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The Wisdom of Psychopaths
In this engrossing journey into the lives of psychopaths and their infamously crafty behaviors, the renowned psychologist Kevin Dutton reveals that there is a...
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It seems that weekly we hear about some professional athlete who sullies himself and his sport through abuse of steroids. The melodrama unfolds, careers and statistics are brought low and asterisked, and everyone bemoans another fallen competitor. Yet there are millions of cases of steroid use that occur daily with barely a second thought: Millions of women take birth control pills, blithely unaware that their effects may be subtly seeping into and modulating brain structure and activity.
It is a huge experiment whose resolution will not be known for a while, but a new study in the journal Brain Research demonstrates that the effects are likely to be dramatic. It found that birth control pills have structural effects on regions of the brain that govern higher-order cognitive activities, suggesting that a woman on birth control pills may literally not be herself -- or is herself, on steroids.
The human brain is a remarkable structure, not least because of its seemingly infinite capacity for change, adapting millisecond by millisecond. Indeed, a structure with tens of billions of neurons, each of which has the ability to elaborate and branch and become more complex, while changing its activity in the process, is the very definition of change. This so-called neuroplasticity is a hallmark of the nervous system. It can, however, be augmented, boosted, by artificial means, and if we are not careful, the brain may go all catawampus.
Steroid hormones, which are excreted by endocrine organs such as testes and ovaries, flow in abundance throughout the bloodstream, reach target organs and structures, and exert powerful effects on them. To wit, the cock’s comb, the buck’s antlers, the lion’s mane, the blood-engorged uterus.
What of the mammal’s nervous system? It turns out that the brain is a veritable sponge for steroid hormones. In the male, the androgen testosterone (or a metabolite) binds to brain receptors and sculpts that structure into the aggression-promoting, sex-craving, risk-taking regulator with which we are all familiar. By the same token, the comparative lack of androgen hormones in the female produces the kinder, gentler, softer neural substrate that distinguishes itself from the male by dint of its vastly different behavioral repertoire.
Whereas the subtle structural effects of naturally-occurring steroid hormones and sex differences in the brain have been extensively studied, few studies have examined the role of synthetic hormones on changes in the human brain. What happens, then, when the female brain gets a significant and artificial dose of steroid hormone, either progesterone, estrogen or both? We know what happens below the waist, the pregnancies prevented. What happens above the neck, as this steroidal tsunami washes over the neural coastline?
It appears that the brain, that sensitive organ replete with steroid receptors, reacts to its hormonal milieu with startling structural modifications. Researcher Belinda Pletzer, of Paris-Lodron-University Salzburg, and her colleagues used MRI and voxel-based morphology to examine the brains of men; women on the pill; and “naturally cycling” women not on the pill.
The researchers found that males have considerably larger areas of gray matter in brain regions associated with learning and memory, known as the parahippocampal gyrus and hippocampus, as well as an area associated with emotional regulation, the amygdala. These data are consistent with many studies that provide evidence for gender differences in brain and behavior.
Further, naturally cycling women showed an increase in gray matter volume in the right fusiform/parahippocampal gyrus when circulating levels of estrogen and progesterone were low versus the phase when levels of these hormones were both high.
Does that increased gray matter translate into enhanced performance? It is not clear. Research into the hormonal regulation of cognition is extremely complicated. As Pletzer mentions, human fMRI studies have revealed that these areas are associated with spatial navigation abilities. Other work suggests that hippocampal–dependent spatial memory is enhanced by higher levels of estrogen. Under some conditions, however, estrogens have no effect or can even impair performance in rats.
Additionally, in Pletzer’s study, women using hormonal contraceptives showed larger gray matter volumes in the prefrontal cortex, pre- and postcentral gyri, the parahippocampal and fusiform gyri and temporal regions, when compared to naturally cycling women. The brain works like a neural beehive; the proper coordinated functioning of groups of tasked neurons are important to successfully accomplish a variety of mental tasks -- even the sensory processing and motor coordination needed for something as simple as picking up a hot cup of coffee without scalding oneself. Again, we do not know whether this increased gray matter translates into better or worse performance, but there likely is little good about treating a woman's brain like a spongy accordion.
Further, although the Pletzer data are suggestive, there are other methodological and interpretational issues worth considering. For example, the authors did not examine levels of circulating hormones in the male and female subjects (e.g., testosterone or estrogen, respectively). Such data would have been helpful in determining the timing of the neural structural effects.
Furthermore, the types of hormonal contraceptive were not examined, lumping them all into a vague “hormonal contraceptives” group. There is a high level of variability and differential ratios in levels of estrogen and progesterones in birth control pills.
