Oral contraceptive use in adolescence predicts lasting vulnerability to depression in adulthood

Anderl, Christine; Li, Gu; Chen, Frances S.

doi:10.1111/jcpp.13115

Cited by 68 publications

(76 citation statements)

References 42 publications

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“…Given several athletes in this cohort have previously used an HC, and the second most common reason for discontinuation was that they wanted to take a "natural" approach, understanding the changing attitudes toward the use of HC may be an important consideration. There is a growing body of literature to suggest negative effects such as depression (Anderl et al, 2020), poorer bone mineral density (Allaway et al, 2020), and greater oxidative stress (Cauci et al, 2016) with HC use. However, these effects may be specific to the HC type, with OC the main focus of research looking at these such side effects.…”

Section: Discussionmentioning

confidence: 99%

“…In recreational to elite level Australian athletes, the use of HC use is slightly lower at ∼40% (Armour et al, 2020), likely due to the inclusion of recreational level participants. Despite the advantages of using HC to control their menstrual cycle and potentially reduce menstrual-related symptoms, evidence suggests potential negative outcomes associated with HC use such as a higher risk for depression (Anderl et al, 2020), lower bone mineral density (Allaway et al, 2020), and greater oxidative stress (Cauci et al, 2016), particularly with OC methods. Understanding the reasons why athletes use HC is important to inform athletes' decision to start, stop, or switch between different HC options.…”

Section: Introductionmentioning

confidence: 99%

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Hormonal Contraceptive Use in Football Codes in Australia

Clarke

Bruinvels

Julian

et al. 2021

Front. Sports Act. Living

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The recent launch of the new National elite women's football competitions in Australia has seen a 20–50% increase in grassroots female participation. With the growing participation across grassroots to elite competitions, understanding the health of female athletes should be prioritized. In elite level athletes, hormonal contraceptive (HC) use is common (~50%), however, little is known about the prevalence and reasons for use and disuse of HC in elite female football athletes. As such, the impact of HC use is often not considered when monitoring the health of female footballers. This study involved a subset of data collected as part of a larger questionnaire investigating menstrual cycle function, hormonal contraception use, and the interaction with training load volume and perceived performance in elite female football code athletes. A total of 177 participants completed the questionnaire across three football codes within Australia (rugby league, rugby union/sevens, Australian football). One third (n = 58) of athletes were currently using HC, predominately in the form of an oral contraceptive pill (OC, n = 47). Reasons for use included: to avoid pregnancy (71%); to control/regulate cycle (38%); and to reduce menstrual pain (36%). However, most athletes using an OC (89%) could not identify the type of pill used (e.g., mono-, bi-, or triphasic). The main reason for disuse was due to the negative side effects (n = 23), such as mood swings, weight gain, and depression/anxiety. Comparing HC users and non-users, there were no statistical differences in the number of reported menstrual symptoms, use of medication to relieve menstrual pain, or frequency for needing to adapt training due to their menstrual cycle (p > 0.05). Since most athletes were unaware of the type of OC they used, female football athletes require further education about the different types of HC, and specifically OC, available to them. Similarities in the symptoms experienced, pain management, and training adaptation requirements between groups suggests that HC use may not have the intended outcome for certain athletes. As such, greater awareness of athlete's personal experiences with the menstrual cycle, how HC may influence their experience, and acknowledgment of non-pharmacological methods to help manage menstrual cycle related symptoms are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hormonal Contraceptive Use in Football Codes in Australia

Clarke

Bruinvels

Julian

et al. 2021

Front. Sports Act. Living

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“…Additionally, these studies point out that adolescents were at higher risk relative to women older than 20 years, which has since been replicated in an independent prospective cohort study (9). Further, another study suggests that first time use of OCs in adolescence compared to in adulthood is associated with longer lasting vulnerability to MDD through adulthood (10). The literature, however, shows conflicting results as smaller studies have reported positive or no mood effect of OC use (11).…”

