Oral contraceptives alter sleep and raise body temperature in young women
Abstract
Female reproductive steroids, oestrogen and progesterone, not only affect reproductive function, but also thermoregulation and sleep. Chronic administration of synthetic steroids, as occurs in women taking oral contraceptives, may affect these regulatory systems differently from endogenous oestrogen and progesterone. We therefore investigated body temperature and sleep in ten young women taking oral contraceptives, in the active and placebo phases of the contraceptive pack, and compared them to a group of nine women with ovulatory cycles, in the mid-follicular and mid-luteal phases. Body temperature was raised throughout 24 h in the women taking oral contraceptives in the active phase, and in the naturally cycling women in the luteal phase, compared to the follicular phase. The women taking oral contraceptives in the placebo phase, however, continued to have raised body temperatures, similar to those in the active phase, indicating a prolonged action of synthetic reproductive steroids on body temperature. Sleep also was influenced by the endogenous and synthetic reproductive steroids, but independently of body temperature. The women taking oral contraceptives had more stage-2 non-rapid eye movement sleep in the active phase, both compared to their placebo phase and the naturally cycling women. The naturally cycling women, however, had more slow wave sleep in the luteal phase compared to the contraceptive group of women. Exogenous reproductive steroids therefore influence body temperature and sleep differently from endogenous progesterone and oestrogen.
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One study found no significant differences between any sleep parameter at the mid-follicular phase and mid-luteal phase in healthy women.
“Comparing the sleep of healthy women at the mid-FP and mid-LP, one study found no significant differences between any sleep parameter (including SE, SOL, REM sleep and SWS) [43]”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [43]
The upward shift in the thermoregulatory set-point is most likely due to progesterone, which has thermogenic properties.
“This upward shift in the thermoregulatory set-point is most likely due to progesterone, which possesses thermogenic properties [36, 43]”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [43]
In healthy women, sleep homeostasis and sleep quality remain stable at different menstrual phases, while sleep architecture shows observable changes.
“These have indicated that while sleep homeostasis [49, 51, 55] and quality [43, 49, 52] remain stable at different menstrual phases, there are observable changes in sleep architecture [49, 51–53]”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [43]
Some investigators found a phase delay in the temperature rhythm, sometimes by as much as 90 min, in the luteal phase compared with the follicular phase.
“Some investigators [66–68,80] found a phase delay in the temperature rhythm (sometimes by as much as 90 min) in the luteal phase compared with the follicular phase”
From Temperature regulation in women: Effects of the menstrual cycle (2020) · cites this paper as [80]
Two studies that recorded 24-h core body temperature rhythms did not find a difference in 24-h mean or minimum body temperatures between the active and placebo phases of the oral contraceptive regime.
“In contrast to recordings of short-term resting temperatures, two studies that have recorded 24-h core body temperature rhythms did not find a difference in 24-h mean or minimum body temperatures between the active and placebo phases of the oral contraceptive regime [69,80]”
From Temperature regulation in women: Effects of the menstrual cycle (2020) · cites this paper as [80]
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Self-citationHormonal contraceptive use and subjective sleep reports in women: An online survey
Bezerra, A. G., Andersen, M. L., Pires, G. N., Banzoli, C. V., Polesel, D. N., Tufik, S. B., & Hachul, H. (2020) · Journal of Sleep Research · doi:10.1111/jsr.12983 · Cited by 31 · see citing works
Response of women using oral contraception to exercise in the heat
MINAHAN, C. L., Melnikoff, M., Quinn, K., & Larsen, B. (2017) · European Journal of Applied Physiology · doi:10.1007/s00421-017-3628-7 · Cited by 30 · see citing works
“Indeed, Baker et al. (2001) reported raised body temperatures in women during the inactive pill phase of an OC cycle, which suggests a prolonged action of exogenous female sex hormones upon temperature regulation.”
Impact of menstrual cycle phase and oral contraceptives on sleep and overnight memory consolidation
Plamberger, C., Wijk, H. E. V., Kerschbaum, H., Pletzer, B. A., Gruber, G., Oberascher, K., Dresler, M., Hahn, M. A., & Hoedlmoser, K. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13239 · Cited by 29 · see citing works
“…that women using OCs have more NREM2 sleep in the active phase (OCs containing exogenous hormones for 21 days) compared to the inactive phase (placebo for 7 days) and compared to women with a natural menstrual cycle in the follicular and luteal phases (Baker et al., 2001; Driver et al., 2008).”