Pletzer’s team, despite showing significant neuroanatomical alterations, did not perform behavioral or cognitive tests of their subjects that could have helped explain the meaning or functional consequences of the changes. Comparing other published work with the Pletzer study allows us to make inferences, but they are, at best, speculative given the unique details of the current research. There are pretty large differences in the structure of the brain that are attributable to cyclic fluctuations in natural hormones, and that appear to be due to unnatural concentrations of synthetic hormones. But since the authors did no cognitive testing of their subjects, we can only speculate about the behavioral effects.
Last, birth control pills also keep hormones low. So, there are two simultaneous events tugging at the data, a confound: the hormonal effects of the pills themselves, and the lowering of the normal hormones, both of which could bring about the structural effects. So even the actual hormonal basis underlying the reported structural differences remains unclear.
Still, overall, the Pletzer data do reveal some startling effects of oral contraceptive hormones. There are natural hormonal fluctuations that are a consequence of menstrual cycle oscillations, and which have organic effects of their own, but these have been a part of female mammals’ lives since time immemorial. Now, we are superimposing onto this sensitive substrate a steroid hormone cocktail with the potential of marking the brain in dramatic fashion.
The possibility that an accepted form of chemical contraception has the ability to alter the gross structure of the human brain is a cause for concern, even if the changes seem benign -- for the moment. In any event, women need to have all of the medical and now, neurobiological, information they can use in informing their personal contraceptive decisions. Like the rest of life, and like the steroid choices made by those ballplayers, there are costs and benefits. The benefits are well established; the costs, however, are still coming to light.
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15 Comments
Add Commentwell about time.. I had a total hystorectomy and was put on estrogen and progesterone and yikes...with in six months I was no longer "ME". the mental changes were horrible. My whole personality changed...became passive/aggressive. Intoverted.(not normal for me). hid in house. and lots of little reactions.
Reply | Report Abuse | Link to thisI had also been on birth-control with the same reactions...went to IUDs hmmm lol ended up in hospital with the dalcon shield (anyone remember them). Eventually settled for another type of iud and SOYA.
Was fine once I was OFF the stuff.
I thought it was common knowledge that a woman`s behavior changes when she is on vs off the pill. At least all women I have ever talked this over with are fully aware that it puts a damper on a lot of things including your libido.
Reply | Report Abuse | Link to thisYes, it is common knowledge that women's behavior is altered during their use of the pill... what is news to me at least is that there are lasting effects even after one has discontinued their use of the pill that seem irreversible based on this article.
Reply | Report Abuse | Link to thisThe article describes the effects of identified physiological changes in the brain:
Reply | Report Abuse | Link to this"Does that increased gray matter translate into enhanced performance? It is not clear. Research into the hormonal regulation of cognition is extremely complicated. As Pletzer mentions, human fMRI studies have revealed that these areas are associated with spatial navigation abilities. Other work suggests that hippocampal–dependent spatial memory is enhanced by higher levels of estrogen."
As I recall, studies of maze navigation differences between the sexes indicate that male tend to apply visualization spatial analyses to determine the desired path through a maze, while females tend to remember the path taken utilizing visual landmarks to avoid retrying paths. Once the desired path is found, females recall the landmark directed path to their destination while males recall a visual map. Apparently either method may work better, depending on the maze.
I think these differences in brain physiology are, to varying extents, present in all males and females, so I wouldn't get too worried about that.
In terms of trip navigation, we all know that it takes a male and a female to find the destination of any trip. If only they could communicate!
This is the female brain. This is steroids. This is the female brain on steroids. The question of men on steroids in order to enhance their performance, like that of Viagra and other types of ually enhancing products, is not treated the same with the female athlete as with the male athlete. Women take steroids and hormonal replacements and there is never an out cry for such. Although, the study only takes into consideration of men and women, for there is a population of "men and women" who are taking hormones that is not part of this, or any other study on brains and steroids. There is a population that is, also, taking large quantities of steroids for the purpose of altering their gender orientation, and there are M2F and F2M who are both pre-operative, post-operative and non-operative. What happens when a "male" who begins to use estrogen, or a "female" who begins to use testosterone, what happens to their brains? This is the male brain on estrogen and this is the female brain on testosterone. Maybe in order to understand the changes of the female brain on steroids, there should be something to compare it to. I have been on estrogen for 18 years and don't have a clue how my brain has been altered by estrogen, but I know how my body has been changed by it though.
Reply | Report Abuse | Link to thisHormones effects women. Who knew.
Reply | Report Abuse | Link to thisChalk this one up as a victory for science!
To add to eriley's pithy comment: we need not tell this readership that science is empirical. The Pletzer et al. data demonstrate the significant effects on brain structure -- and likely function -- that accompanies the use of oral contraceptives. Sure, we know that "hormones effects (sic) women"; we have known for decades. And more recently, we have exploited that simple fact to modulate reproductive events and behavior. But until the brain effects were examined, as they were in the paper in question, we did not know. Now, we do. Thank goodness for science.
