1
|
Bitzer J, Bouchard C, Zatik J, Weyers S, Piltonen T, Suturina L, Apolikhina I, Gemzell-Danielsson K, Jost M, Creinin MD, Foidart JM. Effects of E4/DRSP on self-reported physical and emotional premenstrual and menstrual symptoms: data from the phase 3 clinical trial in Europe and Russia. EUR J CONTRACEP REPR 2024:1-10. [PMID: 38904165 DOI: 10.1080/13625187.2024.2359117] [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: 12/16/2023] [Accepted: 05/14/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE To describe the effects of estetrol (E4) 15 mg/drospirenone (DRSP) 3 mg on physical and emotional premenstrual and menstrual symptoms. MATERIALS AND METHODS We used Menstrual Distress Questionnaire (MDQ) data from a phase-3 trial (NCT02817828) in Europe and Russia with participants (18 - 50 years) using E4/DRSP for up to 13 cycles. We assessed mean changes in MDQ-t-scores from baseline to end of treatment in premenstrual (4 days before most recent flow) and menstrual (most recent flow) scores for 4 MDQ domains in starters and switchers (use of hormonal contraception in prior 3 months) and performed a shift analysis on individual symptoms within each domain. RESULTS Of 1,553 treated participants, 1,398(90.0%), including 531(38%) starters, completed both MDQs. Starters reported improvements for premenstrual Pain (-1.4), Water Retention (-3.3) and Negative Affect (-2.5); and for menstrual Pain (-3.5), Water Retention (-3.4), and Negative Affect (-2.7) (all p < 0.01). For switchers, no changes were significant except an increase in premenstrual (+1.0, p = 0.02) and menstrual (+1.5, p = 0.003) Water Retention. We observed a change in symptom intensity in >40% of participants for Cramps, Backache and Fatigue (domain Pain), Painful or Tender Breast and Swelling (domain Water Retention) and Mood Swings and Irritability (domain Negative Affect). CONCLUSION E4/DRSP starters experienced significant improvements in the domains Pain, Water Retention and Negative Affect particularly benefiting those with more severe baseline symptoms. Switchers showed minimal changes.
Collapse
Affiliation(s)
- Johannes Bitzer
- Department of Obstetrics and Gynaecology, University Hospital of Basel, Basel, Switzerland
| | | | - János Zatik
- Szent Anna Szuleszeti, Nogyogyaszati es Ultrahang Maganrendelo, Debrecen, Hungary
| | - Steven Weyers
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Terhi Piltonen
- Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre, Oulu University Hospital, Oulu, Finland
| | - Larisa Suturina
- Department of Reproductive Health Protection, Scientific Center for Family Health and Human Reproduction, Irkutsk, Russian Federation
| | - Inna Apolikhina
- National Medical Research Center for Obstetrics, Gynaecology and Perinatology named after Academician V.I. Kulakov, Ministry of Healthcare of Russia, Moscow, Russia
| | - Kristina Gemzell-Danielsson
- Department of Women's and Children's Health, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden
| | - Maud Jost
- Estetra SRL, an affiliate company of Mithra Pharmaceuticals, Liège, Belgium
| | - Mitchell D Creinin
- Department of Obstetrics and Gynecology, University of CA, Sacramento, California, USA
| | - Jean-Michel Foidart
- Department of Gynaecology and Obstetrics, University of Liège, Liège, Belgium
| |
Collapse
|
2
|
Quintana DS, Glaser BD, Kang H, Kildal ESM, Audunsdottir K, Sartorius AM, Barth C. The interplay of oxytocin and sex hormones. Neurosci Biobehav Rev 2024; 163:105765. [PMID: 38885888 DOI: 10.1016/j.neubiorev.2024.105765] [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: 01/23/2024] [Revised: 05/31/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
The neuropeptide oxytocin has historically been associated with reproduction and maternal behavior. However, more recent research has uncovered that oxytocin has a much wider range of roles in physiology and behavior. Despite the excitement surrounding potential therapeutical applications of intranasally administered oxytocin, the results of these intervention studies have been inconsistent. Various reasons for these mixed results have been proposed, which tend to focus on methodological issues, such as study design. While methodological issues are certainly important, emerging evidence suggests that the interaction between oxytocin and sex hormones may also account for these varied findings. To better understand the purpose and function of the interaction of oxytocin with sex hormones, with a focus on estrogens, progesterone, and testosterone, we conducted a comprehensive thematic review via four perspectives: evolutionary, developmental, mechanistic, and survival. Altogether, this synergistic approach highlights the critical function of sex hormone activity for accomplishing the diverse roles of oxytocin via the modulation of oxytocin release and oxytocin receptor activity, which is also likely to contribute to the heterogeneity of outcomes after oxytocin administration.
