Event-Related Potentials in Women on the Pill: Neural Correlates of Positive and Erotic Stimulus Processing in Oral Contraceptive Users

Abstract

Background/Aims: Exposure toward positive emotional cues with – and without – reproductive significance plays a crucial role in daily life and regarding well-being as well as mental health. While possible adverse effects of oral contraceptive (OC) use on female mental and sexual health are widely discussed, neural processing of positive emotional stimuli has not been systematically investigated in association with OC use. Considering reported effects on mood, well-being and sexual function, and proposed associations with depression, it was hypothesized that OC users showed reduced neural reactivity toward positive and erotic emotional stimuli during early as well as later stages of emotional processing and also rated these stimuli as less pleasant and less arousing compared to naturally cycling (NC) women.Method: Sixty-two female subjects (29 NC and 33 OC) were assessed at three time points across the natural menstrual cycle and corresponding time points of the OC regimen. Early (early posterior negativity, EPN) and late (late positive potential, LPP) event-related potentials in reaction to positive, erotic and neutral stimuli were collected during an Emotional Picture Stroop Paradigm (EPSP). At each appointment, subjects provided saliva samples for analysis of gonadal steroid concentration. Valence and arousal ratings were collected at the last appointment.Results: Oral contraceptive users had significantly lower endogenous estradiol and progesterone concentrations compared to NC women. No significant group differences in either subjective stimulus evaluations or neural reactivity toward positive and erotic emotional stimuli were observed. For the OC group, LPP amplitudes in reaction to erotic vs. neutral pictures differed significantly between measurement times across the OC regimen.Discussion: In this study, no evidence regarding alterations of neural reactivity toward positive and erotic stimuli in OC users compared to NC was found. Possible confounding factors and lines for future research are elaborated and discussed.

Interplay between sexual excitation and inhibition: impact on sexual function and neural correlates of erotic stimulus processing in women

“…Earlier research has also indicated reduced SF and erotic stimulus processing in OC users ( Wallwiener et al, 2010 ; Abler et al, 2013 ; Monciunskaite et al, 2019 ). However, our moderation models did not yield significant OC effects, consistent with the mixed results in this field ( Schaffir, 2006 ; Schmidt et al, 2022 ). These inconsistencies highlight the importance of considering psychosexual variables such as SE/SI in sexuality research alongside biological predictors like sex steroid concentration or OC use.…”

“…This paradigm has proven to be a suitable implicit measure of sexual interest, especially when combined with ERP techniques ( Ciardha and Gormley, 2009 , 2012 ; Munk et al, 2018 , 2020 ) and several studies confirm the usability of Emotional Stroop Paradigms for eliciting ERPs ( Thomas et al, 2007 ; Bertsch et al, 2009 ; Franken et al, 2009 ; Munk et al, 2018 , 2020 ; Imbir et al, 2021 ; Paul et al, 2022 ). Due to the comprehensive nature of the overall project, several emotional stimulus categories were included ( Schmidt et al, 2022 ). However, regarding SE/SI, only the following stimulus categories were considered in the present study: Pictures of scantily dressed erotic couples in intimate poses (couple erotic), pictures of scantily dresses males (male erotic) and females (female erotic) in upright positions, pictures of fully dressed couples (couple neutral) and fully dressed single individuals (person neutral) in neutral poses and neutral facial expressions.…”

“…Participants completed the paradigm in approximately 20 min. More detailed information on the task can be found in Schmidt et al (2022) .…”

“…For the manipulation check, a repeated measures (rm)ANOVA (within-subjects factor: stimulus category, two steps) was conducted to assess differences between erotic and neutral stimuli regarding LPP amplitudes. As women were assessed in different menstrual cycle/OC regimen phases with possible impact on stimulus processing ( Krug et al, 2000 ; Dreher et al, 2007 ; Munk et al, 2018 , 2020 ; Schmidt et al, 2022 ), phase effects regarding the LPP were tested prior to hypothesis testing by computing rmANOVAs separately for each group (between-subjects factors: cycle phase/OC phase, three steps; within-subjects factor: stimulus category, two steps). Regarding FSFI and SE/SI scores, possible associations with relationship status ( Wylomanski et al, 2014 ; Velten et al, 2019b ) were tested using two-sample t -tests.…”

“…These psychological functions have previously been found to be associated with SE/SI ( Prause et al, 2008 ; Gregory et al, 2015 ; Unterhorst et al, 2018 ; Turner et al, 2019 ). Additionally, the LPP has been shown to be especially sensitive to erotic content, with higher LPP amplitudes observed for erotic compared to neutral and, moreover, other emotional stimuli ( van Lankveld and Smulders, 2008 ; Schmidt et al, 2022 ). Therefore, it might be a particularly suitable marker for studying neural correlates of SE/SI effects.…”