WOMENS HEALTH
Research spotlight: Interplay of hormonal contraceptive use, stress and cardiovascular risk in women
Massachusetts General Hospital
Antonia Seligowski, PhD, of the Neurocardiac Effects of Stress & Trauma Laboratory within the Department of Psychiatry at Mass General Brigham, is the senior author of a paper published in JAMA Network Open, “Hormonal contraceptive use, stress disorders, and cardiovascular and thrombotic risk in women.”
Q: What challenges or unmet needs make this study important?
Over 400,000 women in the United States die each year from cardiovascular disease (CVD), the nation’s leading cause of death. Stress is a major risk factor for CVD, and stress‑related psychiatric disorders like anxiety and post-traumatic stress disorder (PTSD) are more common in women. Because of this, experts have called for more attention to be paid to sex‑specific factors that contribute to women’s cardiovascular health.
One such factor is hormonal contraception, used by about 9.1 million women in the United States. Past research on these contraceptives—which work by introducing different amounts of hormones and suppressing natural estradiol and progesterone levels—has focused almost entirely on young, relatively healthy women. As a result, very little is known about how hormonal contraceptives affect women with stress‑related psychiatric disorders. To our knowledge, this study is the first to examine the combined effects of hormonal contraceptives and stress‑related disorders on cardiovascular or thrombosis risk.
Q: What central question(s) were you investigating?
Our study, led by Jordan Thomas, PhD, of the University of Kansas, explored whether hormonal contraceptive use is linked to cardiovascular and thrombotic risk in women with and without stress‑related disorders. Specifically, we wanted to know if women with a history of depression, anxiety or PTSD who use hormonal contraceptives have a higher risk of major adverse cardiovascular events (MACE) or deep‑vein thrombosis than those without this mental health history.
Q: What methods or approach did you use?
We analyzed healthcare records from 31,824 women who consented to be part of the Mass General Brigham Biobank. Specifically, we looked for medical codes indicating diagnoses of stress‑related disorders, MACE and deep‑vein thrombosis, as well as prescriptions for hormonal contraceptives.
Q: What did you find?
For the majority of women, including those with a history of anxiety or depression, hormonal contraceptive use was associated with lower risk of MACE. However, this protective association was not seen in women with PTSD.
Although preliminary, these findings suggest that cardiovascular risk may vary among women who use hormonal contraceptives—especially differing for those with PTSD. If future studies confirm these results, clinicians may need to consider stress‑related psychiatric disorders when discussing hormonal contraceptive options with patients.
Q: Tell us about any follow-up studies you have planned to validate or build on these findings.
We hope to conduct a clinical study that collects new data on how specific hormonal contraceptive formulas relate to CVD risk factors in women, including blood pressure, vascular endothelial function and blood‑based clotting markers. We also plan to test whether these effects differ for women with and without stress‑related psychiatric disorders. Participants would return yearly for follow‑up visits to track clinical outcomes such as thrombotic events.
Authorship: In addition to Seligowski, Mass General Brigham authors include Robyn Ellis, Shady Abohashem, Anahita Dua, Emily Lau, Karen Miller, Rachel Rosovsky, Ahmed Tawakol and Michael Osborne.
Paper cited: Thomas, J., et al. “Hormonal contraceptive use, stress disorders, and cardiovascular and thrombotic risk in women.” JAMA Network Open. DOI: 10.1001/jamanetworkopen.2025.51878
Disclosures: Miller has received study medication and investigator-initiated research grants from Amgen and has equity in Bristol-Myers Squibb (BMS), General Electric, Boston Scientific and Becton Dickinson. Osborne receives consulting fees from WCG Clinical for unrelated work.
Journal
JAMA Network Open
Article Title
Hormonal contraceptive use, stress disorders, and cardiovascular and thrombotic risk in women
University of Maryland School of Medicine researchers discover that vaginal bacteria don’t always behave the same way
Findings could transform how women’s health conditions are diagnosed and treated
image:
Johanna Holm, PhD, a scientist at the Institute for Genome Sciences at the University of Maryland School of Medicine
view moreCredit: The University of Maryland School of Medicine
For decades, gynecological tests have relied on a simplified view of the vaginal microbiome, categorizing bacteria as either “good” or “bad.” New research from University of Maryland School of Medicine scientists challenges that assumption, revealing that bacteria of the same species can behave in fundamentally different ways, with important implications for women’s health.
- Today, gynecological tests largely focus on detecting two groups of bacteria in the vaginal microbiome: Lactobacillus, generally associated with health, and Gardnerella, which has been linked to Bacterial Vaginosis (BV), increased risk of sexually transmitted diseases, and other adverse outcomes.
- New research identifies 25 distinct vaginal microbiome types, including multiple types dominated by Gardnerella that differ markedly from one another.
- The researchers developed two open-source tools—VIRGO2 and VISTA—that enable analysis of how different strains within the same species can perform distinct biological functions.
- This research provides a foundation for precision gynecological care to women.
