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

ObjectiveTo 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 γ-aminobutyric acid receptor agonists and are important in the modulation of affect and adaptation to stress.DesignProspective observational study.SettingHuman 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.