between OC-use and the emergence of symptoms of mental disorders has been suggested. This systematic review and meta-analysis provide an overview of published research regarding symptoms of mental disorders in association with OC-use, factoring the influence of OC types, age of first-use, duration of OC-intake, and previous diagnoses of mental disorders. A systematic literature search was conducted between June-July 2022. 22 studies were included. While most found no significant OC-use effects on mental symptoms, some hinted at OCs as a potential risk. The existing evidence regarding the potential link between progestin-only OC-use and an elevated risk of mental symptoms in comparison to combined OC-use remains inconclusive. However, due to emerging indications suggesting that the formulation of OC might play a role in mental health outcomes, this topic warrants further investigation. Moreover, indications of an increased risk for depressive symptoms in adolescent OC-users should be noted. Hence, while general population effects seem unlikely, they cannot be completely disregarded. The decision on OC-use should depend on the patient's medical history and should be re-evaluated regularly.
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Affiliation(s)
- Mathilda Z Kraft
- Department of Clinical Psychology, Friedrich Schiller University Jena, Germany
| | - Philine Rojczyk
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Thomas Weiss
- Department of Clinical Psychology, Friedrich Schiller University Jena, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; Lead Graduate School, University of Tübingen, Tübingen, Germany
| | - Zora Kikinis
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ilona Croy
- Department of Clinical Psychology, Friedrich Schiller University Jena, Germany; German Center for Mental Health (DZPG), Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany
| | - Carina Heller
- Department of Clinical Psychology, Friedrich Schiller University Jena, Germany; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany; German Center for Mental Health (DZPG), Germany; Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C), Jena-Magdeburg-Halle, Germany.
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5
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Davignon LM, Brouillard A, Juster RP, Marin MF. The role of sex hormones, oral contraceptive use, and its parameters on visuospatial abilities, verbal fluency, and verbal memory. Horm Behav 2024; 157:105454. [PMID: 37981465 DOI: 10.1016/j.yhbeh.2023.105454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 10/18/2023] [Accepted: 11/07/2023] [Indexed: 11/21/2023]
Abstract
Sex hormones can cross the blood-brain barrier and access brain regions underlying higher-order cognition. Containing synthetic sex hormones, oral contraceptives (OC) have been found to modulate visuospatial and verbal abilities, though inconsistencies have been found in the literature. Among possible explanations, certain OC use parameters (progestin androgenicity, synthetic hormone levels, duration of use) have not received consistent consideration. Thus, the objectives were to (1) examine group differences between men, combined OC users, and naturally cycling women (NC women; not using OC) in visuospatial abilities, verbal fluency, and verbal memory and (2) investigate the contribution of endogenous and exogenous sex hormones on these effects. We also aimed to (3) identify OC use parameters relevant to cognitive outcomes. In total, 70 combined OC users, 53 early follicular (EF) women, 43 pre-ovulatory (PO) women, and 47 men underwent cognitive tests. Performance was compared based on hormonal milieus (OC, EF, PO, men) and OC users' contraceptive androgenicity (anti, low, high). Correlations between performance, hormone levels and OC use duration were also conducted. OC use dampened the sex difference that typically favors men in 3D visuospatial abilities, whereas its duration of use positively predicted verbal fluency. Androgenicity and hormone levels did not predict performance in any task. These results highlight the importance of considering OC use duration. Results also did not support a role for androgenicity in cognition. Importantly, combined OC use (including prolonged use) does not impair visuospatial, verbal, and memory functions in a healthy young sample.
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Affiliation(s)
- Lisa-Marie Davignon
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga Street, Montreal H1N 3J4, Canada; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montreal H2X 2P3, Canada
| | - Alexandra Brouillard
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga Street, Montreal H1N 3J4, Canada; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montreal H2X 2P3, Canada
| | - Robert-Paul Juster
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga Street, Montreal H1N 3J4, Canada; Department of Psychiatry and Addiction, Université de Montréal, 2900 Edouard-Montpetit Boulevard, Montreal H3T 1J4, Canada
| | - Marie-France Marin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga Street, Montreal H1N 3J4, Canada; Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke Street W, Montreal H2X 2P3, Canada; Department of Psychiatry and Addiction, Université de Montréal, 2900 Edouard-Montpetit Boulevard, Montreal H3T 1J4, Canada.
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6
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Barth C, Crestol A, de Lange AMG, Galea LAM. Sex steroids and the female brain across the lifespan: insights into risk of depression and Alzheimer's disease. Lancet Diabetes Endocrinol 2023; 11:926-941. [PMID: 37865102 DOI: 10.1016/s2213-8587(23)00224-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 10/23/2023]
Abstract
Despite widespread sex differences in prevalence and presentation of numerous illnesses affecting the human brain, there has been little focus on the effect of endocrine ageing. Most preclinical studies have focused on males only, and clinical studies often analyse data by covarying for sex, ignoring relevant differences between the sexes. This sex- (and gender)-neutral approach is biased and contributes to the absence of targeted treatments and services for all sexes (and genders). Female health has been historically understudied, with grave consequences for their wellbeing and health equity. In this Review, we spotlight female brain health across the lifespan by informing on the role of sex steroids, particularly oestradiol, on the female brain and on risk for diseases more prevalent in females, such as depression and Alzheimer's disease.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Arielle Crestol
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ann-Marie G de Lange
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychology, University of Oslo, Oslo, Norway
| | - Liisa A M Galea
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health, Toronto, ON, Canada
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Liu Y, Zhao X, Hu W, Ren Y, Wei Z, Ren X, Tang Z, Wang N, Chen H, Li Y, Shi Z, Qin S, Yang J. Neural habituation during acute stress signals a blunted endocrine response and poor resilience. Psychol Med 2023; 53:7735-7745. [PMID: 37309913 DOI: 10.1017/s0033291723001666] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND A blunted hypothalamic-pituitary-adrenal (HPA) axis response to acute stress is associated with psychiatric symptoms. Although the prefrontal cortex and limbic areas are important regulators of the HPA axis, whether the neural habituation of these regions during stress signals both blunted HPA axis responses and psychiatric symptoms remains unclear. In this study, neural habituation during acute stress and its associations with the stress cortisol response, resilience, and depression were evaluated. METHODS Seventy-seven participants (17-22 years old, 37 women) were recruited for a ScanSTRESS brain imaging study, and the activation changes between the first and last stress blocks were used as the neural habituation index. Meanwhile, participants' salivary cortisol during test was collected. Individual-level resilience and depression were measured using questionnaires. Correlation and moderation analyses were conducted to investigate the association between neural habituation and endocrine data and mental symptoms. Validated analyses were conducted using a Montreal Image Stress Test dataset in another independent sample (48 participants; 17-22 years old, 24 women). RESULTS Neural habituation of the prefrontal cortex and limbic area was negatively correlated with cortisol responses in both datasets. In the ScanSTRESS paradigm, neural habituation was both positively correlated with depression and negatively correlated with resilience. Moreover, resilience moderated the relationship between neural habituation in the ventromedial prefrontal cortex and cortisol response. CONCLUSIONS This study suggested that neural habituation of the prefrontal cortex and limbic area could reflect motivation dysregulation during repeated failures and negative feedback, which might further lead to maladaptive mental states.
