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Effects of hormonal contraceptives on mental rotation and verbal fluency
Abstract
Cognitive abilities, such as verbal fluency and mental rotation, are most sensitive to changes in sex steroids but poorly studied in the context of hormonal contraceptive usage. Therefore, we investigated the performance of mental rotation and verbal fluency in young (21.5±1.8 years) healthy oral contraceptive (OC) users (23 women) and non-users (20 women) during the follicular, ovulatory and luteal phases of the menstrual cycle. Salivary 17β-estradiol, progesterone and testosterone levels were assayed to evaluate hormonal differences between groups and the phases of the menstrual cycle. To assess the effects of progestins having androgenic/anti-androgenic properties, OC users were subdivided into the third and new generation OC users. In addition, positive and negative affects as factors possibly affecting cognitive performance were evaluated. Salivary 17β-estradiol and progesterone levels were significantly lower in hormonal contraception users. Level of salivary testosterone was slightly lower in the OC users group with significant difference only during ovulatory phase. Naturally cycling women performed better on verbal fluency task as compared to OC users. Subjects who used the third generation (androgenic) OCs generated significantly fewer words as compared to new generation (anti-androgenic) OC users and non-users. The third generation OC users demonstrated significantly longer RT in MRT task as compared to non-users. The MRT, verbal fluency and mood parameters did not…
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“Griksiene and Ruksenas (2011) found verbal and spatial performance differences between women using different types of hormonal birth control”
From Factors Related to Mean Score Group Differences on Cognitive Ability Tests: A Systematic Review (2025) · cites this paper as Griksiene and Ruksenas (2011)
In the citing paper
“several papers detail oral contraceptive use and type influences CAT performance on verbal and spatial task (Griksiene & Ruksenas, 2011;Hampson et al., 2022)”
From Factors Related to Mean Score Group Differences on Cognitive Ability Tests: A Systematic Review (2025) · cites this paper as Griksiene & Ruksenas, 2011
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Li, J., & Deng, S. W. (2022) · Physiology & Behavior · doi:10.1016/j.physbeh.2022.113808 · Cited by 3
The effect of mental rotation on changes in plasma testosterone and cortisol levels
Durdiaková, J., Hodosy, J., Kubranská, A., Ostatníková, D., & Celec, P. (2012) · Central European Journal of Biology · doi:10.2478/s11535-012-0084-6 · Cited by 2
Mehrez, A. B., Habacha, H., & Souissi, N. (2026) · Psychological Research · doi:10.1007/s00426-026-02344-z · Cited by 1
“…rota - tion performance in naturally cycling women (Hausmann et al., 2000), and that hormonal contraceptive use is associated with altered MR performance relative to naturally cycling women, although the direction of the effect remains debated (Griksiene & Ruksenas, 2011; Pletzer et al., 2018 ).”
Hampson, E. (2025) · Hormones and Behavior · doi:10.1016/j.yhbeh.2025.105800 · Cited by 1
“Recent studies of cognitive function in COC users have not controlled for pregnancy history (e.g., Beltz et al., 2015; Griksiene and Ruksenas, 2011).”
Noachtar, I., & Pletzer, B. (2025) · Hormones and Behavior · doi:10.1016/j.yhbeh.2025.105790 · Cited by 1
“For example, androgenic COC-users compared to non-users responded slower to mental rotation stimuli (Griksiene and Ruksenas, 2011).”
InfluentialTask-domain and hemisphere-asymmetry effects in cisgender and transmale individuals
Burgund, E. D. (2021) · PLoS ONE · doi:10.1371/journal.pone.0260542 · Cited by 4
Cognition across the lifespan: age, gender, and sociodemographic influencesPreprint
Nichols, E. S., Wild, C. J., Owen, A. M., & Soddu, A. (2019) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/804765 · Cited by 2
“Differences in verbal processing have been less clear, with some suggesting that they are due to variability in instruction and strategy (Scheuringer et al., 2017; Scheuringer & Pletzer, 2017), and others suggesting a hormonal link (Burton et al., 2005; Griksiene & Ruksenas, 2011).”
