Menstrual cycle phase predicts women's hormonal responses to sexual stimuli

The standardization of a new Explicit Pornographic Picture Set (EPPS)

Pictures with affective content have been extensively used in scientific studies of emotion and sexuality. However, only a few standardized picture sets have been developed that offer explicit images, with most lacking pornographic pictures depicting diverse sexual practices. This study aimed to fill this gap through developing a standardized affective set of diverse pornographic pictures (masturbation, oral sex, vaginal sex, anal sex, group sex, paraphilia) of same-sex and opposite-sex content, offering dimensional affective ratings of valence, arousal, and dominance, as well as co-elicited discrete emotions (disgust, moral and ethical acceptance). In total, 192 pornographic pictures acquired from online pornography platforms and 24 control IAPS images have been rated by 319 participants (Mage = 22.66, SDage = 4.66) with self-reported same- and opposite-sex sexual attraction. Stimuli were representative of the entire affective space, including positively and negatively perceived pictures. Participants showed differential affective perception of pornographic pictures according to gender and sexual attraction. Differences in affective ratings related to participants' gender and sexual attraction, as well as stimuli content (depicted sexual practices and sexes). From the stimuli set, researchers can select explicit pornographic pictures based on the obtained affective ratings and technical parameters (i.e., pixel size, luminosity, color space, contrast, chromatic complexity, spatial frequency, entropy). The stimuli set may be considered a valid tool of diverse explicit pornographic pictures covering the affective space, in particular, for women and men with same- and opposite-sex sexual attraction. This new explicit pornographic picture set (EPPS) is available to the scientific community for non-commercial use.

Salivary testosterone across the menstrual cycle

Testosterone production in women is thought to systematically shift across the menstrual cycle, peaking during the mid-cycle ovulatory window, and potentially influencing women's behavior. Testosterone is a molecular intermediary to the production of estradiol, which is necessary for ovulation to occur, but the amount of testosterone escape and exposure to the peripheral tissues is not fully understood. Salivary testosterone is a common biomarker in behavioral neuroendocrinological studies and is thought to reflect the bioactive portions in serum. In N = 339 women with confirmed ovulation via luteinizing hormone tests, salivary testosterone, assayed with LC-MS/MS, was sampled four times across the mid-cycle ovulatory window the luteal phase. Within-subject analysis revealed a significant but small pattern of a mid-cycle peak and a luteal decrease at the aggregate level. However, at the individual level, there was substantial variability in the direction and magnitude of the testosterone-cycle pattern. We discuss the relevant underlying physiology, background research, issues with assay methodolody, and considerations for researchers studying testosterone levels in women.

Selective attention towards infants in nulliparous women across the menstrual cycle

Research in women showed that testosterone is associated with decreased selective attention towards infant stimuli, which can be compensated for by oxytocin administration. In theory, caregiving behavior is thought to be mediated by oxytocin. Oxytocin binds to dopaminergic neurons and thus supposedly motivates aspects of caregiving through its influence on dopaminergic transmission. Most previous studies on caregiving behaviors were thereby performed in women under hormonal contraception to avoid hormonal fluctuations. However, recent studies repeatedly demonstrated decisive influences of the hormonal changes across the female menstrual cycle on dopamine-mediated behaviors, suggesting that estradiol acts as dopamine agonist in the follicular phase and progesterone as dopamine antagonist in the luteal phase. In the present study, we investigated selective attention towards infants as one central aspect of caregiving behavior over the natural menstrual cycle and in relation to interindividual differences of estradiol and progesterone. As expected, we found that women with higher estradiol in the follicular phase also showed higher selective attention towards infant faces among adult distractors, whereas the correlation disappeared in the luteal phase. In contrast, progesterone did not correlate with selective attention towards infants. The present findings collectively support the assumption that estradiol may act as dopamine agonist in the follicular phase, thereby supposedly promoting an important aspect of caretaking behavior.

