Dose-Dependent Effects of Oral Contraception on Emotion Recognition

Abstract

Recent research suggests that oral contraceptives (OCs) may inhibit emotion recognition abilities, but the overall evidence is mixed. OCs vary in the form of progestin and dosage they supply, and designs that account for these formulation differences have begun to identify unique influences on women’s social cognition. The current study examined emotion recognition accuracy among 375 women who reported using an OC, of which 305 were in their active pill phase and 70 were in their inactive (placebo) pill phase. Participants provided detailed information about their OC formulation and completed the Reading the Mind in the Eyes Test (RMET) to assess recognition of complex emotional states from images of eyes. OC users in their active pill phase were less accurate at emotion recognition than users in their inactive pill phase. This effect was specific to the more difficult expressions in the set as well as neutral facial expressions, but not those with a positive or negative valence. Among participants in their active pill phase, relative progestin dose (i.e., the ratio of the supplied progestin dose to the minimum dose needed to inhibit ovulation) was positively associated with improved recognition of emotional expressions, including negative and difficult expressions. Our findings indicate that OCs have a more nuanced effect on social cognition than previously considered. By identifying phase- and dose-dependent effects on emotion recognition, we highlight the importance of considering the unique characteristics of OCs in future hormonal contraceptive research.

Keywords: Emotion recognition, Oral contraceptives, Progestin, Reading the Mind in the Eyes Test, Emotional expression, Contraceptive pill phase