Skip to main content
SpringerLink
Log in

Impact of Testosterone on Aspects of Psychology

  • Chapter
  • First Online:
Psychological Aspects of Polycystic Ovary Syndrome

  • 554 Accesses

Abstract

This chapter explores what we know about the psychological effects of testosterone in women, both with polycystic ovary syndrome (PCOS) and without. Many readers will find this chapter fascinating. The topics include ones that people might think they know about, but are widely misunderstood, such as sexual orientation and aggression. There are other topics in which testosterone has the expected impact on healthy women (such as cognition and libido), but works differently in women with PCOS. There are many surprises in this chapter, not least the evidence that testosterone, a prosocial hormone.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agrawal, R., Sharma, S., Bekir, J., Conway, G., Bailey, J., Balen, A. H., & Prelevic, G. (2004). Prevalence of polycystic ovaries and polycystic ovary syndrome in lesbian women compared with heterosexual women. Fertility and Sterility, 82(5), 1352–1357.

    Article  PubMed  Google Scholar 

  • Albert, D. J., Walsh, M. L., & Jonik, R. H. (1993). Aggression in humans: What is its biological foundation? Neuroscience & Biobehavioral Reviews, 17(4), 405–425.

    Article  Google Scholar 

  • Aleman, A., Bronk, E., Kessels, R. P., Koppeschaar, H. P., & van Honk, J. (2004). A single administration of testosterone improves visuospatial ability in young women. Psychoneuroendocrinology, 29(5), 612–617.

    Article  PubMed  Google Scholar 

  • Annagür, B. B., Tazegül, A., Uguz, F., Kerimoglu, Ö. S., Tekinarslan, E., & Celik, Ç. (2013). Biological correlates of major depression and generalized anxiety disorder in women with polycystic ovary syndrome. Journal of Psychosomatic Research, 74(3), 244–247.

    Article  PubMed  Google Scholar 

  • Archer, J., Graham-Kevan, N., & Davies, M. (2005). Testosterone and aggression: A reanalysis of Book, Starzyk, and Quinsey’s (2001) study. Aggression and Violent Behavior, 10(2), 241–261.

    Article  Google Scholar 

  • Asik, M., Altinbas, K., Eroglu, M., Karaahmet, E., Erbag, G., Ertekin, H., & Sen, H. (2015). Evaluation of affective temperament and anxiety–depression levels of patients with polycystic ovary syndrome. Journal of Affective Disorders, 185, 214–218.

    Article  PubMed  Google Scholar 

  • Astapova, O., Minor, B. M., & Hammes, S. R. (2019). Physiological and pathological androgen actions in the ovary. Endocrinology, 160(5), 1166–1174.

    Article  PubMed  PubMed Central  Google Scholar 

  • Azziz, R., Carmina, E., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Futterweit, W., … Witchel, S. F. (2009). The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: The complete task force report. Fertility and Sterility, 91(2), 456–488.

    Article  PubMed  Google Scholar 

  • Baba, T., Endo, T., Honnma, H., Kitajima, Y., Hayashi, T., Ikeda, H., … Saito, T. (2006). Association between polycystic ovary syndrome and female-to-male transsexuality. Human Reproduction, 22(4), 1011–1016.

    Article  PubMed  Google Scholar 

  • Balen, A. H., Schachter, M. E., Montgomery, D., Reid, R. W., & Jacobs, H. S. (1993). Polycystic ovaries are a common finding in untreated female to male transsexuals. Clinical Endocrinology, 38(3), 325–329.

    Article  PubMed  Google Scholar 

  • Balikci, A., Erdem, M., KESKIN, U., Zincir, S. B., Guelsuen, M., Oezcelik, F., … Erguen, A. (2014). Depression, anxiety, and anger in patients with polycystic ovary syndrome. Nöro Psikiyatri Arşivi, 51(4), 328.

