Review

. 2019 Nov 7;21(11):115.

doi: 10.1007/s11920-019-1095-z.

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

Carolin A Lewis^{1

2

3}, Ann-Christin S Kimmig^{4

5}, Rachel G Zsido^{6

7

8}, Alexander Jank⁹, Birgit Derntl^{4

10

11}, Julia Sacher^{6

8

12}

Affiliations

¹ Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany. lewis@cbs.mpg.de.
² International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany. lewis@cbs.mpg.de.
³ Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany. lewis@cbs.mpg.de.
⁴ Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany.
⁵ International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tuebingen, Tuebingen, Germany.
⁶ Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany.
⁷ International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany.
⁸ Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
⁹ Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany.
¹⁰ Werner Reichardt Center for Integrative Neuroscience, University of Tuebingen, Tuebingen, Germany.
¹¹ LEAD Research School and Graduate Network, University of Tuebingen, Tuebingen, Germany.
¹² Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany.

PMID: 31701260
PMCID: PMC6838021
DOI: 10.1007/s11920-019-1095-z

Review

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

Carolin A Lewis et al. Curr Psychiatry Rep. 2019.

. 2019 Nov 7;21(11):115.

doi: 10.1007/s11920-019-1095-z.

Authors

Carolin A Lewis^{1

2

3}, Ann-Christin S Kimmig^{4

5}, Rachel G Zsido^{6

7

8}, Alexander Jank⁹, Birgit Derntl^{4

10

11}, Julia Sacher^{6

8

12}

Affiliations

¹ Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany. lewis@cbs.mpg.de.
² International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany. lewis@cbs.mpg.de.
³ Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany. lewis@cbs.mpg.de.
⁴ Department of Psychiatry and Psychotherapy, University of Tuebingen, Calwerstr, 14, 72076, Tuebingen, Germany.
⁵ International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tuebingen, Tuebingen, Germany.
⁶ Emotion Neuroimaging Lab, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstr. 1A, 04103, Leipzig, Germany.
⁷ International Max Planck Research School on Neuroscience of Communication: Function, Structure, and Plasticity, Leipzig, Germany.
⁸ Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
⁹ Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany.
¹⁰ Werner Reichardt Center for Integrative Neuroscience, University of Tuebingen, Tuebingen, Germany.
¹¹ LEAD Research School and Graduate Network, University of Tuebingen, Tuebingen, Germany.
¹² Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany.

PMID: 31701260
PMCID: PMC6838021
DOI: 10.1007/s11920-019-1095-z

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. 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.

Keywords: Depression; Emotion; Hormonal contraceptives; Mood; Reward; Stress.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

**Fig. 1**
Comparison of ovarian hormone profiles across the natural menstrual cycle (top row), and during intake of most common hormonal contraceptives, such as combined hormonal contraception (middle row), and progestin-only hormonal contraception (bottom row). The modes of action as well as intake characteristics of the most common hormonal contraceptives are described below.

See this image and copyright information in PMC

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

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

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