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Affiliation(s)
- Yadong Liu
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Xiaolin Zhao
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Weiyu Hu
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Yipeng Ren
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Zhenni Wei
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Xi Ren
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Zihan Tang
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Nan Wang
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Haopeng Chen
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Yizhuo Li
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Shaozheng Qin
- State Key Laboratory of Cognitive Neuroscience and Learning, McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China
| | - Juan Yang
- Faculty of Psychology, Southwest University, Chongqing 400715, China
- Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
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Casto KV, Arthur LC, Lynch-Wells S, Blake KR. Women in their mid-follicular phase outcompete hormonal contraceptive users, an effect partially explained by relatively greater progesterone and cortisol reactivity to competition. Psychoneuroendocrinology 2023; 157:106367. [PMID: 37639799 DOI: 10.1016/j.psyneuen.2023.106367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
Early evidence suggests that hormonal contraceptive (HC) use alters psychological functioning and competitive behavior. Yet, there is limited data on endocrine models for explaining how HC use affects these outcomes. In this pre-registered and open-data study, we test if HC users and naturally cycling (NC) females in their low (mid-follicular) and high (mid-luteal) progesterone phase differ in competitive persistence and whether progesterone and cortisol reactivity mediate of this effect. HC users (N = 73) in the active hormone-exposure phase and NC participants in the mid-follicular (N = 69) or mid-luteal (N = 72) phase completed two behavioral measures of competitive persistence, holding up a weight for time followed by attempting to solve an unsolvable anagram. Participants also completed measures of handgrip strength and self-reported competitiveness as well as gave saliva samples before and after the tasks for hormone assay. Results showed that NC-follicular group had greater competitive persistence in the weight-holding task compared to both NC-luteal (d = 0.38) and HC use (d = 0.43) groups independent of physical strength and self-reported competitiveness covariates. Although anagram task performance showed similar trends for group differences, analyses for this task were inconclusive. Baseline progesterone did not mediate the effect of cycle phase group on competitive persistence. HC users showed relatively blunted cortisol and progesterone reactivity, and this effect partially mediated the difference in competitive persistence between HC users and the NC-follicular group. In sum, results suggest that HC use could downregulate competitive behavior at least partly by dampening cortisol-progesterone reactivity. These findings offer a new endocrine model for understanding HC use and cycle phase effects on motivational and energetic outcomes required for optimal performance in competitive contexts.
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Affiliation(s)
- Kathleen V Casto
- Social Sciences Division, New College of Florida, USA; Department of Psychological Sciences, Kent State University, USA.
| | - Lindsie C Arthur
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Siobhan Lynch-Wells
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
| | - Khandis R Blake
- Melbourne School of Psychological Sciences, University of Melbourne, Australia
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Pedersen MV, Hansen LMB, Garforth B, Zak PJ, Winterdahl M. Adrenocorticotropic hormone secretion in response to anticipatory stress and venepuncture: The role of menstrual phase and oral contraceptive use. Behav Brain Res 2023; 452:114550. [PMID: 37343838 DOI: 10.1016/j.bbr.2023.114550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/07/2023] [Accepted: 06/17/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION Oral contraceptives (OCs) are primarily known for their effects on the reproductive system, but they can also impact the hypothalamic-pituitary-adrenal (HPA) axis. The present study aimed to compare plasma adrenocorticotropic hormone (ACTH) responses to the anticipatory stress of participating in a scientific experiment and venepuncture in OC users versus naturally cycling (NC) women, with a focus on variations throughout the menstrual cycle. METHODS We recruited 131 young women (average age 20.5) and obtained blood samples to measure plasma ACTH concentrations immediately after venepuncture and again after 15 min of group activities designed to facilitate interpersonal attachment and stress-buffering. RESULTS ACTH levels decreased in 70% of all participants throughout the group activities. A two-way repeated measures ANOVA highlighted a significant interaction between time and OC use, indicating differential changes in ACTH levels during social interaction between OC users and NC women. Further, the post-hoc analysis revealed that a period of stress-buffering group activities significantly decreased ACTH levels in NC women during menstrual and secretory phases, but not during the proliferative phase. In contrast, OC users did not display a decrease during group activities, regardless of the phase. CONCLUSION This study underscores the influence of OC use on stress regulation, demonstrating that OCs not only modulate reproductive functions but also impact ACTH stress reactivity. Additionally, it emphasizes the importance of considering hormonal contraceptive use and menstrual cycle phases when assessing female stress responses.
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Affiliation(s)
| | | | - Ben Garforth
- Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Paul J Zak
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, USA
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10
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Gravelsins L, Zhao S, Einstein G. Hormonal contraception and cognition: Considering the influence of endogenous ovarian hormones and genes for clinical translation. Front Neuroendocrinol 2023; 70:101067. [PMID: 37084896 DOI: 10.1016/j.yfrne.2023.101067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 03/18/2023] [Accepted: 03/30/2023] [Indexed: 04/23/2023]
Abstract
Despite the well-known influence of ovarian hormones on the brain and widespread use of hormonal contraception (HC) since the 1960s, our knowledge of HC's cognitive effects remains limited. To date, the cognitive findings have been inconsistent. In order to establish what might make HC studies more consistent, we surveyed the literature on HCs and cognition to determine whether studies considered HC formulation, phase, pharmacokinetics, duration, and gene interactions, and assessed whether oversight of these factors might contribute to variable findings. We found that synthetic HC hormones exert dose-dependent effects, the day of oral contraceptive (Pill) ingestion is critical for understanding cognitive changes, and gene-cognition relationships differ in women taking the Pill likely due to suppressed endogenous hormones. When these factors were overlooked, results were not consistent. We close with recommendations for research more likely to yield consistent findings and be therefore, translatable.
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Affiliation(s)
- Laura Gravelsins
- University of Toronto, Address: 100 Saint George Street, Canada, Toronto, Ontario M5S 3G3.
| | - Sophia Zhao
- University of Toronto, Address: 100 Saint George Street, Canada, Toronto, Ontario M5S 3G3
| | - Gillian Einstein
- University of Toronto, Address: 100 Saint George Street, Canada, Toronto, Ontario M5S 3G3; Rotman Research Institute, Address: 3560 Bathurst St, Canada, North York, Ontario M6A 2E1; Linköping University, Address: SE-581 83 Linköping, Sweden
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11
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Jensen A, Thériault K, Yilmaz E, Pon E, Davidson PSR. Mental rotation, episodic memory, and executive control: Possible effects of biological sex and oral contraceptive use. Neurobiol Learn Mem 2023; 198:107720. [PMID: 36621560 DOI: 10.1016/j.nlm.2023.107720] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/02/2022] [Accepted: 01/02/2023] [Indexed: 01/07/2023]
Abstract
Oral contraceptives (OCs) are one of the most common forms of hormonal birth control. A small literature suggests that OC use may affect visuospatial ability, episodic memory, and executive control. However, previous studies have been criticized for small sample sizes and the use of different, single cognitive tests. We investigated the degree to which biological sex and OC use might affect individual mental rotation, episodic memory, and executive control in a large sample of healthy, young adults (N = 155, including 52 OC users, 53 naturally cycling females, and 50 males) tested individually over videoconference. To measure cognition, we used a set of neuropsychological tasks inspired by Glisky and colleagues' two-factor episodic memory and executive control battery, from which two composite scores (based on principal component analysis) were derived for each participant. Our pre-registered analysis revealed a clear female advantage in episodic memory, independent of OC use. In an exploratory analysis, gist memory was elevated in OC users. Interestingly, we found no significant sex-related differences nor effects of OC use on mental rotation or executive control. Duration of OC use was also not related to any of our cognitive measures. These results suggest that the use of combined, monophasic OCs does not lead to many significant changes in cognition in young adults, although young females overall may have better episodic memory than young males. Additional studies, including longitudinal designs and looking in more detail at the menstrual cycle and OC use history, will further clarify the effects of different types of OCs and their duration of use on different aspects of cognition.
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Affiliation(s)
- Adelaide Jensen
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada.
| | - Kim Thériault
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
| | - Ece Yilmaz
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
| | - Ethan Pon
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Canada
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12
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Song JY, Patton CD, Friedman R, Mahajan LS, Nordlicht R, Sayed R, Lipton ML. Hormonal contraceptives and the brain: A systematic review on 60 years of neuroimaging, EEG, and biochemical studies in humans and animals. Front Neuroendocrinol 2023; 68:101051. [PMID: 36577486 PMCID: PMC9898167 DOI: 10.1016/j.yfrne.2022.101051] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/26/2022]
Abstract
Hormonal contraception has been widely prescribed for decades. Although safety and efficacy are well-established, much uncertainty remains regarding brain effects of hormonal contraception. We systematically review human and animal studies on the brain effects of hormonal contraception which employed neuroimaging techniques such as MRI, PET and EEG, as well as animal studies which reported on neurotransmitter and other brain biochemical effects. We screened 1001 articles and ultimately extracted data from 70, comprising 51 human and 19 animal studies. Of note, there were no animal studies which employed structural or functional MRI, MRS or PET. In summary, our review shows hormonal contraceptive associations with changes in the brain have been documented. Many questions remain and more studies are needed to describe the effects of hormonal contraception on the brain.
