Decreased neuroactive steroids induced by combined oral contraceptive pills are not associated with mood changes

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 E-2-0.1-mg levonorgestrel containing OCP for 3 months. Main Outcome Measure(s): Serum neuroactive steroids allopregnanolone, allotetrahydrodeoxycorticosterone, and DHEA; neuroactive steroid precursors P and pregnenolone; E-2; 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 E-2. 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.