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Decreased neuroactive steroids induced by combined oral contraceptive pills are not associated with mood changes
Andrea J Rapkin1, Melinda Morgan, Cristiana Sogliano
1Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California 90095-1740, USA. arapkin@mednet.ucla.edu
Objective:
To evaluate the effects of a low-dose combined oral contraceptive pill (OCP) on peripheral neuroactive steroid concentrations, precursors for neuroactive steroid synthesis, and mood in healthy women desiring contraception. These neuroactive steroids are gamma-aminobutyric acid receptor agonists and are important in the modulation of affect and adaptation to stress.
Design:
Prospective observational study.
Setting:
Human ambulatory patient study.
Patient(S):
Healthy OCP-naive women without current or history of affective disorder.
Intervention(S):
A 0.020-mg ethinyl E2-0.1-mg levonorgestrel containing OCP for 3 months.
Main Outcome Measure(S):
Serum neuroactive steroids allopregnanolone, allotetrahydrodeoxycorticosterone, and DHEA; neuroactive steroid precursors P and pregnenolone; E2; and mood and anxiety as assessed by the Premenstrual Syndrome Daily Ratings Form, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Profile of Mood States.
Result(S):
The combined OCP resulted in a decrease in neuroactive steroids and neuroactive steroid precursors as well as in E2. However, this decline was not associated with adverse mood changes on any of the well-validated assessment tools.
Conclusion(S):
Healthy women without underlying mood or anxiety disorder who were given a low-dose OCP did not experience adverse psychological symptoms despite a significant reduction in neuroactive steroids.
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