Collapse
Affiliation(s)
- Daniel S Quintana
- Department of Psychology, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway; NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway.
| | - Bernt D Glaser
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Heemin Kang
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Emilie S M Kildal
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Lovisenberg Diakonale Sykehus, Oslo, Norway
| | - Kristin Audunsdottir
- Department of Psychology, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | | | - Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| |
Collapse
|
3
|
Krug I, Fung S, Liu S, Treasure J, Huang C, Felmingham K, Fuller-Tyszkiewicz M, McConchie O. The impact of oxytocin on emotion recognition and trust: Does disordered eating moderate these relationships? PLoS One 2024; 19:e0303824. [PMID: 38820421 PMCID: PMC11142561 DOI: 10.1371/journal.pone.0303824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/01/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVES The current study aimed to investigate the impact of oxytocin on emotion recognition, trust, body image, affect, and anxiety and whether eating disorder (ED) symptoms moderated any of these relationships. METHOD Participants (n = 149) were female university students, who were randomly allocated to receive in a double-blind nature, a single dose of oxytocin intranasal spray (n = 76) or a placebo (saline) intranasal spray (n = 73). Participants were asked to complete an experimental measure of emotion recognition and an investor task aimed to assess trust. RESULTS The oxytocin group exhibited better overall performance on the emotion recognition task (especially with recognising positive emotions), and a decline in state positive affect than the control group at post-intervention. However, these effects were not moderated by ED symptom severity, nor were effects found for state anxiety, negative affect, body image and recognising negative emotions in the emotion recognition task. CONCLUSION The current findings contribute to the growing literature on oxytocin, emotion recognition and positive affect and suggest that ED pathology does not moderate these relationships. Future research would benefit from examining the efficacy of an oxytocin intervention using a within-subjects, cross-over design, in those with sub-clinical and clinical EDs, as well as healthy controls.
Collapse
Affiliation(s)
- Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Stephanie Fung
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Shanshan Liu
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Janet Treasure
- Department of Psychological Medicine, King’s College London, Institute of Psychiatry and Neuroscience, Section of Eating Disorders, London, United Kingdom
| | - Chia Huang
- Eating Disorders Program, The Melbourne Clinic, Richmond, Victoria, Australia
| | - Kim Felmingham
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Olivia McConchie
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
4
|
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.
Collapse
Affiliation(s)
| | | | - Ben Garforth
- Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Paul J Zak
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, USA
| | | |
Collapse
|
5
|
Rrapaj A, Landau AM, Winterdahl M. Exploration of possible sex bias in acute social stress research: a semi-systematic review. Acta Neuropsychiatr 2023; 35:205-217. [PMID: 36876342 DOI: 10.1017/neu.2023.16] [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] [Indexed: 03/07/2023]
Abstract
Stress can have a significant impact on the daily lives of individuals and can increase vulnerability to a number of medical conditions. This study aims to estimate the ratio of male to female participants in acute social stress research in healthy individuals. We examined original research articles published over the last 20 years. Each article was screened to determine the total number of female and male participants. We extracted data from 124 articles involving a total of 9539 participants. A total of 4221 (44.2%) participants were female, 5056 (53.0%) were male and 262 (2.7%) were unreported. Articles incorporating only females were significantly underrepresented compared to articles incorporating only males. Forty articles (63.5%) which presented data from both females and males, failed to analyse and interpret the results by sex, a significant methodological limitation. In conclusion, in the literature published over the last 20 years, female participants are significantly underrepresented. In the studies where females are represented, severe methodological limitations are apparent. Researchers should be conscious of sexual dimorphism, menstrual phase and use of hormonal contraception, which may impact the interpretation of their results.