Baltimore, Feb. 5, 2026: In a new study published today in the journal mBio, researchers at the University of Maryland School of Medicine (UMSOM) report that the long-standing view of the vaginal microbiome as either “optimal” or “non-optimal” based on a small number of bacterial species is overly simplistic. By analyzing vaginal microbiome data at unprecedented resolution, the team identified 25 distinct vaginal microbiome types and demonstrated that bacteria of the same species can differ substantially in their functional potential, thereby affecting how these microbes interact with the body.
Historically, vaginal health has often been described in terms of dominance by Lactobacillus species versus Gardnerella, the latter commonly associated with bacterial vaginosis and other adverse reproductive and urogenital outcomes. The new findings show that this classification does not fully capture the biological diversity of vaginal microbial communities.
“Our results show that it is not enough to ask which bacterial species are present, we need to understand what they are capable of doing, and what they are doing,” said Amanda Williams, PhD, a postdoctoral fellow at UMSOM’s Institute for Genome Sciences (IGS) Center for Advanced Microbiome Research and Innovation made (CAMRI), and lead author on the study. “We found that multiple vaginal microbiome types can be dominated by Gardnerella yet differ in their functional profiles and associations with inflammation and risk of adverse outcomes.”
Among the 25 microbiome types identified, six were dominated by Gardnerella. One of these showed functional and inflammatory profiles that more closely resembled microbiomes dominated by Lactobacillus, highlighting the biological heterogeneity within what is often treated as a single category.
To enable this level of analysis, the CAMRI team developed and applied two open-source computational tools. VIRGO2 is an expanded gene catalog comprising approximately 1.7 million genes from bacteria, fungi, and viruses found in the vaginal microbiome, built using samples collected from women across five continents. A recent paper in Nature Communications, led by Michael France, PhD, Research Associate at IGS and CAMRI, explains VIRGO2 in more detail. VISTA (Vaginal Interference of Subspecies and Typing Algorithm) complements this resource by defining metagenomic community state types (mgCST), allowing researchers to examine vaginal microbiomes at the strain-community level rather than relying solely on species identification.
“These tools allow us to study how vaginal microbiomes differ in their functional potential and how those differences may relate to host biology,” said senior author Johanna Holm, PhD, a scientist at IGS and CAMRI, and Assistant Professor of Microbiology and Immunology at UMSOM. “While this work does not immediately change clinical practice, it provides a framework for future studies aimed at improving risk stratification, diagnostics, and treatment strategies in women’s health.”
The researchers emphasize that further research will be needed to determine how these microbiome types relate to clinical outcomes and how such information might eventually inform more tailored approaches to diagnostics and treatment.
About the Institute for Genome Sciences
The Institute for Genome Sciences' (IGS) has been part of the University of Maryland School of Medicine (UMSOM) since 2007. IGS scientists work in diverse areas, applying genomics and systems biology approaches to better understand health issues in premature infants, women, and transgender people; to improve vaccine development; to study evolutionary biology; and to understand cancer, parasitic, fungal, and infectious diseases, as well as identifying the underpinnings of aging, brain development, addiction, and mental health. IGS also remains at the forefront of high-throughput genomic technologies and bioinformatics analyses through its core facility, Maryland Genomics which provides researchers around the world with cutting-edge, collaborative, and cost-effective sequencing and analysis.
About the University of Maryland School of Medicine
The University of Maryland School of Medicine, established in 1807 as the first public medical school in the U.S., continues today as one of the fastest growing, top-tier biomedical research enterprises in the world. The School has nearly $500 million total research funding, 46 departments, centers, and institutes, more than 2,200 student trainees and over 3,000 faculty members, including notable members of the National Academy of Medicine. As the largest public medical school in the DC/MD/VA region, faculty-physicians are working to help patients manage chronic diseases like obesity, cancer, heart disease and addiction, while also working on cutting-edge research to address the most critical generational health challenges. In 2024, the School ranked #12 among public medical schools and #27 among all medical schools for R&D expenditures by the National Science Foundation. With a $1.3 billion total operating budget, the School partners with the University of Maryland Medical Center to serve nearly 2 million patients annually. The School's global reach extends around the world with research and treatment facilities in 33 countries. In Maryland, the School of Medicine is spearheading new initiatives in AI and health computing and partnering with the University of Maryland BioPark to develop new medical technologies and bioengineering ventures. For more information, visit medschool.umaryland.edu.
Journal
mBio
Method of Research
Experimental study
Subject of Research
People
Article Title
University of Maryland School of Medicine Researchers Discover That Vaginal Bacteria Don’t Always Behave the Same Way
Article Publication Date
5-Feb-2026
New study shows Ugandan women reduced psychological distress and increased coping using Transcendental Meditation after COVID-19 lockdown
Maharishi International University
image:
Research participants practicing Transcendental Meditation in a group.
view moreCredit: African Women’s And Girls Organization (AWAGO)
A peer reviewed, randomized controlled study with 199 women living in poverty in the city slums of Uganda was published today in Health Care for Women International. This study was conducted following two extended country-wide lockdowns in Uganda during the Covid 19 pandemic. Researchers found that the Transcendental Meditation® (TM®) technique reduced perceived stress, anger, and fatigue; increased self-efficacy; and improved sleep quality. TM helped these women to improve their mental and physical health and positively impacted their ability to cope in this crisis.
