Published 2026-04-22
Keywords
- oral contraceptives,
- boredom,
- flow,
- deep effortless concentration
How to Cite
Copyright (c) 2026 Alyssa C. Smith, Jeremy Marty-Dugas, Daniel Smilek

This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Across two samples, we investigated the relation between oral contraceptive (OC) use and self-reports of boredom and flow proneness in undergraduate females using OCs (Sample 1: OC group N = 343, Sample 2: OC group N = 162) and females not using any form of hormonal contraceptives (Sample 1: Non-OC group N = 1191, Sample 2: Non-OC group N = 852). We measured boredom proneness and the tendency to experience ‘flow’, defined as the experience of deep and effortless concentration; we also measured semester of data collection and symptoms of depression, anxiety and stress to use as control variables. Although there were some differences between samples, the key findings were that (1) boredom proneness and flow scores showed a modest negative correlation in both samples indicating they are associated but not simply opposite constructs; (2) OC users reported significantly less boredom proneness than non-users in Sample 2 and when the samples were combined, but this relation did not reach significance in Sample 1; (3) the association between OC use and boredom proneness remained even when semester of data collection and symptoms of depression, anxiety and stress were controlled; and that (4) there were no differences between OC and Non-OC groups for measures of flow proneness. Thus, OC use is related to reduced boredom proneness, although this relation is small.
References
- American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association, 21(21), 591–643.
- Andraszewicz, S., Scheibehenne, B., Rieskamp, J., Grasman, R., Verhagen, J., & Wagenmakers, E. J. (2015). An Introduction to Bayesian Hypothesis Testing for Management Research. Journal of Management, 41(2), 521–543. https://doi.org/10.1177/0149206314560412
- Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric Properties of the 42-item and 21-item Versions of the Depression Anxiety Stress Scales in Clinical Groups and a Community Sample. Psychological Assessment, 10(2), 176–181. https://doi.org/10.1037/1040-3590.10.2.176
- Banks, W. A. (2012). Brain Meets Body: The Blood-brain Barrier as an Endocrine Interface. Endocrinology, 153(9), 4111–4119. https://doi.org/10.1210/en.2012-1435
- Becker, D., Creutzfeldt, O. D., Schwibbe, M., & Wuttke, W. (1982). Changes in Physiological, EEG and Psychological Parameters in Women During the Spontaneous Menstrual Cycle and Following Oral Contraceptives. Psychoneuroendocrinology, 7(1), 75–90. https://doi.org/10.1016/0306-4530(82)90057-9
- Beltz, A. M. (2022). Hormonal Contraceptive Influences on Cognition and Psychopathology: Past Methods, Present Inferences, and Future Directions. Frontiers in Neuroendocrinology, 67, 101037. https://doi.org/10.1016/j.yfrne.2022.101037
- Beltz, A. M., Hampson, E., & Berenbaum, S. A. (2015). Oral Contraceptives and Cognition: A Role for Ethinyl Estradiol. Hormones and Behavior, 74, 209–217. https://doi.org/10.1016/j.yhbeh.2015.06.012
- Beltz, A. M., Loviska, A. M., Kelly, D. P., & Nielson, M. G. (2022). The Link Between Masculinity and Spatial Skills Is Moderated by the Estrogenic and Progestational Activity of Oral Contraceptives. Frontiers in Behavioral Neuroscience, 15, 777911. https://doi.org/10.3389/fnbeh.2021.777911
- Bradshaw, H. K., Mengelkoch, S., & Hill, S. E. (2020). Hormonal Contraceptive Use Predicts Decreased Perseverance and Therefore Performance on Some Simple and Challenging Cognitive Tasks. Hormones and Behavior, 119, 104652. https://doi.org/10.1016/j.yhbeh.2019.104652
- Carriere, J. S., Cheyne, J. A., & Smilek, D. (2008). Everyday Attention Lapses and Memory Failures: The Affective Consequences of Mindlessness. Consciousness and Cognition, 17(3), 835–847. https://doi.org/10.1016/j.concog.2007.04.008
- Cheslack-Postava, K., Keyes, K. M., Lowe, S. R., & Koenen, K. C. (2015). Oral Contraceptive Use and Psychiatric Disorders in a Nationally Representative Sample of Women. Archives of Women’s Mental Health, 18, 103–111. https://doi.org/10.1007/s00737-014-0453-4
- Cheyne, J. A., Carriere, J. S., & Smilek, D. (2006). Absent-mindedness: Lapses of Conscious Awareness and Everyday Cognitive Failures. Consciousness and Cognition, 15(3), 578–592. https://doi.org/10.1016/J.CONCOG.2005.11.009
- Csikszentmihalyi, M. (2000). Beyond Boredom and Anxiety. Jossey-bass.