    Article  PubMed  PubMed Central  Google Scholar 

  • Barnard, L., Ferriday, D., Guenther, N., Strauss, B., Balen, A. H., & Dye, L. (2007). Quality of life and psychological well being in polycystic ovary syndrome. Human Reproduction, 22(8), 2279–2286.

    Article  PubMed  Google Scholar 

  • Barry, J. A., & Owens, R. (2019). From fetuses to boys to men: The impact of testosterone on male lifespan development. In The Palgrave handbook of male psychology and mental health (pp. 3–24). Cham: Palgrave Macmillan.

    Chapter  Google Scholar 

  • Barry, J. A., Hardiman, P. J., Saxby, B. K., & Kuczmierczyk, A. (2011a). Testosterone and mood dysfunction in women with polycystic ovarian syndrome compared to subfertile controls. Journal of Psychosomatic Obstetrics and Gynecology, 32(2), 104–111.

    Article  PubMed  Google Scholar 

  • Barry, J. A., Hardiman, P. J., Siddiqui, M. R., & Thomas, M. (2011b). Meta-analysis of sex difference in testosterone levels in umbilical cord blood. Journal of Obstetrics and Gynaecology, 31(8), 697–702.

    Article  PubMed  Google Scholar 

  • Barry, J. A., Parekh, H. S. K., & Hardiman, P. J. (2013). Visual-spatial cognition in women with polycystic ovarian syndrome: The role of androgens. Human Reproduction, 28(10), 2832–2837.

    Article  PubMed  Google Scholar 

  • Barry, J. A., Leite, N., Sivarajah, N., Keevil, B., Owen, L., Miranda, L. C., … Hardiman, P. (2017). Relaxation and guided imagery significantly reduces androgen levels and distress in polycystic ovary syndrome: Pilot study. Contemporary Hypnosis and Integrative Therapy, 32(1), 21–29.

    Google Scholar 

  • Barry, J. A., Qu, F., & Hardiman, P. J. (2018). An exploration of the hypothesis that testosterone is implicated in the psychological functioning of women with polycystic ovary syndrome (PCOS). Medical Hypotheses, 110, 42–45.

    Article  PubMed  Google Scholar 

  • Batool, S., ul ain Ahmed, F., Ambreen, A., Sheikh, A., & Faryad, N. (2016). Depression and anxiety in women with polycystic ovary syndrome and its biochemical associates. Journal of South Asian Federation of Obstetrics and Gynaecology, 8(1), 44–47.

    Google Scholar 

  • Bernstein, I. S., Gordon, T. P., & Rose, R. M. (1983). The interaction of hormones, behavior, and social context in nonhuman primates. In Hormones and aggressive behavior (pp. 535–561). Boston: Springer.

    Chapter  Google Scholar 

  • Björkqvist, K., & Niemelä, P. (1992). New trends in the study of female aggression. In K. Björkqvist & P. Niemelä (Eds.), Of mice and women: Aspects of female aggression (pp. 3–16). San Diego, CA, US: Academic Press.

    Chapter  Google Scholar 

  • Boehmer, U., Bowen, D. J., & Bauer, G. R. (2007). Overweight and obesity in sexual-minority women: Evidence from population-based data. American Journal of Public Health, 97(6), 1134–1140.

    Article  PubMed  PubMed Central  Google Scholar 

  • Book, A. S., Starzyk, K. B., & Quinsey, V. L. (2001). The relationship between testosterone and aggression: A meta-analysis. Aggression and Violent Behavior, 6(6), 579–599.

    Article  Google Scholar 

  • Booth, A., Shelley, G., Mazur, A., Tharp, G., & Kittok, R. (1989). Testosterone, and winning and losing in human competition. Hormones and Behavior, 23, 556–571.

    Article  PubMed  Google Scholar 

  • Booth, A., Granger, D. A., Mazur, A., & Kivlighan, K. T. (2006). Testosterone and social behavior. Social Forces, 85(1), 167–191.

