Adolescence challenges one’s parenting skills: your child moves from depending on you to possessing a much greater degree of autonomy as they develop their own identity. So many factors influence the path your child takes and the new self-identity they attain, especially hormones. Their own hormones offer enough turbulence and drive towards young adulthood, but this study indicates that the extra hormones found in synthetic birth control pills may exert unexpected and even unwanted effects upon our budding young adults.
As children enter puberty, the calmness of childhood often gives way to the turbulence of their bodies adjusting to new and higher levels of reproductive hormones like progesterone, estrogen, testosterone, and DHEA. While surface physical changes become evident over the onset of puberty, many internal changes also take place including inside their brains. The moods and personalities develop through ups and downs as they adapt to newly offered autonomy and new challenges of social life. Influences during this time of life often set the course for their lives as adults.
During this time, a significant number of young girls choose by themselves or with their parent’s participation to take what we know as birth control hormones for a number of reasons. For some, they are told that it will improve their acne which leaves them frustrated and ashamed of their complexion. For some, their menstrual cycles start from the beginning with disruptive and/or very unpleasurable characteristics. The synthetic hormones offer regularity and less intense periods. For still others, the onset of sexual activity during these years spurs them to use such medications in order to prevent a pregnancy.
Parents and the child’s medical providers can debate the appropriate use of such hormones on each of these fronts based on the short-term risk/benefits of the condition being treated versus potential immediate short-term effects. Regardless of where either parent, provider, or patient make the final decision for or against, all should agree that full knowledge of potential risks both short and long-term should be fully disclosed by the medical world offering such therapies.
The effects of such medications on the adolescent’s developing brain stands out as one area where understanding and explanation of such risks are deficient. This study sought to better elucidate potential effects on the recipient’s brain and thus long-term neurologic and psychologic consequences in the millions of children who do or will receive these medications.
By administering the exact same synthetic hormones often used for adolescent birth control (ethinyl estradiol and levonorgestrel) to laboratory rats at weight adjusted doses during their equivalent adolescence, researchers found hormonal and neurologic changes which persisted after the hormones were later discontinued. After confirming that the hormones demonstrated equivalent birth control effects in the rats, they found a few concerning and intriguing effects elsewhere.
In the rat’s brains, a decrease in excitatory synapse growth signals while no change in inhibitory synapse growth signals gave them concern. Synapses are the actual connections between nerve cells across which nerve signals must cross to continue through nerve chains and networks. Excitatory synapse increases other nerve cell signaling while inhibitory ones turn further signaling down. This delicate balance affects everything our nervous system does from sensing to thinking to movement and further. In other studies, other researchers found that lower levels of the excitatory synapses correlated with chronically stressed test animals. If lower levels of such excitatory nerves and synapses play a role in the long-term negative effects of stress, then these hormones might also adversely affect our human adolescents.
Besides these potential changes in the pre-frontal cortex where decision making occurs, the researchers in the focus article found that rats treated with the synthetic hormones demonstrated higher levels of an adrenal hormone similar to human cortisol. At baseline and post experimental stress, the hormone treated rats had higher measured levels of this stress hormone. As adult rats, the actual size of the rat adrenal glands were also larger after hormone therapy. Therefore, the synthetic reproductive hormones appeared to have a long-term effect on the stress hormone system of these rats.
In considering what this might mean for human adolescents in our care, direct application of such studies must be carefully extrapolated. We cannot simply test out such therapies on our teens and dissect their brains later to measure brain changes. Instead, this should make us consider the pros and cons of hormone therapy for such developing children with all the potential factors as we should with any other medical decision. Informed consent means medical providers show know and discuss such risk with the parents and the teens. Informed consent means that parents and ideally teens should ask and require such full disclosure before embarking upon long-term therapies with potential life-long effects.
Helping our teens live a healthier, more abundant life both in their teen years and their future adult life requires careful understanding and discernment as we help them choose the right path to that abundant life. This process includes considering and explaining the effects of birth control on their brains.
Original research poster citation:
*R. GILFARB, M. STEWART, A. RAJESH, S. RANADE, C. DYE, K. M. LENZ, B. LEUNER; Ohio State Univ., Columbus, OH. Hormonal contraceptive exposure during adolescence impacts the prefrontal cortex and HPA axis response of female rats.. Program No. 438.16. 2022 Neuroscience Meeting Planner. Chicago, IL: Society for Neuroscience, 2022. Online
Thanks to Science Daily:
Ohio State University. “How hormonal birth control may affect the adolescent brain: Research in rats hints at increased stress, signaling changes.” ScienceDaily. ScienceDaily, 15 November 2022. <www.sciencedaily.com/releases/2022/11/221115114115.htm>.
Further reading:
Radiological Society of North America. “Study finds key brain region smaller in birth control pill users.” ScienceDaily. ScienceDaily, 4 December 2019. <www.sciencedaily.com/releases/2019/12/191204090819.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