- Csikszentmihalyi, M., & Csikszentmihalyi, I. S. (1988). Optimal Experience: Psychological Studies of Flow in Consciousness. Cambridge University Press.
- Dadzie, V. B., Drody, A., & Danckert, J. (2024). Exploring the Relationship Between Boredom Proneness and Agency. Personality and Individual Differences, 222, 112602. https://doi.org/10.1016/j.paid.2024.112602
- Damoiseaux, V. A., Proost, J. H., Jiawan, V. C., & Melgert, B. N. (2014). Sex Differences in the Pharmacokinetics of Antidepressants: Influence of Female Sex Hormones and Oral Contraceptives. Clinical Pharmacokinetics, 53, 509–519. https://doi.org/10.1007/s40262-014-0145-2
- Danckert, J., & Merrifield, C. (2018). Boredom, Sustained Attention and the Default Mode Network. Experimental Brain Research, 236, 2507–2518. https://doi.org/10.1007/s00221-016-4617-5
- Doornweerd, A. M., Branje, S., Nelemans, S. A., Meeus, W. H., Montoya, E. R., Engelhard, I. M., Oldehinkel, A. J., & Gerritsen, L. (2022). Stable Anxiety and Depression Trajectories in Late Adolescence for Oral Contraceptive Users. Frontiers in Psychiatry, 13, 799470. https://doi.org/10.3389/fpsyt.2022.799470
- Duke, J. M., Sibbritt, D. W., & Young, A. F. (2007). Is There an Association Between the Use of Oral Contraception and Depressive Symptoms in Young Australian Women?. Contraception, 75(1), 27–31. https://doi.org/10.1016/j.contraception.2006.08.002
- Eastwood, J. D., Frischen, A., Fenske, M. J., & Smilek, D. (2012). The Unengaged Mind: Defining Boredom in Terms of Attention. Perspectives on Psychological Science, 7(5), 482–495. https://doi.org/10.1177/1745691612456044
- Farmer, R., & Sundberg, N. D. (1986). Boredom Proneness: The Development and Correlates of a New Scale. Journal of Personality Assessment, 50(1), 4–17. https://doi/10.1207/s15327752jpa5001_2
- Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G* Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/bf03193146
- Fester, L., & Rune, G. M. (2021). Sex Neurosteroids: Hormones Made by the Brain for the Brain. Neuroscience Letters, 753, 135849. https://doi.org/10.1016/j.neulet.2021.135849
- Frye, C. A. (2006). An Overview of Oral Contraceptives: Mechanism of Action and Clinical Use. Neurology, 66(3), S29–S36. https://doi.org/10.1212/wnl.66.66_suppl_3.s29
- Galea, L. A., Frick, K. M., Hampson, E., Sohrabji, F., & Choleris, E. (2017). Why Estrogens Matter for Behavior and Brain Health. Neuroscience & Biobehavioral Reviews, 76, 363–379. https://doi.org/10.1016/j.neubiorev.2016.03.024
- Gravelsins, L., Duncan, K., & Einstein, G. (2021). Do Oral Contraceptives Affect Young Women’s Memory? Dopamine-dependent Working Memory Is Influenced by COMT Genotype, but Not Time of Pill Ingestion. PloS One, 16(6), e0252807. https://doi.org/10.1371/journal.pone.0252807
