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Here, we used a randomized, double\u2010blind, placebo\u2010controlled crossover design to test for conceptual replication of three prior studies and to explore broader network\u2010level effects of OCPs. Replication analyses largely did not confirm previously reported seed\u2010based connectivity changes in edges containing amygdala, putamen, or dorsal anterior cingulate nodes (<jats:italic>p<\/jats:italic>s &gt;\u20090.05). In the absence of a clear replication, we pursued exploratory analyses using functional connectome fingerprinting, a multivariate, data\u2010driven method that allows parsimonious interrogation of connectivity changes simultaneously across the whole by detecting whole\u2010brain connectivity patterns that distinguish individuals from one another. This approach revealed network\u2010level changes during OCP use, especially within subcortical, executive, and somatomotor circuits. OCPs also increased between\u2010subject similarity in functional connectomes (<jats:italic>I<\/jats:italic><jats:sub><jats:italic>other<\/jats:italic><\/jats:sub>, <jats:italic>p<\/jats:italic><jats:sub>FWE<\/jats:sub> &lt;\u20090.001), suggesting a loss of individual idiosyncrasy while using OCPs. Intraclass correlations indicated that idiosyncrasy was significantly lowered in the default mode, executive, limbic, salience, somatomotor, and subcortical networks (all <jats:italic>p<\/jats:italic><jats:sub>FWE<\/jats:sub> &lt;\u20090.05). Finally, changes in functional connectivity were significantly associated with increases in negative affect, with 13 connectivity edges showing significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) correlations with DRSP symptom scores. These findings suggest that OCPs induce widespread and individually meaningful alterations to brain network organization, which may underlie mood\u2010related side effects and should be considered in future neuroimaging research involving hormonal contraceptive users.<\/jats:p>","DOI":"10.1002\/hbm.70318","type":"journal-article","created":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T12:19:34Z","timestamp":1754741974000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Oral Contraceptive Pills on Brain Networks: A Conceptual Replication and Extension"],"prefix":"10.1002","volume":"46","author":[{"given":"Gino","family":"Haase","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences University of Cambridge, Addenbrooke's Hospital  Cambridge UK"},{"name":"Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine, UCLA  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine, UCLA  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Jordan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine, UCLA  Los Angeles California USA"},{"name":"Department of Anesthesiology Emory School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rapkin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology David Geffen School of Medicine at UCLA  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edythe D.","family":"London","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine, UCLA  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4341-8282","authenticated-orcid":false,"given":"Nicole","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine, UCLA  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010018\u201025089\u20101"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201010575\u20109"},{"key":"e_1_2_10_4_1","unstructured":"Andersson J. 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