Ovarian hormones, hormonal contraceptives and reward processing

SUMMARY Research on ovarian hormones increasingly reveals their important role in brain function. This includes reward processing, the umbrella phrase for functions that promote motivation for, response to and learning about rewards. This article seeks to provide a concise overview of how ovarian hormones influence reward function, with a specific focus on the ovarian hormone derivatives found in hormonal contraceptives. Despite the complexity of findings, the research suggests a general pattern in which oestradiol may promote multiple reward functions and progesterone often appears to play an inhibitory role. Allopregnanolone’s effects on reward functions appear to be concentration dependent and follow an inverted-U pattern. Limited research on hormonal contraceptives suggests that these agents may interfere with reward neurobiology, potentially contributing to deficits in sexual desire and positive mood, although some individuals may be more susceptible than others. Effects of ovarian hormones and their derivatives on reward processing have multiple clinical implications. These are discussed in relation to hormonal therapy in menopause, avoiding side-effects with hormonal contraceptives, and ongoing research on the use of progesterone in substance use disorders.