Stress-Evoked Hormone Changes Associated with Depression Severity in Students Using Hormonal Contraceptives

Abstract

Globally, millions use hormonal contraception. Conflicting evidence regarding potential associations between hormonal birth control use and depression has not been adequately addressed. Data are from a longitudinal study that investigated hormone reactivity as a predictor of distress and performance in response to an acute stressor (the Trier Social Stress Test, or TSST) in UT-Austin students. Regularly cycling women in the luteal phase of their menstrual cycle (N = 63) completed self-report measures, participated in the TSST, and provided salivary samples for hormone assay. Depression severity was measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Multiple linear regressions were used to analyze potential associations between hormone responsivity to stress (AUCI) and depression severity. For females taking birth control (N = 21), higher levels of cortisol and progesterone in response to stress (AUCI) were significantly positively associated with CES-D scores (Cortisol: β =.2, p = 0.043; Progesterone: β =.313, p = 0.0463), and higher levels of estradiol in response to stress (AUCI) were significantly negatively associated with CES-D scores (β = -.438, p = 0.0424). There were no associations between stress-evoked hormone changes and CES-D score for females not taking birth control (N = 42). Testosterone was not associated with CES-D score. For females taking birth control, stress-evoked changes in progesterone, cortisol, and estradiol activity were associated with depression severity. Results suggest that altered or dysregulated hormone reactivity to acute stress (via hormonal contraceptive use) may moderate an individual’s risk for depression.