Hormonal contraception use alters stress responses and emotional memory

Abstract

Emotionally arousing material is typically better remembered than neutral material. Since norepinephrine and cortisol interact to modulate emotional memory, sex-related influences on stress responses may be related to sex differences in emotional memory. Two groups of healthy women – one naturally cycling (NC women, N = 42) and one using hormonal contraceptives (HC women, N = 36) – viewed emotionally arousing and neutral images. Immediately after, they were assigned to Cold Pressor Stress (CPS) or a control procedure. One week later, participants received a surprise free recall test. Saliva samples were collected and later assayed for salivary alpha-amylase (biomarker for norepinephrine) and cortisol. Compared to NC women, HC women exhibited significantly blunted stress hormone responses to the images and CPS. Recall of emotional images differed between HC and NC women depending on noradrenergic and cortisol responses. These findings may have important implications for understanding the neurobiology of emotional memory disorders, especially those that disproportionately affect women.

Associations between Basal Cortisol Levels and Memory Retrieval in Healthy Young Individuals

“…There might be differences in the association of cortisol and memory in women in different stages of the cycle. We additionally conducted separate analyses for women taking hormonal contraceptives and women not using hormonal contraceptives given the reported differences in responses to stress effects on memory (e.g., Nielsen, Segal, Worden, Yim, & Cahill, 2013). However, we did not find any significant differences between correlation coefficients between these groups.…”

“…Including B2 as covariate did not alter the result pattern (association with long-delay recall performance: r = −0.14, R 2 = 1.96%; p (uncorrected) = .000001; association with short-delay recall performance: r = −0.11, R 2 = 1.21%; p (uncorrected) = .00007). Given the differences in responses to stress effects on memory in women using hormonal contraceptives and women not using hormonal contraceptives (e.g., Nielsen, Segal, Worden, Yim, & Cahill, 2013), we additionally conducted separate analyses in women taking hormonal contraceptives and women not using hormonal contraceptives. Descriptively, associations were stronger for women not using hormonal contraceptives (r = −0.19, R 2 = 3.61%; p (uncorrected) = .0003) than for women taking hormonal contraceptives (r = −0.10, R 2 = 1.0%; p (uncorrected) = .04); for association between decrease in cortisol levels during recall on Day 2 (B3-B2) and long-delay recall performance.…”

Circulating cortisol levels after exogenous cortisol administration are higher in women using hormonal contraceptives: data from two preliminary studies

“…Hormonal contraceptives/hormonal birth control (hereafter abbreviated HBC) is known to affect responses to laboratory stress (Kirschbaum et al, 1999; Nielsen et al, 2013). Women taking HBC have distinct HPA axis signatures compared to those not taking HBC, including lower cortisol awakening responses (Pruessner, Hellhammer, & Kirschbaum, 1999); a lower salivary cortisol response to psychosocial stress (Kirschbaum, Pirke, & Hellhammer, 1995); a blunted cortisol response to physical exercise (Bonen, Haynes, & Graham, 1991; Kirschbaum, Pirke, & Hellhammer, 1996); greater glucocorticoid sensitivity to pro-inflammatory cytokines after acute stress (Rohleder, Wolf, Piel, & Kirschbaum 2003); and altered circadian cortisol (Bouma et al, 2009; Pruessner et al, 1997; Reinberg et al, 1996, but refer to Wust et al, 2000).…”

Decreased susceptibility to false memories from misinformation in hormonal contraception users

“…Therefore, since HC profoundly alters HPG activity and HPA reactivity (Bentz et al, 2013;Kirschbaum, Kudielka, Gaab, Schommer, & Hellhammer, 1999;Nielsen, Ahmed, & Cahill, 2013;Nielsen, Segal, Worden, Yim, & Cahill, 2013) and the HPG and HPA axes have a bi-directional relationship (Turner, Keating, & Tilbrook, 2012), it is likely that under conditions of arousal and/or stress, use of hormonal contraceptives alters learning and memory in these women.…”

“…For example, studies involving exogenous cortisol administration found that verbal retrieval (Kuhlmann & Wolf, 2005) and fear learning (Merz et al, 2012) were modified in hormonal contraceptive users compared to naturally cycling (NC) women and men. Other work has utilised classical conditioning paradigms (Beck et al, 2008;Holloway, Beck, & Servatius, 2011;Merz, Stark, Vaitl, Tabbert, & Wolf, 2013; and longterm memory paradigms with an emotional story (Nielsen, Ertman, Lakhani, & Cahill, 2011;Nielsen, Ahmed, et al, 2013) and emotional images (Nielsen, Segal, et al, 2013) to demonstrate that women on HC exhibit altered learning and memory patterns under arousal and stress.…”