Section: Introductionmentioning

confidence: 99%

Oral contraceptives and the serotonin 4 receptor: a molecular brain imaging study in healthy women

Larsen

Köhler‐Forsberg

Dam

et al. 2020

Acta Psychiatr Scand

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VG. Oral contraceptives and the serotonin 4 receptor: a molecular brain imaging study in healthy women. Objective: Sex steroid hormones potently shape brain functions, including those critical to maintain mental health such as serotonin signaling. Use of oral contraceptives (OCs) profoundly changes endogenous sex steroid hormone levels and dynamics. Recent registerbased studies show that starting an OC is associated with increased risk of developing depression. Here, we investigate whether use of OCs in healthy women is associated with a marker of the serotonin system in terms of serotonin 4 receptor (5-HT4R) brain imaging. Methods: [ 11 C]SB207145-PET imaging data on 53 healthy women, of whom 16 used OCs, were available from the Cimbi database. We evaluated global effects of OC use on 5-HT4R binding in a latent variable model based on 5-HT4R binding across cortical and subcortical regions. Results: We demonstrate that OC users have 9-12% lower global brain 5-HT4R binding potential compared to non-users. Univariate regionbased analyses (pallidostriatum, caudate, hippocampus, amygdala, anterior cingulate cortex, and neocortex) supported the global effect of OC use with the largest difference present in the hippocampus (À12.8% (95% CI [À21.0; À3.9], P corrected = 0.03). Conclusion: We show that women who use OCs have markedly lower brain 5-HT4R binding relative to non-users, which constitutes a plausible molecular link between OC use and increased risk of depressive episodes. We propose that this reflects a reduced 5-HT4R gene expression, possibly related to a blunted ovarian hormone state among OC users.

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“…Consistent with the associations between cortisol concentrations and OC intake, the use of OC has been associated with a higher risk of depression and higher use of antidepressant medication, especially in adolescents [ 12 , 61 , 62 ]. A history of psychiatric symptoms strengthened the effects [ 35 ].…”

Section: Discussionmentioning

confidence: 77%

Broad Metabolome Alterations Associated with the Intake of Oral Contraceptives Are Mediated by Cortisol in Premenopausal Women

et al. 2021

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The use of oral contraceptives (OCs) has been associated with elevated blood cortisol concentrations. However, metabolic downstream effects of OC intake are not well described. Here, we aimed to determine if the blood metabolome is associated with the use of OCs and to estimate if these associations might be statistically mediated by serum cortisol concentrations. Plasma metabolites measured with the Biocrates AbsoluteIDQ p180 Kit and serum cortisol concentrations measured by an immunoassay were determined in 391 premenopausal women (116 OC users) participating in two independent cohorts of the Study of Health in Pomerania (SHIP). After correction for multiple testing, 27 metabolites were significantly associated with OC intake in SHIP-TREND (discovery cohort), of which 25 replicated in SHIP-2. Inter alia, associated metabolites included 12 out of 38 phosphatidylcholines with diacyl residue, 7 out of 14 lysophosphatidylcholines and 5 out of 21 amino acids. The associations with phosphatidylcholines were statistically mediated by cortisol, whereas lysophosphatidylcholines showed no mediation effect. The results represent a step toward a better understanding of the metabolic consequences of OC intake. Connecting cortisol with metabolic consequences of OC intake could help to understand the mechanisms underlying adverse effects. The blood metabolome may serve as a biomarker for identifying users at high risk for developing such adverse effects.

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Oral contraceptive use in adolescence predicts lasting vulnerability to depression in adulthood

Cited by 68 publications

References 42 publications

Hormonal Contraceptive Use in Football Codes in Australia

Hormonal Contraceptive Use in Football Codes in Australia

Oral contraceptives and the serotonin 4 receptor: a molecular brain imaging study in healthy women

Broad Metabolome Alterations Associated with the Intake of Oral Contraceptives Are Mediated by Cortisol in Premenopausal Women

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