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Birth control pills may affect the body’s ability to regulate stress, say researchers

Scientists measured the stress hormone ACTH, making it possible to observe and analyse rapid changes in a woman’s stress response

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Contraceptive pills may have an impact on the body’s ability to regulate stress, a new study has found.

Researchers from Aarhus University and the United States have studied the stress response of 131 young women by measuring the levels of the stress hormone ACTH in the their blood. Some of the participants were on birth control, while others were not.

The study showed that 15 minutes of social activity after having a blood sample taken lowered stress hormone levels in women who were not on birth control. In contrast, women on birth control did not experience any reduction in their ACTH levels.

To avoid causing any additional stress to the test subjects, a small intravenous catheter was inserted in connection with the first blood sample. The researchers could then draw blood after the social activity without having to prick the women with a needle again.

After having a blood sample taken, they could then participate in one of six different group activities such as playing board games, getting to know each other in a group session, singing songs together or attending a church service.

“Being with other people is one of the most effective ways of reducing stress,” explained Michael Winterdahl, a visiting scholar at the translational neuropsychiatry unit at the department of clinical medicine.

“Our results are important because they indicate that people who use birth control pills do not experience the same reduced stress hormone levels in connection with social activity as people who don’t.”

It has long been established that birth control pills affect the stress response in women. However, looking at the stress hormone ACTH in connection with a social activity is a new approach.

The research differs from previous studies that have primarily focused on the stress hormone cortisol in extreme circumstances.

In this study, scientists measured the stress hormone ACTH, which changes significantly faster than cortisol, making it possible to observe and analyse rapid changes in a person’s stress response.

“By studying ACTH levels, we take another step towards understanding how the brain regulates stress as ACTH acts as a neurotransmitter from the brain to the adrenal cortex, which produces cortisol,” said Winterdahl.

“When we analyse ACTH levels, we can gain insight into the quick-response mechanism that controls the body’s reaction to stress.”

Birth control pills are known for being able to affect the hypothalamic-pituitary-adrenal (HPA) axis. As the name indicates, the stress signal travels from the hypothalamus in the brain through the pituitary gland that releases ACTH to the adrenal glands that release cortisol.

However, researchers still need an explanation to why women on birth control do not experience the same reduction of stress hormone levels in connection with social activities as those who are not on the pill.

Winterdahl said there are several competing hypotheses that try to explain the lower cortisol levels in women on birth control.

“Our research has pushed us closer to an explanation that centres on the brain and the ACTH dynamics. The biochemistry is complex, but we are working based on the assumption that birth control pills can suppress the body’s own production of progesterone.”

The study additionally revealed that the stress response in women who did not take birth control pills depended on where they were at in their menstrual cycle.

The stress-reducing group activities had no effect on the ACTH levels of the women who were in the proliferative phase of their cycle – just after their period has ended and the body begins producing hormones to get ovulation started.

“Progesterone levels are very low during the proliferative phase of a natural cycle. This leads to a minimal conversion of progesterone into the hormone allopregnanolone,” said Winterdahl.

“Since allopregnanolone is important for activating the receptors that regulate the stress response, we don’t see a reduction in ACTH levels in women with a natural cycle who have just had their period.”

He pointed out that women also tend to be more physically active during the proliferative phase which could be seen as an adaption in which the stress response and behaviour change in step with the cycle.

In women on birth control, he said, the stress response is “disconnected”, meaning it can not be adapted to a given situation.

Research still can’t explain exactly how this affects women. Additional studies are needed to clarify the complex mechanisms involved in the correlation between hormone levels and the stress response.

“There are different generations of the pill, each with its own chemical structure due to the hormones used, which means the pills have different side-effect profiles,” Winterdahl concluded.

“It’s therefore crucial that our experiments are reproduced with a larger and more diverse group of test subjects.”

Pregnancy

UK research paves way for new preeclampsia therapies

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A preeclampsia study has found unusual cell activity in mothers and babies that could reveal new targets for treatment.

