Associations Between Past and Current Use of Oral Contraceptives and Fear Regulation

Area of Science:

• Neuroscience
• Psychology
• Endocrinology

Background:

• Low endogenous estradiol (E2) is linked to impaired fear extinction memory recall.
• Hormonal contraceptives (oral contraceptives, OC) may have long-term psychological effects.
• The long-term impact of OC use on extinction memory is underexplored.

Purpose of the Study:

• Replicate findings on OC use and altered extinction recall.
• Investigate potential long-term associations of OC use with extinction memory.
• Examine neural correlates of OC use and extinction recall.

Main Methods:

• Administered a fear protocol (conditioning, extinction learning, extinction recall, fear renewal) to 147 healthy adults.
• Examined psychophysiological (skin conductance responses, SCRs) and neural differences.
• Grouped participants by estradiol (E2) levels and oral contraceptive (OC) history.

Main Results:

• Current OC users showed higher SCRs during extinction recall compared to preovulatory women and never users.
• SCRs during extinction recall in OC users correlated with hippocampus, ACC, and vmPFC activations.
• Past OC users in the early follicular phase exhibited SCRs similar to current OC users.

Conclusions:

• Current OC use is associated with impaired fear extinction recall.
• Neural correlates involve the ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), and hippocampus.
• Past OC use may have lasting effects on fear regulation, particularly in low E2 states.