Oral Contraceptives and Cognition: A Methodological Perspective on Heterogeneity

Eighty-five percent of women in the United States will use oral contraceptives (OCs) for at least 5 years of their life. Given its prevalence, surprisingly little is known about the psychological and cognitive consequences of “the pill” – consequences that may influence women’s decisions to initiate, continue, or discontinue pill use. Relatively consistent findings are beginning to emerge with respect to memory and spatial abilities, but research on the cognitive correlates of OC use is challenging and riddled with limitations. A primary challenge is heterogeneity: Women are biologically and socially unique, and they use different types of OCs for different reasons. This suggests that the cognitive effects of OC use may also be unique – to subgroups of users or even to individual women! In this talk, I will present methodological innovations that overcome past heterogeneity-related research limitations in order to capture the effects of OC use on cognition, highlighting effects that are relatively uniform across users and those that are unique to individuals. I will accomplish this by: (1) discrediting the notion that differences in personal characteristics between OC users and naturally cycling women are responsible for differences in cognition, (2) removing heterogeneity among OC users by placing them into homogeneous groups (based on the active ingredients in their pills) before examining effects on cognition, and (3) capitalizing on heterogeneity by applying person-specific temporal network models to 75-day diary and cognitive testing data from naturally cycling women and women using different types of OCs.