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

Background: 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. Objectives: Our study aimed to investigate the cognitive and emotional effects of various OC formulations. Design: Online between-subjects experimental design. Methods: 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. Results: 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. Conclusion: 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.