Oral contraceptives, also often known as contraception pills, are utilized by greater than 150 million women worldwide. Approximately one-third of teenagers in North America and Europe use them, making them probably the most prescribed drug for teenagers.
It is well-known that oral contraceptives have the facility to change a lady’s menstrual cycle. What’s less well-known is that they can even affect the brain, particularly within the regions which can be necessary for regulating emotions.
As a doctoral student and professor of psychology at UQAM, we were occupied with the impact of oral contraceptives on the brain regions involved in emotional processes. We published our leads to the scientific journal Frontiers in Endocrinology.
How does the pill work?
There are several methods of hormonal contraception, but probably the most common type in North America is the contraceptive pill, more specifically, combined oral contraceptives (COCs). These are made up of two artificial hormones that simulate certainly one of the forms of estrogen (generally ethinyl estradiol) and progesterone.
Like natural hormones, often known as endogenous hormones, the bogus hormones contained within the pill, often known as exogenous hormones, affect the brain. They bind to receptors in numerous areas and signal the brain to scale back the production of endogenous sex hormones. It is that this phenomenon that results in the cessation of menstrual cycles, stopping ovulation.
In other words, while using COCs, users’ bodies and brains are usually not exposed to the fluctuations in sex hormones typically seen in women with a natural cycle.
The pill’s effects on the brain: neuroscience to the rescue!
When they begin taking COCs, teenage women and girls are informed of their different unintended effects, mainly physical (nausea, headaches, weight changes, breast tenderness). However, the proven fact that sex hormones affect the brain, particularly in areas necessary for regulating emotions, just isn’t generally discussed.
Studies have associated the usage of COCs with poorer ability to control emotions and a higher risk of developing psychopathologies.
In addition, women are more likely than men to suffer from anxiety and chronic stress disorders. Given the widespread use of COCs, it will be important to realize a greater understanding of their effects on the anatomy of the brain regions which can be answerable for emotional regulation.
We due to this fact conducted a study to look at the results of COCs on the anatomy of brain regions involved in emotional processes. We were occupied with the results related to their current use, but in addition in the opportunity of lasting effects, i.e. whether COCs could affect brain anatomy even after women stopped taking them.
To do that, we recruited 4 profiles of healthy individuals: women currently using COCs, women who had used COCs prior to now, women who had never used any approach to hormonal contraception, and men.
Using brain imaging, we found that only women currently using COCs had a rather thinner ventromedial prefrontal cortex than men. This a part of the brain is understood to be essential for regulating emotions equivalent to fear. The scientific literature shows that the thicker this region is, the higher the emotional regulation will likely be.
COCs could due to this fact alter emotional regulation in women. Although now we have in a roundabout way tested the link between brain morphology and mental health, our team is currently investigating other points of the brain and mental health, which is able to allow us to higher understand our anatomical findings.
An effect related to the dose, but that doesn’t last
We tried to higher understand what could explain the effect using COCs on this region of the brain. We discovered that it was related to the dose of ethinyl estradiol. In fact, amongst COC users, only those using a low-dose COC (10-25 micrograms) – not the next dose (30-35 micrograms) – were related to a thinner ventromedial prefrontal cortex.
It could seem surprising that a lower dose was related to a cerebral effect…
Given that each one COCs reduce concentrations of endogenous sex hormones, we propose that estrogen receptors on this brain region could also be insufficiently activated when low levels of endogenous estrogen are combined with a low intake of exogenous estrogen (ethinyl estradiol).
Conversely, higher doses of ethinyl estradiol could help to realize adequate binding to estrogen receptors within the prefrontal cortex, simulating moderate to high activity just like that of ladies with a natural menstrual cycle.
It is vital to notice that this lower grey matter thickness was specific to current COC use: women who had used COCs prior to now showed no thinning in comparison with men. Our study due to this fact supports the reversibility of the impact of COCs on cerebral anatomy, particularly on the thickness of the ventromedial prefrontal cortex.
In other words, the usage of COCs could affect brain anatomy, but in a reversible way.
And now?
Although our research has no direct clinical orientation, it helps to advance our understanding of the anatomical effects related to the usage of COCs.
We are usually not calling for girls to stop using their COCs: adopting such discourse can be each too hasty and alarming.
It’s also necessary to do not forget that the results reported in our study seem like reversible.
Our aim is to advertise basic and clinical research, but in addition to extend scientific interest in women’s health, an area that continues to be understudied.