Conducting high-quality research on the psychological impact of oral contraceptive use

Abstract

Oralcontraceptivesarethemostextensivelystudiedpillsinthe history of medicine [1]. It is therefore unfortunate to seehow little of this research has been directed towards the studyof potential psychological consequences resulting from use.Scientists, health care providers and advocates who read thisjournal are privy to the latest breaking research on improvedcontraceptive technology from researchers in the fields ofchemistry, biochemistry, physiology, endocrinology, demog-raphyand biology; however, rarely are readers presented withresearch testing the potential influence of oral contraceptivesonpsychologicalwell-being.Whileweobviouslyconcedethatit is of extreme importance to identify physical health risksassociatedwithoralcontraceptivepilluse,itisunfortunatethatsuch research is often carried out entirely independently ofresearch examining the potential for psychological conse-quences. To date, systematically controlled studies investigat-ing the psychological effects of oral contraceptives tend to belimitedtoresearchongeneralizedmood,depressionandlibido.Whilegreat workhas beendoneinthese areas (e.g., Refs.[2–4]), research has not yet adequately addressed the psycholog-ical impact of contraceptive use within a wider context,namely, interpersonal relationships. Accordingly, a number ofinteresting questions remain unanswered, for example: Arechanges in female mood reported in contraceptive usersnoticeabletomalepartners,friendsorcolleagues?Dochangesin libido affect the durability of romantic relationships?In a stimulating article, Alvergne and Lummaa [5]reviewed evidence which suggests that use of oralcontraceptive pills may disrupt human mating preferences.That is, they review studies which support the conclusionthatuseoforalcontraceptive pillsmayleadtothechoiceofapartner which is otherwise less preferred, therefore callinginto question the satisfaction of these relationships. Considerthis: a plethora of studies exist which clearly show that, inwomen who are regularly cycling, mating preferences andbehavior shift with conception risk. For example, prefer-ences for male facial masculinity [6], low-pitch masculinevoices [7,8] and the scent of dominant men [9] have beenshown to increase during periods of female fertility.Increased preference for non-physical traits, includingpreferences for dominant male behavior [10], creativity[11] and intelligent appearance [12], has also beendocumented during fertility. These features are thought tosignal underlying genetic quality in the possessor. Re-searchers have also shown that a woman's stage within hermenstrual cycle contributes to changes in her motivation toseek out men [13] and to appear attractive [14,15].Furthermore, female faces [16], voices [17,18] and scent[19–21] are rated as more attractive when fertile than whennon-fertile. Since hormonal contraceptives suppress cyclicalvariation in hormones, not surprisingly, women who chooseto use oral contraceptives show no variation in many of theabovementioned traits with respect to cycle stage [17,22,23].What may be the consequence of this? If cyclicalvariations in mating preferences and behavior influenceeither mate choice or satisfaction within existing relation-ships, then the use of hormonal contraceptives may bedisrupting these processes. Recent research by Roberts et al.[24] supports this possibility. They showed that women whomet their partner while using oral contraceptives reported tobe more satisfied with their partner's paternal provisions;however, these women reported lower sexual satisfactionwith their partner (controlling for current pill use) thanwomen who met their partner off the pill. These authors also