BackgroundResultGender identity and transition: relationships with sleep disorders in US youth
Gavidia, R., Whitney, D. G., Hershner, S. D., Selkie, E. M., Tauman, R., & Dunietz, G. L. (2022) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10158 · Cited by 29 · see citing works
The thermoneutral zone in women takes an “arctic” shift compared to men
Brychta, R. J., McGehee, S., Huang, S., Leitner, B. P., Duckworth, C. J., Fletcher, L. A., Kim, K., Cassimatis, T. M., Israni, N. S., Lea, H. J., et al. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2311116121 · Cited by 28 · see citing works
“…and varied formulations and doses make it difficult to draw conclusions about the effect of contraceptives on thermoregulation from our data, but previous reports suggest women taking oral contraceptives have warmer core temperatures than naturally cycling women in the follicular phase (40, 41).”
Impact of sex steroids and reproductive stage on sleep-dependent memory consolidation in women
Baker, F. C., Sattari, N. S., de Zambotti, M., Goldstone, A., Alaynick, W. A., & Mednick, S. C. (2018) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2018.03.017 · Cited by 25 · see citing works
Self-citationSleep and Pregnancy-Induced Hypertension: A Possible Target for Intervention?
Haney, A., Buysse, D. J., & Okun, M. L. (2013) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.3290 · Cited by 26 · see citing works
“1,65,66 Estrogen can also cause physical changes that can affect sleep, including hyperemia, mucosal edema, hypersecretion, and increased friability in the upper airways.”
Schrader, J. A., Walaszczyk, E. J., & Smale, L. (2009) · Physiology & Behavior · doi:10.1016/j.physbeh.2009.08.012 · Cited by 25 · see citing works
“Progesterone and prolactin increase Tb in rodents [27,28], as do birth control pills, which contain progestagens, in humans [29-31].”
Authier, S., Bassett, L., Pouliot, M., Rachalski, A., Troncy, É., Paquette, D., & Mongrain, V. (2014) · Journal of Pharmacological and Toxicological Methods · doi:10.1016/j.vascn.2014.05.003 · Cited by 25 · see citing works
Diminished Nap Effects on Memory Consolidation Are Seen Under Oral Contraceptive Use
Genzel, L., Bäurle, A., Potyka, A., Wehrle, R., Adamczyk, M., Frieß, E., Steiger, A., & Dresler, M. (2014) · Neuropsychobiology · doi:10.1159/000369022 · Cited by 23 · see citing works
Variation in Normal Ear Temperature
Sund‐Levander, M., & Grodzinsky, E. (2017) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2017.05.013 · Cited by 23 · see citing works
Variations in sleep associated with different types of hormonal contraceptives
Guida, M., Rega, A., Vivone, I., Saccone, G., Sarno, L., Carlo, C. D., Aquino, C. I., & Troisi, J. (2019) · Gynecological Endocrinology · doi:10.1080/09513590.2019.1640204 · Cited by 23 · see citing works
“found that women taking oral contraceptives had more stage-2 non-rapid eye movement sleep and less slow wave sleep than naturally cycling women [14].”
BackgroundResultPower, C. J., Fox, J. L., Elliott-Sale, K. J., Bender, A. M., Dalbo, V. J., & Scanlan, A. T. (2023) · Sports Medicine · doi:10.1007/s40279-023-01963-5 · Cited by 24 · see citing works
“…in N3 sleep (20 ± 3% versus 27 ± 5%, P 0.01) but a higher percentage of total sleep duration in N2 sleep (48 ± 4% versus non-oral contraceptive users in the follicular phase = 40 ± 3% and luteal phase = 39 ± 5%, P 0.001) than non-oral contraceptive users ( n = 9, 21 ± 4 years of age) [125].”
InfluentialPlante, D. T., & Goldstein, M. R. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.08.012 · Cited by 20 · see citing works
“…through which progesterone may potentiate sleep spindles is via increased temperature, since oral contraceptives (containing both estrogen and progestins) have been demonstrated to increase core body temperature (Baker et al., 2001), which may in turn, alter spindle range activity (Deboer, 1998).”
BackgroundThe effects of hormonal contraceptive use on sleep in women: A systematic review and meta‐analysis
Bezerra, A. G., Andersen, M. L., Pires, G. N., Tufik, S., & Hachul, H. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13757 · Cited by 17 · see citing works
Hormonal Contraception and the Brain: Examining Cognition and Psychiatric Disorders
Laird, S., Ney, L., Felmingham, K., & Gogos, A. (2019) · Current Psychiatry Research and Reviews · doi:10.2174/1573400515666190521113841 · Cited by 18 · see citing works
The influence of sex and gonadal hormones on sleep disorders
Parry, B. L., Orff, H. J., Meliska, C. J., & Martinez, F. (2014) · ChronoPhysiology and Therapy · doi:10.2147/cpt.s44667 · Cited by 16 · see citing works
“Research suggests, however, that use of exogenous hormones may negatively impact sleep by raising body temperature and altering sleep (producing greater stage 2 sleep and less slow-wave sleep), an effect not observed to occur from endogenous progesterone and estrogen produced in naturally cycling women.(95)”
First-Night Effect on Sleep in Different Female Reproductive States
Virtanen, I., Kalleinen, N., Urrila, A. S., et al. (2016) · Behavioral Sleep Medicine · doi:10.1080/15402002.2016.1228646 · Cited by 14 · see citing works
Albuquerque, R. G., Rocha, M., Hirotsu, C., Hachul, H., Bagatin, E., Tufik, S., & Andersen, M. L. (2015) · Archives of Dermatological Research · doi:10.1007/s00403-015-1600-0 · Cited by 13 · see citing works
“A further factor to consider is that as temperature regulation is physiologically necessary for sleep maintenance, hormonal contraceptives could alter sleep due to their known effect of altering body temperature [7].”
