The pill was approved by the FDA in 1960.

More than 100 million people use hormonal contraceptives every day, making them one of the most prescribed drugs in the world.

Synthetic hormones are delivered into the bloodstream to prevent pregnant women from getting pregnant. Synthetic hormones prevent the body's own hormones from stimulating ovulation, so no eggs are released, no fertilization can take place, and pregnancies are prevented.

Natural hormones have been shown to affect behavior in humans and other animals. The behavioral effects of synthetic hormones are unknown.

The hormones affected by the pill are related to competitive behavior. We wanted to find out more about how hormonal contraceptives change this behavior, so we looked at all the research we could find.

Hormones and competition

Life is a competition. Money, food, mates and allies are some of the resources we compete for to fulfill our needs.

Social status can be an intangible thing that gives us access to more direct goods. It is possible that a high-status individual has better opportunities for education and employment.

Three hormones have been linked to competitive behavior, and contraceptives affect them.

We reviewed 46 studies to understand the role of contraceptives in competition. There was a measure of competition in the research.

Status and motivation

Hormonal contraceptives may have an impact on women's motivation and ability to achieve higher status, according to our review.

Lower achievement motivation is shown in one study.

There is a study showing lower performance on tasks. People achieve higher status by demonstrating skills.

Mating choices

Competition could be affected by the pill. Women who use hormonal contraceptives do not feel more attractive mid-cycle.

It's possible that contraceptives diminish a fertility-inducing increase in feelings of desirability.

We found no evidence that contraceptive users are attracted to different types of men. There was no evidence that users behave differently when competing for financial resources than non- users.

The effect of contraceptives on sex was dependent on the relationship status of the participants. One study showed that the use of contraceptives made women less competitive in their relationships.

Synthetic hormones could affect women differently. It's possible that single and partner women have other differences that influence their behavior.

Small effect sizes and methodological limitations

The behavioral differences between those who use contraceptives and those who don't were relatively small.

Much of the existing research on the effects of contraceptives is hampered by methodological limitations.

The gold standard for determining the effectiveness of a drug or treatment is randomized controlled trials.

We found that many studies didn't account for other differences between contraceptive users and non-users. There are factors that could explain behavior differences.

It's hard to generalize to a wider population because of the small sample sizes. Non-white women were not included in the research.

The types of contraceptives that people were using weren't reported in many studies. It's not possible to determine if contraceptives are associated with the same outcomes.

The findings in our review are only preliminary.

Where to from here?

The effects of contraceptives are poorly understood despite 60 years of widespread use. They can be used for many other things besides birth control, such as to reduce premenstrual symptoms, resolve hormone imbalances, or deal with the symptoms of cysts.

There are huge benefits to having access to contraceptives. Increased female participation in higher education is associated with reduced female poverty.

We need reliable and robust evidence about the full effects of contraceptives in order to make informed decisions.

We have the right to contraceptives, but we also have the right to better contraceptives. It will require a lot more research.

Lindsie Arthur is a PhD Candidate in the School of Psychological Sciences at The University ofMELBOURne.

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