Neurobiology of hormonal contraception

项目总结/文摘

PROJECT SUMMARY/ABSTRACT During K23 funding, I will become an independent investigator focusing on the neural effects of sex steroids and their analogues as they relate to behavioral processes. My research aims to improve gonadal steroid manipulations across the female lifespan. As a critical first step, this research plan will evaluate the effect of hormonal contraception on reward processing in the brain and assess its relationship to behavioral side effects and patient utilization. Behavioral side effects of hormonal contraception such as negative mood and decreased sexual desire represent some of the most frequently cited reasons for discontinuation. Discontinuation of hormonal contraception is a known risk factor for unintended pregnancies. In order to personalize treatment that limits such side effects as well as improve tolerability of future agents, progress in steroid neuroscience is necessary. Current understanding of how hormonal contraception influences brain function has been limited by a lack of prospective controlled investigations. Utilizing a placebo-controlled design, this project will be the first to elucidate how a common oral contraceptive agent containing ethynyl estradiol and levonorgestrel (EE/LNG) influences brain reward function via both neuroimaging and behavioral assessment. This research will reveal how EE/LNG affects ecologically relevant behaviors (i.e., motivation, sexual function) in reproductive women, and serve as the basis for investigation of other steroid contraceptive agents on these processes. My research background in behavioral neuroscience combined with my clinical interests in women’s behavioral health eventually led to my current focus in psychoneuroendocrinology. Now, as an Assistant Professor at the University of Colorado Anschutz Medical Campus (CU-AMC), I have significant support and resources to train to independence utilizing the K23 mechanism. My mentorship team is led by C. Neill Epperson, M.D. and includes experts in neuroimaging (Drs. Tregellas and Epperson), sex steroids (Drs. Epperson and Santoro), and statistical modeling (Dr. Sammel). My training objectives include deepening my understanding of: 1) neurobehavioral effects of sex steroids; 2) advanced techniques in neuroimaging and 3) clinical trials and statistical modeling. I will also 4) improve my research collaborating, writing and presentation skills and 5) obtain additional training in the responsible conduct of research. I will accomplish these training objectives through coursework and seminars, guidance from mentors/consultants, and completion of the proposed research.