Gonadal Hormones are Associated with Body Shape and Symptoms of Disordered Eating in Women
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Simonson, J., Durdle, C. A., & Miller, M. B. (2023) · Psi Chi Journal of Psychological Research · doi:10.24839/2325-7342.jn28.4.264 · Cited by 1
“Previous studies have found that birth control can have widespread effects on areas such as brain structure (gray matter volume; Pletzer et al., 2010), emotion (Lewis et al., 2019), and improved verbal fluency (Griksiene & Ruksenas, 2011) among other cognitive domains (Warren et al., 2014).”
BackgroundA New Combination of Testosterone and Nestorone Transdermal Gels for Male Hormonal Contraception
Meikle, A. (2013) · Yearbook of Endocrinology · doi:10.1016/j.yend.2012.12.002 · Cited by 1
Factors Related to Mean Score Group Differences on Cognitive Ability Tests: A Systematic Review
Cuppello, S., Zibarras, L. D., & Corr, P. J. (2025) · Trends in Psychology · doi:10.1007/s43076-025-00504-5
Li, X., Zang, N., Zhao, Q.-R., Sun, Y.-X., Kumar, U. K. S., Hua, M., Zhou, W.-Y., Qi, Y.-Y., Chen, H., Xia, L., et al. (2026) · Science Bulletin · doi:10.1016/j.scib.2026.08.057
Wang, X., & Guo, Y. (2026) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70875
“54,55 The most likely reason for the differences in the results of previous studies is the different types of OCPs.”
Lagunas, N., Sánchez-Giraldo, L. M., Grassi, D., Diéguez-Risco, T., & de la Torre‐Luque, A. (2026) · Acta Neuropsychiatrica · doi:10.1017/neu.2025.10053
“Differences in phonological fluency have previously been reported in relation to menstrual cycle phase and COC use (Griksiene and Ruksenas, 2011; Simi´c & Santini, 2012).”
Could the Contraceptive Pill Pose a Risk to Brain Development in Young Girls?
Ecochard, R. (2025) · The Linacre Quarterly · doi:10.1177/00243639251389448
“We have the following for example: (cid:129) Hormonal contraception has an impact on women ’ s verbal and spatial abilities (Griksiene and Ruksenas 2011).”
InfluentialExposure to Estrogenic Endocrine Disrupting Chemicals and Brain Health
Preciados, M. (2018) · FIU - Digital Commons (Florida International University) · doi:10.25148/etd.fidc006573
Premenstrual Dysphoric Disorder
Agyemang, A. (2017) · doi:10.1007/978-3-319-57111-9_9173
“…as olfaction (Doty & Cameron, 2009), vision (Lusk, Carr, Ranson, Bryant, & Felmingham, 2015), and pain (Veldhuijzen et al., 2013), verbal fluency (Griksiene & Ruksenas, 2011; Maki, Rich, & Rosenbaum, 2002; Mordecai, Rubin, & Maki, 2008; Solís-Ortiz & Corsi-Cabrera, 2008), visuospatial abilities…”
Metadata
- Authors
- Griksiene, R., & Ruksenas, O.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 36
- Issue
- 8
- Pages
- 1239-1248
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2011880684
- Cited by
- 128
- References
- 0
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 4 · 2023: 9 · 2022: 16 · 2021: 9 · 2020: 16 · 2019: 9 · 2018: 9 · 2017: 5 · 2016: 10 · 2015: 6 · 2014: 10 · 2013: 9 · 2012: 1
- FWCI
- 6.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Spatial Cognition and Navigation
- Keywords
- oral contraceptives, mental rotation, verbal fluency, progestins, androgenic progestins, salivary estradiol, salivary progesterone, salivary testosterone, menstrual cycle phases, cognitive performance, spatial ability, mood, young women
- MeSH terms
- Adult, Affect, Contraceptives, Oral, Hormonal, Female, Humans, Male, Mental Processes, Neuropsychological Tests, Rotation, Space Perception, Task Performance and Analysis, Verbal Behavior, Young Adult
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