    Article  Google Scholar 

  • Borghi, L., Leone, D., Vegni, E., Galiano, V., Lepadatu, C., Sulpizio, P., & Garzia, E. (2018). Psychological distress, anger and quality of life in polycystic ovary syndrome: Associations with biochemical, phenotypical and socio-demographic factors. Journal of Psychosomatic Obstetrics and Gynecology, 39(2), 128–137.

    Article  PubMed  Google Scholar 

  • Bosinski, H. A., Peter, M., Bonatz, G., Arndt, R., Heidenreich, M., Sippell, W. G., & Wille, R. (1997). A higher rate of hyperandrogenic disorders in female-to-male transsexuals. Psychoneuroendocrinology, 22(5), 361–380.

    Article  PubMed  Google Scholar 

  • Cesta, C. E., Månsson, M., Palm, C., Lichtenstein, P., Iliadou, A. N., & Landén, M. (2016). Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort. Psychoneuroendocrinology, 73, 196–203.

    Article  PubMed  Google Scholar 

  • Chen, C. H., Wang, P. H., Hsieh, M. T., Tzeng, C. R., Wu, Y. H., Lee, C. S., … Chang, H. Y. (2014). Sexual orientations of women with polycystic ovary syndrome: Clinical observation in Taiwan. Taiwanese Journal of Obstetrics and Gynecology, 53(4), 542–546.

    Article  PubMed  Google Scholar 

  • Cooney, L. G., Lee, I., Sammel, M. D., & Dokras, A. (2017). High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: A systematic review and meta-analysis. Human Reproduction, 32(5), 1075–1091.

    Article  PubMed  Google Scholar 

  • Dabbs, J. M., Jr., Strong, R., & Milun, R. (1997). Exploring the mind of testosterone: A beeper study. Journal of Research in Personality, 31(4), 577–587.

    Article  Google Scholar 

  • Davis, S. (2001). Testosterone treatment: Psychological and physical effects in postmenopausal women. American Society for Reproductive Medicine: Menopausal Medicine, 9(2).

    Google Scholar 

  • De Sutter, P., Dutré, T., Vanden Meerschaut, F., Stuyver, I., Van Maele, G., & Dhont, M. (2008). PCOS in lesbian and heterosexual women treated with artificial donor insemination. Reproductive Biomedicine Online, 17(3), 398–402.

    Article  PubMed  Google Scholar 

  • Defreyne, J., Kreukels, B., T’Sjoen, G., Stahporsius, A., Den Heijer, M., Heylens, G., & Elaut, E. (2019). No correlation between serum testosterone levels and state-level anger intensity in transgender people: Results from the European Network for the Investigation of Gender Incongruence. Hormones and Behavior, 110, 29–39.

    Article  PubMed  Google Scholar 

  • Dittman, R. W., Kappes, M. E., & Kappes, M. H. (1992). Sexual behaviour and adolescent and adult females with congenital adrenal hyperplasia. Psychoneuroendocrinology, 17, 153–170.

    Article  Google Scholar 

  • Dunphy, L. (2018, January 18). Lesbian mum who viciously beat bride walks free after telling court she has high levels of “male hormones”. Retrieved from https://www.mirror.co.uk/news/uk-news/lesbian-mum-who-viciously-beat-11872183#ICID=sharebar_twitter.

  • Eisenegger, C., Naef, M., Snozzi, R., Heinrichs, M., & Fehr, E. (2010). Prejudice and truth about the effect of testosterone on human bargaining behaviour. Nature, 463(7279), 356.

    Article  PubMed  Google Scholar 

  • Eisenegger, C., Haushofer, J., & Fehr, E. (2011). The role of testosterone in social interaction. Trends in Cognitive Sciences, 15(6), 263–271.

    Article  PubMed  Google Scholar 

  • Elsenbruch, S., Hahn, S., Kowalsky, D., Offner, A. H., Schedlowski, M., Mann, K., & Janssen, O. E. (2003). Quality of life, psychosocial well-being, and sexual satisfaction in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology and Metabolism, 88, 5801–5807.

