Effects of Hormonal Contraceptives on Mood: A Focus on Emotion Recognition and Reactivity, Reward Processing, and Stress Response

Curr Psychiatry Rep. 2019 Nov 7;21(11):115. doi: 10.1007/s11920-019-1095-z.


Purpose of review: We review recent research investigating the relationship of hormonal contraceptives and mood with a focus on relevant underlying mechanisms, such as emotion recognition and reactivity, reward processing, and stress response.

Recent findings: Adverse effects of hormonal contraceptives (HCs) on mood seem most consistent in women with a history of depressive symptoms and/or previous negative experience with HC-intake. Current evidence supports a negativity bias in emotion recognition and reactivity in HC-users, although inconsistent to some extent. Some data, however, do indicate a trend towards a blunted reward response and a potential dysregulation of the stress response in some HC-users. HC-effects on psychological and neurophysiological mechanisms underlying mood are likely context-dependent. We provide suggestions on how to address some of the contributing factors to this variability in future studies, such as HC-dose, timing, administration-mode, and individual risk. A better understanding of how and when HCs affect mood is critical to provide adequate contraceptive choices to women worldwide.

Keywords: Depression; Emotion; Hormonal contraceptives; Mood; Reward; Stress.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Affect / drug effects*
  • Contraceptive Agents / adverse effects*
  • Depression / complications*
  • Depression / psychology
  • Estrogens / pharmacology
  • Female
  • Humans
  • Mood Disorders / chemically induced*
  • Progesterone / pharmacology


  • Contraceptive Agents
  • Estrogens
  • Progesterone