- Gogos, A. (2013). Natural and Synthetic Sex Hormones: Effects on Higher-order Cognitive Function and Prepulse Inhibition. Biological Psychology, 93(1), 17–23. https://doi.org/10.1016/j.biopsycho.2013.02.001
- Goldberg, Y. K., Eastwood, J. D., LaGuardia, J., & Danckert, J. (2011). Boredom: An Emotional Experience Distinct from Apathy, Anhedonia, or Depression. Journal of Social and Clinical Psychology, 30(6), 647–666. https://doi/10.1521/jscp.2011.30.6.647
- Gurvich, C., Warren, A. M., Worsley, R., Hudaib, A. R., Thomas, N., & Kulkarni, J. (2020). Effects of Oral Contraceptive Androgenicity on Visuospatial and Social-emotional Cognition: A Prospective Observational Trial. Brain Sciences, 10(4), 194. https://doi.org/10.3390/brainsci10040194
- Gurvich, C., Nicholls, I., Lavale, A., & Kulkarni, J. (2023). Oral Contraceptives and Cognition: A Systematic Review. Frontiers in Neuroendocrinology, 69, 101052. https://doi.org/10.1016/j.yfrne.2022.101052
- Hamstra, D. A., de Kloet, E. R., de Rover, M., & Van der Does, W. (2017). Oral Contraceptives Positively Affect Mood in Healthy PMS-free Women: A Longitudinal Study. Journal of Psychosomatic Research, 103, 119–126. https://doi.org/10.1016/j.jpsychores.2017.10.011
- Herrera, A. Y., Velasco, R., Faude, S., White, J. D., Opitz, P. C., Huang, R., Harrewijn, A., & Mather, M. (2020). Brain Activity During a Post-stress Working Memory Task Differs Between the Hormone-present and Hormone-absent Phase of Hormonal Contraception. Neurobiology of Stress, 13, 100248. https://doi.org/10.1016/j.ynstr.2020.100248
- Hunter, A., & Eastwood, J. D. (2018). Does State Boredom Cause Failures of Attention? Examining the Relations Between Trait Boredom, State Boredom, and Sustained Attention. Experimental Brain Research, 236, 2483–2492. https://doi.org/10.1007/s00221-016-4749-7
- Isacescu, J., Struk, A. A., & Danckert, J. (2017). Cognitive and Affective Predictors of Boredom Proneness. Cognition and Emotion, 31(8), 1741–1748. https://doi.org/10.1080/02699931.2016.1259995
- Islam, F., Sparkes, C., Roodenrys, S., & Astheimer, L. (2008). Short-term Changes in Endogenous Estrogen Levels and Consumption of Soy Isoflavones Affect Working and Verbal Memory in Young Adult Females. Nutritional Neuroscience, 11(6), 251–262. https://doi.org/10.1179/147683008x301612
- Jaafar, K., Nabhan, E., Daoud, R., & Nasser, Z. (2024). Prevalence of Anxiety and Depression among Lebanese Women Using Oral Contraceptives: A Cross-sectional Study. BMC Women’s Health, 24(1), 47. https://doi.org/10.1186/s12905-024-02897-4
- Jackson, S. A., & Marsh, H. W. (1996). Development and Validation of a Scale to Measure Optimal Experience: The Flow State Scale. Journal of Sport and Exercise Psychology, 18(1), 17–35.
- Jackson, S. A., & Eklund, R. C. (2002). Assessing Flow in Physical Activity: The Flow State Scale–2 and Dispositional Flow Scale–2. Journal of Sport and Exercise Psychology, 24(2), 133–150.