Reply | Report Abuse | Link to thisHopefully someone who is more knowledgeable about the effects of hormonal birth control can answer this question for me:
Reply | Report Abuse | Link to thisI have heard the effects of hormonal birth control described, in layman's terms, as "tricking the body into thinking it is already pregnant." Do the hormonal changes of pregnancy itself have a similar effect on the brain as this study has found for the pill? Just curious.
Having spent a fair amount of time in our marriage researching various birth control methods (before finally opting for the ultimate - snip, snip - method), I have often wondered at the lack of reporting, both in the media and from doctors of the emotional effects of the pill on women.
Reply | Report Abuse | Link to thisIn our case, use of the pill turned my wife into an irrational, emotional wreck. It very nearly ruined our marriage. Not until she got off the pill, and her emotional state return to normal did we realize what had happened. We still have our fights and she still gets mad at me for the same kinds of things, but the emotions without the pill are 10x less intense.
I thought our experience was unique, but many of my friends have reported similar experience with the pill. I've often speculated that the divorce rate, which began to rise about the time the pill was introduced, could be attributed to the pill.
I would really like to be able to actually look at the article in brains research on the study done on the birth control pill. Unfortunately your link does not lead to the article, and I can't find your works cited page so have no way of accessing the article by other means either. At least not easily. Suffice to say, that not enough information is given that we can accurately make a good decision on this topic. The article says that only one study has been published so far and that is hardly enough to make an accurate decision. Granted we should be careful with our bodies, and the pharmaceutical companies push way to many drugs on us but, like I say; we need more info.
Reply | Report Abuse | Link to thisDear HyacinthGirl,
Reply | Report Abuse | Link to thisThere are many data showing effects on the brains of mothers of various species. In humans, Jeff Lorberbaum, at Penn State, has published many nice data showing brain responses of mothers. James Swain and colleagues, at Michigan, have a paper coming out in the journal Behavioral Neuroscience showing really large and interesting changes in mothers compared to non-mothers. So yes, in animals ranging from invertebrates to mice to humans, there are striking effects on the nervous system, including the brain of humans.
Dear opabinia51,
Reply | Report Abuse | Link to thisEmail the authors and they will send you a copy of the full Pletzer et al. article so you can read the original data and interpretations.
Dear kristi276,
Reply | Report Abuse | Link to thisThe "m2f" and "f2m" cases that you cite would be fascinating ones to examine, neurally. Clearly, the hormonal treatments are designed to align the person's external and secondary sexual indicators (including the brain) with his/her subjective sexuality. In a sense it is superimposing the software onto the biological hardware. It is a given that the brain of that person would be substantially changed, along the lines of the Pletzer et al. research.
I was married in 2001. Beautiful 23 years old and a virgin. No one told me about birth control I just thought its what you did when you got married to prevent pregnancy. The first time on the was before getting married (they say three month to let it be effective) My soon to be husband noticed a significant change right away in my temper and mood swings and asked me to look into if birth control was causing it...I went to doctor and they took me off that dose to the lowest dose of estrogen BC. Everything seemed fine for a couple month and them gradually I became a completely different person. Four years it stole from our life! I went from a sweet, outgoing, talkative bold young women to an agoraphobic, antisocial, angry women!!! The fact that my husband stayed with me during those years is a miracle and testament to the type of man he is. When I came to the end of the 4 years I was so depressed...gained 80 pounds and wanted to DIE. I went to my doctor and asked if there was any possibility that the pill could be causing how I was acting??? She said "No, studies haven't shown what you are going thru, you're just depressed". She gave me a prescription for Prozac and sent me home. My husband was so furious that we didn't even attempt to look into it but just treated symptom upon symptom....he didn't want me to take the medication given...he told me to get off the pill (like he did many times) but I wouldn't...thankfully a couple weeks later it just happened that I forgot a couple days in a row to take my pill so at that point I decided to try not taking it and throw it out. After a month of being off pill it was as though a Rainy CLOUD had been lifted off my head. As if I have been walking around with a wet blanket. My thoughts were clear, no more frustration and the way I felt about my husband....I loved him again. I was so ANGRY that this drug is being promoted everywhere for women and its making us CRAZY!!! No wonder the divorce rate is 50/50 and rising...the Men marry women for who they think they are and then when they get on pill it changes EVERYTHING they loved let alone the love she felt for them.....More studies should be done to investigate and more warning should be given. That's my peace...I needed to vent ...thanks for listening...Danielle
Reply | Report Abuse | Link to thisI know personally that taking the contraceptive pill has had very obvious effects on my physical appearance, so who knows how much my brain chemistry has changed. I had to change the pill brand I used three times before I found one that didn't cause severe mood swings - however I never once considered that the change in brain chemistry whilst on steroids might be permanent.
Reply | Report Abuse | Link to thisGirls as young as 11 years old are being prescribed the pill during crucial years of brain development and growth. I dread to think how this may physiologically shape their brains and therefore change their perspectives and personalities. Could this be one reason why so many young girls suffer with mental illness currently?