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Affiliation(s)
- Joan Y Song
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; The Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | | | - Renee Friedman
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Lakshmi S Mahajan
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Rachel Nordlicht
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Rahman Sayed
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Michael L Lipton
- The Gruss Magnetic Resonance Research Center, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA; The Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
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13
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Kheloui S, Smith A, Ismail N. Combined oral contraceptives and mental health: Are adolescence and the gut-brain axis the missing links? Front Neuroendocrinol 2023; 68:101041. [PMID: 36244525 DOI: 10.1016/j.yfrne.2022.101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/16/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
Combined oral contraceptives (containing synthetic forms of estradiol and progestins) are one of the most commonly used drugs among females. However, their effects on the gut-brain axis have not been investigated to a great extent despite clear evidence that suggest bi-directional interactions between the gut microbiome and endogenous sex hormones. Moreover, oral contraceptives are prescribed during adolescence, a critical period of development during which several brain structures and systems, such as hypothalamic-pituitary-gonadal axis, undergo maturation. Considering that oral contraceptives could impact the developing adolescent brain and that these effects may be mediated by the gut-brain axis, further research investigating the effects of oral contraceptives on the gut-brain axis is imperative. This article briefly reviews evidence from animal and human studies on the effects of combined oral contraceptives on the brain and the gut microbiota particularly during adolescence.
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Affiliation(s)
- Sarah Kheloui
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Andra Smith
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada; uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Nafissa Ismail
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada; uOttawa Brain and Mind Research Institute, Ottawa, ON, Canada; LIFE Research Institute, Ottawa, ON, Canada.
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14
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Lacasse JM, Boulos V, Fisher C, Hamilton S, Heron M, Mac Cionnaith CE, Peronace V, Tito N, Brake WG. Combined effects of the contraceptive hormones, ethinyl estradiol and levonorgestrel, on the use of place and response memory in gonadally-intact female rats. Psychoneuroendocrinology 2023; 147:105974. [PMID: 36403510 DOI: 10.1016/j.psyneuen.2022.105974] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/11/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
During maze navigation rats can rely on hippocampus-mediated place memory or striatum-mediated response memory. Ovarian hormones bias whether females use place or response memory to reach a reward. Here, we investigated the impact of the contraceptive hormones, ethinyl estradiol (EE) and levonorgestrel (LNG), on memory bias. A total of 63 gonadally-intact female rats were treated with either 10 μg/kg of EE alone, 20 μg/kg of LNG alone, both 10 μg/kg of EE and 20 μg/kg of LNG together, or a sesame oil injection with 5% ethanol as a vehicle control. Rats in the control condition were tested during the diestrus phase of the estrous cycle in order to control for the low circulating levels of gonadotropin and ovarian hormones that occur with oral contraceptive administration. Rats treated with LNG alone had a bias towards the use of place memory compared to diestrus phase control rats. This bias was not observed if LNG was administered in combination with EE. Rats treated with EE or EE+LNG did not have a statistically significant difference in memory bias compared to rats in the control group. These data show that synthetic hormones contained in oral contraceptives administered to females influence which cognitive strategy is predominantly used during navigation.
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Affiliation(s)
- Jesse M Lacasse
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada.
| | - Vanessa Boulos
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Caleigh Fisher
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Sarran Hamilton
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Megan Heron
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Conall E Mac Cionnaith
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Vanessa Peronace
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Noémie Tito
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Wayne G Brake
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada.
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15
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Griksiene R, Monciunskaite R, Ruksenas O. What is there to know about the effects of progestins on the human brain and cognition? Front Neuroendocrinol 2022; 67:101032. [PMID: 36029852 DOI: 10.1016/j.yfrne.2022.101032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/24/2022] [Accepted: 08/19/2022] [Indexed: 12/27/2022]
Abstract
Progestins are an important component of hormonal contraceptives (HCs) and hormone replacement therapies (HRTs). Despite an increasing number of studies elucidating the effects of HCs and HRTs, little is known about the effects of different types of progestins included in these medications on the brain. Animal studies suggest that various progestins interact differently with sex steroid, mineralocorticoid and glucocorticoid receptors and have specific modulatory effects on neurotransmitter systems and on the expression of neuropeptides, suggesting differential impacts on cognition and behavior. This review focuses on the currently available knowledge from human behavioral and neuroimaging studies pooled with evidence from animal research regarding the effects of progestins on the brain. The reviewed information is highly relevant for improving women's mental health and making informed choices regarding specific types of contraception or treatment.
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Affiliation(s)
- Ramune Griksiene
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
| | - Rasa Monciunskaite
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
| | - Osvaldas Ruksenas
- Department of Neurobiology and Biophysics, Life Sciences Center, Vilnius University, Lithuania
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16
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Heller C, Kimmig ACS, Kubicki MR, Derntl B, Kikinis Z. Imaging the human brain on oral contraceptives: A review of structural imaging methods and implications for future research goals. Front Neuroendocrinol 2022; 67:101031. [PMID: 35998859 DOI: 10.1016/j.yfrne.2022.101031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/30/2022] [Accepted: 08/15/2022] [Indexed: 12/21/2022]
Abstract
Worldwide over 150 million women use oral contraceptives (OCs), which are the most prescribed form of contraception in both the United States and in European countries. Sex hormones, such as estradiol and progesterone, are important endogenous hormones known for shaping the brain across the life span. Synthetic hormones, which are present in OCs, interfere with the natural hormonal balance by reducing the endogenous hormone levels. Little is known how this affects the brain, especially during the most vulnerable times of brain maturation. Here, we review studies that investigate differences in brain gray and white matter in women using OCs in comparison to naturally cycling women. We focus on two neuroimaging methods used to quantify structural gray and white matter changes, namely structural MRI and diffusion MRI. Finally, we discuss the potential of these imaging techniques to advance knowledge about the effects of OCs on the brain and wellbeing in women.
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Affiliation(s)
- Carina Heller
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany; Department of Clinical Psychology, Friedrich Schiller University Jena, Germany.
| | - Ann-Christin S Kimmig
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | - Marek R Kubicki
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Innovative Neuroimaging, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; Lead Graduate School, University of Tübingen, Tübingen, Germany
| | - Zora Kikinis
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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17
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Lacasse JM, Gomez-Perales E, Brake WG. Modeling hormonal contraception in female rats: A framework for studies in behavioral neurobiology. Front Neuroendocrinol 2022; 67:101020. [PMID: 35952797 DOI: 10.1016/j.yfrne.2022.101020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/19/2022] [Accepted: 08/03/2022] [Indexed: 12/12/2022]
Abstract
Research on hormonal contraceptives (HC) in animal models is lacking, and as a result, so is our understanding of the impact of HC on the brain and behavior. Here, we provide a review of the pharmacology of HC, as well as the methodology and best practices for designing a model of HC in female rats. We outline specific methodological considerations regarding dosing, route of administration, exposure time/timing, and selecting a control group. We also provide a framework outlining important levels of analysis for thinking about the impact of HC on behavioral and neurobiological outcomes. The purpose of this review is to equip researchers with foundational knowledge, and some basic elements of experimental design for future studies investigating the impact of HC on the brain and behavior of female rats.
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Affiliation(s)
- Jesse M Lacasse
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada.
| | - Eamonn Gomez-Perales
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada
| | - Wayne G Brake
- Centre for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal H4B 1R6, Canada.
