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Menstrual cycle influence on cognitive function and emotion processing—from a reproductive perspective
Open accessAbstract
The menstrual cycle has attracted research interest ever since the 1930s. For many researchers the menstrual cycle is an excellent model of ovarian steroid influence on emotion, behavior, and cognition. Over the past years methodological improvements in menstrual cycle studies have been noted, and this review summarizes the findings of methodologically sound menstrual cycle studies in healthy women. Whereas the predominant hypotheses of the cognitive field state that sexually dimorphic cognitive skills that favor men are improved during menstrual cycle phases with low estrogen and that cognitive skills that favor women are improved during cycle phases with increased estrogen and/or progesterone, this review has not found sufficient evidence to support any of these hypotheses. Mental rotation has gained specific interest in this aspect, but a meta-analysis yielded a standardized mean difference in error rate of 1.61 (95% CI -0.35 to 3.57), suggesting, at present, no favor of an early follicular phase improvement in mental rotation performance. Besides the sexually dimorphic cognitive skills, studies exploring menstrual cycle effects on tasks that probe prefrontal cortex function, for instance verbal or spatial working memory, have also been reviewed. While studies thus far are few, results at hand suggest improved performance at times of high estradiol levels. Menstrual cycle studies on emotional processing, on the other hand, tap into the emotional disorders of the luteal phase, and may be of relevance for women with premenstrual disorders. Although evidence at present is limited, it is suggested that emotion recognition, consolidation of emotional memories, and fear extinction is modulated by the menstrual cycle in women. With the use of functional magnetic resonance imaging, several studies report changes in brain reactivity across the menstrual cycle, most notably increased amygdala reactivity in the luteal phase. Thus, to the extent that behavioral changes have been demonstrated over the course of the menstrual cycle, the best evidence suggests that differences in sexually dimorphic tasks are small and difficult to replicate. However, emotion-related changes are more consistently found, and are better associated with progesterone than with estradiol such that high progesterone levels are associated with increased amygdala reactivity and increased emotional memory.
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“The results are in line with the conclusions of researchers who argued that cognitive performance does not change throughout the cycle [10,28–32,34].”
From Menstrual cycle effects on cognitive performance: A meta-analysis (2025) · cites this paper as [34]
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“one prior meta-analysis that examined a narrow set of cognitions using similar methods (mental rotation tasks) also did not find significant cycle differences [34].”
From Menstrual cycle effects on cognitive performance: A meta-analysis (2025) · cites this paper as [34]
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“Sample sizes are typically small [27,34], which limits generalizability of any one study.”
From Menstrual cycle effects on cognitive performance: A meta-analysis (2025) · cites this paper as [34]
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“杏仁核是大脑引起月经周期相关研究中关注的 主要区域之一 [33] ，其机制与杏仁核中表达了大量与月 经周期相关的孕酮和雌激素受体有关 [34] 。 Bayer 等 [35] 发现整个月经周期的激素波动会显著影响杏仁核的 活动。此外，一项月经周期研究 [36] 表明，所有这些变 化都可能与女性的经前紊乱有关。因此，杏仁核容 易受到月经周期相关变化的影响，并可能参与经前 紊乱的表征。健康女性在月经周期黄体中期或晚期 期间，在负效图像处理中，左杏仁核激活增强 [37] ，孕 酮治疗后的类似发现也证实了这一点 [38] 。 PMS/PMDD 作为一种与月经周期变化及激素节律性分泌相关的 疾病 [2]…”
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Premenstrual Dysphoric Disorder: Etiology, Risk Factors, and Biomarkers
Keijser, R., Hysaj, E., Opatowski, M., Yang, Y., & Lu, D. (2025) · Springer eBooks · doi:10.1007/978-3-031-73368-0_123 · Cited by 1
Fu, Z., Feng, M., Chao, C., & Gong, P. (2024) · International Symposium of Chinese CHI (Chinese CHI) · doi:10.1145/3758871.3758943
Influence of premenstrual syndrome on attentional capture by expressions in the luteal phase
Álvarez, F., Veiga-Zarza, E., Fernández‐Folgueiras, U., Pita, M., Kessel, D., & Carretié, L. (2025) · Hormones and Behavior · doi:10.1016/j.yhbeh.2025.105846 · Cited by 1
Association of Menstrual Cycle with Fronto-Striatal Connectivity and Delay Discounting
Yang, M. W. O., Xie, J., An, X.-F., & Zhuang, J.-Y. (2025) · Behavioral Sciences · doi:10.3390/bs15121747
“Inconsistencies extend to the behavioral level, where methodologically sound studies often fail to demonstrate robust menstrual cycle effects on cognitive performance (Le et al., 2020; Sundström-Poromaa, 2018; Sundström-Poromaa & Gingnell, 2014).”