    Article  PubMed  Google Scholar 

  • Enjezab, B., Eftekhar, M., & Ghadiri-Anari, A. (2017). Association between severity of depression and clinico-biochemical markers of polycystic ovary syndrome. Electronic Physician, 9(11), 5820.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ercan, C. M., Coksuer, H., Aydogan, U., Alanbay, I., Keskin, U., Karasahin, K. E., & Baser, I. (2013). Sexual dysfunction assessment and hormonal correlations in patients with polycystic ovary syndrome. International Journal of Impotence Research, 25, 127–132.

    Article  PubMed  Google Scholar 

  • Eriksson, E., Sundblad, C., Lisjö, P., Modigh, K., & Andersch, B. (1992). Serum levels of androgens are higher in women with premenstrual irritability and dysphoria than in controls. Psychoneuroendocrinology, 17(2–3), 195–204.

    Article  PubMed  Google Scholar 

  • Futterweit, W., Weiss, R. A., & Fagerstrom, R. M. (1986). Endocrine evaluation of forty female-to-male transsexuals: Increased frequency of polycystic ovarian disease in female transsexualism. Archives of Sexual Behavior, 15(1), 69–78.

    Article  PubMed  Google Scholar 

  • Gallinelli, A., Matteo, M. L., Volpe, A., & Facchinetti, F. (2000). Autonomic and neuroendocrine responses to stress in patients with functional hypothalamic secondary amenorrhea. Fertility and Sterility, 73(4), 812–816.

    Article  PubMed  Google Scholar 

  • Gul, A., Gul, H., Ergur, A. T., & Ozen, N. E. (2018). Anxiety-anger relationship in hyperandrogenemia: A comparative study with polycystic ovary syndrome (PCOS) and healthy control adolescents. Journal of Mood Disorders, 8(1), 26–31.

    Google Scholar 

  • Hahn, S., Janssen, O. E., Tan, S., Pleger, K., Mann, K., Schedlowski, M., … Elsenbruch, S. (2005). Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome. European Journal of Endocrinology, 153, 853–860.

    Article  PubMed  Google Scholar 

  • Himelein, M. J., & Thatcher, S. S. (2006). Depression and body image among women with polycystic ovary syndrome. Journal of Health Psychology, 11(4), 613–625.

    Article  PubMed  Google Scholar 

  • Klimczak, D., Szlendak-Sauer, K., & Radowicki, S. (2015). Depression in relation to biochemical parameters and age in women with polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 184, 43–47.

    Article  Google Scholar 

  • Legro, R. S., Schlaff, W. D., Diamond, M. P., Coutifaris, C., Casson, P. R., Brzyski, R. G., … Ohl, D. (2010). Total testosterone assays in women with polycystic ovary syndrome: Precision and correlation with hirsutism. The Journal of Clinical Endocrinology & Metabolism, 95(12), 5305–5313.

    Article  Google Scholar 

  • Lujan, M. E., & Mergler, R. J. (2015). Cognitive function in women with polycystic ovary syndrome (PCOS): Impact of reproductive and metabolic factors. Fertility and Sterility, 104(3), e129.

    Article  Google Scholar 

  • Manlove, A. H., Guillermo, C., & Gray, P. B. (2008). Do women with polycystic ovary syndrome (PCOS) report differences in sex-typed behavior as children and adolescents?: Results of a pilot study. Annals of Human Biology, 35(6), 584–595.

    Article  PubMed  Google Scholar 

  • McCook, J. G. (2002). The influence of hyperandrogenism, obesity and infertility on the psychosocial health and wellbeing of women with polycystic ovary syndrome. Unpublished doctoral dissertation, University of Michigan.

    Google Scholar 

  • Monzani, F., Pucci, F., Caraccio, N., Bagnolesi, A., Molli, D., Fenu, A., & Prunetti, C. (1994). Psychological and psychopathological correlates in the polycystic ovary syndrome (PCOS). Medicina Psicosomatica, 39, 225–236.