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18
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Tronson NC, Schuh KM. Hormonal contraceptives, stress, and the brain: The critical need for animal models. Front Neuroendocrinol 2022; 67:101035. [PMID: 36075276 DOI: 10.1016/j.yfrne.2022.101035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/26/2022] [Accepted: 09/01/2022] [Indexed: 01/10/2023]
Abstract
Hormonal contraceptives are among the most important health and economic developments in the 20thCentury, providing unprecedented reproductive control and a range of health benefits including decreased premenstrual symptoms and protections against various cancers. Hormonal contraceptives modulate neural function and stress responsivity. These changes are usually innocuous or even beneficial, including their effects onmood. However, in approximately 4-10% of users, or up to 30 million people at any given time, hormonal contraceptives trigger depression or anxiety symptoms. How hormonal contraceptives contribute to these responses and who is at risk for adverse outcomes remain unknown. In this paper, we discussstudies of hormonal contraceptive use in humans and describe the ways in which laboratory animal models of contraceptive hormone exposure will be an essential tool for expanding findings to understand the precise mechanisms by which hormonal contraceptives influence the brain, stress responses, and depression risk.
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Affiliation(s)
- Natalie C Tronson
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| | - Kristen M Schuh
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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19
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Reddy V, Wurtz M, Patel SH, McCarthy M, Raval AP. Oral contraceptives and stroke: Foes or friends. Front Neuroendocrinol 2022; 67:101016. [PMID: 35870646 DOI: 10.1016/j.yfrne.2022.101016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/23/2022] [Accepted: 07/06/2022] [Indexed: 01/09/2023]
Abstract
Incidents of strokes are increased in young women relative to young men, suggesting that oral contraceptive (OC) use is one of the causes of stroke among young women. Long-term exposures to the varying combinations of estrogen and progestogen found in OCs affect blood clotting, lipid and lipoprotein metabolism, endothelial function, and de novo synthesis of neurosteroids, especially brain-derived 17β-estradiol. The latter is essential for neuroprotection, memory, sexual differentiation, synaptic transmission, and behavior. Deleterious effects of OCs may be exacerbated due to comorbidities like polycystic ovary syndrome, sickle cell anemia, COVID-19, exposures to endocrine disrupting chemicals, and conventional or electronic cigarette smoking. The goal of the current review is to revisit the available literature regarding the impact of OC use on stroke, to explain possible underlying mechanisms, and to identify gaps in our understanding to promote future research to reduce and cure stroke in OC users.
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Affiliation(s)
- Varun Reddy
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA
| | - Megan Wurtz
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA
| | - Shahil H Patel
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA
| | - Micheline McCarthy
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA
| | - Ami P Raval
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratory, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami Florida 33136, USA; Bruce W. Carter Department of Veterans Affairs Medical Center, Miami, FL, USA.
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20
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Beltz AM. Hormonal contraceptive influences on cognition and psychopathology: Past methods, present inferences, and future directions. Front Neuroendocrinol 2022; 67:101037. [PMID: 36154817 DOI: 10.1016/j.yfrne.2022.101037] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/24/2022] [Accepted: 09/16/2022] [Indexed: 11/04/2022]
Abstract
In the last decade, there has been a remarkable surge in research on the neural and behavioral correlates of hormonal contraceptive use, particularly oral contraceptive use. Questions have evolved swiftly and notably, with studies no longer revealing if hormonal contraceptives matter for the brain and behavior, but rather how, when, and for whom they matter most. Paralleling this shift, the goal of this review is to move beyond an average synthesis of hormonal contraceptive influences on human cognition and psychopathology (and their neural substrates) in order to consider the nature and specificity of effects. Accompanied by an evaluation of study methods and informed by findings from animal models, this consideration uncovers promising areas of research in the next ten years, including potential activational and organizational effects of hormonal contraceptive use, individual differences in effects that matter for the wellbeing of unique individuals, and correlates of intrauterine device use.
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Affiliation(s)
- Adriene M Beltz
- University of Michigan, 2227 East Hall, 530 Church Street, Ann Abor, MI 48109, USA.
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21
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Pisu MG, Concas L, Siddi C, Serra M, Porcu P. The Allopregnanolone Response to Acute Stress in Females: Preclinical and Clinical Studies. Biomolecules 2022; 12:biom12091262. [PMID: 36139100 PMCID: PMC9496329 DOI: 10.3390/biom12091262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
The neuroactive steroid allopregnanolone ((3α,5α)-3-hydroxypregnan-20-one or 3α,5α-THP) plays a key role in the response to stress, by normalizing hypothalamic-pituitary-adrenal (HPA) axis function to restore homeostasis. Most studies have been conducted on male rats, and little is known about the allopregnanolone response to stress in females, despite that women are more susceptible than men to develop emotional and stress-related disorders. Here, we provide an overview of animal and human studies examining the allopregnanolone responses to acute stress in females in the context of stress-related neuropsychiatric diseases and under the different conditions that characterize the female lifespan associated with the reproductive function. The blunted allopregnanolone response to acute stress, often observed in female rats and women, may represent one of the mechanisms that contribute to the increased vulnerability to stress and affective disorders in women under the different hormonal fluctuations that occur throughout their lifespan. These studies highlight the importance of targeting neuroactive steroids as a therapeutic approach for stress-related disorders in women.
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Affiliation(s)
- Maria Giuseppina Pisu
- Neuroscience Institute, National Research Council of Italy (CNR), 09042 Cagliari, Italy
| | - Luca Concas
- Department of Life and Environment Sciences, Section of Neuroscience and Anthropology, University of Cagliari, 09042 Cagliari, Italy
| | - Carlotta Siddi
- Department of Life and Environment Sciences, Section of Neuroscience and Anthropology, University of Cagliari, 09042 Cagliari, Italy
| | - Mariangela Serra
- Department of Life and Environment Sciences, Section of Neuroscience and Anthropology, University of Cagliari, 09042 Cagliari, Italy
| | - Patrizia Porcu
- Neuroscience Institute, National Research Council of Italy (CNR), 09042 Cagliari, Italy
- Correspondence:
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22
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Jett S, Schelbaum E, Jang G, Boneu Yepez C, Dyke JP, Pahlajani S, Diaz Brinton R, Mosconi L. Ovarian steroid hormones: A long overlooked but critical contributor to brain aging and Alzheimer's disease. Front Aging Neurosci 2022; 14:948219. [PMID: 35928995 PMCID: PMC9344010 DOI: 10.3389/fnagi.2022.948219] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/28/2022] [Indexed: 01/19/2023] Open
Abstract
Ovarian hormones, particularly 17β-estradiol, are involved in numerous neurophysiological and neurochemical processes, including those subserving cognitive function. Estradiol plays a key role in the neurobiology of aging, in part due to extensive interconnectivity of the neural and endocrine system. This aspect of aging is fundamental for women's brains as all women experience a drop in circulating estradiol levels in midlife, after menopause. Given the importance of estradiol for brain function, it is not surprising that up to 80% of peri-menopausal and post-menopausal women report neurological symptoms including changes in thermoregulation (vasomotor symptoms), mood, sleep, and cognitive performance. Preclinical evidence for neuroprotective effects of 17β-estradiol also indicate associations between menopause, cognitive aging, and Alzheimer's disease (AD), the most common cause of dementia affecting nearly twice more women than men. Brain imaging studies demonstrated that middle-aged women exhibit increased indicators of AD endophenotype as compared to men of the same age, with onset in perimenopause. Herein, we take a translational approach to illustrate the contribution of ovarian hormones in maintaining cognition in women, with evidence implicating menopause-related declines in 17β-estradiol in cognitive aging and AD risk. We will review research focused on the role of endogenous and exogenous estrogen exposure as a key underlying mechanism to neuropathological aging in women, with a focus on whether brain structure, function and neurochemistry respond to hormone treatment. While still in development, this research area offers a new sex-based perspective on brain aging and risk of AD, while also highlighting an urgent need for better integration between neurology, psychiatry, and women's health practices.
