The birth-control pill may be blunting women’s drive to achieve across the month, according to a new Australian study that is poised to divide health experts amid the authors’ fears it could threaten women’s reproductive rights.
The world-first University of Melbourne study of 278 women found participants who weren’t taking any hormonal contraception experienced an increase in their motivational drive to achieve around the time of ovulation. It was six times larger than the motivational increase that was experienced by hormonal contraceptive users during the same time of the month. Those who used hormonal contraceptives had their desire to achieve “flattened” over the course of a month.
Dr Khandis Blake and Lindsie Arthur-Hulme have headed up a world-first study that examines what impact hormonal contraceptives have on women’s competitive drive. Credit:Simon Schluter
“It’s crazy, it blows my mind,” says Lindsie Arthur-Hulme, the leading researcher,about the fact that until now, no one has known much about the psychological impact of the pill on the more than 100 million women who take it each day.
This is the first time in 61 years of hormonal contraceptive use that any study has looked at how it affects a woman’s competitive drive. And it’s the first study to show that women’s desire to be in competitive situations varies throughout their menstrual cycle, says Arthur-Hulme.
“We didn’t know that before,” she says. “But we don’t know why these fluctuations are happening.” And the fact that hormonal contraceptives “disrupt” this process is significant, she says.
“Over generations of women, we’ve evolved to have these fluctuations that benefit different goals or outcomes. Hormones are doing that to our bodies. Because people can’t compete all the time. We need to do other things, like eat and sleep.”
More research is required to know how women might be disadvantaged by losing their competitive drive while they are fertile, Arthur-Hulme says. “[But] we know, for example, that during the second part of the menstrual cycle, the immune system is compromised. So if women were competing in the second half of the cycle, they may be putting themselves at risk [for illness].”
Significantly, hormonal contraceptive users and naturally cycling women experience roughly the same amount of the drive to achieve overall.
The peer-reviewed findings, published in international science journal Adaptive Human Behavior and Physiology last week, are the result of a nine-month study that examined nearly 4000 diary entries from women in 21 countries.
Each day during a 28-day cycle, study participants were asked to rate the accuracy of various questions about a series of topics, including their sex drive, impulsiveness, self-esteem, and their competitive drive. They included: “In the past day, I was willing to do whatever it took to win”, “I enjoy competitions because they allow me to discover my abilities”, and “I didn’t care about competitions”.
More than 100 million women take a contraceptive pill each day.Credit:istock
Collecting this much data is high compared with other psychological research, says Arthur-Hulme. “Most psychology research is just one time-point, someone does a survey once. Ours is a better quality of research because it asks the same question of one person at multiple time points. It’s richer.”
The data showed a clear motivational peak around the time of ovulation for women not using hormonal contraception.
“During the middle of the [menstrual] cycle, only naturally cycling women see this [motivational] peak,” says Arthur-Hulme, a PhD candidate at the University Of Melbourne. This peak refers to self-developmental competition, or a drive to compete against your own prior achievements.
In practical terms, the study means that mid-cycle could be an ideal time for naturally cycling women to book a job interview or tackle a particularly challenging task, says Arthur-Hulme. Nearly 75 per cent of the study’s 86 participants who were on hormonal contraceptives took the contraceptive pill – the remaining participants on contraceptives used either the vaginal ring, contraceptive implant or contraceptive patch.
But the researchers say the work was not a randomised control study, and while the results are significant, more work will need to be done in the space.
Tessa Cowley-Court, 31, who participated in the study as part of the group not taking contraceptives, says the results confirmed her own suspicions about the pill, which she took from the age of 15 to 25.
“Now I realise there’s been a pattern there all along [with my natural cycle], where I have some times of the month [around ovulation] where … that would be a time of the month that I get out there and start, you know, definitely socialising more and putting myself out there to kind of progress things,” says Cowley-Court, a Melbourne graduate student.
But the authors are already preparing themselves for backlash, says Dr Khandis Blake, co-author of the study.
“There’s a long history of biology being used to oppress women,” says Blake, director of the Evolution lab at the University of Melbourne.
She is referring to more than 2000 years of medical theories proposed by the likes of Hippocrates, Sigmund Freud and modern physicians that, respectively, a “wandering uterus”, hysteria and hormones made women weaker than men, and unable to control their behaviour.
“So it became a faux pas to investigate biology and women,” says Blake. “A lot of people think that right now, they think we should not do this [study].”
Because, she says, showing evidence that a woman’s biology can impact her behaviour flies in the face of 60 years of messaging from the feminist movement: namely, that biology is not destiny.
