The Unexpected Way That The Contraceptive Pill Affects Your Brain

With every new study, it becomes clear how much we still don't know about hormonal contraception. Vicky Spratt speaks to the psychologist behind the latest revelations about the pill...

How the contraceptive pill affects your  brain

by Vicky Spratt |
Updated on

This story starts in Puerto Rico.

It’s the late 1950s and the first large-scale human trial of the hormonal contraceptive pillhas launched in a clinic called Rio Piedras in a brand-new public housing project just outside of San Juan.

Within weeks of the trial beginning a local newspaper, El Imparcial, accused the pill's creators – a gynaecologist called John Rock){href='' target='_blank' rel='noopener noreferrer'} and the biologist Gregory Pincus – of attempting population control.

[The pill ](http://vicky spratt grazia side effects of the pill)had previously been tested in a smaller-scale trial in Boston but large-scale trials were needed for the drug to be approved by the FDA in the US so it could become available to women.

At the Boston trial, women had complained of side effects when taking the pill but what emerged during the Puerto Rico trial was more pronounced because more women were involved. Dr Edris Rice-Wray was overseeing proceedings. She concluded that while the pill was 100% effective if taken properly, 17% of the women in the study experienced nausea, dizziness, headaches, stomach pain and vomiting.

Rice-Wray concluded that Enovid caused “too many side reactions to be generally acceptable”. Three women died during the trials but Pincus and Rock never investigated to see whether their deaths were related to the pill, they also dismissed Rice-Wray’s concerns.

Years later, accusations of exploitation would linger over Rock and Pincus’s work. The first large-scale trial of the pill has remained overshadowed by what was overlooked and ignored.

Now, firstly it’s really important to point out, at this point, that this early incarnation of the pill, Enovid, contained far higher hormone doses than the pills we take today. So, the risks are nowhere near as high. Secondly, the reduced dosage of synthetic hormones in pills today mean that any potential side effects of the pill have been greatly reduced.

But, questions remain. What’s becoming increasingly clear is that there is a lot we don’t know about how hormonal contraceptives affect the women who take them because, put simply, the research into side effects – particularly those that involve mental health - was never done. The story of the pill’s creation serves as a reminder of that.

This week a new study which looks at how the pill affects women’s cognition (how she perceives and understands things around her) was published in the journal Frontiers in Neuroscience. It has made serious waves.

It was conducted by researchers at the University of Greifswald in Germany and focused on how the pill affects a woman’s ability to read the emotional of others from their facial expressions.

Millions of women in this country take the pill and yet, still, as the researchers themselves put it ’remarkably little is known about the effects of oral contraceptives on emotion, cognition and behaviour’.

The study involved 95 women aged between 18 and 35, 42 of whom took and pill and 53 who did not. The entire group were shown images of human faces and asked to correctly identify the emotion – such as pride or contempt - being expressed.

The researchers found that the women who were taking the pill were less able to accurately recognize facial expressions than the women who were not taking it. This was particularly noticeable when the facial expressions were subtle. Women who were taking the pill were approximately 10% worse at emotion recognition than those not taking it.

Overall, these findings raise serious questions about how the pill affects a woman’s social interactions and relationships.

This might sound shocking but it’s actually something that’s already known in the medical community. In recent years, researchers have begun to look more and more at what happens to women’s brains when they take hormonal contraception and found that the pill not only affects a woman’s behaviour but the way her brain looks. This study from 2014 found that hormonal contraceptives ‘influence the baseline state of the brain’ which could ‘influence cognitive performance and affective experience’. Which, roughly translated, means a woman’s ability to do things like come up with words, solve problems or read emotions.

Dr. Alexander Lischke, is an experimental psychologist and was the lead author of the latest University of Greifswald study. He explained to Grazia that there is no cause for alarm because the changes noticed by his team were ‘subtle’. However, he added that ‘we’re only now doing the research which looks at the emotional, cognitive and mental health side effects of the pill’ so there’s a lot more to be uncovered and understood.

The hormones in the pill, Dr Lischke explains, ‘appear to moderate the activity and connectivity in brain regions which are important for emotional processing. This is something which has been shown before but now we’re investigating it further’.

However, Dr Lischke stresses that the emotions the women in the study were asked to recognize were ‘complex’ and deliberately ‘difficult to recognise' because his team wanted to see if the pill has a ‘subtle effect on emotional recognition’.

Dr Lischke says there will be a follow up study. ‘We know that the synthetic hormones in hormonal contraceptives suppress natural hormones but we want to test this further and see how it affects the way women’s brains function when it comes to recognising emotion.’

This most recent study comes just weeks after the official recognition that it is completely safe for women to take the pill without a 7-day break each month. That’s another story that leads back to John Rock who imposed a break between pill packets because he thought it would gain the support of the Catholic Church at a time when contraception was a controversial idea.

‘The pill is one of the most studied drugs out there’ Dr Lischke concludes ‘we know a lot about how effective it is because, from the start, that was the most important thing but we don’t know a lot about the effects of the pill on emotion, mood and cognition. The psychological effects are not well-studied and that’s why more work is needed’.

Millions of women rely on hormonal contraception and this is yet another reminder of how much we still don’t know about how it actually affects us. Scientists are still looking at how it changes women’s brains and impacts our behavior. We know the pill effectively prevents pregnancy but when it comes to the mental health and emotional side effects, there are a lot of questions still unanswered.

If you have any concerns about your contraception please contact your GP immediately.

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