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, surprisingly little is known about the influence of HCs on psychological processes under stress. We examined how hormonal contraceptive use, including use of oral contraceptives and hormonal intrauterine devices (IUDs), relates to physiological and affiliative responses under 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. Although there were no group differences in women's self-reported extraversion at baseline (prior to the TSST), women using oral contraceptives, compared to the other three groups, showed less social affiliative behavior following the TSST across two dependent measures. There were no differences in affiliation between naturally cycling women in their follicular or luteal phase, failing to replicate past research. Importantly, differences in affiliation were unrelated to differences in cortisol responses. Results suggest that hormonal contraceptives may subtly alter multiple stress-responsive processes via independent mechanisms, and in ways that are consistent with past research demonstrating that some women who use hormonal contraceptives experience heightened risk of negative stress-related outcomes.