Hormonal Contraception = Decreased Perseverance

It has long been known that hormonal contraception alters women’s brains, moods, and bodies in ways that are still being discovered. Now, a team of researchers from Texas Christian University are seeking to uncover the impact of hormonal contraception on one very specific brain function—perseverance.

The authors open by highlighting the adage, “If at first you don’t succeed, try, try again.” This adage, they say, “appropriately highlights the incredible power of perseverance in achieving success.” But given what the researchers know about hormonal contraception (HC) and its impact on the brain, they hypothesize “that women taking HCs (when compared to naturally-cycling women) would exhibit diminished perseverance on both simple and challenging cognitive tasks.” And they further hypothesize that through this mediating influence of diminished perseverance, these women would perform at a lesser level than their naturally-cycling peers at these cognitive tasks.

The researchers open by detailing what is already known of HC’s impact on the body. It is, as they say, associated with a reduced risk of ovarian cancer, but also with heightened risk of thrombotic stroke, myocardial infarction (heart attack), and breast cancer. And although “less frequently discussed,” research also indicates that HC use may have an impact on women’s brain structure and function. “For example,” the authors continue, “compared to naturally-cycling women, women using HCs exhibit decreased resting state functional connectivity in the brain’s executive control network . . . which plays an important role in self-regulatory behaviors such as attention, learning, and memory.” Other research has suggested “that HC use is associated with higher likelihood of academic performance problems in a sample of young female college students.”

To test their hypothesis related to HC use and female cognitive perseverance, the researchers recruit a sample of 149 young women for study 1, and 175 for study 2. Of the first group, 73 were on hormonal birth control; the second group had 89 women on hormonal birth control.

To conduct their study, the researchers collected detailed information from the participants about their HC use or cycles, and then had them complete a series of cognitive tasks: First, a “spot-the-difference” task; second, some GRE quantitative problems; and finally, a series of anagrams, three of which were solvable, and three unsolvable. (The unsolvable tasks were included to assess perseverance, or the length of time spent on the task.)

The results indicated that the researchers’ hypotheses seem to have been correct. For the “spot-the-difference” task, naturally-cycling women “spent significantly more time . . . than HC women . . . and this increased time spent on the spot-the-difference task predicted increased performance on the task.” For the GRE math problems, “naturally-cycling women not only exhibit more perseverance on GRE math problems, they also perform better.” And for the word scrambles, once again, naturally-cycling women spent more time on the problems, which predicted slightly better outcomes. The researchers then ran mediation analyses, and determined that perseverance did, in fact, mediate the results—it explained the longer amounts of time spent, and the improved performance. Type of hormonal birth control used did not seem to matter.

In their discussion, the researchers highlight a number of ways that hormonal contraceptive use impacts brain structure and function, and suggested that these differences are what accounted for the differing levels of perseverance in completing cognitive tasks between HC users and non-users. They close in highlighting a number of possible limitations to their study, but state that their results “add to a growing body of literature demonstrating the far-reaching, and often unanticipated, effects of taking HCs.”

(Hannah K. Bradshaw, Summer Mengelkoch, and Sarah E. Hill, “Hormonal contraceptive use predicts decreased perseverance and therefore performance on some simple and challenging cognitive tasks,” Hormones and Behavior 119 (2020), doi: 10.1016/j.yhbeh.2019.104652.)