Oral Contraceptive Androgenicity and Cognitive Performance Among Women

Oral contraceptives (OCs) may lower endogenous sex hormones while introducing synthetic progestins with varying degrees of biological androgenicity or masculinizing effects. No study has examined the relationship between OC androgenicity and female performance on visuospatial (i.e., line orientation, matrix reasoning), verbal (i.e., word memory, analogical reasoning) and facial expression processing (i.e., emotion recognition, emotion intensity differentiation). We hypothesized a positive relationship between androgen status and line orientation, matrix reasoning and analogical reasoning performance and a negative relationship between androgen status and word memory, emotion recognition and emotion intensity differentiation. One hundred seventy nine females (82.1% Caucasian) ages 15-21 from the Philadelphia Neurodevelopmental Cohort were assigned to groups based on the androgenicity of their OC progestins: "highly androgenic" (Levonorgestrel), "androgenic" (Norethindrone), "antiandrogenic" (Drospirenone) and controls. A multivariate analysis of variance revealed that composite emotion recognition performance was significantly different among groups F(6,348) = 2.23, p < .05; Wilk's [lambda] = 0.927, partial [eta]2 =.037. Univariate one-way analyses of variance revealed marginally significant emotion recognition (p = .107, partial [eta]2 =.034) and emotion intensity differentiation (p = .064, partial [eta]2 =.040) among groups. Tukey's post hoc tests revealed that "highly androgenic" OC users (M = 81.85, SD = 8.21) outperformed controls (M = 77.05, SD = 8.25) on emotion intensity differentiation. There were no differences in line orientation, matrix reasoning, word memory, analogical reasoning, anger recognition or anger intensity differentiation. Findings suggest that some aspects of facial expression processing (i.e., emotion intensity) may be more sensitive to sex hormone changes than others (i.e., emotion recognition). Emotion intensity differentiation patterns suggest that OCs may not exert clinically meaningful androgenic effects on cognition.