Differences in Cortisol Responding and Post-Stress Affiliation among Women who are Naturally Cycling, Using Oral Contraceptives, and Using IUDs

Despite the pervasiveness of women’s use of hormonal contraceptives (HCs), surprisingly little is known about the influence of HCs on psychological processes. Moreover, though women using HCs may suffer from greater occurrences of negative stress-related outcomes (e.g., depression), the mechanisms underlying these differences are unknown. One possible mechanism is through the alteration of women’s responses to stress. Women often respond to stress via social-affiliative behavior, which is an effective form of coping. Given HCs affect stress-responsive hormones, women’s affiliative response to stress may also be altered among women using HCs. We examined how HC use, including use of oral contraceptives and hormonal intrauterine devices (IUDs), relates to physiological and affiliative responses to stress. Women (N = 190) underwent the Trier Social Stress Test (TSST), provided saliva samples for assays of free cortisol and progesterone, and completed three measures of affiliation. Women using both oral contraceptives and hormonal IUDs showed blunted cortisol responses to the TSST relative to naturally cycling women. Additionally, women using oral contraceptives, relative to all other groups, behaved differently, showing less social affiliative behavior across two behavioral tasks. However, there were no differences in affiliative behavior between naturally cycling women in their follicular or luteal phase, failing to replicate past research. Importantly, differences in affiliative behavior were unrelated to differences in cortisol responses. Results suggest that HCs alter multiple stress-responsive processes via independent mechanisms, and in ways that are consistent with the previously reported association between women’s use of HCs and heightened risk of negative stress-related outcomes.