- Jackson, S. A., Thomas, P. R., Marsh, H. W., & Smethurst, C. J. (2001). Relationships Between Flow, Self-concept, Psychological Skills, and Performance. Journal of Applied Sport Psychology, 13(2), 129–153. https://doi/10.1080/104132001753149865
- Keyes, K. M., Cheslack-Postava, K., Westhoff, C., Heim, C. M., Haloossim, M., Walsh, K., & Koenen, K. (2013). Association of Hormonal Contraceptive Use with Reduced Levels of Depressive Symptoms: A National Study of Sexually Active Women in the United States. American Journal of Epidemiology, 178(9), 1378–1388. https://doi.org/10.1093/aje/kwt188
- Kowalczyk, M., Kornacka, M., Kostrzewa, Z., & Krejtz, I. (2024). Differences in Anxiety, Worry, and Perceived Stress among Naturally Cycling Women and Oral Contraceptives Users: A Cross-sectional Study Investigating the Role of Contraceptive Types. Archives of Women’s Mental Health, 27(2), 241–247. https://doi.org/10.1007/s00737-023-01405-1
- Kuhlmann, S., & Wolf, O. T. (2005). Cortisol and Memory Retrieval in Women: Influence of Menstrual Cycle and Oral Contraceptives. Psychopharmacology, 183, 65–71. https://doi.org/10.1007/s00213-005-0143-z
- Laird, S., Ney, L. J., Felmingham, K. L., & Gogos, A. (2019). Hormonal Contraception and the Brain: Examining Cognition and Psychiatric Disorders. Current Psychiatry Research and Reviews Formerly: Current Psychiatry Reviews, 15(2), 116–131. https://doi.org/10.2174/1573400515666190521113841
- LePera, N. (2011). Relationships Between Boredom Proneness, Mindfulness, Anxiety, Depression, and Substance Use. The New School Psychology Bulletin, 8(2), 15–25.
- Macbeth, J. (1988). Ocean Cruising. In M. Csikszentmihalyi, & I. S. Csikszentmihalyi (Eds.). Optimal Experience: Psychological Studies of Flow in Consciousness (pp. 214–231). Cambridge University Press.
- Malkovsky, E., Merrifield, C., Goldberg, Y., & Danckert, J. (2012). Exploring the Relationship Between Boredom and Sustained Attention. Experimental Brain Research, 221, 59–67. https://doi.org/10.1007/s00221-012-3147-z
- Marty-Dugas, J., & Smilek, D. (2019). Deep, Effortless Concentration: Re-examining the Flow Concept and Exploring Relations with Inattention, Absorption, and Personality. Psychological Research, 83(8), 1760–1777. https://doi.org/10.1007/s00426-018-1031-6
- Marty-Dugas, J., & Smilek, D. (2020). The Relations Between Smartphone Use, Mood, and Flow Experience. Personality and Individual Differences, 164, 109966. https://doi/10.1016/j.paid.2020.109966
- McDermott, L. M., & Ebmeier, K. P. (2009). A Meta-analysis of Depression Severity and Cognitive Function. Journal of Affective Disorders, 119(1-3), 1–8. https://doi.org/10.1016/j.jad.2009.04.022
- McEwen, B. (2002). Estrogen Actions Throughout the Brain. Recent Progress in Hormone Research, 57, 357–384. https://doi.org/10.1210/rp.57.1.357
- Mellon, S. H., & Griffin, L. D. (2002). Neurosteroids: Biochemistry and Clinical Significance. Trends in Endocrinology & Metabolism, 13(1), 35–43. https://doi.org/10.1016/s1043-2760(01)00503-3
- Moray, N. (1969). Attention: Selective Processes in Vision and Hearing. Routledge.
- Nakamura, J., & Csikszentmihalyi, M. (2002). The Concept of Flow. In C. R. Snyder, & S. J. Lopez (Eds.), Handbook of Positive Psychology (pp. 89–105). Oxford University Press.
- Patel, S. A., Frick, K. M., Newhouse, P. A., & Astur, R. S. (2022). Estradiol Effects on Spatial Memory in Women. Behavioral Brain Research, 417, 113592. https://doi.org/10.1016/j.bbr.2021.113592
- Parasuraman, R., & Davies, D. R. (1984). Varieties of Attention. Academic Press.
