Do Adverse Childhood Experiences Influence Sensitivity to Side-effects and Reward Behavior on Hormonal Contraceptives?
Andrew M. Novick MD PHD1, Joel Stoddard MD MAS1, Rachel L. Johnson MS2, Mary D. Sammel ScD1,2, and C. Neill Epperson MD1,3
1Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA; 2Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA; 3Department of Family Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO USA
Background: Intolerable changes in mood and libido restrict the availability of hormonal contraceptives (HC) to women. However, it is currently unclear what places women at risk for HC-induced side-effects. History of adverse childhood experiences (ACE) may make women vulnerable to deficits in reward processing as well as negative neuropsychiatric effects to changes in ovarian steroids. We thus hypothesized that women with high levels of ACE would demonstrate increased reporting of mood and sexual side-effects on HC as well as deficits in reward behavior. Methods: N=1029 women (n=534 on various HC) completed an online survey on HC side-effect history, ACE, and then a reward task measuring their expected and experienced valence of erotic, non-erotic pleasant, and neutral images. Results: After adjusting for relevant covariates, high ACE women were more likely to report history of mood or sexual side-effects on HC compared to women with low levels of ACE (p=0.037). ACE modified the association between HC use and expected (p=0.029) and experienced valence ratings for erotic images (p=0.025), such that use of HC in high ACE women was associated with decreased valence ratings. In low ACE women, HC was associated with increased expected and experienced erotic valence ratings. Conclusions: ACE may moderate the effects of HC on reward processing of erotic stimuli, and be a risk factor for negative side-effects. Future studies will investigate the neural mechanism of HC effects on reward in high and low ACE individuals to help guide more personalized contraceptive selection and prevent discontinuation.
Breakout Room: Novick, Andrew
View Poster: https://uclacns.org/symposium2021/15-Novick-Andrew.pdf