Sex Differences and Exogenous Estrogen Influence Learning and Brain Responses to Prediction Errors

Cereb Cortex. 2022 Apr 20;32(9):2022-2036. doi: 10.1093/cercor/bhab334.


Animal studies show marked sex differences as well as effects of estrogen (E2) in the mesocorticolimbic dopaminergic (DA) pathways, which play a critical role in reward processing and reinforcement learning and are also implicated in drug addiction. In this computational pharmacological fMRI study, we investigate the effects of both factors, sex and estrogen, on reinforcement learning and the dopaminergic system in humans; 67 male and 64 naturally cycling female volunteers, the latter in their low-hormone phase, were randomly assigned, double-blind, to take E2 or placebo. They completed a reinforcement learning task in the MRI scanner for which we have previously shown reward prediction error (RPE)-related activity to be dopaminergic. We found RPE-related brain activity to be enhanced in women compared with men and to a greater extent when E2 levels were elevated in both sexes. However, both factors, female sex and E2, slowed adaptation to RPEs (smaller learning rate). This discrepancy of larger RPE-related activity yet smaller learning rates can be explained by organizational sex differences and activational effects of circulating E2, which both affect DA release differently to DA receptor binding capacities.

Keywords: dopamine; estrogen; fMRI; reinforcement learning; sex differences; ventral striatum.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Brain / diagnostic imaging
  • Brain / metabolism
  • Dopamine / metabolism
  • Estrogens
  • Female
  • Humans
  • Learning* / physiology
  • Magnetic Resonance Imaging
  • Male
  • Reward
  • Sex Characteristics*


  • Estrogens
  • Dopamine