“Every talk I give, you basically have to make sure you position yourself in a way so people don’t automatically stop listening and people don’t think you’re a right-wing, crazy suppressor of women,” Blake says.
The timing of the research, arriving shortly after the overturning of a woman’s constitutional right to abortion in the United States is “a bit scary”, too, she adds.
“We don’t want this research used by the wrong people to say, ‘See, we should take this away’,” says Blake, noting that some right-wing politicians in the United States have begun to argue that women should no longer have access to birth control.
Alex Polyakov, an obstetric gynaecologist and fertility specialist in Melbourne, says the study is “very interesting”, but has a variety of limitations that makes him question the usefulness of the findings.
“It’s an interesting sort of idea that hormone levels influence behaviour, and it certainly is true as a general comment,” says Polyakov, Associate Professor in the medicine and health sciences department at the University of Melbourne. “But whether you can actually determine how hormone changes influence particular behaviours such as aggressiveness or competitiveness, I’m not quite sure they have done a good job at that.”
One problem, he says, is that there are a wide variety of possible differences between the groups besides whether they take contraception or not, that aren’t accounted for.
“Human competition in women and men is a very complex phenomenon,” he says. “And it will be different in various groups, for example, depending on their age, the life stage, marriage not married, had children not had children, homosexual not homosexual. All those things probably play a role. And to ascertain the role of hormonal fluctuations in this diverse population is really very, very difficult.”
Additionally, the fact that the researchers relied on participants self-reporting where they were in their cycle rather than testing them for their hormone levels is problematic.
“If they measured hormones, it would have been better. You could say this level is associated with this behaviour.”
Blake and Arthur-Hulme are currently studying the hormone levels of women who are on hormonal contraceptives versus those who are not, for their next study.
For Australian social activist Eva Cox, the new study strikes a crucial blow against the damaging medical trend of neglecting women’s health issues.
“How come after all these years, this is the first time anybody’s looked at this particular issue?” says Cox of the psychological impact of the pill, which was launched in Australia in 1961. “It’s another bloody example of the fact that blokes control the research and the [medical] understandings. Because they control the research stuff, the new drugs type stuff, and use it to their own advantage. To get [erections] and avoid women having babies that they have to take care of.”
Cox is referring to the wide variety of studies that have examined the psychological impacts of Viagra, which treats erectile dysfunction, on men. And the fact that women have long been excluded from clinical drug trials because of claims that female hormonal changes made women too difficult to study.
A number of studies of hormonal contraceptives have revealed worrying results.
One 2020 study published in the journal Hormones and Behavior showed that naturally cycling women persist longer at cognitive tasks – like doing an anagram – than women who take hormonal contraceptives. Another one of Blake’s studies, published in the Journal of Experimental Social Psychology in November, found that naturally cycling women experienced an increase in the belief that they could achieve a goal around the time of ovulation. (This finding was not found among women taking hormonal contraceptives.)
But Arthur-Hulme is cautious that her latest diary study doesn’t overly damn hormonal contraceptives. She just wants women to be “empowered” to make an informed choice.
“It’s just about understanding what they do,” she says. “Women have the right to make those decisions. But if we don’t have the research, then we can’t make informed decisions.” The study did not demonstrate, she adds, that naturally-cycling women felt more competitive against other people mid-cycle than women using hormonal contraceptives. And it does not suggest that hormonal contraceptives make women less achievement-motivated overall.
And hormonal contraceptives are still, says Blake, a key to women being able to be competitive in achieving their goals. “I’d say the ability to know you can regulate your own reproduction is going to help make you massively competitive, because you’ve got agency,” she says.
The findings of the diary study are not conclusive because it was not a randomised control trial.
“There might be differences between the kinds of people that choose to use contraceptives and the kind that don’t, and we can’t say for sure that there’s not some underlying group differences that are [impacting the results],” says Arthur-Hulme.
“But it’s also not [as tenuous as] ‘smoke suggests fire’,” says Blake. “We actually do find the presence of a difference in achievement motivation. It’s not the kind of finding we would expect to have to do another study to rely on. This finding is a reliable finding. The question is more, ‘What’s the size of the effect?’”
This will partly depend on a woman’s genetic profile and her personality, says Blake. “These things could determine the strength of that finding,” she says. “For some women it could be a very large effect, for some a negligible effect.”
Either way, she doesn’t want women to panic.
“It’s a notable effect, and it’s something that we should pay attention to,” she says of the diary study.” But it’s not going to be like you start taking hormonal contraceptives and all of a sudden you can’t get off the couch and have no ambition left and you want to wallow in your own self-pity.”
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