The Pill and Anxiety: New Research Explores a Potential Link

Recent research from the University of Quebec at Montreal (UQAM) suggests a possible association between hormonal contraceptive apply and increased fear responses, even after discontinuation. While the study doesn’t establish a cause-and-effect relationship, it highlights a need for further investigation into the impact of hormonal contraception on women’s mental health.

How the Study Worked

Researchers conducted a two-day fear conditioning and extinction protocol with 147 healthy participants, including men, women who were cycling naturally, and women using oral contraceptives. Participants underwent fear conditioning in one context (CX+) and extinction in another (CX-). On the second day, cues were presented in both contexts, and fear responses were measured using skin conductance and brain activation scans.

Key Findings

• Increased Fear in Former and Current Users: Women who were currently using oral contraceptives, as well as those who had stopped using them, exhibited elevated fear responses in the safety-associated context (CX-) compared to women who had never used oral contraceptives (Davignon et al., 2025).
• Dose Matters: Participants using oral contraceptives with higher doses of ethinyl estradiol (EE) showed greater fear returns than those using lower doses (Davignon et al., 2025).
• Brain Activity Changes: CX- fear returns were negatively associated with activation in the hippocampus and ventromedial prefrontal cortex (Davignon et al., 2025). The hippocampus, a brain region crucial for memory, is known to be sensitive to hormonal fluctuations.

What Does This Mean?

The study suggests that oral contraceptives may impair the retrieval of safety signals from context, potentially leading to increased anxiety in certain situations. Interestingly, this effect appears to persist even after women discontinue use, with fear responses remaining elevated for at least a year after stopping the pill (Davignon et al., 2025).

Beyond Fear: Other Cognitive Effects

Research from UQAM, led by Lisa-Marie Davignon, has also explored the broader cognitive effects of oral contraceptives. A separate study found that oral contraceptive use can dampen the typical sex difference favoring men in 3D visuospatial abilities, while the duration of use positively predicted verbal fluency (Davignon, 2023. Davignon et al., 2023). However, this study did not find evidence that androgenicity or hormone levels directly predicted performance on cognitive tasks (Davignon et al., 2023).

The Need for More Research

Lisa-Marie Davignon emphasizes the importance of further research, particularly randomized controlled trials, to better understand the complex relationship between hormonal contraception and mental health. She notes that women have historically been understudied in research, and that more investigation is needed to address this gap (Davignon et al., 2025).

Key Takeaways

• Oral contraceptive use may be associated with increased fear responses, even after discontinuation.
• Higher doses of ethinyl estradiol may be linked to greater fear returns.
• The hippocampus, a brain region sensitive to hormones, appears to play a role in these effects.
• More research is needed to fully understand the impact of hormonal contraception on women’s mental health.

Disclaimer: This article provides information for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

References

• Davignon, L. M., et al. (2025). Lasting effects of oral contraceptives on fear responses. American College of Neuropsychopharmacology. https://pubmed.ncbi.nlm.nih.gov/40885850/
• Davignon, L. M. (2023). The Role of Sex Hormones, Oral Contraceptive Use, and its Parameters on Cognition. SSRN. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4465753
• Davignon, L. M., et al. (2023). The role of sex hormones, oral contraceptive use, and its parameters on cognition. Elsevier. https://pubmed.ncbi.nlm.nih.gov/37981465/