Forget the morning coffee and meditation: neuroscientist Carina Heller’s routine involved climbing into a brain scanner at 7:30 a.m. for 75 days over a year. She lay perfectly still for an hour and a half, avoiding sleep. This made her one of the most-scanned women in science, though that wasn’t her goal.
Heller aimed to track how her brain changes during her menstrual cycle, with and without oral contraceptives. Preliminary results, shared at the Society for Neuroscience conference, suggest that brain morphology and connectivity shift daily throughout the cycle and are influenced by the pill.
Heller is part of a group of women’s health researchers frustrated with the lack of data in this area. They have taken action by using brain imaging to gather more information. Heller believes more data could help women and their doctors make better-informed decisions about birth control options.
Oral contraceptives typically contain synthetic versions of hormones like progesterone and estrogen, which prevent pregnancy. Since the first pill was approved in 1960, its use has surged. Today, over 150 million people of reproductive age use it, often for reasons beyond contraception, such as acne management or regulating menstrual cycles.
While oral contraceptives are generally considered safe, their effects on the brain remain under-researched. Some people report reduced anxiety, while others experience worsening symptoms. This inconsistency is puzzling.
Many start taking the pill during puberty, a crucial time for brain development. Understanding its impact on neurodevelopment is vital, says Kathryn Lenz, a behavioral neuroscientist at Ohio State University.
Most neuroimaging studies scan 10-30 participants once or twice, missing daily variations in brain function. A newer approach, called dense sampling, scans fewer participants more frequently, creating a richer data set. This method helps capture nuances but limits generalizability.
By comparing data across participants, researchers can explore different reactions to the pill and their side effects. Heller scanned herself 25 times over five weeks during her natural menstrual cycle. Afterward, she took the pill for three months, then scanned herself another 25 times. After stopping the pill, she waited another three months and scanned herself one last time. She also recorded her mood and had blood drawn after each session.
Heller observed rhythmic changes in brain volume and connectivity throughout her cycle. When she took oral contraceptives, these metrics dipped slightly, but they mostly returned to baseline after she stopped the medication, indicating the brain’s adaptability.
Inspired by a study where Laura Pritschet scanned her brain for 30 days during her cycle and another 30 while on the pill, Heller is now building on that research. Pritschet’s project, 28andMe, highlighted how estrogen enhances connectivity in key brain networks, while progesterone has the opposite effect. Pritschet also scanned her husband to examine hormone effects in male brains.
Heller’s next step is to compare her data with that of a woman with endometriosis. This condition affects up to 10% of women of reproductive age. The combined data will offer insights into how hormonal fluctuations relate to changes in brain structure and behavior, Lenz says.
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