The relationship between the menstrual cycle and female sexual interest in women with PMS complaints and volunteers

doi:10.1016/0306-4530(94)90067-1

Psychoneuroendocrinology

Volume 19, Issue 3, 1994, Pages 293-304

https://doi.org/10.1016/0306-4530(94)90067-1 Get rights and content

Abstract

This study assesses the influence of menstrual cycle phases and hormones on female sexual interest in both a nonclinical sample of volunteers (n = 18) and women who complained of premenstrual tension (n = 150). Women were assessed prospectively for two menstrual cycles with daily symptom charts. In addition mental status was assessed clinically and the Moos Menstrual Distress Questionnaire completed in the follicular and premenstrual phases. On the basis of these assessments women were assigned to subject groups. During the second cycle, daily 24-h urinary estrogens and urinary pregnanediol were determined. Sexual interest and feelings of well-being were recorded on a daily symptom rating chart. Sexual interest was found to be significantly higher in the follicular and ovulatory phases, than in the luteal, premenstrual, or menstrual phases. Sexual interest and feelings of well-being were correlated (R = 0.29). Sexual interest and feelings of well-being were not correlated with urinary estrogen or pregnanediol levels.

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Are Endogenous Androgens Linked to Female Sexual Function? A Systemic Review and Meta-Analysis
2022, Journal of Sexual Medicine
Citation Excerpt :
The hormonal milieu that characterizes the periovulatory phase, and in particular the testosterone peak, is believed to alter the processing of sexual stimuli, leading to a shift toward an incentive value for sex.76 This has been hypothesized to translate in a peak of female-initiated sexual behavior during the fertile phase, observed not only in rats and primates, but also in humans.77 In the present work, the cycle phase did not appear to influence the relationship between total T and free T and sexual function; however, it has been recognized that only one study reported androgens levels at ovulation.
The benefits of treatment with testosterone (T) in women with loss of desire suggest that low androgens may distinguish women with sexual dysfunction (SD) from others; however, evidence on this point is lacking.
To answer the question: is there an association between endogenous levels of androgens and sexual function in women?
An extensive search was performed in MEDLINE, Embase and PsycInfo. Four separate meta-analyses were conducted for total T, free T, Free Androgen Index (FAI), and Dehydroepiandrosterone sulphate (DHEAS). Cohort, cross-sectional, and prospective studies were included.
The main outcome was the association between endogenous androgens and sexual desire. Global sexual function was considered as a secondary outcome. The effect measure was expressed as standardized mean difference (SMD).
The meta-analysis on total T included 34 studies involving 3,268 women, mean age 36.5 years. In 11 studies, a significant association was found between sexual desire, measured by validated psychometric instruments, and total T (SMD = 0.59 [0.29;0.88], P < 0.0001), with a moderate effect. The association with global sexual function (n = 12 studies) was also significant (SMD = 0.44 [0.21;0.67], P <0.0001). Overall, total T was associated with a better sexual function (SMD = 0.55 [0.28;0.82)], P < 0.0001), with similar results obtained when poor quality studies were removed. Age showed a negative relationship with the overall outcome. No differences were found when stratifying the studies according to menopausal status, type of menopause, age at menopause, use of hormonal replacement therapy, relationship status, method for T measurement, phase of the menstrual cycle or use of hormonal contraception. The meta-analysis of T derivatives (free T and FAI) also showed a significant, moderate association with sexual desire. In contrast, DHEAS seems not to exert any significant influence on desire, whilst showing a positive association with global sexual function.
Endogenous androgens show a moderate association with a better sexual function in women; however, the role of psychological, relational and other hormonal factors should not be overlooked.
This represents the first attempt at meta-analyzing data available on the topic. A significant publication bias was found for total T.
There appears to be a moderate association between total T and sexual desire/global sexual function, which is confirmed, although weak, in studies employing liquid chromatography-mass spectrometry (LC-MS). Similar results on desire were obtained for free T and FAI. DHEAS only showed a positive association with global sexual function. More research is needed.
Maseroli E and Vignozzi L. Are Endogenous Androgens Linked to Female Sexual Function? A Systemic Review and Meta-Analysis. J Sex Med 2022;19:553–568.
Endocrinology of human female sexuality, mating, and reproductive behavior
2017, Hormones and Behavior