BackgroundThe Menstrual Cycle and Circadian Rhythms
Armitage, R., Baker, F. C., & Parry, B. L. (2005) · Elsevier eBooks · doi:10.1016/b0-72-160797-7/50115-4 · Cited by 12 · see citing works
Self-citationBezerra, A. G., Andersen, M. L., Pires, G. N., Tufik, S., & Hachul, H. (2018) · Sleep Science · doi:10.5935/1984-0063.20180025 · Cited by 12 · see citing works
“Further studies also show increase in N2 sleep, despite presenting a decrease in non-REM sleep time 60,61 .”
BackgroundMeasurement and evaluation of body temperature : Implications for clinical practice
Sund‐Levander, M. (2004) · DiVA (Linkoping University) · Cited by 12 · see citing works
Grant, A. D., Wilbrecht, L., & Kriegsfeld, L. J. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.752363 · Cited by 9 · see citing works
Authier, S., Bassett, L., Pouliot, M., Rachalski, A., Troncy, É., Paquette, D., & Mongrain, V. (2014) · Journal of Pharmacological and Toxicological Methods · doi:10.1016/j.vascn.2014.10.004 · Cited by 9 · see citing works
The Relationship Between Mood and Sleep in Different Female Reproductive States
Polo‐Kantola, P., & Toffol, E. (2023) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2023.06.002 · Cited by 10 · see citing works
Sex Differences and Menstrual-Related Changes in Sleep and Circadian Rhythms
Baker, F. C., O'Brien, L. M., & Armitage, R. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4160-6645-3.00137-7 · Cited by 9 · see citing works
Self-citationSex/Gender Differences in Sleep Physiology and Sleep Disorders
Lee, H. W. (2024) · Springer eBooks · doi:10.1007/978-981-97-0130-8_27 · Cited by 8 · see citing works
Boivin, D. B., Caetano, G., Kervezee, L., Gonzales-Aste, F., & Boudreau, P. (2023) · SLEEP Advances · doi:10.1093/sleepadvances/zpac049 · Cited by 8 · see citing works
Lack of estradiol modulation of sleep deprivation-induced c-Fos in the rat brain
Rahia Mashoodh, A., Stamp, J. A., Wilkinson, M., Rusak, B., & Semba, K. (2008) · Physiology & Behavior · doi:10.1016/j.physbeh.2008.08.001 · Cited by 7 · see citing works
“Of particular interest, women spend more time in SWS (stages 3 and 4) than men, and show greater amplitude and power of EEG slow waves Physiology & Behavior 95 (2008) 562–569 ⁎ Corresponding author.”
InfluentialCaloric Restriction, the Menstrual Cycle, and Sleep in Women Without Obesity
Kim, A. E., Shekhar, S., Hirsch, K. R., Purse, B., McGrath, J. A., Zava, T., Smith‐Ryan, A. E., & Hall, J. E. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf145 · Cited by 6 · see citing works
Continuous body temperature as a window into adolescent development
Grant, A. D., & Kriegsfeld, L. J. (2023) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2023.101221 · Cited by 6 · see citing works
Convit, L., Kelly, M. K., Jardine, W. T., Périard, J. D., Carr, A. J., Warmington, S. A., Bowe, S. J., & Snipe, R. M. J. (2024) · Journal of Sports Sciences · doi:10.1080/02640414.2024.2396225 · Cited by 4 · see citing works
Sex Differences and Menstrual-Related Changes in Sleep and Circadian Rhythms
Baker, F. C., & O'Brien, L. M. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-24288-2.00155-0 · Cited by 4 · see citing works
Self-citationGrigg, M. J., Thake, C. D., Allgrove, J. E., & Broom, D. R. (2025) · Physiology & Behavior · doi:10.1016/j.physbeh.2025.114914 · Cited by 3 · see citing works
Dittmar, M., Möllgaard, L., & Engelhard, F. (2024) · Chronobiology International · doi:10.1080/07420528.2024.2342945 · Cited by 3 · see citing works
“However, synthetic hormonal contraceptives may have prolonged action on body temperature (Baker et al. 2001) and downregulate the endogenous progesterone (Elliott-Sale et al. 2020).”