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Affiliation(s)
- Steven Jett
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Eva Schelbaum
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Grace Jang
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Camila Boneu Yepez
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
| | - Jonathan P. Dyke
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Silky Pahlajani
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Roberta Diaz Brinton
- Department of Pharmacology, University of Arizona, Tucson, AZ, United States
- Department of Neurology, University of Arizona, Tucson, AZ, United States
| | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York, NY, United States
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
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23
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Concas A, Serra M, Porcu P. How hormonal contraceptives shape brain and behavior: A review of preclinical studies. Front Neuroendocrinol 2022; 66:101017. [PMID: 35843303 DOI: 10.1016/j.yfrne.2022.101017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/13/2022] [Accepted: 07/12/2022] [Indexed: 12/12/2022]
Abstract
Steroid hormones influence different aspects of brain function, including development, neurogenesis, neuronal excitability, and plasticity, thus affecting emotional states, cognition, sociality, and reward. In women, their levels fluctuate across the lifespan and through the reproductive stages but are also altered by exogenous administration of hormonal contraceptives (HC). HC are widely used by women throughout their fertile life both for contraceptive and therapeutic benefits. However, awareness of their effects on brain function and behavior is still poorly appreciated, despite the emerging evidence of their action at the level of the central nervous system. Here, we summarize results obtained in preclinical studies, mostly conducted in intact female rodents, aimed at investigating the neurobiological effects of HC. HC can alter neuroactive hormones, neurotransmitters, neuropeptides, as well as emotional states, cognition, social and sexual behaviors. Animal studies provide insights into the neurobiological effects of HC with the aim to improve women's health and well-being.
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Affiliation(s)
- Alessandra Concas
- Department of Life and Environment Sciences, Section of Neuroscience and Anthropology, University of Cagliari, Cagliari, Italy
| | - Mariangela Serra
- Department of Life and Environment Sciences, Section of Neuroscience and Anthropology, University of Cagliari, Cagliari, Italy
| | - Patrizia Porcu
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy.
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24
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Hormonal contraceptives as disruptors of competitive behavior: Theoretical framing and review. Front Neuroendocrinol 2022; 66:101015. [PMID: 35835214 DOI: 10.1016/j.yfrne.2022.101015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/16/2022] [Accepted: 07/06/2022] [Indexed: 12/14/2022]
Abstract
Emerging evidence suggests that hormonal contraceptives (HCs) impact psychological outcomes through alterations in neurophysiology. In this review, we first introduce a theoretical framework for HCs as disruptors of steroid hormone modulation of socially competitive attitudes and behaviors. Then, we comprehensively examine prior research comparing HC users and non-users in outcomes related to competition for reproductive, social, and financial resources. Synthesis of 46 studies (n = 16,290) led to several key conclusions: HC users do not show the same menstrual cycle-related fluctuations in self-perceived attractiveness and some intrasexual competition seen in naturally-cycling women and, further, may show relatively reduced status- or achievement-oriented competitive motivation. However, there a lack of consistent or compelling evidence that HC users and non-users differ in competitive behavior or attitudes for mates or financial resources. These conclusions are tentative given the notable methodological limitations of the studies reviewed. Implications and recommendations for future research are discussed.
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25
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Anderl C, de Wit AE, Giltay EJ, Oldehinkel AJ, Chen FS. Association between adolescent oral contraceptive use and future major depressive disorder: a prospective cohort study. J Child Psychol Psychiatry 2022; 63:333-341. [PMID: 34254301 PMCID: PMC9291927 DOI: 10.1111/jcpp.13476] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Because of the widespread use of oral contraceptives (OCs) and the devastating effects of depression both on an individual and a societal level, it is crucial to understand the nature of the previously reported relationship between OC use and depression risk. Insight into the impact of analytical choices on the association is important when interpreting available evidence. Hence, we examined the association between adolescent OC use and subsequent depression risk in early adulthood analyzing all theoretically justifiable models. METHODS Data from the prospective cohort study TRacking Adolescents' Individual Lives Survey, among women aged 13-25 years were used. Adolescent OC use (ages 16-19 years) was used as a predictor and major depressive disorder (MDD) in early adulthood (ages 20-25 years), as assessed by the Diagnostic and Statistical Manual of Mental Disorders-IV oriented Lifetime Depression Assessment Self-Report and the Composite International Diagnostic Interview, was used as an outcome. A total of 818 analytical models were analyzed using Specification Curve Analysis in 534 adolescent OC users and 191 nonusers. RESULTS Overall, there was an association of adolescent OC use and an episode of MDD in early adulthood [median odds ratio (OR)median = 1.41; ORmin = 1.08; ORmax = 2.18, p < .001], which was driven by the group of young women with no history of MDD (ORmedian = 1.72; ORmin = 1.21; ORmax = 2.18, p < .001). CONCLUSIONS In summary, adolescent OC use was associated with a small but robust increased risk for experiencing an episode of MDD, especially among women with no history of MDD in adolescence. Understanding the potential side effects of OCs will help women and their doctors to make informed choices when deciding among possible methods of birth control.
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Affiliation(s)
- Christine Anderl
- Department of PsychologyUniversity of British ColumbiaVancouverBCCanada
| | - Anouk E. de Wit
- Department of PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Erik J. Giltay
- Department of PsychiatryUniversity Medical Center LeidenLeidenThe Netherlands
| | - Albertine J. Oldehinkel
- Department of PsychiatryUniversity of GroningenUniversity Medical Center GroningenGroningenThe Netherlands
| | - Frances S. Chen
- Department of PsychologyUniversity of British ColumbiaVancouverBCCanada
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26
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Zareian B, Anderl C, LeMoult J, Galea LAM, Prior JC, Rights JD, Ross CJ, Ge S, Hayward AC, Chen FS. Assessing the role of adolescent hormonal contraceptive use on risk for depression: a 3-year longitudinal study protocol. BMC Womens Health 2022; 22:48. [PMID: 35197045 PMCID: PMC8864455 DOI: 10.1186/s12905-022-01623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/09/2022] [Indexed: 08/14/2024] Open
Abstract
BACKGROUND The incidence of depression in human females rises steadily throughout adolescence, a critical period of pubertal maturation marked by increasing levels of gonadal hormones including estrogens and progesterone. These gonadal hormones play a central role in social and emotional development and may also contribute to the increased occurrence of depression in females that begins in early adolescence. In this study, we examine whether and how introducing synthetic estrogen and progestin derivatives through the use of combined hormonal contraceptives (CHC), affects adolescent females' risk for developing depression. We further assess potential links between CHC use and alterations in stress responses and social-emotional functioning. METHODS Using a longitudinal cohort design, we will follow a sample of adolescent females over the span of three years. Participants will be assessed at three time points: once when they are between 13 and 15 years of age, and at approximately 18 and 36 months after their initial assessment. Each time point will consist of two online sessions during which participants will complete a clinical interview that screens for key symptoms of mental health disorders, along with a series of questionnaires assessing their level of depressive symptoms and history of contraceptive use. They will also complete a standardized social-evaluative stress test and an emotion recognition task, as well as provide saliva samples to allow for assessment of their circulating free cortisol levels. DISCUSSION In this study we will assess the effect of CHC use during adolescence on development of Major Depressive Disorder (MDD). We will control for variables previously found to or proposed to partially account for the observed relationship between CHC use and MDD, including socioeconomic status, age of sexual debut, and CHC-related variables including age of first use, reasons for use, and its duration. In particular, we will discover whether CHC use increases depressive symptoms and/or MDD, whether elevated depressive symptoms and/or MDD predict a higher likelihood of starting CHC, or both. Furthermore, this study will allow us to clarify whether alterations in stress reactivity and social-emotional functioning serve as pathways through which CHC use may result in increased risk of depressive symptoms and/or MDD.
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Affiliation(s)
- Bita Zareian
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Christine Anderl
- Department of Psychology, University of British Columbia, Vancouver, Canada.,Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | - Joelle LeMoult
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Liisa A M Galea
- Department of Psychology, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Jerilynn C Prior
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology and Metabolism, University of British Columbia, Vancouver, Canada.,BC Women's Health Research Institute, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jason D Rights
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Colin J Ross
- BC Children's Hospital Research Institute, Vancouver, Canada.,Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Sabrina Ge
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Annie C Hayward
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Frances S Chen
- Department of Psychology, University of British Columbia, Vancouver, Canada.
