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

Abstract

Purpose of Review We review recent research investigating the relationship of hormonal contraceptives and mood with a focus on relevant underlying mechanisms, such as emotion recognition and reactivity, reward processing, and stress response. Recent Findings Adverse effects of hormonal contraceptives (HCs) on mood seem most consistent in women with a history of depressive symptoms and/or previous negative experience with HC-intake. Current evidence supports a negativity bias in emotion recognition and reactivity in HC-users, although inconsistent to some extent. Some data, however, do indicate a trend towards a blunted reward response and a potential dysregulation of the stress response in some HC-users. Summary HC-effects on psychological and neurophysiological mechanisms underlying mood are likely context-dependent. We provide suggestions on how to address some of the contributing factors to this variability in future studies, such as HC-dose, timing, administration-mode, and individual risk. A better understanding of how and when HCs affect mood is critical to provide adequate contraceptive choices to women worldwide.

Shaping of the Female Human Brain by Sex Hormones: A Review

“…Moreover, some women suffering from premenstrual mood swings may show an improvement in mood with OC intake [139]. Overall, women seem to report more anxiety, irritability or mood swings as well as higher intake of antidepressant medication when using OCs especially in women with previous depressive symptoms (for review please see [140]). In 2 randomized control trials including a placebo condition, women taking OCs reported a decrease in well-being, higher negative affect and a small effect on overall mood [138, 141].…”

Influence of ovarian hormones on value-based decision-making systems: Contribution to sexual dimorphisms in mental disorders

“…Hormonal transition phases, e.g. puberty, postpartum or menopause, are defined by larger alterations in endogenous hormone levels in women; these phases have been associated with considerable mood changes and elevated risk for depression onset (Freeman et al, 2014;Munk-Olsen et al, 2006;Zsido et al, 2017;Lewis et al, 2019).…”

Androgenic Morality? Associations of sex, oral contraceptive use and basal testosterone levels with moral decision making

“…Generally, COC use leads to a substantial decrease of endogenous estrogens and progesterone while at the same time providing high levels of a synthetic estrogen (usually ethinyl estradiol) and a synthetic progesterone (progestin; Burkman et al, 2011;Christin-Maitre, 2013). As Lewis et al (2019) pointed out in a recent review, it is currently unknown, how these states of low endogenous and high exogenous hormones interact and how their net-effect on psychological outcomes deviate from those of regularly changing endogenous hormones over the course of the menstrual cycle. In this context, changes in receptor density and sensitivity due to the long-term alteration of hormone levels might also occur and need further investigation (cf.…”

“…In this context, changes in receptor density and sensitivity due to the long-term alteration of hormone levels might also occur and need further investigation (cf. Lewis et al, 2019).…”