Dose, scan, repeat: Tracking the neurological effects of oral contraceptives

When I was 15 years old, I began using oral contraceptives to treat my acne. At 27, I decided to stop taking them, and my skin started breaking out again. I experienced light mood swings and irritability, common premenstrual symptoms I hadn’t had for the 12 years I was on oral contraceptives. Even more surprising was the fact that my menstrual cycle did not return for nearly five months.

These experiences highlighted for me the profound ways oral contraceptives can affect the body beyond their intended purposes. The medication had influenced not only my skin and cycle, but my mood and overall sense of well-being.

I chose myself as the research participant because the process would be intense, and I knew I would be reliable.

Oral contraceptives have been available since the 1960s and are widely used, but the study of their influence on the brain in particular—and, by extension, on cognition and mental health—is still a relatively new field of research. A quick search on PubMed reveals only 279 articles on oral contraceptives and mental health, as of 7 January, and just 124 that focus specifically on the brain and MRI. Most of the available studies are small, cross-sectional and narrow in scope, meaning they have a limited focus that makes them vulnerable to selection bias, confounding variables and reproducibility issues.

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