Abstract
Background/Aims: Exposure toward positive emotional cues with – and without – reproductive significance plays a crucial role in daily life and regarding well-being as well as mental health. While possible adverse effects of oral contraceptive (OC) use on female mental and sexual health are widely discussed, neural processing of positive emotional stimuli has not been systematically investigated in association with OC use. Considering reported effects on mood, well-being and sexual function, and proposed associations with depression, it was hypothesized that OC users showed reduced neural reactivity toward positive and erotic emotional stimuli during early as well as later stages of emotional processing and also rated these stimuli as less pleasant and less arousing compared to naturally cycling (NC) women.Method: Sixty-two female subjects (29 NC and 33 OC) were assessed at three time points across the natural menstrual cycle and corresponding time points of the OC regimen. Early (early posterior negativity, EPN) and late (late positive potential, LPP) event-related potentials in reaction to positive, erotic and neutral stimuli were collected during an Emotional Picture Stroop Paradigm (EPSP). At each appointment, subjects provided saliva samples for analysis of gonadal steroid concentration. Valence and arousal ratings were collected at the last appointment.Results: Oral contraceptive users had significantly lower endogenous estradiol and progesterone concentrations compared to NC women. No significant group differences in either subjective stimulus evaluations or neural reactivity toward positive and erotic emotional stimuli were observed. For the OC group, LPP amplitudes in reaction to erotic vs. neutral pictures differed significantly between measurement times across the OC regimen.Discussion: In this study, no evidence regarding alterations of neural reactivity toward positive and erotic stimuli in OC users compared to NC was found. Possible confounding factors and lines for future research are elaborated and discussed.
Highlights
The majority of previous research regarding effects of oral contraception (OC) has been focusing on its physiological aspects (Frye, 2006) and side effects like cancer risk (Gierisch et al, 2013), or thromboembolic events (Oedingen et al, 2018)
Neuroanatomical alterations regarding gray and white matter density and/or volume have been reported in OC users – typically in areas of the limbic system (Brønnick et al, 2020; Taylor et al, 2021) which is known for its key role in emotional processing (Frühholz et al, 2014)
Pairwise comparison revealed that estradiol levels were significantly lower during follicular phase (FO) compared to OV, p = 0.010, and luteal phase (LU), p = 0.015
Summary
The majority of previous research regarding effects of oral contraception (OC) has been focusing on its physiological aspects (Frye, 2006) and side effects like cancer risk (Gierisch et al, 2013), or thromboembolic events (Oedingen et al, 2018). Called combined OCs (COCs) are the most commonly used ones and contain 20–35 μg ethinyl-estradiol (EE) and varying progestin components (Dhont, 2010; Liang et al, 2012). These synthetic steroids unfold negative feedback effects on the hypothalamus-pituitary-gonadal (HPG-) axis. Sharma et al (2020b) reported greater white matter volume in OC users’ right amygdala, left parahippocampal gyrus and left hippocampus while not observing any gray matter differences in these regions. Differences between OC users and naturally cycling (NC) women have been reported in a variety of psychophysiological functions, including stress responsivity, fear conditioning, cognition and socio-emotional behaviors such as emotional processing (Warren et al, 2014; Montoya and Bos, 2017; Lewis et al, 2019)
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