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27
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Liu Y, Ren X, Zeng M, Li J, Zhao X, Zhang X, Yang J. Resting-state dynamic functional connectivity predicts the psychosocial stress response. Behav Brain Res 2022; 417:113618. [PMID: 34610370 DOI: 10.1016/j.bbr.2021.113618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 12/18/2022]
Abstract
Acute stress triggers a complex cascade of psychological, physiological, and neural responses, which show large and enduring individual differences. Although previous studies have examined the relationship between the stress response and dynamic features of the brain's resting state, no study has used the brain's dynamic activity in the resting state to predict individual differences in the psychosocial stress response. In the current study, resting-state scans of forty-eight healthy participants were collected, and then their individual acute stress responses during the Montreal Imaging Stress Test (MIST) paradigm were recorded. Results defined a connectivity state (CS) characterized by positive correlations across the whole brain during resting-state that could negatively predict participants' feelings of social evaluative threat during stress tasks. Another CS characterized by negative correlations between the frontal-parietal network (FPN) and almost all other networks, except the dorsal attentional network (DAN), could predict participants' subjective stress, feelings of uncontrollability, and feelings of social evaluative threat. However, no CS could predict participants' salivary cortisol stress response. Overall, these results suggested that the brain state characterized as attentional regulation, linking self-control, and top-down regulation ability, could predict the psychosocial stress response. This study also developed an objective indicator for predicting human stress responses.
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Affiliation(s)
- Yadong Liu
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Xi Ren
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Mei Zeng
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Jiwen Li
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Xiaolin Zhao
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Xuehan Zhang
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China
| | - Juan Yang
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Cognition and Personality, Ministry of Education, Southwest University, Chongqing 400715, China.
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28
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Schmidt NM, Hennig J, Munk AJL. Event-Related Potentials in Women on the Pill: Neural Correlates of Positive and Erotic Stimulus Processing in Oral Contraceptive Users. Front Neurosci 2022; 15:798823. [PMID: 35058744 PMCID: PMC8764149 DOI: 10.3389/fnins.2021.798823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Aims: Exposure toward positive emotional cues with - and without - reproductive significance plays a crucial role in daily life and regarding well-being as well as mental health. While possible adverse effects of oral contraceptive (OC) use on female mental and sexual health are widely discussed, neural processing of positive emotional stimuli has not been systematically investigated in association with OC use. Considering reported effects on mood, well-being and sexual function, and proposed associations with depression, it was hypothesized that OC users showed reduced neural reactivity toward positive and erotic emotional stimuli during early as well as later stages of emotional processing and also rated these stimuli as less pleasant and less arousing compared to naturally cycling (NC) women. Method: Sixty-two female subjects (29 NC and 33 OC) were assessed at three time points across the natural menstrual cycle and corresponding time points of the OC regimen. Early (early posterior negativity, EPN) and late (late positive potential, LPP) event-related potentials in reaction to positive, erotic and neutral stimuli were collected during an Emotional Picture Stroop Paradigm (EPSP). At each appointment, subjects provided saliva samples for analysis of gonadal steroid concentration. Valence and arousal ratings were collected at the last appointment. Results: Oral contraceptive users had significantly lower endogenous estradiol and progesterone concentrations compared to NC women. No significant group differences in either subjective stimulus evaluations or neural reactivity toward positive and erotic emotional stimuli were observed. For the OC group, LPP amplitudes in reaction to erotic vs. neutral pictures differed significantly between measurement times across the OC regimen. Discussion: In this study, no evidence regarding alterations of neural reactivity toward positive and erotic stimuli in OC users compared to NC was found. Possible confounding factors and lines for future research are elaborated and discussed.
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Affiliation(s)
- Norina M. Schmidt
- Department of Differential and Biological Psychology, University of Giessen, Giessen, Germany
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29
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Brouillard A, Davignon LM, Fortin J, Marin MF. A Year Through the COVID-19 Pandemic: Deleterious Impact of Hormonal Contraception on Psychological Distress in Women. Front Psychiatry 2022; 13:835857. [PMID: 35370813 PMCID: PMC8966723 DOI: 10.3389/fpsyt.2022.835857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women are more at risk than men of suffering from psychological distress during disease outbreaks. Interestingly, no biological factors have been studied to explain this disparity in such contexts. Sex hormone variations induced by hormonal contraceptives (HC) have been associated with mental health vulnerabilities. However, most studies have examined current effects of HC without considering whether a chronic modulation of sex hormone levels could induce long-lasting effects that persist after HC cessation. OBJECTIVES To date, the role of HC on psychological health in women during a disease outbreak is still unknown. We aimed to investigate both current and long-term effects of HC on psychological distress throughout the COVID-19 pandemic. METHOD At four time points during the COVID-19 pandemic (June 2020, September 2020, December 2020, March 2021), we collected self-reported data on psychological distress, assessing symptoms of post-traumatic stress [via the Impact of Event Scale-Revised (IES-R)], symptoms of depression, anxiety, and stress [via the Depression Anxiety Stress Scales (DASS-21)]. Linear mixed models were first used to compare men (n = 49), naturally cycling women (n = 73), and women using HC (n = 32) across time. To examine long-lasting effects of HC, exploratory analyses were restricted to women, comparing current HC users (n = 32), past users (n = 56), and never users (n = 17). RESULTS The first model revealed that women taking HC reported stable post-traumatic stress symptoms across time, compared to naturally cycling women and men who showed a significant decrease from T1 to T2. HC users also reported greater DASS-21 total scores over time. Moreover, HC users reported higher stress and anxiety symptoms than men. In the second model, results showed that past HC users had similar anxiety levels as current HC users. These two groups reported significantly more anxiety symptoms than never users. CONCLUSION HC users report increased distress during the pandemic relative to naturally cycling women and men. Our results also suggest a long-lasting effect of HC intake, highlighting the importance of considering both the current use of HC and its history. This could provide some insight into potential avenues for explaining why some women are prone to higher psychological distress than men.
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Affiliation(s)
- Alexandra Brouillard
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | - Lisa Marie Davignon
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | - Justine Fortin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
| | - Marie France Marin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychology, University of Quebec in Montreal, Montreal, QC, Canada
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30
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Lewis CA, Kimmig ACS, Kroemer NB, Pooseh S, Smolka MN, Sacher J, Derntl B. No Differences in Value-Based Decision-Making Due to Use of Oral Contraceptives. Front Endocrinol (Lausanne) 2022; 13:817825. [PMID: 35528016 PMCID: PMC9075610 DOI: 10.3389/fendo.2022.817825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/11/2022] [Indexed: 12/17/2022] Open
Abstract
Fluctuating ovarian hormones have been shown to affect decision-making processes in women. While emerging evidence suggests effects of endogenous ovarian hormones such as estradiol and progesterone on value-based decision-making in women, the impact of exogenous synthetic hormones, as in most oral contraceptives, is not clear. In a between-subjects design, we assessed measures of value-based decision-making in three groups of women aged 18 to 29 years, during (1) active oral contraceptive intake (N = 22), (2) the early follicular phase of the natural menstrual cycle (N = 20), and (3) the periovulatory phase of the natural menstrual cycle (N = 20). Estradiol, progesterone, testosterone, and sex-hormone binding globulin levels were assessed in all groups via blood samples. We used a test battery which measured different facets of value-based decision-making: delay discounting, risk-aversion, risk-seeking, and loss aversion. While hormonal levels did show the expected patterns for the three groups, there were no differences in value-based decision-making parameters. Consequently, Bayes factors showed conclusive evidence in support of the null hypothesis. We conclude that women on oral contraceptives show no differences in value-based decision-making compared to the early follicular and periovulatory natural menstrual cycle phases.
