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The pill messes with memory? Forget about it!

Media report that the pill affects memory—but does the research hold up?

by Jessica Morse, MD, MPH

Sure, we know remembering to take your birth control every day can be hard. But some recent headlines are saying that birth control pills actually alter women’s memory… Really? The short answer is that—in spite of the headlines—we still don’t know.

Memory and hormones: Is there a connection?

The real story on hormones and memory is complicated. Neurobiologists have shown that hormone levels are related to how all humans remember things. For women, hormone levels change naturally during every menstrual cycle. For women on birth control pills, levels of these hormones are generally low and constant. In theory, more constant levels of hormones in women taking the pill could have some effect on memory, so researchers are trying to figure out if that’s true.

We do know that women with really low estrogen levels—like women in menopause—have a harder time remembering words. When they take estrogen pills, their memory for words improves again. Women taking birth control pills have relatively low estrogen levels, so do they have a harder time remembering words compared to women not taking the pill? Studies have shown just the opposite! Women on the pill do better on tests of word and language memory than women not on the pill. (FYI, they also did better than men.) The researchers studying this issue were a little confused by this, so they decided to take another approach.

The big picture, or the details?

Generally, for emotional events, women are thought to remember the details while men remember the gist. What does that mean? If a couple had a horrible argument over dinner one night, the guy would remember the general idea (“We always fight over money!”), while the girl would remember the argument and details from the evening (“He ordered the fettuccini alfredo and spilled some of it on his shirt, the blue one I got him for his birthday”). If these differences in how men and women remember emotional events are real, then women with lower estrogen levels from taking the pill might be more likely to remember emotional events in a male way—the big picture and not the details.

A recent study—the one that was in the news—tried to see if that was the case. They compared memories of an emotional event between women on the pill and women not taking any hormones. They found that women not taking hormones were more likely to remember the details, and that women on the pill were more likely to remember the gist. But the jury is out about what this means, particularly since the study had a few important limitations:

  • The study had only 72 women in it.
  • It didn’t take into account the natural hormonal changes happening for women not taking the pill.
  • There could’ve been lots of differences between the women in the two groups besides what type of birth control they were using (like how much sleep they’d had, for example).
  • The researchers measured lots of ways that women in the two groups might remember things differently, and they found that they were different in only one test.

That’s pretty slim evidence for declaring that the pill changes women’s memory.

What does this mean for you?

There are lots of rumors about the way the pill affects women, and many of them aren’t true. If the pill is working for you, these studies are definitely not a reason to stop taking it. Effective birth control that keeps you from getting pregnant may be good for memory in the big picture. Rumor has it that in those first few months after a baby is born, when mom’s not exactly getting a lot of sleep, memory takes a hit.

If you take the pill and you’re still worried about changes to your memory, you’ve got some good options for birth control without hormones, like the copper IUD. Once it’s placed by a health care provider, you can forget about it. Now that’s worth remembering!

Jessica Morse is an ob/gyn at Duke University where she works with residents providing a full spectrum of reproductive health care. Her main research interest is increasing the number of women who know about long-acting reversible contraceptives (IUDs and implants), in the U.S., Uganda, Rwanda and Honduras. She lives in Durham, NC, with her husband and silly 3-year-old son, where they spend weekends hiking, hanging out at playgrounds, and exploring the Bull City.

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