Periodic Reporting for period 2 - BECONTRA (How Birth Control Pills Affect the Female Brain)
Período documentado: 2021-12-01 hasta 2023-05-31
Birth control pills have been on the market for more than 60 years and have been researched extensively with regards to adverse side effects. According to a current UN report, birth control pills are used by 150 million women worldwide and are the most common contraceptive choice in Europe and the US. From the beginnings psychological side effects of hormonal contraception have been reported. However, the effects of birth control pills on the brain have only been addressed by a select few studies in the past 10 years. The current project seeks to understand the effects of birth control pills on the brain. Understanding these effects is essential for girls and women to make informed contraceptive choices.
Overall this project seeks to answer the following questions:
- Why do women react differently to birth control pills, with some showing emotional side effects, while others show emotional stabilization? Are there risk factors in the brain that can explain these differences?
- Does contraceptive treatment result in observable changes in brain structure, function and connectivity?
- Are brain changes due to contraceptive treatment related to cognitive changes?
- Are brain changes due to contraceptive treatment reversible after women stop contraceptive treatment?
- Do brain changes due to contraceptive treatment depend on the specific formulation of birth control pills?
- Do brain changes due to contraceptive treatment interact with brain development in adolescents?
Overall this project seeks to answer the following questions:
- Why do women react differently to birth control pills, with some showing emotional side effects, while others show emotional stabilization? Are there risk factors in the brain that can explain these differences?
- Does contraceptive treatment result in observable changes in brain structure, function and connectivity?
- Are brain changes due to contraceptive treatment related to cognitive changes?
- Are brain changes due to contraceptive treatment reversible after women stop contraceptive treatment?
- Do brain changes due to contraceptive treatment depend on the specific formulation of birth control pills?
- Do brain changes due to contraceptive treatment interact with brain development in adolescents?
Since the beginning of this project we have invited girls and women, who want to start or stop using birth control pills to take part in our study and complete brain scans prior to starting/stopping combined oral contraceptive treatments and every 3 months after that. While data acquisition is still ongoing, we were able to adress the following questions from existing data sets and control participants:
(i) Which brain paramters are sensitive to hormonal changes during the tasks utilized in this study?
(ii) Which brain parameters relate to adverse mood effects during combined oral contraceptive treatment?
(iii) Which brain parameters relate to oral contraceptive treatment duration?
Overall, the brain parameters most sensitive to hormonal changes and birth control pills appear to be measures of brain connectivity. Thus, steroid hormones, whether endogenous or exogenous modulate how different brain areas communicate with each other rather than just the activity of specific brain areas.
Mental health has been convincingly linked to the interplay between three brain networks, which have been linke to self-referential processing, attention and inhibitory control. In the period covered by this report we were able to demonstrate that the interplay between those three networks is not only modulated by endogenous ovarian hormones but also by birth control pills. In women, who reported adverse mood symptoms during combined oral contraceptive use, changes in brain connectivity were related to mood lability. This raises the question, whether these changes in large-scale network connectivity are specific to women who experience adverse mood symptoms and whether women, who experience beneficial effects show different brain connectivity patterns.
Oral contraceptive treatment duration was also related to changes in brain connectivity during verbal and spatial tasks on the one hand and face processing on the other hand. While these associations were irrespective of the contraceptive type for verbal and spatial tasks, associations between oral contraceptive treatment duration and brain connectivity during face processing were mostly observed for combined oral contraceptives containing an androgenic progestin, i.e. levonorgestrel.
(i) Which brain paramters are sensitive to hormonal changes during the tasks utilized in this study?
(ii) Which brain parameters relate to adverse mood effects during combined oral contraceptive treatment?
(iii) Which brain parameters relate to oral contraceptive treatment duration?
Overall, the brain parameters most sensitive to hormonal changes and birth control pills appear to be measures of brain connectivity. Thus, steroid hormones, whether endogenous or exogenous modulate how different brain areas communicate with each other rather than just the activity of specific brain areas.
Mental health has been convincingly linked to the interplay between three brain networks, which have been linke to self-referential processing, attention and inhibitory control. In the period covered by this report we were able to demonstrate that the interplay between those three networks is not only modulated by endogenous ovarian hormones but also by birth control pills. In women, who reported adverse mood symptoms during combined oral contraceptive use, changes in brain connectivity were related to mood lability. This raises the question, whether these changes in large-scale network connectivity are specific to women who experience adverse mood symptoms and whether women, who experience beneficial effects show different brain connectivity patterns.
Oral contraceptive treatment duration was also related to changes in brain connectivity during verbal and spatial tasks on the one hand and face processing on the other hand. While these associations were irrespective of the contraceptive type for verbal and spatial tasks, associations between oral contraceptive treatment duration and brain connectivity during face processing were mostly observed for combined oral contraceptives containing an androgenic progestin, i.e. levonorgestrel.
These findings demonstrate that (i) large-scale network approaches are required to capture the complex interactions between steroid hormones and the brain, (ii) individualized approaches are necessary when studying the effects of combined oral contraceptives on the brain, and (iii) different results can be expected depending on the contraceptive type investigated. Until the end of the project, we expect to follow the trajectories of large scale brain connections from the start of combined oral contraceptive treatment to its discontinuation, including not only women who develop adverse mood effects, but also women who benefit from combined oral contraceptive treatment.