- Pashler, D. E. (1998). The Psychology of Attention. The MIT Press.
- Petersen, N., Kilpatrick, L. A., Goharzad, A., & Cahill, L. (2014). Oral Contraceptive Pill Use and Menstrual Cycle Phase Are Associated with Altered Resting State Functional Connectivity. Neuroimage, 90, 24–32. https://doi.org/10.1016/j.neuroimage.2013.12.016
- Pletzer, B., Kronbichler, M., Nuerk, H. C., & Kerschbaum, H. (2014). Hormonal Contraceptives Masculinize Brain Activation Patterns in the Absence of Behavioral Changes in Two Numerical Tasks. Brain Research, 1543, 128–142. https://doi.org/10.1016/j.brainres.2013.11.007
- Pletzer, B., Crone, J. S., Kronbichler, M., & Kerschbaum, H. (2016). Menstrual Cycle and Hormonal Contraceptive-dependent Changes in Intrinsic Connectivity of Resting-state Brain Networks Correspond to Behavioral Changes due to Hormonal Status. Brain Connectivity, 6(7), 572–585. https://doi.org/10.1089/brain.2015.0407
- R Core Team. (2017). A Language and Environment for Statistical Computing (Version 3.4.0) [Computer software]. R Foundation for Statistical Computing. https://www.R-project.org/
- Raymond, C., Marin, M. F., Juster, R. P., Leclaire, S., Bourdon, O., Cayer-Falardeau, S., & Lupien, S. J. (2019). Increased Frequency of Mind Wandering in Healthy Women Using Oral Contraceptives. Psychoneuroendocrinology, 101, 121–127. https://doi.org/10.1016/j.psyneuen.2018.11.005
- Rehbein, E., Hornung, J., Sundström Poromaa, I., & Derntl, B. (2021). Shaping of the Female Human Brain by Sex Hormones: A Review. Neuroendocrinology, 111(3), 183–206. https://doi.org/10.1159/000507083
- Rivera, R., Yacobson, I., & Grimes, D. (1999). The Mechanism of Action of Hormonal Contraceptives and Intrauterine Contraceptive Devices. American Journal of Obstetrics and Gynecology, 181(5), 1263–1269. https://doi.org/10.1016/s0002-9378(99)70120-1
- Seli, P., Beaty, R. E., Marty-Dugas, J., & Smilek, D. (2019). Depression, Anxiety, and Stress and the Distinction Between Intentional and Unintentional Mind Wandering. Psychology of Consciousness: Theory, Research, and Practice, 6(2), 163–170. https://doi.org/10.1037/cns0000182
- Sharma, R., Fang, Z., Smith, A., & Ismail, N. (2020). Oral Contraceptive Use, Especially during Puberty, Alters Resting State Functional Connectivity. Hormones and Behavior, 126, 104849. https://doi.org/10.1016/j.yhbeh.2020.104849
- Skovlund, C. W., Mørch, L. S., Kessing, L. V., & Lidegaard, Ø. (2016). Association of Hormonal Contraception with Depression. JAMA Psychiatry, 73(11), 1154–1162. https://doi.org/10.1001/jamapsychiatry.2016.2387
- Smith, A. C., & Smilek, D. (2024). On the Relation Between Oral Contraceptive Use and Self-control. Frontiers in Endocrinology, 15, 1335384. https://doi.org/10.3389/fendo.2024.1335384
- Smith, A. C., Marty-Dugas, J., & Smilek, D. (2023). Examining the Relation Between Oral Contraceptive Use and Attentional Engagement in Everyday Life. Frontiers in Human Neuroscience, 17, 1147515. https://doi.org/10.3389/fnhum.2023.1147515
- Sohrabji, F. (2006). Guarding the Blood–brain Barrier: A Role for Estrogen in the Etiology of Neurodegenerative Disease. Gene Expression, 13(6), 311–319. https://doi.org/10.3727/000000006781510723