    Google Scholar 

  • Moran, L. J., Deeks, A. A., Gibson-Helm, M. E., & Teede, H. J. (2012). Psychological parameters in the reproductive phenotypes of polycystic ovary syndrome. Human Reproduction, 27, 2082–2088.

    Article  PubMed  Google Scholar 

  • Nathorst-Böös, J., Flöter, A., Jarkander-Rolff, M., Carlström, K., & Von Schoultz, B. (2006). Treatment with percutaneous testosterone gel in postmenopausal women with decreased libido–effects on sexuality and psychological general well-being. Maturitas, 53(1), 11–18.

    Article  PubMed  Google Scholar 

  • Nordqvist, S., Sydsjö, G., Lampic, C., Åkerud, H., Elenis, E., & Skoog Svanberg, A. (2014). Sexual orientation of women does not affect outcome of fertility treatment with donated sperm. Human Reproduction, 29(4), 704–711.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pastore, L. M., Patrie, J. T., Morris, W. L., Dalal, P., & Bray, M. J. (2011). Depression symptoms and body dissatisfaction association among polycystic ovary syndrome women. Journal of Psychosomatic Research, 71(4), 270–276.

    Article  PubMed  PubMed Central  Google Scholar 

  • Peters, M., Laeng, B., Latham, K., Jackson, M., Zaiyouna, R., & Richardson, C. (1995). A redrawn Vandenberg and Kuse mental rotations test-different versions and factors that affect performance. Brain and Cognition, 28(1), 39–58.

    Article  PubMed  Google Scholar 

  • Pintzka, C. W., Evensmoen, H. R., Lehn, H., & Håberg, A. K. (2016). Changes in spatial cognition and brain activity after a single dose of testosterone in healthy women. Behavioural Brain Research, 298, 78–90.

    Article  PubMed  Google Scholar 

  • Rahiminejad, M. E., Moaddab, A., Rabiee, S., Esna-Ashari, F., Borzouei, S., & Hosseini, S. M. (2014). The relationship between clinicobiochemical markers and depression in women with polycystic ovary syndrome. Iranian Journal of Reproductive Medicine, 12(12), 811.

    PubMed  PubMed Central  Google Scholar 

  • Rasgon, N. L., Rao, R. C., Hwang, S., Altshuler, L. L., Elman, S., Zuckerbrow-Miller, J., & Korenman, S. G. (2003). Depression in women with polycystic ovary syndrome: Clinical and biochemical correlates. Journal of Affective Disorders, 74(3), 299–304.

    Article  PubMed  Google Scholar 

  • Rellini, A. H., Stratton, N., Tonani, S., Santamaria, V., Brambilla, E., & Nappi, R. E. (2013). Differences in sexual desire between women with clinical versus biochemical signs of hyperandrogenism in polycystic ovarian syndrome. Hormones and Behavior, 63, 65–71.

    Article  PubMed  Google Scholar 

  • Roberts, G. (1998). Competitive altruism: From reciprocity to the handicap principle. Proceedings of the Royal Society of London B: Biological Sciences, 265(1394), 427–431.

    Article  Google Scholar 

  • Robinson, K., Galloway, K. Y., Bewley, S., & Meads, C. (2017). Lesbian and bisexual women’s gynaecological conditions: A systematic review and exploratory meta-analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 124(3), 381–392.

    Article  Google Scholar 

  • Roche Diagnostics. (2000). Elecsys Testosterone Product Information. Retrieved May 5, 2010, from http://www.roche-diagnostics.ch/resource.php?id=Resourcefile-37084379e9754cf58.

  • Rosner, W., Auchus, R. J., Azziz, R., Sluss, P. M., & Raff, H. (2007). Position statement: Utility, limitations, and pitfalls in measuring testosterone: An endocrine society position statement. Journal of Clinical Endocrinology & Metabolism, 92, 405–413.