Leeners, B., Kruger, T. H. C., Geraedts, K., Tronci, E., Mancini, T., Ille, F., Egli, M., Röblitz, S., Saleh, L., Spanaus, K., et al. (2017) · Zürcher Hochschule für Angewandte Wissenschaften digital collection (Zurich University of Applied Sciences) · doi:10.21256/zhaw-1585
Oestradiol modulates the brain age gapPreprint
Denninger, A. F., Kaufmann, T., Poromaa, I. S., Derntl, B., & Kogler, L. (2025) · medRxiv · doi:10.64898/2025.12.23.25342899
Liebram, R., Bockshecker, A., Hoffmann, S. F., Liepelt, R., & Smolnik, S. (2025) · Lecture notes in information systems and organisation · doi:10.1007/978-3-032-00815-2_10
Torabi, R., Nasiri, F., & Rahmani, F. (2026) · Archives of Women s Mental Health · doi:10.1007/s00737-026-01684-4
How do menstrual cycle and emotional expressions affect attentional and memory biases?
Ertan, Ö., Gunduz, H., Erdoğan, Ş., Doğan, D., & Baran, Z. (2026) · Current Psychology · doi:10.1007/s12144-025-08617-x
Douglas, K. M., Sukhapure, M., Porter, R., Fenton, A. J., & Eggleston, K. (2026) · Archives of Women s Mental Health · doi:10.1007/s00737-026-01725-y
Aravind, A. B., S., V. P., Rajeswari, S., Meera, M. R., Bastine, A. M., Santhosh, G., Ashraf, M., Tomy, C., Ajay, A., & Sasidharan, N. (2026) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20261771
Deng, Z., Sun, Z., Wu, Y., Wu, J., Pan, P., Wei, L., & Song, X. (2026) · Science and Medicine in Football · doi:10.1080/24733938.2026.2682128
Lerner, Y., Krasnoshtein, M., Bloch, M., Tevet, M., Doron, M., Gonen, T., Hendler, T., & Tene, O. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1776826
AHMADOVA, P. (2026) · Mediterranean Journal of Humanities · doi:10.13114/mjh.1894548
The Menstrual Distress Questionnaire (MEDI-Q): reliability and validity of the German version
Görlich, Y., & Richter, E. (2026) · BMC Women s Health · doi:10.1186/s12905-026-04608-7
Salvatore, G. M., Benasi, G., Harsora, R., Butryn, M. L., Mogle, J. A., & Arigo, D. (2026) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2026.2706211
Khanam, G., Singh, S., Ubaidullah, M., & Verma, D. K. (2026) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20262642
Schlüter, M.-C., Pinnow, M., Brüne, M., & Lewald, J. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.07.29.741520
Vascular Involvement in Cognitive Impairment: Sex Differences
Griffin, A., Bhopatkar, A. A., Butler, K. R., Williams, J. M., Hinton, A., & Wallace, K. L. (2026) · Physiology in health and disease · doi:10.1007/978-3-032-26472-5_23
Giudetti, F., Tonetti, L., Natale, V., & Fabbri, M. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1885699
“Thus, future studies should record and control for the menstrual cycle phase, even though research on menstrual cycle-dependent cognitive changes has yielded inconsistent results, suggesting that such effects on cognitive functions are relatively small (e.g., Sundström Poromaa and Gingnell, 2014).”
Zhao, R., Yun, M., Zhang, W., Hu, X., & 张新平 (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1935645
Metadata
- Authors
- Sundström Poromaa, I., & Gingnell, M.
- Affiliations
- Uppsala University (SE)
- ORCID
- Gingnell, Malin
- Venue
- Frontiers in Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2014-11-24
- Volume
- 8
- Pages
- 380-380
- ISSN
- 1662-453X (ISSN-L)
- PMC
- PMC4241821
- OpenAlex
- W2019634736
- Cited by
- 291
- References
- 132
- Citations by year
- 2026: 20 · 2025: 25 · 2024: 18 · 2023: 18 · 2022: 18 · 2021: 30 · 2020: 34 · 2019: 32 · 2018: 30 · 2017: 28 · 2016: 17 · 2015: 19 · 2014: 1
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Neuroscience (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Estrogen and related hormone effects
- Keywords
- menstrual cycle, cognitive function, emotional processing, ovarian steroids, estradiol, progesterone, sexual dimorphism, mental rotation, working memory, prefrontal cortex, luteal phase, premenstrual disorders, amygdala reactivity, emotional memory, fear extinction, emotion recognition
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