Pletzer, B., Harris, T., & Hidalgo-Lopez, E. (2019). Previous contraceptive treatment relates to grey matter volumes in the hippocampus and basal ganglia. Scientific Reports, 9(1), 11003. https://doi.org/10.1038/s41598-019-47446-4
Pletzer B, Harris T, Hidalgo-Lopez E. Previous contraceptive treatment relates to grey matter volumes in the hippocampus and basal ganglia. Sci Rep. 2019;9(1):11003. doi:10.1038/s41598-019-47446-4
Pletzer, Belinda, et al. "Previous contraceptive treatment relates to grey matter volumes in the hippocampus and basal ganglia." Scientific Reports, vol. 9, no. 1, 2019, pp. 11003.
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Department of Psychology & Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
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RRM Academy Synopsis
Longer past oral contraceptive use correlates with two brain volumes
Among 52 women who had used one oral contraceptive before, longer past use correlated with larger hippocampus and basal ganglia volumes. The correlational MRI study compared 131 women aged 18 to 35 with natural cycles. Only the basal ganglia link stayed significant after adjusting for time since stopping.
Key Findings
Among 52 women who had used one oral contraceptive, longer past use correlated with hippocampal volume (r = 0.29 on the left and 0.31 on the right, both pFDR = 0.02).
Longer past use also correlated with larger basal ganglia volume (r = 0.37 on each side, both pFDR = 0.01).
After adjusting for time since discontinuation, the hippocampal associations were no longer significant (pFDR = 0.09 on each side), while the basal ganglia associations remained (pFDR = 0.04 on each side).
Longer time since discontinuation correlated with smaller volumes in both regions (hippocampus: r = −0.27, pFDR = 0.045 on each side; basal ganglia: r = −0.24, pFDR = 0.045 on each side).
Hippocampal and basal ganglia volumes did not differ between 52 women with no past contraceptive use and 52 with one past oral contraceptive (all F <0.95, all p > 0.33).
Interpretation
The study is a correlational MRI analysis that compares women with one another. All analyses controlled for age and total intracranial volume. Participants were recruited at the University of Salzburg and online. The 52 women in the main analysis had used an oral contraceptive for an average of 3.60 years and stopped an average of 3.32 years earlier. Researchers measured brain volumes only, with no mood or thinking outcomes. The authors suggest some effects may last beyond treatment and note that social and relationship status were not assessed. Also, 20 of the 52 women could not recall their pill brand, so the comparison of androgenic and anti-androgenic pills is preliminary.
RRM Context
Oral contraceptives are a form of suppressive medication. The paper reports that about 150 million women worldwide use them for longer and longer stretches. The authors cite earlier work showing that hippocampal volume rises with estradiol levels before ovulation, a link between this region and the natural cycle. Restorative reproductive medicine reads the cycle as a vital sign. Findings on cycle-responsive tissue after long-term suppression fit that view.
Our editorial summary of this paper, not the article's abstract.
Abstract
Oral contraceptive (OC) effects on the brain have gained increasing interest, but are highly controversial. Previous studies suggest that OC users have larger hippocampi, parahippocampi, fusiform gyri and Cerebelli. Preliminary evidence from one of those studies even suggests an effect of previous contraceptive use on the hippocampi of women who are not current users of OCs. Furthermore, more recent studies postulate an involvement of previous OC treatment in later development of mood disorders. To address the question whether previous OC treatment affects women's brain structure later in life, high resolution structural images were obtained from 131 naturally cycling women. Among them, 52 women had never used OC before, 52 had previously used one OC for a continuous time period and 27 had previously used multiple contraceptives. The groups did not differ in gray matter volumes. Since endogenous sex hormones modulate gray matter volumes of the hippocampus and basal ganglia along the menstrual cycle, we hypothesize effects of OC use on these areas. Specifically, we hypothesize that a longer duration of previous OC treatment is related to larger hippocampi and larger basal ganglia. Indeed we found the duration of previous OC use to be positively correlated to hippocampal and basal ganglia volumes bilaterally. For the hippocampus, but not for the basal ganglia, this association disappeared after controlling for the time since discontinuation. These results suggest that for the hippocampus, but not for the basal ganglia, effects of previous contraceptive treatment are reversed after a time period comparable to treatment duration. These data question the immediate reversibility of OC effects on brain structure. Accordingly, some changes in the brain due to long-term contraceptive use, while subtle, may be long-lasting.
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