Section - Quick Takes

05. Effects of Hormonal Contraceptives on Mood: A Focus on Emotion Recognition and Reactivity, Reward Processing, and Stress Response

Published on August 1, 2020 Expired on April 1, 2023

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

Hormonal contraceptives can have strong, subtle, or no impact on mood. However, oral contraceptives are not neutral neurophysiologically: 1 study suggests that associated increases in basal cortisol levels might have effects analogous to chronic psychological stressors, including hippocampal volume reductions.

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Do hormonal contraceptives affect mood? Well, the answer is yes, although not as clearly or strongly as you might expect it appears. Do we know anything about the mechanism of the effects of reproductive hormones on mood? We will look in this Quick Take at an article by Carolin Lewis and colleagues from Germany that tackles these neuromechanisms.

First, let’s make sure we start from the same place since gender politics make this somewhat tricky territory. It is clear that reproductive hormones have something to do with mood. For example, women are approximately twice as likely as men to develop depression. Moreover, during windows of heightened risk, like puberty, pregnancy, postpartum, and the perimenopause, the risk of developing depression is increased. However, did you know that there has been a link between antidepressant prescription and hormonal contraceptive use? The relative risk is 1.8 in the Danish Registry. There has even

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Learning Objectives:

After completing this activity, the learner will be able to:

Evaluate a new randomized trial of nasal esketamine – in this case, a negative trial per the primary endpoint. But there is more to learn here, about this medication – and industry support of research.
Evaluate the evidence for cannabinoids as potential treatments for depression, anxiety, PTSD, and other mental illnesses.
Evaluate several meta-analyses of omega-3 fatty acid efficacy in the treatment of depression and draw a working conclusion as to whether to recommend them (and if so, which formulations and dosages).
Evaluate the conflicting evidence base for long-acting injectable antipsychotics, relative to oral antipsychotics, for the prevention of relapse and rehospitalization in patients with schizophrenia.
Review the most recent investigations of the effect of hormonal contraception on mood, including associated neurophysiologic changes.

Original Release Date: August 1, 2020

Review and Re-release Date: March 1, 2023

Expiration Date: April 1, 2023

Relevant Financial Disclosures:

James Phelp declares the following interests:

- McGraw-Hill: book on bipolar disorder

- W.W. Norton & Co.: book on bipolar disorder

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.