A recent study investigated the association between the use of Hormonal Contraception (HC) and inflammatory responses to an ecological stressor (namely, public speaking). The article was published in the Journal of Brain, Behavior, and Immunity and coauthored by Sarah E. Hill, author of the book This Is Your Brain on birth control. 

The participants of the study were 153 young women. Among the participants, 75 women reported being non-users of contraception for more than a year, and 78 women reported using at least three months (first, second, or third generation combined oral contraceptive pills). The women participated in the luteal phase of the cycle because past research demonstrated a difference between the stress response of naturally cycling women and women using birth control. The women were given 5 minutes to give a speech about their dream job in front of a researcher. The participants provided saliva samples to measure cortisol and cytokines (proteins that regulate inflammation) before and after the test and a subjective assessment of their mood and stress levels. 

The authors of the study reported that women on birth control had higher cortisol levels in response to acute stress compared to the response to the same stressor of naturally cycling women. Also, increases in cortisol levels following the stressful situation were associated with more negative moods for HC users. In contrast, women not using contraception reported a better mood. Thus, HC users reported higher stress levels than NC women. 

Women using HC experienced an increase in cytokines, suggesting more inflammation compared to naturally cycling women.  Women using HCs exhibited a significant decrease in IL-1β levels and an increase in TNF-α (tumor necrosis factor that induces inflammation). Non-contraceptive women experience the opposite. The authors reported that “these differences could be explained by the androgenic effects of HCs on the inflammatory response, with HC users having an inflammatory stress response that is biased toward a more male-typical response.” Consistent with this interpretation, research finds that women generally exhibit a larger but more delayed IL-6 response and a smaller TNF-α response to stress than men. 

The results of this study suggest that hormonal contraception use impacts corticoid, inflammatory, and psychological responses to psychosocial stress. 

The authors mentioned that HC users are at elevated risk of developing some autoimmune disorders when compared to NC women. This increased risk may be mediated through the increase in inflammatory cytokines such as TNF-α. in response to stress. 

Future research is needed to examine this possibility and to better understand the mechanisms by which HC use impacts women’s inflammatory reactivity to stress and women’s mental and physical health.

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