Differences in verbal memory, visuospatial ability and cognitive inhibition among young women using drospirenone and ethinyl oestradiol oral contraceptives versus naturally cycling controls

Abstract Objective: This study aimed to investigate the differences on cognitive performance across four cognitive domains – verbal memory, language fluency, visuospatial ability and cognitive inhibition – between drospirenone and ethinyl oestradiol (DRSP/EE) users and naturally cycling women in the luteal phase (LP). The goal was to determine whether hormonal suppression associated with DRSP/EE use is linked to domain-specific cognitive alterations. Methods: A total of 48 young adult women were assessed: 23 using DRSP/EE (with pharmacologically suppressed endogenous hormonal levels) and 25 naturally cycling during the LP. Participants completed standardised neuropsychological tasks measuring verbal memory, language fluency, visuospatial ability and cognitive inhibition. Group comparisons analyses were conducted. Results: Significant group differences were observed in verbal memory, visuospatial ability and cognitive inhibition, while no significant group differences were found in language fluency. Women using DRSP/EE showed significantly lower performance in verbal memory ( U = 165, p = 0.009, r = 0.38) and visuospatial ability ( U = 155, p = 0.006, r = 0.40) tasks compared to naturally cycling women. In contrast, they demonstrated higher performance in cognitive inhibition, quantified by a significantly higher Stroop interference score ( t (46) = 2.710, p = 0.009, d = 0.783). Conclusion: The present findings suggest that the use of DRSP/EE oral contraceptives is associated with differences across specific cognitive domains compared to naturally cycling women in the LP. The observed pattern – lower performance in hippocampus-related domains (verbal memory and visuospatial ability) paired with higher performance on a frontal-lobe-dependent task (cognitive inhibition) – is consistent with existing evidence suggesting that suppression of endogenous ovarian hormones may differentially influence cognitive functions. These behavioural associations underscore the need for further domain-specific research into the long-term cognitive implications of combined oral contraceptives.