The influence of estradiol and progesterone on neurocognition during three phases of the menstrual cycle: Modulating factors

This paper is dedicated to the memory of the first professor of Behavioral Endocrinology in the Faculty of Psychology at the University of Granada, Prof. Filomena Molina. We are grateful to Daniel Robert Caldera Jr. for his assistance with the English. This study was supported by the Spanish Ministry of Economy, Industry and Competitiveness (National I + D Plan: PSI2017-89324-C2-1-P and PSI2017-89324C2-2-P). Funding for open access charge: Universidad de Granada/CBUA.
Estradiol is an ovarian steroid hormone that peaks shortly before ovulation and significantly affects various brain regions and neurotransmitter systems, with similar and differential effects with progesterone, another ovarian hormone. Studies investigating the neurocognitive processes during the menstrual cycle have focused on the early follicular phase (EFP) characterized by low estradiol and progesterone levels and the mid-luteal phase (MLP) with high estradiol and progesterone levels. However, most studies have failed to include the ovulatory phase, characterized by high estradiol and low progesterone levels. Given the various hormonal changes in the menstrual cycle, we revisited studies suggesting that the menstrual cycle did not affect verbal and spatial abilities and observed that many contain mixed results. Comparing these studies makes it possible to identify relevant modulating factors, such as sample size, participant age, accurate selection of days for testing, asymmetrical practice effects, genetic polymorphisms, and task difficulty. More robust findings are related to improved mental rotation capacity during EFP with challenging tasks and differences in brain activation among menstrual cycle phases during the execution of spatial and verbal tasks. During MLP, less robust findings were observed, possibly modulated by the complex effects of the two hormones on the brain. In conclusion, we propose that it is crucial to include all three menstrual cycle phases and consider these modulating factors to avoid confounding findings.
Spanish Ministry of Economy, Industry and Competitiveness PSI2017-89324-C2-1-P PSI2017-89324C2-2-P
Universidad de Granada/CBUA