Oral Contraceptives Enhance Social Behaviors & Reduce Threat Avoidance Under Stress in Women (2024 Study)

Oral contraceptives (OCs) reduce avoidance bias and increase approach behavior under stress, with effects varying based on the type of contraceptive used.

Highlights:

1. Participants: The study involved 130 women, split evenly between those taking oral contraceptives (OCs) and those not using any hormonal contraception.
2. Avoidance Bias: Women taking oral contraceptives showed a reduced tendency to avoid social threat signals compared to those not on hormonal contraception.
3. Approach Bias: Under stress, women on oral contraceptives exhibited an increased approach bias towards positive social signals.
4. Contraceptive Preparation: The observed effects varied depending on the specific preparation of the contraceptive, particularly between androgenic and anti-androgenic formulations.
5. Cortisol Response: There was no significant difference in cortisol stress responses between women taking OCs and those not using hormonal contraception.

Source: Psychoneuroendocrinology (2024)

Effects of Oral Contraceptives on Female Brains (Overview)

Oral contraceptives (OCs), commonly known as birth control pills, are widely used by women for preventing pregnancy.

Beyond their primary function, OCs have significant effects on various aspects of women’s health, including their brains and psychological well-being.

These effects can be attributed to the hormonal changes induced by OCs, particularly involving synthetic estrogens and progestins.

While many women experience no significant psychological changes, others report mood alterations, changes in emotional reactivity, and cognitive effects.

Mood Changes

Some women report mood swings, depression, or anxiety after starting OCs, while others experience mood stabilization and reduced premenstrual symptoms.

The prevalence of mood-related side effects varies, with studies indicating that 4-10% of OC users may experience negative mood changes.

Emotional Reactivity

OCs can influence how women respond to emotional stimuli. Some studies have found altered recognition and response to emotional expressions, such as reduced recognition of anger or fear.

Changes in emotional reactivity might be linked to fluctuations in hormone levels induced by OCs.

Cognitive Effects

Research has shown mixed results on the impact of OCs on cognitive functions. Some studies report improvements in verbal memory, while others suggest potential impairments in spatial abilities.

These cognitive effects are thought to result from hormonal modulation of brain regions involved in memory and cognition.

Libido & Sexual Function

OCs can affect libido and sexual function, with some women experiencing reduced sexual desire, while others notice no change or an increase.

The impact on libido is believed to be related to the hormonal regulation of androgen levels.

Major Findings: Oral Contraceptives on Female Social Behavior & Stress Response (2024)

1. Participants

The study comprised 130 female participants, split into two groups: 65 women taking oral contraceptives and 65 women not using any hormonal contraception.

This cross-sectional design enabled a detailed comparison of behavioral and physiological responses between the two groups.

2. Reduced Avoidance of Negative Social Signals

• Finding: Women using oral contraceptives showed a significantly reduced tendency to avoid negative social signals.

In the study, avoidance behavior was measured by how quickly participants pushed away images of angry faces.

Women on oral contraceptives were as likely to pull these angry faces towards them as to push them away, indicating a reduced avoidance of negative stimuli.

This suggests that oral contraceptives may diminish the instinctive reaction to avoid potential social threats.

3. Increased Positive Social Behavior Under Stress

• Finding: Oral contraceptives were associated with an increase in positive social behavior in stressful situations.

The study used the Socially Evaluated Cold Pressor Test to induce stress.

After the stress test, women on oral contraceptives exhibited a stronger approach behavior towards happy faces compared to their responses before the stress test.

This enhanced positive social engagement under stress points to a potential “tend-and-befriend” response facilitated by oral contraceptives, where stressed individuals seek out positive social interactions.

4. Variation Based on Contraceptive Type

• Finding: The effects of oral contraceptives on social behavior varied depending on the specific hormonal composition of the contraceptive.

The study highlighted that different formulations of oral contraceptives, particularly those with androgenic (male hormone-like) versus anti-androgenic properties, had distinct effects on behavior.

Women using androgenic oral contraceptives showed a pronounced increase in approach behavior to positive stimuli after stress.

This variation underscores the importance of considering the specific type of oral contraceptive when evaluating their behavioral impacts.

5. Cortisol Stress Response

• Finding: There was no significant difference in cortisol stress responses between women taking oral contraceptives and those not using hormonal contraception.

Cortisol, a hormone released in response to stress, was measured at three time points: before the stress test, immediately after, and during recovery.

Both groups—those on oral contraceptives and those not—showed a similar pattern of cortisol increase following the stress test.

This indicates that while oral contraceptives may influence behavioral responses to stress, they do not significantly alter the physiological cortisol response.

Study Details: Oral Contraceptives & Social Behaviors (2024 Study)

Participants

Sample: 130 women

Group Division:

• 65 women taking oral contraceptives
• 65 women not using any hormonal contraception

Age Range: 19 to 30 years

Inclusion Criteria:

• Normal or corrected-to-normal vision
• BMI between 17.5 and 25
• No neurological, psychiatric, cardiovascular, or endocrinological pre-existing diseases

Methods

Design: Cross-sectional study

Tasks and Measurements:

• Approach Avoidance Task (AAT): Participants were asked to respond to socio-affective signals (happy and angry faces) by pushing or pulling a joystick to measure automatic approach and avoidance behaviors.
• Stress Induction: Socially Evaluated Cold Pressor Test (SECPT), where participants submerged their hand in ice water while being observed and videotaped.
• Cortisol Measurement: Saliva samples were collected at three time points (before the AAT, after the SECPT, and during recovery) to measure cortisol levels, indicating stress response.
• Questionnaires: Participants filled out computerized questionnaires assessing emotion regulation, personality, and approach/avoidance tendencies.

