Do oral contraceptives affect young women's memory? Dopamine-dependent working memory is influenced by COMT genotype, but not time of pill ingestion

Background Despite the widespread use of oral contraceptives (OCs), and the well-documented influence of estrogens, notably 17 beta-estradiol (E2), on cognition, research relating OCs to working memory is limited and mixed. Two factors may contribute to these mixed findings: 1) pharmacokinetics of oral contraceptives, which drive fluctuations in synthetic hormone levels; and 2) genetic polymorphisms related to dopamine degradation and working memory, which interact with E2. This research investigated whether the pharmacokinetics of oral contraceptives, in concert with the single nucleotide polymorphism (Val(158)Met; rs4680) of the catechol-o-methyltransferase gene (COMT), influence working memory performance. Methods University-age women taking and not taking OCs were tested for working memory and genotyped for COMT. If they were not taking OCs (n = 62), sessions occurred in the early follicular (low E2) and late follicular (high E2) phase. If they were taking OCs (n = 52), sessions occurred 1-2 hours after (high ethinyl estradiol, EE) and similar to 24 hours after (low EE) pill ingestion. Working memory was tested using the N-back, AX-CPT, Digit Span, and Digit Ordering Tasks. Data were analyzed using multilevel models with estrogen condition, COMT, and group as predictors, controlling for mood and practice effects. Results For women taking OCs, time of pill ingestion did not influence performance. However, the subgroup with COMT val/val (low dopamine) were less accurate on 2-back lure trials than those with COMT met/met (high dopamine). For women not taking OCs, cycle phase moderated COMT's influence on lure accuracy. When compared, women taking OCs had higher AX-CPT proactive control indices than those not taking OCs. Conclusion These findings suggest that oral contraceptives are not detrimental for young women's working memory and that they may increase proactive control. The more pronounced effects of COMT in women taking OCs suggests that, in women taking OCs, suppressed endogenous E2-not fluctuating EE levels-may be more relevant for working memory. Future studies are needed to differentiate effects of endogenous versus synthetic estrogens on working memory.

Automated summary

This study revealed that oral contraceptives do not have a negative impact on working memory in young women, and may even enhance proactive control. The more pronounced influence of COMT in women taking oral contraceptives suggests that suppressed endogenous E2 levels, rather than fluctuating EE levels, may be more relevant for working memory. Future research is needed to distinguish between the effects of endogenous and synthetic estrogens on working memory.