The scientific body of knowledge – Whose body does it serve? A spotlight on oral contraceptives and women’s health factors in neuroimaging
Section snippets
Brief review of sex hormone action in the central nervous system
Sex steroid hormones (androgens, estrogens, progestogens) are produced primarily by the gonads and coordinate the physiological changes that occur during puberty, the menstrual cycle, pregnancy, and menopause. Within the central nervous system, estrogen and progesterone receptors are expressed widely throughout the brain (McEwen, 2002, McEwen and Alves, 1999, Rossetti et al., 2016), with enriched expression in extra-hypothalamic regions such as the hippocampus and prefrontal cortex (PFC) (Almey
Identifying blind spots in human neuroimaging
While animal studies have documented the role of sex hormones in the brain for decades, human neuroimaging research has not kept pace. Given a groundswell of evidence that sex hormones regulate the structure and function of the mammalian brain, we sought to document the frequency with which human neuroimaging studies consider endocrine factors. We approached this in two ways. First, to capture a contemporary state of the field, we analyzed every empirical human neuroimaging paper (i.e.,
A spotlight on oral hormonal contraceptives
Perhaps one of the most striking illustrations of this oversight is neuroscience’s neglect with respect to one of the largest natural experiments in human history (Beltz and Moser, 2019): over the past half-century, women have used oral hormonal contraceptives without full knowledge of their influence on the central nervous system, as few rigorous human neuroimaging studies of oral hormonal contraception (OC) have been conducted. Here, we use OC to highlight the missed opportunities in our
A roadmap for the future: Harnessing new methodological and technological approaches to bolster women’s health research
Beyond OC, there are many other opportunities to expand research efforts to advance knowledge on women’s health in cognitive neuroscience. Below we propose three programmatic initiatives to aid in this pursuit. We describe “Big Data” approaches, including the University of California Women’s Brain Initiative, that are beginning to address unmet areas of women’s health research at the population level. Next, we describe innovations in methodological and computational approaches in human
Conclusion
Fifty years of basic science research has established a critical role for sex hormones in higher-order brain regions, including the hippocampus and prefrontal cortex. Yet, human brain imaging studies often overlook basic elements of endocrinology and women’s reproductive health. Moving forward, large-scale population-based studies, targeted dense-sampling studies, and translational research will provide novel insight into sex hormone action in the mammalian brain. Applying a women’s health lens
Funding
This work was supported by the Harvey L. Karp Discovery Award (CMT), the Brain and Behavior Research Foundation (EGJ), and the Hellman Family Fund (EGJ).
Acknowledgments
Thank you to Bridget Queenan and Michael J. Goard for helpful edits and feedback. We also thank Emily Cao and Bridget Bush for assistance with data collection.
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