BackgroundResultInfluentialIwamoto, R., Santos, A. L. R., Chavannes, N. H., et al. (2017) · JMIR Human Factors · doi:10.2196/humanfactors.6778 · Cited by 3 · see citing works
Elkinbard, I. S., Ritterbusch, D., Shandra, O. O., & Rowe, R. K. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1672744 · Cited by 3 · see citing works
“For example, one study reported increased slow-wave sleep during the luteal phase, when progesterone concentrations peak (Baker et al., 2001), while another study found poorer sleep quality during the late luteal phase, when progesterone levels drop (Jia et al., 2024).”
Petrie, K. A., Messman, B., Moore, E. W. G., Slavish, D. C., & Petrie, T. A. (2022) · Journal for the Study of Sports and Athletes in Education · doi:10.1080/19357397.2022.2113327 · Cited by 2 · see citing works
“This change may be due to more fl exible schedules and fewer social demands (Baker et al., 2001; Baker & Driver, 2007).”
The Effects of Hormonal Contraceptives on the Sleep of Women of Reproductive Age
Bezerra, A. G., Pires, G. N., Andersen, M. L., Tufik, S., & Hachul, H. (2023) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2023.06.005 · Cited by 2 · see citing works
Smith, P. C., Cusmano, D. M., Viechweg, S. S., Schwartz, M. D., & Mong, J. A. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.07.29.223669 · Cited by 2 · see citing works
Women’s Sleep and Circadian Rhythms From Puberty to Menopausal Transition
Izci‐Balserak, B., & Lee, K. A. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197602751.013.29 · Cited by 1 · see citing works
Relationship between estradiol level and sleep quality in healthy women.
Keskin, N. O., & Kılıçoğlu, A. (2009) · DergiPark (Istanbul University) · Cited by 1 · see citing works
Sleep and Sleep Disorders in Women
Baker, F. C. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1185-1_22 · Cited by 1 · see citing works
Self-citationWomen's Sleep Throughout the Lifespan
Kloss, J. D., & Nash, C. O. (2013) · Wiley eBooks · doi:10.1002/9781394260454.ch10 · Cited by 1 · see citing works
Conclusion and Recommendations for Research
Sharma, V., Palagini, L., & Mazmanian, D. S. (2025) · Springer eBooks · doi:10.1007/978-3-031-95948-6_16 · Cited by 1 · see citing works
THE MENSTRUAL CYCLE, DYSMENORRHEA, AND SLEEP
Woosley, J. A. (2012) · W. S. Hoole Special Collections Library Manuscript Collections
The impact of long-term partial sleep deprivation in unipara mothers
Strous, T. T. (2014) · University of the Witwatersrand, Johannesburg Institutional Repository on DSpace (University of the Witwatersrand, Johannesburg)
Seary, M. E. (2011) · Library and Archives Canada (Government of Canada)
Impact of Menstrual Cycle Phase on Metabolic Effects of Sleep Restriction
Leroux, A. (2013) · Library and Archives Canada (Government of Canada)
Assessment and Evaluation of Body Temperature
Grodzinsky, E., & Sund‐Levander, M. (2019) · Springer eBooks · doi:10.1007/978-3-030-21886-7_7
Sleep and Sleep Disorders in Women
Baker, F. C., Lee, K. A., & Manber, R. (2007) · Humana Press eBooks · doi:10.1007/978-1-59745-421-6_19
Self-citationOnus, K., Cannon, J., & Marino, F. E. (2022) · South African Journal of Sports Medicine · doi:10.17159/2078-516x/2022/v34i1a11757
- Authors
- Baker, F., Mitchell, D., & Driver, H.
- Affiliations
- University of the Witwatersrand (ZA)
- Corresponding author
- Baker, Fiona
- Venue
- Pfl�gers Archiv European Journal of Physiology
- Published
- 2001-08-01
- Volume
- 442
- Issue
- 5
- Pages
- 729-737
- ISSN
- 0031-6768 (ISSN-L)
- 1432-2013
- OpenAlex
- W2010863374
- Semantic Scholar
- 9b8e1fac6d4bcc7521d58b8c4aa63f3b84bc4376
- Cited by
- 106
- References
- 31
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 8 · 2021: 5 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 10 · 2013: 8 · 2012: 2
- FWCI
- 0.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Pflügers Archiv - European Journal of Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- oral contraceptives, body temperature, sleep, thermoregulation, estrogen, progesterone, reproductive steroids, slow-wave sleep, NREM sleep, menstrual cycle, luteal phase, follicular phase, young women
- MeSH terms
- Adult, Analysis of Variance, Body Temperature, Contraceptives, Oral, Female, Humans, Sleep
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