Hormonal contraceptive intake during adolescence and cortical brain measures in the ABCD Study

Adolescence is a critical period for brain development, shaped in part by rising levels of sex steroids. During this time, some females initiate the use of hormonal contraception (HC), which suppresses endogenous ovarian hormone production. Using data from the ABCD Study’s four-year follow-up (average age = 14 years), we used exploratory analyses to examine cortical thickness, surface area, and volume in 65 HC users (HC + ) and 1169 non-users (HC−). HC + participants showed significantly thinner cortex in the bilateral paracentral gyrus, adjusting for puberty stage or age, as well as intracranial volume. While salivary testosterone and dehydroepiandrosterone levels were lower in HC + , regression and correlation analyses revealed minimal contribution of endogenous hormones on brain structure ( < 2.8% explained variance). These findings suggest that group differences in brain structure are not primarily driven by endogenous hormone levels. Longitudinal studies are needed to investigate the effects of HC use on adolescent brain development as additional data become available.