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Affiliation(s)
- Carolin A. Lewis
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany
- *Correspondence: Carolin A. Lewis,
| | - Ann-Christin S. Kimmig
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
- International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tuebingen, Tuebingen, Germany
| | - Nils B. Kroemer
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
| | - Shakoor Pooseh
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
- Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Michael N. Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Julia Sacher
- Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tuebingen, Tuebingen, Germany
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31
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Shaw GA. Mitochondria as the target for disease related hormonal dysregulation. Brain Behav Immun Health 2021; 18:100350. [PMID: 34746877 PMCID: PMC8554460 DOI: 10.1016/j.bbih.2021.100350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 12/13/2022] Open
Abstract
Mitochondria play an important role in the synthesis of steroid hormones, including the sex hormone estrogen. Sex-specific regulation of these hormones is important for phenotypic development and downstream, sex-specific activational effects in both brain and behavior. First, mitochondrial contribution to the synthesis of estrogen, followed by a discussion of the signaling interactions between estrogen and the mitochondria will be reviewed. Next, disorders with an established sex difference related to aging, mood, and cognition will be examined. Finally, review of mitochondria as a biomarker of disease and data supporting efforts in targeting mitochondria as a therapeutic target for the amelioration of these disorders will be discussed. Taken together, this review aims to assess the influence of E2 on mitochondrial function within the brain via exploration of E2-ER interactions within neural mitochondria and how they may act to influence the development and presentation of neurodegenerative and neurocognitive diseases with known sex differences.
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Affiliation(s)
- Gladys A. Shaw
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, VA, USA
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32
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Martínez-García M, Paternina-Die M, Desco M, Vilarroya O, Carmona S. Characterizing the Brain Structural Adaptations Across the Motherhood Transition. Front Glob Womens Health 2021; 2:742775. [PMID: 34816246 PMCID: PMC8593951 DOI: 10.3389/fgwh.2021.742775] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/10/2021] [Indexed: 12/23/2022] Open
Abstract
Women that become mothers face notable physiological adaptations during this life-period. Neuroimaging studies of the last decade have provided grounded evidence that women's brains structurally change across the transition into motherhood. The characterization of this brain remodeling is currently in its early years of research. The current article reviews this scientific field by focusing on our longitudinal (pre-to-post pregnancy) Magnetic Resonance Imaging (MRI) studies in first-time parents and other longitudinal and cross-sectional studies of parents. We present the questions that are currently being answered by the parental brain literature and point out those that have not yet been explored. We also highlight potential confounding variables that need to be considered when analyzing and interpreting brain changes observed during motherhood.
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Affiliation(s)
- Magdalena Martínez-García
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - María Paternina-Die
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Oscar Vilarroya
- Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spain.,Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Susanna Carmona
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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33
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Shaw GA, Hyer MM, Dustin E, Dyer SK, Targett IL, Neigh GN. Acute LPS exposure increases synaptosomal metabolism during estrus but not diestrus. Physiol Behav 2021; 239:113523. [PMID: 34229031 DOI: 10.1016/j.physbeh.2021.113523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/09/2021] [Accepted: 06/30/2021] [Indexed: 11/15/2022]
Abstract
The hormones estrogen and progesterone alter physiological functions, including the estrus cycle and relevant neurological and synaptic activity. Here, we determined the extent to which estrus cycle stage interacts with an inflammatory stimulus, lipopolysaccharide (LPS), to alter synaptic mitochondrial respiration in female rats. LPS elevated synaptic mitochondrial respiration of rats in estrus, but not diestrus. Likewise, estrogen concentration correlated with multiple respiratory metrics in LPS treated females in estrus. These data suggest estrogen likely modulates synaptic mitochondrial respiration in a high progesterone environment.
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Affiliation(s)
- Gladys A Shaw
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, 1101 East Marshall Street, Box 980709, Richmond, VA 23298, United States
| | - Molly M Hyer
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, 1101 East Marshall Street, Box 980709, Richmond, VA 23298, United States
| | - Elizabeth Dustin
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, 1101 East Marshall Street, Box 980709, Richmond, VA 23298, United States
| | - Samya K Dyer
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, 1101 East Marshall Street, Box 980709, Richmond, VA 23298, United States
| | - Imogen L Targett
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, 1101 East Marshall Street, Box 980709, Richmond, VA 23298, United States
| | - Gretchen N Neigh
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, 1101 East Marshall Street, Box 980709, Richmond, VA 23298, United States.
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34
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The regulatory roles of progesterone and estradiol on emotion processing in women. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:1026-1038. [PMID: 33982247 DOI: 10.3758/s13415-021-00908-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 12/28/2022]
Abstract
Emotion processing is known to interact with memory. Ovarian steroid hormones, such as progesterone and estradiol, modulate emotion processing and memory. However, it is unclear how these hormones influence brain activity when emotion processing is integrated with working memory (WM). Therefore, the objective of this study was to examine the relationship between endogenous hormonal concentration and brain activity during emotion processing in the context of a WM n-back task in 74 young women using functional magnetic resonance imaging (fMRI). Results show that positive emotion processing activates reward-related areas, such as the caudate and putamen, whereas negative emotion processing activates a corticolimbic network, including the amygdala and hippocampus. Furthermore, our findings provide evidence that progesterone modulates more bottom-up brain activation during both positive and negative emotion processing, whereas estradiol activates lateralized, top-down regulation. These findings provide insight on the neural correlates of emotion processing during an n-back task in young women and highlight how important it is to consider women's endogenous hormonal concentration in neurobiological and cognition research.
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35
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Henze GI, Konzok J, Kreuzpointner L, Bärtl C, Giglberger M, Peter H, Streit F, Kudielka BM, Kirsch P, Wüst S. Sex-Specific Interaction Between Cortisol and Striato-Limbic Responses to Psychosocial Stress. Soc Cogn Affect Neurosci 2021; 16:972-984. [PMID: 33961049 PMCID: PMC8421693 DOI: 10.1093/scan/nsab062] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/15/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Although women and men differ in psychological and endocrine stress responses as well as in the prevalence rates of stress-related disorders, knowledge on sex differences regarding stress regulation in the brain is scarce. Therefore, we performed an in-depth analysis of data from 67 healthy participants (31 women, taking oral contraceptives), who were exposed to the ScanSTRESS paradigm in a functional magnetic resonance imaging study. Changes in cortisol, affect, heart rate and neural activation in response to psychosocial stress were examined in women and men as well as potential sex-specific interactions between stress response domains. Stress exposure led to significant cortisol increases, with men exhibiting higher levels than women. Depending on sex, cortisol elevations were differently associated with stress-related responses in striato-limbic structures: higher increases were associated with activations in men but with deactivations in women. Regarding affect or heart rate responses, no sex differences emerged. Although women and men differ in their overall stress reactivity, our findings do not support the idea of distinct neural networks as the base of this difference. Instead, we found differential stress reactions for women and men in identical structures. We propose considering quantitative predictors such as sex-specific cortisol increases when exploring neural response differences of women and men.
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Affiliation(s)
| | - Julian Konzok
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | | | - Christoph Bärtl
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Marina Giglberger
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Hannah Peter
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Stefan Wüst
- Institute of Psychology, University of Regensburg, Regensburg, Germany
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36
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Pribék IK, Szűcs KF, Süle M, Grosz G, Ducza E, Vigh D, Tóth E, Janka Z, Kálmán J, Datki ZL, Gáspár R, Andó B. Detection of acute stress by smooth muscle electromyography: A translational study on rat and human. Life Sci 2021; 277:119492. [PMID: 33864819 DOI: 10.1016/j.lfs.2021.119492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 03/22/2021] [Accepted: 04/03/2021] [Indexed: 11/28/2022]
Abstract
AIMS Non-invasive and simultaneous recording of gastrointestinal (GI) activity during stress induction is still an unexplored field. In our previous investigation, the stress-induced alteration of the gastrointestinal tract was explored in rats. Our aims were to expand our previous rat experiment and to induce stress response in rats (Study 1) and humans (Study 2) to detect the GI tract activity, heart rate and body temperature. MATERIALS AND METHODS In the preclinical sample, acute stress was induced by immobilization in Sprague-Dawley rats (N = 10). Acute stress response was generated by the Trier Social Stress Test among healthy volunteers (N = 16). Detection of acute stress was measured by using smooth muscle electromyography, which recorded the myoelectric waves of the gastrointestinal tract (stomach, ileum and colon) simultaneously with heart rate and body temperature in rats and humans. KEY FINDINGS The myoelectric waves of the stomach, the cecum and the ileum increased during immobilization in rats, rising in parallel with heart rate and the dermal temperature of the abdominal surface. The same alterations were found during the stress period among humans, except in the case of the colon, where no change was detected. SIGNIFICANCE The crucial role of the GI tract in stress response was revealed by translating the outcome of basic research into human results. The similar GI alterations during stress in rats and humans underpin the robustness of our findings. In summary, our preliminary translational-based study can serve as an appropriate basis for further human studies.