- Struk, A. A., Scholer, A. A., & Danckert, J. (2016). A Self-regulatory Approach to Understanding Boredom Proneness. Cognition and Emotion, 30(8), 1388–1401. https://doi.org/10.1080/02699931.2015.1064363
- Struk, A. A., Carriere, J. S., Cheyne, J. A., & Danckert, J. (2017). A Short Boredom Proneness Scale: Development and Psychometric Properties. Assessment, 24(3), 346–359. https://doi.org/10.1177/1073191115609996
- Swann, C., Keegan, R. J., Piggott, D., & Crust, L. (2012). A Systematic Review of the Experience, Occurrence, and Controllability of Flow States in Elite Sport. Psychology of Sport and Exercise, 13(6), 807–819. https://doi/10.1016/j.psychsport.2012.05.006
- Tam, K. Y., Van Tilburg, W. A., & Chan, C. S. (2021). What Is Boredom Proneness? A Comparison of Three Characterizations. Journal of Personality, 89(4), 831–846. https://doi.org/10.1111/jopy.12618
- Toffol, E., Heikinheimo, O., Koponen, P., Luoto, R., & Partonen, T. (2012). Further Evidence for Lack of Negative Associations Between Hormonal Contraception and Mental Health. Contraception, 86(5), 470–480. https://doi.org/10.1016/j.contraception.2012.02.014
- Ulrich, M., Keller, J., Hoenig, K., Waller, C., & Grön, G. (2014). Neural Correlates of Experimentally Induced Flow Experiences. Neuroimage, 86, 194–202. https://doi.org/10.1016/j.neuroimage.2013.08.019
- Ullén, F., de Manzano, Ö., Almeida, R., Magnusson, P. K., Pedersen, N. L., Nakamura, J., Csíkszentmihályi, M., & Madison, G. (2012). Proneness for Psychological Flow in Everyday Life: Associations with Personality and Intelligence. Personality and Individual Differences, 52(2), 167–172. https://doi.org/10.1016/j.paid.2011.10.003
- United Nations (2019). Contraceptive Use by Method 2019: Data Booklet. New York Department of Economic and Social Affairs.
- van Hooff, M. L., & van Hooft, E. A. (2016). Work-related Boredom and Depressed Mood from a Daily Perspective: The Moderating Roles of Work Centrality and Need Satisfaction. Work & Stress, 30(3), 209–227. https://doi.org/10.1080/02678373.2016.1206151
- Warren, A. M., Gurvich, C., Worsley, R., & Kulkarni, J. (2014). A Systematic Review of the Impact of Oral Contraceptives on Cognition. Contraception, 90(2), 111–116. https://doi.org/10.1016/j.contraception.2014.03.015
- Watt, J. D., & Blanchard, M. J. (1994). Boredom Proneness and the Need for Cognition. Journal of Research in Personality, 28(1), 44–51. https://doi.org/10.1006/jrpe.1994.1005
- Weibel, D., & Wissmath, B. (2024). Flow as an Experience Beyond Boredom. In M. Bieleke, W. Wolff, & C. Martarelli (Eds.), The Routledge International Handbook of Boredom (pp. 163–177). Routledge.
- Wharton, W., Hirshman, E., Merritt, P., Doyle, L., Paris, S., & Gleason, C. (2008). Oral Contraceptives and Androgenicity: Influences on Visuospatial Task Performance in Younger Individuals. Experimental and Clinical Psychopharmacology, 16(2), 156–164. https://doi.org/10.1037/1064-1297.16.2.156
- Wolff, W., Özay-Otgonbayar, S., Danckert, J., Bieleke, M., & Martarelli, C. S. (2025). Effort and Boredom Shape Our Experience of Time. Neuroscience & Biobehavioral Reviews, 106375. https://doi.org/10.1016/j.neubiorev.2025.106375