Hormones orchestrate and coordinate human female sexual development, sexuality, and reproduction in relation to three types of phenotypic changes: life history transitions such as puberty and childbirth, responses to contextual factors such as caloric intake and stress, and cyclical patterns such as the ovulatory cycle. Here, we review the endocrinology underlying women's reproductive phenotypes, including sexual orientation and gender identity, mate preferences, competition for mates, sex drive, and maternal behavior. We highlight distinctive aspects of women's sexuality such as the possession of sexual ornaments, relatively cryptic fertile windows, extended sexual behavior across the ovulatory cycle, and a period of midlife reproductive senescence—and we focus on how hormonal mechanisms were shaped by selection to produce adaptive outcomes. We conclude with suggestions for future research to elucidate how hormonal mechanisms subserve women's reproductive phenotypes.
Theoretical frameworks for human behavioral endocrinology
2016, Hormones and Behavior
Citation Excerpt :
Numerous studies have demonstrated mid-cycle elevations of desire or woman-initiated sex (for a review, see Wallen, 2001), which indirectly implicates roles for ovarian hormones given the hormone secretion patterns (see Fig. 3). However, early studies that tested for within-cycle correlations between hormones and measures of women's sexual motivation reported null results (Dennerstein et al., 1994; Morris et al., 1987; Persky et al., 1978a, 1978b; Van Goozen et al., 1997), although these studies generally had low power and did not employ newer statistical techniques for the analysis of non-independent data. More recently, with a much larger sample size and use of multi-level regression models for data analysis, Roney and Simmons (2013, 2016) reported positive, within-cycle correlations between fluctuations in women's estradiol and daily self-report ratings of their sexual desire, and even larger negative correlations between progesterone and desire.
How can we best discover the ultimate, evolved functions of endocrine signals within the field of human behavioral endocrinology? Two related premises will guide my proposed answer. First, hormones typically have multiple, simultaneous effects distributed throughout the brain and body, such that in an abstract sense their prototypical function is the coordination of diverse outcomes. Second, coordinated output effects are often evolved, functional responses to specific eliciting conditions that cause increases or decreases in the relevant hormones. If we accept these premises, then a natural way to study hormones is to hypothesize and test how multiple eliciting conditions are mapped into coordinated output effects via hormonal signals. I will call these input–output mappings “theoretical frameworks.” As examples, partial theoretical frameworks for gonadal hormones will be proposed, focusing on the signaling roles of testosterone in men and on estradiol and progesterone in women. Recent research on oxytocin in humans will also be considered as an example in which application of the theoretical framework approach could be especially helpful in making functional sense of the diverse array of findings associated with this hormone. The theoretical framework approach is not especially common in the current literature, with many theories having eschewed explicit consideration of input–output mappings in favor of parsimony-based arguments that attempt to find the one main thing that a hormone does with respect to psychology or behavior. I will argue that these parsimony-based models have many shortcomings, and conclude that the construction and testing of theoretical frameworks provides a better means of discovering the evolved functions of human endocrine signals.
Increasing women's sexual desire: The comparative effectiveness of estrogens and androgens
2016, Hormones and Behavior
Citation Excerpt :
The results of Lovejoy and Wallen (1990) agreed with those of Sherwin et al. (1985) and indicated that ovarian steroids, not adrenal androgens, were the critical regulators of female sexual motivation in both human and nonhuman primates. Thus by the mid 1990's, researchers had established that women's sexual desire fluctuated across the menstrual cycle (Dennerstein et al., 1994; Harvey, 1987; Stanislaw and Rice, 1988; Van Goozen et al., 1997) and decreased following oophorectomy (Sherwin et al., 1985). This combined body of work finally ended the idea that adrenal androgens were critical for sexual desire in women and – more than 25 years after Waxenberg et al. (1959) – it became generally accepted that women's sexual desire was modulated by ovarian steroids (Wallen, 1995).