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Affiliation(s)
- Ildikó Katalin Pribék
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Kálmán Ferenc Szűcs
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | | | | | - Eszter Ducza
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - Dóra Vigh
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Erika Tóth
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zoltán Janka
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - János Kálmán
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zsolt László Datki
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Róbert Gáspár
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Szeged, Szeged, Hungary.
| | - Bálint Andó
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Szeged, Hungary.
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Effects of oral contraceptive pills on mood and magnetic resonance imaging measures of prefrontal cortical thickness. Mol Psychiatry 2021; 26:917-926. [PMID: 33420480 PMCID: PMC7914152 DOI: 10.1038/s41380-020-00990-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/23/2020] [Accepted: 12/07/2020] [Indexed: 01/29/2023]
Abstract
Gonadal hormones influence neuronal organization and plasticity. Yet the consequences of altering their concentrations by administering contraceptive agents, which are used by most reproductive-age women in the United States, are unclear. Cross-sectional studies have found both larger and smaller cortical regions alongside a variety of mood alterations in women who use oral contraceptive pills (OCPs) compared to naturally-cycling women. The goal of this study, therefore, was to determine whether there is an effect of OCPs on MRI measures of prefrontal cortical brain structure that may influence regulation of mood. We performed a double-blind, placebo-controlled, randomized crossover study comparing effects of OCPs (0.15 mg levonorgestrel + 0.30 μg ethinyl estradiol) vs placebo (N = 26) on MRI measures of prefrontal cortical thickness and on mood, as indicated by self-report on the Daily Record of Severity of Problems, which also includes one item related to somatic symptoms. MRI measures that reflect cortical thickness were smaller bilaterally in the pars triangularis and in the pars opercularis and frontal pole of the right hemisphere during the OCP arm vs. placebo. Only the effect in the right pars triangularis survived multiple comparisons correction. Right pars triangularis MRI measures of cortical thickness were not related to mood symptoms, but negatively correlated across conditions with severity of somatic symptoms on the DSRP. The somatic symptoms and MRI measures may be independently related to the actions of steroid hormones in OCPs, with OCPs simultaneously inducing both more effects on MRI measures of cortical thickness and somatic symptoms.
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Taylor CM, Pritschet L, Jacobs EG. The scientific body of knowledge - Whose body does it serve? A spotlight on oral contraceptives and women's health factors in neuroimaging. Front Neuroendocrinol 2021; 60:100874. [PMID: 33002517 PMCID: PMC7882021 DOI: 10.1016/j.yfrne.2020.100874] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/13/2022]
Abstract
Women constitute half of the world's population, yet neuroscience research does not serve the sexes equally. Fifty years of preclinical animal evidence documents the tightly-coupled relationship between our endocrine and nervous systems, yet human neuroimaging studies rarely consider how endocrine factors shape the structural and functional architecture of the human brain. Here, we quantify several blind spots in neuroimaging research, which overlooks aspects of the human condition that impact women's health (e.g. the menstrual cycle, hormonal contraceptives, pregnancy, menopause). Next, we illuminate potential consequences of this oversight: today over 100 million women use oral hormonal contraceptives, yet relatively few investigations have systematically examined whether disrupting endogenous hormone production impacts the brain. We close by presenting a roadmap for progress, highlighting the University of California Women's Brain Initiative which is addressing unmet needs in women's health research.
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Affiliation(s)
- Caitlin M Taylor
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States.
| | - Laura Pritschet
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States
| | - Emily G Jacobs
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States; Neuroscience Research Institute, University of California, Santa Barbara, United States.
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Høgsted ES, Borgsted C, Dam VH, Nasser A, Rye Jørgensen N, Ozenne B, Stenbæk DS, Frokjaer VG. Stress-Hormone Dynamics and Working Memory in Healthy Women Who Use Oral Contraceptives Versus Non-Users. Front Endocrinol (Lausanne) 2021; 12:731994. [PMID: 34819917 PMCID: PMC8606688 DOI: 10.3389/fendo.2021.731994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women who use oral contraceptives (OCs) may have a higher risk of developing a depression, which is associated with both vulnerability to stress and cognitive dysfunction. OCs disrupt the hypothalamic-pituitary-gonadal (HPG) axis by suppressing endogenous sex steroid production including estradiol. The HPG axis and the hypothalamic-pituitary-adrenal (HPA) axis are known to interact, possibly through modulations driven by estradiol. OCs may affect HPA regulation capacity, i.e., disturb cortisol dynamics such as the cortisol awakening response (CAR), and influence cognition such as working memory (WM). We hypothesize that OC use is associated with blunted cortisol dynamics and impaired WM performance relative to non-users. METHODS Data from 78 healthy women in the reproductive age were available from the CIMBI database. We evaluated if CAR and WM differed between OC users (n=25) and non-users (n=53) and if the level of estradiol modulated the OC use effect on CAR or WM in generalized least square models. RESULTS We found that OC users had a blunted CAR (p= 0.006) corresponding to a 61% reduction relative to non-users; however, no estradiol-BY-OC use interaction effect was observed on CAR. Also, OC users had higher cortisol levels at awakening compared to non-users (p = 0.03). We observed no effect of OC use or an estradiol-BY-OC use interaction effect on WM. Also, within the OC user group, neither CAR nor WM was associated with suppressed estradiol. CAR was not associated with WM. CONCLUSION Healthy women who use OCs have blunted cortisol dynamics relative to non-users. However, we could not detect OC use effects on working memory in our sample size. We speculate that disrupted cortisol dynamics may be important for the emergence of depressive symptoms in OC users.
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Affiliation(s)
- Emma Sofie Høgsted
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Camilla Borgsted
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke H. Dam
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Arafat Nasser
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry Centre of Diagnostic Investigations, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G. Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Vibe G. Frokjaer,
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Sharma R, Fang Z, Smith A, Ismail N. Oral contraceptive use, especially during puberty, alters resting state functional connectivity. Horm Behav 2020; 126:104849. [PMID: 32971138 DOI: 10.1016/j.yhbeh.2020.104849] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 10/23/2022]
Abstract
Millions of women worldwide use oral contraceptives (OCs), often starting during puberty/adolescence. It is, however, unknown how OC use during this critical period of development affects the brain. The objective of the current study was to examine resting state functional connectivity (FC) in the default mode network (DMN), central executive network (CEN), salience network (SN), reward network (RN), and subcortical limbic network of the brain using independent component analysis (ICA) between pubertal- and adult-onset OC users (n = 27) and naturally cycling women (n = 48). It was hypothesized that OC use would result in network-specific increases and decreases in FC and that pubertal-onset OC use would result in differences to the aforementioned networks compared to adult-onset OC use. Pubertal-onset OC use is related to heightened FC in the SN compared to adult-onset OC users. In general, OC use also increases connectivity in the SN, CEN, RN, and subcortical limbic network compared to NC women. No significant differences in connectivity were observed in the DMN between OC users and NC women. These findings provide a mechanistic insight for the altered executive functioning and emotion/reward processing previously seen in OC users, which may then increase their vulnerability to mental health conditions.
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Affiliation(s)
- Rupali Sharma
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, 136 Jean-Jacques Lussier, K1N 6N5 Ottawa, ON, Canada
| | - Zhuo Fang
- Brain Imaging Group (BIG) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, 136 Jean-Jacques Lussier, K1N 6N5 Ottawa, ON, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5 Ottawa, ON, Canada
| | - Andra Smith
- Brain Imaging Group (BIG) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, 136 Jean-Jacques Lussier, K1N 6N5 Ottawa, ON, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5 Ottawa, ON, Canada
| | - Nafissa Ismail
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, School of Psychology, Faculty of Social Science, University of Ottawa, 136 Jean-Jacques Lussier, K1N 6N5 Ottawa, ON, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5 Ottawa, ON, Canada.
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