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Over 150 million women worldwide use oral contraceptives, with the most common type being combined oral contraceptives (COCs), which contain synthetic hormones. These sex hormones have been found to influence the brain’s network involved in processing fear.
A team of Canadian researchers has investigated the immediate and long-term effects of COC use, as well as the impact of both natural and synthetic sex hormones on the areas of the brain related to fear. Alexandra Brouillard, a researcher at Universite du Quebec a Montreal and the lead author of the study published in Frontiers in Endocrinology, stated, “In our study, we observed that healthy women currently using COCs had a thinner ventromedial prefrontal cortex compared to men.” This region of the prefrontal cortex is believed to play a role in regulating emotions, such as reducing fear responses in safe situations. This finding suggests a potential mechanism through which COCs might affect emotion regulation in women.
Brouillard explained that when COCs are prescribed, women are informed about various physical side effects, such as the suppression of their menstrual cycle and prevention of ovulation. However, the impact of sex hormones on brain development, which continues into early adulthood, is seldom discussed. Given the widespread use of COCs, it is crucial to gain a better understanding of their immediate and long-term effects on brain structure and emotional regulation.
The study recruited women who were currently using COCs, those who had used them in the past but were not currently, women who had never used hormonal contraception, and men. This allowed the researchers to assess whether COC use was linked to current or long-term changes in brain structure and to identify any gender differences, as women are known to be more susceptible to anxiety and stress-related disorders than men.
“While our study shows a reduction in cortical thickness of the ventromedial prefrontal cortex in COC users compared to men, our results suggest that COCs may pose a risk factor for deficits in emotion regulation during their current use,” noted Brouillard.
However, the researchers indicated that the effects of COC use may be reversible once the intake is stopped. The observed effect on the ventromedial prefrontal cortex in current users was not seen in past users, suggesting that the anatomical changes associated with COC use may not be long-lasting. Nevertheless, further studies will be needed to confirm this.
There is still much to discover about the impact of COC use on women’s brains. For instance, Brouillard and her team are currently investigating how the age at which COCs are started and the duration of use may influence potential long-term effects. Since many teenage girls initiate COC use during adolescence, a critical period for brain development, age might also affect reversibility.
The researchers acknowledged certain limitations in their study, emphasizing that no causal relationship can be inferred between COC use and brain morphology. They also cautioned against drawing conclusions about behavioral and psychological impacts based solely on anatomical findings.
Brouillard concluded, “Our objective is not to discourage the use of COCs, but it is important to be aware that the pill can have an effect on the brain. Our aim is to generate greater scientific interest in women’s health and to raise awareness about the early prescription of COCs and its impact on brain development, a relatively unexplored area.”
