Do combined oral contraceptives have long-term effects? Little evidence of an enduring effect on cognitive function in former users
Bibliographic record
Abstract
The use of combined oral contraceptives (COCs) is associated with subtle differences in brain activity and in certain cognitive, perceptual, or affective processes among current COC users compared with non-users. Whether any differences persist after the COCs are discontinued is essentially unknown. In a retrospective analysis of a cognitive dataset from healthy adults ( N = 221, M age = 23.78 yrs), we asked whether any residual effects of COC use could be identified in former users (who had discontinued their COCs ∼30 mo prior) on standardized tests of verbal fluency and visuospatial function. A detailed reproductive history was available, including specifics of any past COC use. Cognition was evaluated during the early follicular phase of the menstrual cycle when the ovaries are quiescent and hormone production is lowest. Based on their reproductive history, participants were classified as former users of COCs ( N = 86, mean duration of COC use = 29.89 mo), never-users ( N = 106, no past use of hormonal contraceptives), or current users ( N = 29, currently using a COC, mean duration of COC use = 29.72 mo). All COCs contained either levonorgestrel or a progestin from the norethindrone family, and 30–35 μg/day of ethinyl estradiol. Analysis of covariance (ANCOVA) contrasting cognitive performance in the 3 groups showed that despite the use of androgenic progestins and an estradiol dose that was relatively high, there was no evidence of a difference between former-users and never-users on any of the cognitive tests. Current users scored lower than former or never users on a conventional visuospatial task (Space Relations). Partial correlations controlling for age, estimated IQ, and pregnancy history revealed that duration of past COC use in former users was significantly associated with verbal fluency on one of two phonemic fluency tasks administered. A longer duration of COC use was associated with poorer word generation ability. This dataset produced little evidence of any enduring effects of COC use, however a duration-dependent association between former COC use and verbal fluency reinforces a similar trend reported previously among current users. • Compared 86 former users of oral contraceptives, 106 never users, 29 current users. • Cognitive performance evaluated during the early follicular phase of cycle. • No group differences on 5 tests of verbal fluency and visuospatial abilities • Duration of past use was negatively correlated with word production in former users. • A group of current users showed lower mean accuracy on the Space Relations Test.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".