    Article  Google Scholar 

  • Rubinow, D. R., & Schmidt, P. J. (1989). Models for the development and expression of symptoms in premenstrual syndrome. Psychiatric Clinics, 12(1), 53–68.

    PubMed  Google Scholar 

  • Salvador, A., Suay, F., Gonzalez-Bono, E., & Serrano, M. A. (2003). Anticipatory cortisol, testosterone and psychological responses to judo competition in young men. Psychoneuroendocrinology, 28(3), 364–375.

    Article  PubMed  Google Scholar 

  • Schattmann, L., & Sherwin, B. B. (2007). Testosterone levels and cognitive functioning in women with polycystic ovary syndrome and in healthy young women. Hormones and Behavior, 51(5), 587–596.

    Article  PubMed  Google Scholar 

  • Schüring, A. N., Nolte, S., Fobker, M., Kannenberg, F., & Nofer, J. R. (2016). Head-to-head assessment of diagnostic performance of testosterone immunoassays in patients with polycystic ovary syndrome. Journal of Clinical Laboratory Analysis, 30(5), 479–484.

    Article  PubMed  Google Scholar 

  • Shepard, R. N., & Metzler, J. (1971). Mental rotation of three-dimensional objects. Science, 171(3972), 701–703.

    Article  PubMed  Google Scholar 

  • Sills, E. S., Perloe, M., Tucker, M. J., Kaplan, C. R., Genton, M. G., & Schattman, G. L. (2001). Diagnostic and treatment characteristics of polycystic ovary syndrome: Descriptive measurements of patient perception and awareness from 657 confidential self-reports. BMC Women’s Health, 1(1), 3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Smith, A. M., Rissel, C. E., Richters, J., Grulich, A. E., & de Visser, R. O. (2003). Sex in Australia: Sexual identity, sexual attraction and sexual experience among a representative sample of adults. Australian and New Zealand Journal of Public Health, 27(2), 138–145.

    Google Scholar 

  • Smith, H. A., Markovic, N., Matthews, A. K., Danielson, M. E., Kalro, B. N., Youk, A. O., & Talbott, E. O. (2011). A comparison of polycystic ovary syndrome and related factors between lesbian and heterosexual women. Women’s Health Issues, 21(3), 191–198.

    Article  PubMed  Google Scholar 

  • Taher, S., Rothon, C., & Panay, N. (2008). Testosterone gel and improvement in libido, psychological state and general wellbeing in natural and surgical post-menopausal women: P3. 24. Bjog: An International Journal of Obstetrics and Gynaecology, 115(187).

    Google Scholar 

  • Udiawar, M. (2017). Cardiometabolic and neuroimaging correlates of cognitive function in polycystic ovary syndrome. Doctoral dissertation, Cardiff University.

    Google Scholar 

  • Weiner, C. L., Primeau, M., & Ehrmann, D. A. (2004). Androgens and mood dysfunction in women: Comparison of women with polycystic ovarian syndrome to healthy controls. Psychosomatic Medicine, 66(3), 356–362.

    PubMed  Google Scholar 

  • Wibral, M., Dohmen, T., Klingmüller, D., Weber, B., & Falk, A. (2012). Testosterone administration reduces lying in men. PLoS One, 7(10), e46774.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zucker, K. J., Bradley, S. J., Oliver, G., Blake, J., Fleming, S., & Hood, J. (1996). Psychosexual development of women with congenital adrenal hyperplasia. Hormones and Behavior, 30(4), 300–318.

    Article  PubMed  Google Scholar 

  • Zung, W. W. (1965). A self-rating depression scale. Archives of General Psychiatry, 12(1), 63–70.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University College London, London, UK

    John A. Barry

Authors
  1. John A. Barry
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John A. Barry .

Rights and permissions

Reprints and permissions

Copyright information

© 2019 The Author(s)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Barry, J.A. (2019). Impact of Testosterone on Aspects of Psychology. In: Psychological Aspects of Polycystic Ovary Syndrome. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-30290-0_4

Download citation

Publish with us

Policies and ethics

Search

Navigation