Procedure:

• Participants completed initial questionnaires and provided a saliva sample.
• They performed the AAT, provided another saliva sample, underwent the SECPT, and performed the AAT again.
• A final saliva sample was collected, and participants completed demographic and contraceptive-related questionnaires.

Limitations

• Survivor Effect: The study may have included only those women who did not experience severe side effects from oral contraceptives, potentially biasing results.
• Cross-Sectional Design: This design limits the ability to draw causal inferences about the effects of oral contraceptives.
• Hormonal Measurements: The study did not measure steroid hormone levels directly, which could have provided more precise insights into the hormonal mechanisms underlying the observed behaviors.
• Timing of Testing: Testing in the afternoon might have affected cortisol measurements, as cortisol levels can vary based on the time of day.
• Heterogeneity of Contraceptive Preparations: Different formulations of oral contraceptives were used by participants, which could introduce variability in the results.
• Lack of Neutral Condition: The AAT did not include neutral stimuli, which could help clarify the specific effects of oral contraceptives on reactions to emotional versus neutral signals.
• Exploratory Analyses: Some analyses were exploratory and need further validation in future studies.
• Sample Size for Cortisol Analysis: Saliva samples from 20 participants could not be used, reducing the sample size for cortisol analysis and potentially affecting the power to detect differences.

How do oral contraceptives alter brain activity & social behavior in females?

The effects of oral contraceptives on the female brain and psychology are primarily mediated through hormonal pathways. Here are the key mechanisms:

Hormonal Regulation

OCs contain synthetic versions of estrogen and progestin, which regulate the menstrual cycle by suppressing the natural production of these hormones in the ovaries.

This suppression leads to reduced levels of endogenous estrogen and progesterone, which can influence brain function and behavior.

Neurotransmitter Systems

Estrogen and progesterone interact with neurotransmitter systems, including serotonin, dopamine, and GABA, which are crucial for mood regulation.

Changes in these neurotransmitter systems due to OC use can result in altered mood and emotional reactivity.

Brain Structure & Function

Hormones in OCs can lead to structural and functional changes in the brain. For instance, estrogen is known to have neuroprotective effects and can promote synaptic plasticity.

Areas of the brain involved in emotion regulation, such as the amygdala and prefrontal cortex, are particularly sensitive to hormonal changes induced by OCs.

Stress Response

OCs can modulate the hypothalamic-pituitary-adrenal (HPA) axis, which controls the body’s response to stress.

Some studies suggest that OCs may blunt the cortisol response to stress, potentially altering how women perceive and react to stressful situations.

Androgen Suppression

Certain progestins in OCs have anti-androgenic properties, reducing levels of androgens such as testosterone.

Androgens play a role in sexual desire and motivation, and their suppression can influence libido and other related behaviors.

What women should know about the effects of oral contraceptives on social behavior & stress responses…

Based on the study findings, here are important considerations for women regarding how oral contraceptives might impact their behavior and thinking:

1. Reduced Avoidance of Negative Social Signals

Women taking oral contraceptives might find themselves less inclined to avoid negative social situations or conflicts. This can mean a greater willingness to face challenging interpersonal interactions.

Being aware of this change can help women navigate social situations more consciously, potentially improving conflict resolution skills.

2. Increased Positive Social Behavior Under Stress

Oral contraceptives may increase positive social behaviors, especially under stress. Women might feel more inclined to seek social support and engage positively with others when stressed.

Recognizing this tendency can help women leverage their social networks more effectively during stressful times, fostering better stress management and emotional well-being.

3. Variation Based on Contraceptive Type

The effects of oral contraceptives on behavior and thinking can vary significantly depending on the specific hormonal composition of the contraceptive.

Androgenic versus anti-androgenic formulations can lead to different behavioral outcomes.

Women should discuss with their healthcare providers which type of oral contraceptive might best suit their needs and be aware that switching types could alter their behavioral responses.

4. No Significant Change in Cortisol Stress Response

While oral contraceptives may alter behavior under stress, they do not significantly change the physiological cortisol response to stress.

Women might experience changes in how they approach and handle stress without significant changes in how their bodies physiologically respond to stress.

Being aware of this distinction can help women understand that while their stress coping behaviors might change, their underlying stress physiology remains stable.

What should you do if taking an oral contraceptive?

Monitor Changes

Women should monitor any behavioral or emotional changes they experience after starting oral contraceptives. Keeping a journal can help track patterns and identify any significant shifts.

If any changes become problematic, discussing them with a healthcare provider is crucial. Adjustments to the type or dosage of the contraceptive might be necessary.

Personalized Approach

The impact of oral contraceptives can vary widely among individuals. What works well for one woman might not be suitable for another.

A personalized approach to choosing and using oral contraceptives, in consultation with a healthcare provider, can help optimize benefits and minimize adverse effects.

Stay Informed

Staying informed about the potential effects of oral contraceptives on behavior and thinking empowers women to make better decisions about their reproductive health.

Accessing reliable information and engaging in open conversations with healthcare providers can ensure women are well-prepared to manage any changes they may experience.

Conclusion: Oral Contraceptives & Social Stress Avoidance

References

• Study: Reduced threat avoidance but increased stress induced approach bias in women taking oral contraceptives (2024)
• Authors: Jasmin Thurley et al.