Both estradiol and testosterone have been implicated as the steroid critical for modulating women's sexual desire. By contrast, in all other female mammals only estradiol has been shown to be critical for female sexual motivation and behavior. Pharmaceutical companies have invested heavily in the development of androgen therapies for female sexual desire disorders, but today there are still no FDA approved androgen therapies for women. Nonetheless, testosterone is currently, and frequently, prescribed off-label for the treatment of low sexual desire in women, and the idea of testosterone as a possible cure-all for female sexual dysfunction remains popular. This paper places the ongoing debate concerning the hormonal modulation of women's sexual desire within a historical context, and reviews controlled trials of estrogen and/or androgen therapies for low sexual desire in postmenopausal women. These studies demonstrate that estrogen-only therapies that produce periovulatory levels of circulating estradiol increase sexual desire in postmenopausal women. Testosterone at supraphysiological, but not at physiological, levels enhances the effectiveness of low-dose estrogen therapies at increasing women's sexual desire; however, the mechanism by which supraphysiological testosterone increases women's sexual desire in combination with an estrogen remains unknown. Because effective therapies require supraphysiological amounts of testosterone, it remains unclear whether endogenous testosterone contributes to the modulation of women's sexual desire. The likelihood that an androgen-only clinical treatment will meaningfully increase women's sexual desire is minimal, and the focus of pharmaceutical companies on the development of androgen therapies for the treatment of female sexual desire disorders is likely misplaced.
Female Sexual Behavior
2015, Knobil and Neill's Physiology of Reproduction: Two-Volume Set
This chapter reviews the current state of knowledge concerning the neurobiology of female sexual behavior, including sexual arousal, appetitive desire, pacing of sexual stimulation, the receptive postures that allow vaginal penetration to occur, and the inhibitory or refractory states induced by sexual stimulation, sexual nonreward, and/or the steroid hormone milieu. Data from a variety of species, including humans, is discussed at several levels of analysis that link neuroendocrinology, neuropharmacology, and molecular biology. The context in which sexual behavior occurs, especially during an animal's first sexual experiences, is considered in terms of culture and experimental conditioning, processes that alter neuronal responses, and ultimately behavior in the presence of external sexual incentive cues that predict sexual pleasure or nonreward. New vistas for further research are discussed.
Sexual activity, endogenous reproductive hormones and ovulation in premenopausal women
2014, Hormones and Behavior
We investigated whether sexual activity was associated with reproductive function in the BioCycle Study, a prospective cohort study that followed 259 regularly menstruating women aged 18 to 44 years for one (n = 9) or two (n = 250) menstrual cycles in 2005–2007. Women were not attempting pregnancy nor using hormonal contraceptives. History of ever having been sexually active was assessed at baseline and frequency of sexual activity, defined as vaginal–penile intercourse, was self-reported daily throughout the study. Serum concentrations of estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, and testosterone were measured up to 8 times/cycle. Sporadic anovulation was identified using peak progesterone concentration. Linear mixed models were used to estimate associations between sexual activity and reproductive hormone concentrations and generalized linear models were used to estimate associations with sporadic anovulation. Models were adjusted for age, race, body mass index, perceived stress, and alcohol consumption and accounted for repeated measures within women. Elevated concentrations of estrogen (+ 14.6%, P < .01), luteal progesterone (+ 41.0%, P < .01) and mid-cycle LH (+ 23.4%, P < .01), but not FSH (P = .33) or testosterone (P = .37), were observed in sexually active women compared with sexually inactive women (no prior and no study-period sexual activity); sexually active women had lower odds of sporadic anovulation (adjusted odds ratio = 0.34, 95% confidence interval: 0.16–0.73). Among sexually active women, frequency of sexual activity was not associated with hormones or sporadic anovulation (all P > .23). Findings from our study suggest that ever having been sexually active is associated with improved reproductive function, even after controlling for factors such as age.

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^∗: Current address: School of Nursing, Wollongong University, Wollongong, NSW, Australia, 2500.

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The relationship between the menstrual cycle and female sexual interest in women with PMS complaints and volunteers

Abstract

Horm Behav

J Psychiatr Res

Fertil Steril

Am J Obstet Gynecol

J Psychosom Res

Rise in female initiated sexual activity at ovulation and its suppression by oral contraceptives

N Engl J Med

Sperm fertility, viability and persistence in the female tract

J Reprod Fertil Suppl

An evaluation of the method of Cox for the rapid analysis of pregnanediol in urine by gas-liquid chromatography

J Endocrinol

Hormonal basis of proceptivity and receptivity in female primates

Arch Sex Behav

Endocrinology of ovulation prediction

A rapid method for measuring oestrogens in human urine using a semi-automatic extractor

J Endocrinol

Progesterone, fluid and electrolytes in premenstrual syndrome

Br Med J

The development of a scale for the assessment of sexual response in Australian women

Aust NZ J Psychiatry