Poster No:
1065
Submission Type:
Abstract Submission
Authors:
Ann-Christin Kimmig1, Lorean Göbel2, Birgit Derntl1
Institutions:
1University of Tübingen, Tübingen, Baden-Württemberg, 2University of Tübingen, Tübingen, Baden-Wuerttemberg
First Author:
Co-Author(s):
Lorean Göbel
University of Tübingen
Tübingen, Baden-Wuerttemberg
Introduction:
Oral contraceptives (OCs) are widely used, yet their mental side effects and neural mechanisms are poorly understood. Evidence suggests OCs influence female sexuality (Gassen, 2024; Zethraeus, 2016), including desire, motivation, and mating preferences, varying by pharmacological properties like progestin androgenicity (Casado-Espada, 2019). This study explores OC androgenicity and changes in OC status (e.g., initiation or discontinuation) on erotic stimulus processing and sexual appetence.
Methods:
A total of 110 heterosexual women participated in an fMRI-based Erotic Approach-Avoidance Task (eAAT) across two sessions spaced 3 to 9 months apart. Participants were categorized by hormonal state: 23 women discontinued OCs, 11 initiated OCs, while control groups included 26 continuous OC users and 50 naturally cycling women (25 in the early follicular phase and 25 in the peri-ovulatory phase). For cross-sectional analyses, OC users were subdivided into anti-androgenic (aaOC) and androgenic (anOC) subgroups, each with 25 participants. Neuroimaging was conducted using a 3T Siemens MR scanner with a 64-channel head coil. High-resolution anatomical (MP2Rage, 1 mm resolution) and functional (T2-weighted EPI, 2 mm resolution, multiband: 3) images were acquired, with T2*-weighted field maps used for distortion correction. Functional preprocessing included discarding the first five scans, distortion correction, slice-timing, realignment, co-registration, normalization to MNI space, and smoothing with a 6 mm Gaussian kernel.
The eAAT evaluated both implicit and explicit sexual appetence toward images of erotic and positive non-erotic heterosexual couples. In the implicit task, participants pushed or pulled a joystick based on frame color, independent of image content. The explicit task displayed images for 3 seconds, during which participants rated their sexual approach tendencies. General linear models (GLMs) were specified to analyze implicit (6 regressors of interest and 7 nuisance/motion regressors) and explicit tasks (3 regressors of interest and 7 nuisance/motion regressors). Longitudinal group analyses employed full factorial models with within-subject factors of image type (erotic/non-erotic couples), timepoint (t1, t2), and movement (push/pull for implicit tasks only). Between-subject factors included group membership (starters, stoppers, continuous OC users, early follicular, and peri-ovulatory non-users). Cross-sectional androgenicity analysis included aaOC users, anOC users, early follicular, and peri-ovulatory non-users, without a within-time factor. Results were statistically significant at a cluster-corrected FWE threshold (p < .05).
Results:
Behaviorally, OC discontinuers were more likely to approach erotic male stimuli post-discontinuation, while OC starters showed reduced sexual approach ratings, particularly for positive, non-erotic males. Neurally, OC discontinuers exhibited increased bilateral secondary visual cortex activity during implicit processing of appetitive images and decreased left cerebellar lobule V activity during explicit viewing of erotic versus non-erotic images. Androgenicity effects emerged in visual regions (V1, V4, lateral occipital cortex, cuneus) and the (para-)hippocampal region, which showed higher activity to erotic and non-erotic images in anOC compared to aaOC users.
Conclusions:
This study provides the first longitudinal neuroimaging evidence of altered erotic and appetitive processing, as well as changes in sexual approach behavior, under OC use. Findings align with prior research indicating that anti-androgenic OCs are associated with reduced neural responses to erotic and non-erotic couple images (Schmidt, 2021), potentially explaining stronger sexual side effects compared to androgenic OCs (Handy, 2023). Understanding these effects could inform personalized contraceptive choices and improve outcomes in women's sexual and mental health.
Emotion, Motivation and Social Neuroscience:
Sexual Behavior 2
Modeling and Analysis Methods:
Activation (eg. BOLD task-fMRI) 1
Novel Imaging Acquisition Methods:
BOLD fMRI
Keywords:
FUNCTIONAL MRI
Other - Oral Contraceptives; Erotic Processing; Sexual Approach;
1|2Indicates the priority used for review
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Please indicate below if your study was a "resting state" or "task-activation” study.
Task-activation
Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Healthy subjects
Was this research conducted in the United States?
No
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
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Were any animal research approved by the relevant IACUC or other animal research panel?
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Please indicate which methods were used in your research:
Functional MRI
Structural MRI
Behavior
Neuropsychological testing
For human MRI, what field strength scanner do you use?
3.0T
Which processing packages did you use for your study?
SPM
Provide references using APA citation style.
Casado-Espada, N. M., De Alarcón, R., De la Iglesia-Larrad, J. I., Bote-Bonaechea, B., & Montejo, Á. L. (2019). Hormonal Contraceptives, Female Sexual Dysfunction, and Managing Strategies: A Review. Journal of Clinical Medicine, 8(6). doi:10.3390/jcm8060908
Gassen, J., Mengelkoch, S., Shanmugam, D., Pearson, J. T., van Lamsweerde, A., Benhar, E., & Hill, S. E. (2024). Longitudinal changes in sexual desire and attraction among women who started using the Natural Cycles app. Hormones and Behavior, 162, 105546. doi:10.1016/j.yhbeh.2024.105546
Handy, A. B., McMahon, L. N., Goldstein, I., & Meston, C. M. (2023). Reduction in genital sexual arousal varies by type of oral contraceptive pill. The Journal of Sexual Medicine, 20(8), 1094-1102. doi:10.1093/jsxmed/qdad072
Schmidt, N. M., Hennig, J., & Munk, A. J. L. (2021). Event-Related Potentials in Women on the Pill: Neural Correlates of Positive and Erotic Stimulus Processing in Oral Contraceptive Users. Frontiers of Neuroscience, 15, 798823. doi:10.3389/fnins.2021.798823
Zethraeus, N., Dreber, A., Ranehill, E., Blomberg, L., Labrie, F., von Schoultz, B., . . . Hirschberg, A. L. (2016). Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial. Journal of Clinical Endocrinolology & Metabolism, 101(11), 4046-4053. doi:10.1210/jc.2016-2032
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