Introduction
depressed mood, adverse mood side effects, depressive symptoms
Combined oral contraceptives (COC) are among the most commonly used contraceptive methods worldwide [Although mood-related side effects are usually more pronounced in women with a history of depressive symptoms, depressed mood is not consistently reported to change after treatment in RCTs [Recent years have witnessed an increased integration of psychiatry and neurosciences, which allows us to change our perspective on mental well-being and further understand its underlying neural correlates. The triple network model proposes that a balanced connectivity between three ‘core’ networks, i.e., the default mode network (DMN), the salience network (SN) and the executive control network (ECN), is crucial for mental health [Given the sparsity of literature, it is challenging to draw a general conclusion regarding the differences between COC users and naturally cycling women in resting state fMRI (for a review, see [Despite the advantages of functional connectivity, these approaches may be too coarse and insufficient to capture within and between network connectivity dynamics. In general, they do not capture changes in the large-scale organization of the brain, given that (i) functional connectivity measures do not provide information about the directionality of connectivity changes and/or (ii) intrinsic connectivity approaches are inadvertently restricted to changes in connectivity within a given network, while information processing requires the balanced integration of information across different networks. We here aim to disentangle the directed connectivity patterns particularly in women experiencing adverse mood side effects to an androgenic COC. Given that the triple network model has already been proved useful to investigate connectivity changes related to hormonal fluctuations [Given that previous research hints at an enhanced connectivity within the DMN (especially medial areas), but decreased connectivity within the ECN related to depressive symptoms [