The condition affects 2 to 4 per cent of pregnancies worldwide and is a leading cause of maternal and foetal mortality.

There is currently no cure, and severe cases can put both the mother and baby at risk.

Scientists from UCL and University College London Hospitals found that stressed placental cells, poorly functioning blood vessels and an overactive immune response all contribute to the condition.

Preeclampsia causes high blood pressure during pregnancy. It can affect blood flow to the baby and cause symptoms such as swelling, headaches, blurred vision and pain under the ribs.

Without treatment, it can damage the mother’s health, slow the baby’s growth and, in severe cases, become life-threatening.

Previous research has focused only on the placenta, the organ that develops during pregnancy to support the baby’s growth, rather than the tissues around it.

The researchers said the findings could reveal new therapeutic targets, which are biological processes that future treatments could be designed to alter.

Senior author professor Sara Hillman, of the UCL EGA Institute for Women’s Health, said: “We studied individual cells from both the mother and the baby to see how their activity changes in healthy pregnancies compared with preeclampsia.

“This helped us to confirm some changes already suspected in the condition and also discover new ones.”

The team studied 20 pregnant women recruited at UCLH, including 10 with severe preeclampsia and 10 without the condition.

They used genomic testing to examine individual cells in the placenta and other tissues where cells from the developing baby and mother come into contact.

Genomic testing examines genetic information to help researchers understand how cells behave and the roles they may play.

The other tissues studied were the myometrium, the muscular layer of the womb, and the chorioamniotic membranes, which surround the baby during pregnancy.

The team compared cells from healthy pregnancies and those affected by preeclampsia at different gestational ages, meaning different stages of pregnancy.

They used technology that can read the genetic information of thousands of individual cells at the same time, allowing them to see what each cell was doing and where it was located in the tissue.

In preeclamptic pregnancies where babies were born prematurely, before 37 weeks, during the third trimester, placental cells showed signs of stress and low oxygen levels.

The cells also did not use energy in the normal way.

Some cells responsible for reshaping the mother’s blood vessels were not working properly, the researchers found, which may affect blood flow to the baby.

There were also signs of an overactive immune response in the placenta, nearby tissues and the mother’s blood.

The researchers said this response, together with other stress molecules released by the placenta, helps explain why preeclampsia affects the whole body and can become serious.

They hope the findings will help researchers find treatments for the condition and potentially save lives.

Co-lead author Dr Yara Sanchez Corrales, of the UCL Great Ormond Street Institute of Child Health, said: “These findings point to specific biological processes that could be targeted with treatments. Acting early in pregnancy, especially in more severe early-onset cases, could help improve outcomes and reduce the high risks associated with severe preeclampsia.

“We hope that our findings may set us on the path to reducing premature births and fatalities associated with preeclampsia.”

Co-lead author Mr Theodoros Xenakis, of the UCL Great Ormond Street Institute of Child Health, said: “Future studies may provide an even clearer picture of the biological changes linked to the disease by including more participants and using even more precise methods.”

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Planetary Health Diet lowers heart risk in older women, study finds

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A 20-year study of 66,892 postmenopausal women linked the Planetary Health Diet to lower cardiovascular disease risk.

Women whose eating habits most closely followed the diet had around a 28 per cent lower risk of cardiovascular disease than those in the lowest-adherence group.

Even moderate adherence to the diet was linked with a lower risk.

Donya Shahamati is a doctoral student in public health at the University of California, Irvine.

The researcher said: “Our results suggest that people may not need to follow a perfect or very restrictive diet to see potential heart-health benefits.

“This is especially important for postmenopausal women, because cardiovascular risk increases with age and tends to rise after menopause.”

The diet emphasises fruit, vegetables, whole grains, legumes, nuts and unsaturated fats, while limiting red and processed meats, added sugars, refined grains and saturated fats.

Postmenopausal women are those who have gone through menopause, when periods stop and hormone levels change.

Cardiovascular risk tends to increase with age and rise after menopause.