Collapse
Affiliation(s)
- Artemida Rrapaj
- Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Anne M Landau
- Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
- Department of Nuclear Medicine and PET-Centre, Aarhus University, Aarhus, Denmark
| | - Michael Winterdahl
- Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
- Department of Nuclear Medicine and PET-Centre, Aarhus University, Aarhus, Denmark
| |
Collapse
|
6
|
Exploring a Possible Interplay between Schizophrenia, Oxytocin, and Estrogens: A Narrative Review. Brain Sci 2023; 13:brainsci13030461. [PMID: 36979271 PMCID: PMC10046503 DOI: 10.3390/brainsci13030461] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Schizophrenia is characterized by symptoms of psychosis and sociocognitive deficits. Considering oxytocin’s antipsychotic and prosocial properties, numerous clinical, and preclinical studies have explored the neuropeptide’s therapeutic efficacy. Sex differences in the clinical course of schizophrenia, as well as in oxytocin-mediated behaviors, indicate the involvement of gonadal steroid hormones. The current narrative review aimed to explore empirical evidence on the interplay between schizophrenia psychopathology and oxytocin’s therapeutic potential in consideration of female gonadal steroid interactions, with a focus on estrogens. The review was conducted using the PubMed and PsychINFO databases and conforms to the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. The results suggest a potential synergistic effect of the combined antipsychotic effect of oxytocin and neuroprotective effect of estrogen on schizophrenia. Consideration of typical menstrual cycle-related hormonal changes is warranted and further research is needed to confirm this assumption.
Collapse
|
7
|
No decrease in perseverance and performance on cognitive tasks in Danish cohort of hormonal contraceptive users. Acta Neuropsychiatr 2023:1-6. [PMID: 36644877 DOI: 10.1017/neu.2023.7] [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] [Indexed: 01/17/2023]
Abstract
Cognitive consequences of hormonal contraceptives (HCs) are largely underexplored, despite the popularity of use. This study investigates the association between perseverance during cognitively challenging tasks and the use of HCs among Danish women. We hypothesised that women using HCs show decreased perseverance across tasks compared to their naturally cycling counterparts. We further hypothesised that HC using women would show decreased performance as a measure of accuracy (i.e. more incorrect answers) compared to naturally cycling women. The study used a cross-sectional repeated measures design, consisting of a Danish version of the Anagram Persistence Task and the Hagen Matrices Test, followed by an extensive survey documenting menstrual and HC history for each participant. The study was conducted online. Data processing was conducted on data from 129 participants. The former hypothesis was analysed through multilevel regression with a nested random effects structure on log-transformed data. The latter hypothesis was analysed through a multilevel generalised linear model with a nested random effects structure using the binomial family. No support was found for either of the hypotheses.
