# Oral contraceptive formulation and socio-cognitive performance: a short communication

## TL;DR

This study found that birth control pills with anti-androgenic hormones may slightly affect emotional perception and social sensitivity, but not overall mood or cognitive performance.

## Contribution

The study identifies subtle emotional effects of anti-androgenic progestin in OCs, without affecting general cognitive or affective outcomes.

## Key findings

- Anti-androgenic OC users showed higher emotional face intensity ratings and greater rejection sensitivity after social exclusion.
- Cognitive test performance and overall mood were similar across all OC formulations.
- Differences in OC formulations did not translate to significant changes in general affect or cognitive function.

## Abstract

Oral contraceptives (OC) offer a range of ethinyl estradiol (EE) doses and progestin types, with evidence indicating marked differences in cognitive and emotional abilities in OC users. However, it remains unclear whether dose variations in EE (low vs high) and progestin androgenicity (androgenic vs anti-androgenic) are associated with variations in cognitive and emotional abilities.

Our study aimed to investigate the cognitive and emotional effects of various OC formulations.

Online between-subjects experimental design.

Based on regular monophasic OC formulation use, 96 participants (26 ± 7 years) were recruited and categorised into one of four groups: low EE androgenic (n = 26), high EE androgenic (n = 24), low EE anti-androgenic (n = 21) and high EE anti-androgenic (n = 25). The Repeatable Battery for the Assessment of Neuropsychological Status, emotion recognition task, and the Positive and Negative Affect Schedule were administered. Visual analogue scales were also administered to assess rejection sensitivity before and after a social exclusion task (Cyberball task). Analysis of variance (2 × 2) models were used to compare cognitive and socio-emotional abilities between groups.

Anti-androgenic users demonstrated higher intensity ratings for emotional faces, and heightened feelings of insecurity after a social stressor. Overall positive and negative affect, as well as performance on objective cognitive tests, were similar across OC formulations.

In OC users, OC formulations containing an anti-androgenic progestin were associated with greater perceived intensity of emotional faces as well as heightened rejection sensitivity. However, these subtle differences in task performance did not translate to differences in overall affect or cognitive performance.

Comparing the psychological effects of different types of birth control pills

Birth control pills, also known as oral contraceptives (OCs), contain different types and amounts of hormones. These hormones include ethinyl estradiol (EE), which is a form of estrogen, and progestins, which can have different effects on the body depending on whether they are androgenic (having male hormone-like effects) or anti-androgenic (blocking male hormone effects). Past research has shown that OCs can influence how people think and feel, but it is still unclear how different hormone levels and types in OCs affect these areas. This study looked at how different OC formulations may affect thinking skills (like memory and attention) and emotional responses. Ninety-six women who regularly used the same type of OC were divided into four groups based on whether their pill had a low or high dose of EE and whether it contained an androgenic or anti-androgenic progestin. The four groups were: low EE androgenic, high EE androgenic, low EE anti-androgenic, and high EE anti-androgenic. Participants completed tests that measured thinking abilities, recognized emotions in facial expressions, and reported their mood. They also completed a social rejection task to see how sensitive they were to being excluded. The study found that women taking OCs with anti-androgenic progestins rated emotional facial expressions as more intense and felt more insecure after being socially excluded. However, there were no major differences between the groups in general mood or in cognitive test scores. In conclusion, the type of progestin in OCs may slightly affect how women experience emotions and social interactions, but these changes do not appear to impact overall mood or thinking skills. This information may be helpful for people choosing an OC that best suits their emotional and cognitive needs.