“Moving towards a more plant-forward, higher-quality diet can be accomplished through small, realistic changes,” said Shahamati.

“These changes might include filling half the plate with vegetables more often; using avocado or olive oil in place of butter; choosing oatmeal or whole-grain cereal for breakfast; or trying a meatless meal once per week.”

For the research, investigators followed 66,892 participants in the Women’s Health Initiative, a long-term national health study funded by the National Heart, Lung and Blood Institute at the National Institutes of Health.

All the women included in the analysis were free from cardiovascular disease at the start of the study, between 1994 and 1998, and had complete information about their diet and other important health and lifestyle factors.

Researchers used information collected through a food frequency questionnaire at the start of the study to calculate a Planetary Health Diet Index score for each participant. Higher scores indicated that a participant’s diet was more closely aligned with the Planetary Health Diet.

They then divided the women into five groups according to how closely their diets followed it.

The women were around 63 years old at the start of the study and were followed for about 20 years to see who developed cardiovascular disease.

When analysing the data, researchers adjusted for factors that could affect cardiovascular risk, including age, race and ethnicity, education, income, smoking, alcohol intake, physical activity, body mass index and total calorie intake.

“We did not only look at overall cardiovascular disease,” said Shahamati.

“We also looked separately at coronary heart disease, stroke and heart failure. This helped us see whether the pattern was similar across different types of cardiovascular outcomes.”

Overall, women whose diets were most closely aligned with the Planetary Health Diet had the lowest risk of cardiovascular disease.

They also had a lower risk of coronary heart disease, heart failure and stroke than women in the lowest-adherence group.

Moderate adherence was also associated with a lower risk, with each 10-point increase in the Planetary Health Diet Index score linked to a further reduction.

The researchers cautioned that, because the study was observational, it could not show that the diet directly caused the lower risk among women.

Observational studies identify links between factors such as diet and disease risk, but cannot prove that one caused the other.

The research team is now exploring other aspects of diet and health among older adults, including how diet quality changes over time.

The researchers said this information could help support healthy ageing and prevent chronic diseases.

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Entrepreneur

Fertility startup American Baby Company secures US$4m

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A fertility startup has raised US$4m and will open its first lower-cost IVF clinic in West Palm Beach later this year.

It will offer a full IVF cycle, including medications, for US$8,995.

Around 12 per cent of American couples struggle with infertility, according to the company, but only 14 per cent of them receive IVF because of the cost.

A single IVF cycle costs an average of US$23,500, it said, with the cost nearly doubling if further cycles are needed.

Co-founder and chief executive Van Spina said: “We’re building ABC around a straightforward premise: IVF has become unnecessarily expensive, and many patients are priced out before they ever have a real chance to start a family.”

“This is personal for me. My fiancée and I went through IVF ourselves, including multiple failed cycles,” Spina continued, citing Jamie Rapp.

“That experience pushed me to build the kind of fertility company we wished had existed when we began treatment.”

The US$4m seed round was led by Wormhole Capital and Tower Research Ventures.

In a blog post, New York-based Tower Research described ABC as a new model for fertility care, praising its “evidence-based protocols, AI-assisted intake, and modern lab workflows.”

“When we met the team at The American Baby Company (ABC), we saw an opportunity to rethink how fertility care is delivered in the US from the ground up,” the post said.

Co-founder and chief medical officer Dr Paul Magarelli is a board-certified reproductive endocrinologist and one of the most prominent voices in the US on expanding access to fertility care, according to Tower.

Reproductive endocrinology is a branch of medicine concerned with hormones and fertility.

Magarelli developed the Clinical Fertility Physician certification programme, which trains generalist clinicians to deliver routine fertility procedures under specialist oversight.

Spina spent his early career as a technology investor at Warburg Pincus before founding an institutionally backed data business in private credit.

“We’re on a mission to become the place Americans go to start their families,” Spina said.

“Our 10-year goal is to help make 250,000 babies per year.”

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