Collapse
|
8
|
Geißert L, Schmidt NM, Henkel K, Luxem A, Hennig J. Dopamine and oxytocin and their relevance for attachment: A gene x gene interaction study. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
9
|
Zak PJ, Curry B, Owen T, Barraza JA. Oxytocin Release Increases With Age and Is Associated With Life Satisfaction and Prosocial Behaviors. Front Behav Neurosci 2022; 16:846234. [PMID: 35530727 PMCID: PMC9069134 DOI: 10.3389/fnbeh.2022.846234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/14/2022] [Indexed: 12/30/2022] Open
Abstract
Helping behaviors and life satisfaction generally increase after middle-age. Identifying the neural substrates of prosocial behaviors in older adults may offer additional insights into these changes over the lifespan. The present study examines the endogenous release of the neuromodulator oxytocin (OT) in participants aged 18-99 and its relationship to prosocial behaviors. OT has been shown to influence trust, altruism, charity, and generosity, yet the effect of age on OT release has not been well-established. Blood samples before and after a video stimulus were obtained from 103 participants in order to examine the impact of OT on prosocial behaviors. We found that OT release following a social prime increased with age (r = 0.49, p = 0.001) and that OT moderated the relationship between age and donations to charity. We tested for robustness by examining three additional prosocial behaviors, money and goods donated to charity during the past year and social-sector volunteering. OT moderated the impact of age on all three prosocial behaviors (ps < 0.05). The analysis also showed that participants' change in OT was positively associated with satisfaction with life (p = 0.04), empathic concern (p = 0.015), dispositional gratitude (p = 0.019), and religious commitment (p = 0.001). Our findings indicate that the neural chemistry that helps sustain social relationships and live a fulfilled life appear to strengthen with age.
Collapse
Affiliation(s)
- Paul J. Zak
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, United States
| | - Ben Curry
- TripActions, San Francisco, CA, United States
| | - Tyler Owen
- Center for Neuroeconomics Studies, Claremont Graduate University, Claremont, CA, United States
| | - Jorge A. Barraza
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| |
Collapse
|
10
|
HALARİS A, SİNGH J, CARTER CS, NAZARLOO H, HAGE B. The Complex Role of Oxytocin in Major Depressive Disorder. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.975706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
11
|
Kuipers YJ, Beeck EV, Cijsouw A, van Gils Y. The impact of motherhood on the course of women's psychological wellbeing. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
12
|
Kerem L, Lawson EA. The Effects of Oxytocin on Appetite Regulation, Food Intake and Metabolism in Humans. Int J Mol Sci 2021; 22:7737. [PMID: 34299356 PMCID: PMC8306733 DOI: 10.3390/ijms22147737] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 12/18/2022] Open
Abstract
The hypothalamic peptide oxytocin and its receptor are involved in a range of physiological processes, including parturition, lactation, cell growth, wound healing, and social behavior. More recently, increasing evidence has established the effects of oxytocin on food intake, energy expenditure, and peripheral metabolism. In this review, we provide a comprehensive description of the central oxytocinergic system in which oxytocin acts to shape eating behavior and metabolism. Next, we discuss the peripheral beneficial effects oxytocin exerts on key metabolic organs, including suppression of visceral adipose tissue inflammation, skeletal muscle regeneration, and bone tissue mineralization. A brief summary of oxytocin actions learned from animal models is presented, showing that weight loss induced by chronic oxytocin treatment is related not only to its anorexigenic effects, but also to the resulting increase in energy expenditure and lipolysis. Following an in-depth discussion on the technical challenges related to endogenous oxytocin measurements in humans, we synthesize data related to the association between endogenous oxytocin levels, weight status, metabolic syndrome, and bone health. We then review clinical trials showing that in humans, acute oxytocin administration reduces food intake, attenuates fMRI activation of food motivation brain areas, and increases activation of self-control brain regions. Further strengthening the role of oxytocin in appetite regulation, we review conditions of hypothalamic insult and certain genetic pathologies associated with oxytocin depletion that present with hyperphagia, extreme weight gain, and poor metabolic profile. Intranasal oxytocin is currently being evaluated in human clinical trials to learn whether oxytocin-based therapeutics can be used to treat obesity and its associated sequela. At the end of this review, we address the fundamental challenges that remain in translating this line of research to clinical care.
Collapse
Affiliation(s)
- Liya Kerem
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA;
- Division of Pediatric Endocrinology, Massachusetts General Hospital for Children, Boston, MA 02114, USA
| | - Elizabeth A. Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA;
| |
Collapse
|