Two recent studies have examined the impact of hormonal contraceptives on women’s physical and mental health. The first found that pill users have different inflammatory and psychological responses to stress, including higher levels of TNF-alpha, a marker of inflammation, and greater negative emotional response, compared to women with natural cycles. Another study, in rats, showed that synthetic estrogens, such as ethinylestradiol, can induce greater anxiety and alter spatial memory compared to natural estrogens, such as estradiol valerate.
Hormonal contraceptives play a significant role in women’s health and behavior, but new studies reveal that they can have complex effects on stress, inflammation, and emotional behavior. Let’s integrate the two articles into a single, detailed, layman’s explanation.
Hormonal contraceptives are widely used by more than 300 million women worldwide to prevent pregnancy and, in some cases, treat hormonal conditions. They work by introducing synthetic hormones, such as estrogen and progesterone, into the body to regulate the menstrual cycle and prevent ovulation.
Researchers at UCLA Health examined how hormonal contraceptives affect stress and inflammation responses, publishing their findings in the journal Brain, Behavior, and Immunity.
They conducted a study of 130 women, divided between birth control pill users and nonusers. For the study, the women provided saliva samples to measure markers of inflammation and rated their stress levels and mood before the experiment.
The stress test consisted of giving an impromptu speech about a “dream job” in front of an unresponsive researcher. They then performed mental arithmetic under pressure.
After the test, saliva samples were collected again and stress levels were assessed.
The results showed that pill users reported greater negative emotional responses and had higher levels of the inflammatory cytokine TNF-alpha, suggesting a more “masculine” stress response pattern. In contrast, non-users had higher levels of cortisol and interleukin-6, which are associated with a “feminine” response.
Pill users also demonstrated a higher risk of chronic inflammation, which can contribute to cardiovascular disease, cancer, and autoimmune disorders.
These findings highlight how synthetic hormones can alter normal responses to stress and inflammation, suggesting that different formulations may have different effects.
Another study in rats provided a more in-depth look at how the types of estrogens used in hormonal contraceptives can influence anxiety-related behaviors and cognitive functions.
Female rats were treated with two types of estrogens:
Ethinylestradiol (synthetic) with dienogest.
Estradiol valerate (natural) with dienogest.
A control group received no additional estrogen.
Anxiety and memory tests were conducted between days 20 and 28 when the rats performed maze tasks to measure spatial memory and anxiety. On day 28, blood samples were drawn to assess hormone levels.
Results showed that rats treated with synthetic estrogen showed more signs of anxiety and altered responses on spatial memory tasks, compared to those given natural estrogen or no treatment. Both types of estrogen reduced blood testosterone levels, but estradiol levels in the ethinyl estradiol group were significantly lower.
These results suggest that synthetic estrogen may have more profound effects on the brain, altering hormonal feedback loops between the brain and the gonads.
What this means for women is that the studies indicate that different types of hormones in contraceptives may influence physical and mental health in unexpected ways.
Changes in stress responses may affect overall well-being and increase the risk of chronic diseases. In terms of behavior and anxiety, synthetic hormones such as ethinyl estradiol may be associated with increased anxiety in some women.
These findings highlight the importance of tailoring the use of hormonal contraceptives. Women with a history of mood disorders or inflammatory conditions may benefit from carefully choosing their contraceptive methods.
In addition, the research opens the door to the development of new contraceptives with less impact on mental health and the immune system.
Studies emphasize that while hormonal contraceptives are effective and safe for most women, individual impacts can vary significantly. More research is needed to fully understand.
READ MORE:
Study 1:
Hormonal contraceptive use is associated with differences in women’s inflammatory and psychological reactivity to an acute social stressor
Summer Mengelkoch, Jeffrey Gassen, George M. Slavich, and Sarah E. Hill b
Brain, Behavior and Immunity, Volume 115, 2024, ISSN 0889-1591
Abstract:
Women using hormonal contraceptives (HCs) exhibit numerous signs of chronic inflammation, including elevated C-reactive protein levels and a greater risk of developing mood and autoimmune disorders. However, users and non-users of HCs often have similar circulating proinflammatory cytokine levels, making the mechanism of association unclear. One possible explanation for this paradox is that HC users exhibit differences in their inflammatory responses to psychosocial stress that, over time, could contribute to chronic inflammation and its pathologies. Here, we tested this possibility by examining women’s glucocorticoid, inflammatory, and psychological responses to the Trier Social Stress Test (TSST) in 67 naturally cycling (NC) and 60 oral HC-using women (Mage = 19.31, SDage = 1.95). As hypothesized, HC users and NC women exhibited different glucocorticoid and proinflammatory cytokine responses to the TSST. For NC women, TSST-induced increases in glucocorticoids were uncommon, and increases in glucocorticoids were accompanied by elevations in IL-6. In contrast, for women using HCs, increases in glucocorticoids in response to the TSST were common, and increases in glucocorticoids were accompanied by increases in TNF-α. HC users and NC women also differed in their psychological responses to the TSST, with HC users reporting elevated stress levels compared to NC women. Together, these results suggest that HC use impacts women’s glucocorticoid, inflammatory, and psychological responses to psychosocial stress, potentially contributing to observed differences in these women’s mental and physical health.
Study 2:
Hegwood A. et al.
The Prakapenka Lab at ENDO 2024, the Endocrine Society’s annual meeting in Boston, MA.
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