Evidence suggests impairment in aspects of cognitive function in women with polycystic ovary syndrome (PCOS). Direct effects of raised testosterone levels associated with PCOS are a potential mechanism. We aimed to explore the relationship between testosterone levels and cognitive functioning in women. Women with a range of testosterone levels, including women with PCOS, were recruited. Depressive and anxiety symptoms were measured by self-report. Participants underwent a comprehensive battery of cognitive tests assessing psychomotor speed, visuospatial learning and memory, verbal learning and memory, and executive function. Free testosterone serum levels were assessed. All measures were completed at the same time point. Correlation analysis (Spearman’s Rho) was used to explore associations between free testosterone and cognitive test variables. Eighty-one women were recruited, with 40 meeting diagnostic criteria for PCOS. Free testosterone was normally distributed, with significant overlap between women with PCOS and controls. Mean depressive and anxiety symptoms were in the mild range. Higher free testosterone levels were significantly correlated with poorer performance on measures assessing psychomotor speed and visuospatial learning. These significant correlations remained after adjusting for confounders (premorbid verbal IQ, depressive, and anxiety symptoms). Higher free testosterone levels in women were associated with poorer cognitive function, specifically psychomotor speed and visuospatial learning. Women with PCOS and raised free testosterone levels may experience impairment in these aspects of cognitive function which are not accounted for by mood or anxiety symptoms.
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KD was supported by a Sir Charles Hercus Health Research Fellowship from the Health Research Council of New Zealand (ref: 19/082) during completion of this paper.
The study was approved by the University of Otago Human Ethics Committee (ref: H14/047).
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RP and KD have used software provided by Scientific Brain Training Pro (SBT-Pro) for research at no cost. RP has received support for travel to educational meetings from Servier and Lundbeck.
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Sukhapure, M., Eggleston, K., Douglas, K. et al. Free testosterone is related to aspects of cognitive function in women with and without polycystic ovary syndrome. Arch Womens Ment Health 25, 87–94 (2022). https://doi.org/10.1007/s00737-021-01158-9