“Millions of women worldwide use oral contraceptives (i.e., birth control pill; OCs), often starting during puberty/adolescence,” the study abstract read. “[W]e examined stress reactivity, and brain structure and function in OC users using the Trier Social Stress Test and structural and functional magnetic resonance imaging (MRI). Our results show that OC use during puberty/adolescence gives rise to a blunted stress response and alters brain activation during working memory processing. OC use, in general, is also linked to increased prefrontal brain activation during working memory processing for negatively arousing stimuli.”
To sum up, “OC use is also related to significant structural changes in brain regions implicated in memory and emotional processing. Together, these findings highlight that OC use induces changes to brain structure and function and alters stress reactivity.”
“Oral contraceptives have been commercially available for over 60 years and are currently used by 150 million women worldwide. However, little is known about their behavioral and neurophysiological effects, especially during puberty/early adolescence, a critical period of development,” Ismail told PsyPost. “We were particularly interested in investigating the effect of oral contraceptives on brain structure and function, especially in women who began taking oral contraceptives during puberty and adolescence.”
Using brain imaging, 75 women were given a test of working memory, which is a cognitive system made to hold information temporarily, allowing someone to keep something in mind while they’re doing something else. Additionally, 140 more women were given the Trier Social Stress Test, a laboratory test designed to increase stress levels while participants perform math exercises and give a speech. Women who began using birth control during puberty or adolescence had a “blunted” cortisol response to the stress test.
“We found that there are differences in brain structure and function between oral contraceptive users and non-OC users. Oral contraceptive users display different brain activity during working memory processing of negative images compared to non-OC users,” Ismail said. “Women who started using oral contraceptives during puberty/adolescence display a blunted stress response and experience different brain activity during working memory processing of neutral images compared to women who started using oral contraceptives during adulthood.”
Birth control use during puberty was also linked with structural changes in areas of the brain linked to emotion and memory. Ismail explained that this “could provide a neural mechanism for why some women develop mood-related disorders following oral contraceptive use.” She added, “One possibility is depression. Some women have complained of depression symptoms during oral contraceptive use. We need to be aware of it and talk to our physician if we are experiencing these symptoms.”
There are numerous potential side effects of hormonal birth control, including various mental health issues. Many women are not informed of the risks before taking it even though some side effects — like blood clots — can be deadly.
The aim of studies like this one is not necessarily to discourage women from taking birth control, but to ensure that women truly have informed consent before taking it. “The goal of our research is not to worry women or to discourage them from taking oral contraceptives,” Ismail said. “We just want to advise them so that they can make an informed decision about what is best for them. There is still a lot of work to be done to fully understand the impact of oral contraceptives on women’s health.”