“The Covid lockdowns in Uganda, which resulted in food shortages, lack of employment, and increased domestic violence, exacerbated the already challenging circumstances faced by these women,” said lead author Leslee Goldstein, PhD, Senior Researcher, Center for Social Emotional Health and Consciousness at Maharishi International University. “Leaders at the Amazing Women Community Organization serving them reached out to African Women and Girls Organization (AWAGO), the TM women’s organization in Uganda, for their programs to help these women reduce stress, which exponentially increased during the lockdowns.”
Amazing Women Executive Member, Teopista Nambaziira explained why they reached out to AWAGO: “Women were losing hope, thinking there was no future for themselves. They were so fatigued, so stressed, they couldn’t sleep well. We decided to partner with AWAGO to see if TM could help them.”
Study design and outcomes
This single-blind, randomized controlled study was conducted with women ranging in ages from 16-73 (average age 34). Of the 199 participants, 40% had completed only primary school or lower, and only 53% were able to read and write. Most women (87%) were mothers, and 40% were single mothers. The study involved a TM group and a wait list (delayed start) control group with a pre-test at baseline and a post-test after three months. Researchers found statistically significant decreases in perceived stress, the primary outcome measure, as well as anger, and fatigue. Also found, was a significant improvement in sleep quality, and an increase in self-efficacy—self-beliefs in one’s ability to cope with a variety of difficult demands in life.
The control group participants were later given the opportunity to learn Transcendental Meditation, and all chose to do so.
At eight months, a short-answer questionnaire was completed by 93 out of the original 96 TM group participants. Ninety-one women reported improvements in physical and mental health, all mothers reported improved relationships with children, and 85 participants reported improved relationships with neighbors. Nine of the 10 women who were asked if they had experienced domestic violence during the lockdowns reported that it decreased after starting TM.
Comments from research participants
Improved physical and mental health
“TM has helped me improve on my health in the way that I no longer fall sick like before.”
“I now have inner peace and self-control.”
“I feel confident with new situations.”
Improved relationships with children
“At first I could get angry with children so fast, but now I take things easy so there is peace at home.”
“I used not to control my temper with them, but now I do.”
“We are now friendly and communicate so well, they even tell me I am the best mother now since I learned TM.”
Improved relationships with neighbors
“I used to fight with the neighbors, but now we are fine.”
“We now talk and laugh, which was not the case before meditation.”
“We now work together, which used not to happen.”
Decreased domestic violence
“I am more resilient.”
“I handle the situation better now.”
“I don’t respond to arguments like I used to.”
“The fact that now I have peace of mind, it’s hard for me to pick up a fight.”
Observations from community leaders
Community leaders’ observations supported our research findings. Janat Kivumbi, a Town Council leader who handles problems that arise in the community, reported that before TM trainings, a lot of family cases were arising on a daily basis. “This was due to stress amongst the women and a lot of anger, with fighting between husbands and wives as well as children. TM has enabled us to reduce the cases that I was receiving and recording in my office.”
Fausta Zadoch, local church leader and counselor in the community, reported improved mental health among the women. Before the women learned TM, her office regularly received many women and girls for counseling because of different issues. After the women joined AWAGO’s TM trainings, she received fewer numbers of women and girls seeking counseling. “TM has changed these women and girls. They are now stress free, and everything has improved spiritually, financially, and physically. We are grateful for this beautiful program.”
Teopista Nambaziira shared her observations regarding women’s improved ability to cope:
At first women didn’t think TM would help them, and they told TM teachers ‘just give us money.’ After learning TM everything changed. They could not believe how easy TM is and that they could experience such peace inside themselves. They are feeling better, sleeping better, getting along better, and have more energy. They are taking better care of themselves and their personal hygiene and are looking better and feeling good about themselves. Now they take everything easier and at the end of the day, they say ‘I am OK.’
Authors’ Conclusion
The authors conclude that TM offers these women an effective tool they can utilize for themselves by themselves each day to help them gain inner strength and outer energy and vitality. This empowers them with a newfound ability to handle their stressful situations, improving the way they feel about themselves, and impacting their social interactions at home and in the community. We see this growth in human potential that has been demonstrated, as a powerful foundation for transforming society toward greater equity and progress.
This research was supported by funding from the Rona and Jeffery Abramson Foundation, which is interested in improving the mental health and well-being of women in Uganda through Transcendental Meditation.
About the Transcendental Meditation Technique
Transcendental Meditation is a simple, natural technique practiced 20 minutes twice each day while sitting comfortably with the eyes closed. It is easily learned, and is not a religion, philosophy, or lifestyle. It does not involve concentration, control of the mind, contemplation, or monitoring of thoughts or breathing. The practice allows the active thinking mind to settle down to a state of inner calm. For more information visit https://www.tm.org.
Journal
Health Care For Women International
Method of Research
Randomized controlled/clinical trial
Subject of Research
People
Article Title
The Impact of Transcendental Meditation on Psychological Distress and Coping in the Lives of Women in Uganda: A Randomized Controlled Trial
Article Publication Date
5-Feb-2026
No comments:
Post a Comment