Brain flexibility increases during the peri-ovulatory phase as compared to early follicular phase of the menstrual cycle

The brain operates in a flexible dynamic regime, generating complex patterns of activity (i.e. neuronal avalanches). This study aimed at describing how brain dynamics change according to menstrual cycle (MC) phases. Brain activation patterns were estimated from resting-state magnetoencephalography (MEG) scans, acquired from women at early follicular (T1), peri-ovulatory (T2) and mid-luteal (T3) phases of the MC. We investigated the functional repertoire (number of brain configurations based on fast high-amplitude bursts of the brain signals) and the region-specific influence on large-scale dynamics across the MC. Finally, we assessed the relationship between sex hormones and changes in brain dynamics. A significantly larger number of visited configurations in T2 as compared to T1 was specifically observed in the beta frequency band. No relationship between changes in brain dynamics and sex hormones was evident. Finally, we showed that the left posterior cingulate gyrus and the right insula were recruited more often in the functional repertoire during T2 as compared to T1, while the right pallidum was more often part of the functional repertoires during T1 as compared to T2. In summary, we showed hormone-independent increased flexibility of the brain dynamics during the ovulatory phase. Moreover, we demonstrated that several specific brain regions play a key role in determining this change.

Determining menstrual cycle phase: An empirical examination of methodologies and recommendations for improvement in behavioral and brain sciences

The recent decade has brought an exciting proliferation of behavioral, psychological and neuroscientific research involving the menstrual cycle. However, the reliability and validity of many popular methodologies for determining menstrual cycle phase lack empirical examination. These under-investigated methods include: (1) predicting menstrual cycle phase using self-report information only (e.g., "count" methods), (2) utilizing ovarian hormone ranges to determine menstrual cycle phase, and (3) using ovarian hormone changes from limited measurements (e.g., two time points) to determine menstrual cycle phase. In the current study, we examine the accuracy of these methods for menstrual cycle phase determination using 35-day within-person assessments of circulating ovarian hormones from 96 females across the menstrual cycle. Findings indicate that all three common methods are error-prone, resulting in phases being incorrectly determined for many participants, with Cohen's kappa estimates ranging from -0.13 to 0.53 indicating disagreement to only moderate agreement depending on the comparison. Such methodological challenges are surmountable through careful study design, more frequent hormone assays (when possible), and utilization of sophisticated statistical methods. With increased methodological rigor in behavioral, psychological and neuroscientific research, the field will be poised to detect biobehavioral correlates of ovarian hormone fluctuations for the betterment of the mental health and wellbeing of millions of females.

Chemical contraceptive impacts on cyclic progesterone and sexual behavior in zoo-housed Western lowland gorillas

For regularly cycling primates in captivity, chemical contraceptives can be used to reduce the likelihood of unintentional offspring, but the effects on cyclic progesterone and sexual behavior have not been well studied in gorillas (Gorilla gorilla gorilla). As zoos are invested in maintaining naturalistic behaviors and physiology, this is an important aspect of gorilla physical and mental health. We examined how exposure to combination and progestin-only oral birth control pills altered cyclic progesterone and timing of sexual behaviors in four female gorillas at four institutions compared to cycling controls. Hormonal data were collected using fecal steroid metabolites as detected by enzyme immunoassay. Behavioral data were collected via one-zero sampling done by keeper staff. All methods of oral contraceptive eliminated the ovarian cycle, with fecal progestogens being maintained below baselines in cycling control individuals. There was also no evidence of any cyclic patterning in endogenous progesterone, suggesting that the methods tested do not allow for detection of a recovery of endogenous progesterone during a short no-pill period. We also found that the oral contraceptives altered the timing of behavioral displays when compared to cycling control individuals but was not directly related to any fluctuations in endogenous progesterone. This study reveals a need for additional research on contraceptive use in gorillas and reinforces that sexual behavior in gorillas is both hormonally and socially mediated.

Ovarian hormones in relation to naturally cycling women's conception risk: Empirical evidence and implications for behavioral endocrinology

A substantial body of literature has examined how women's psychology and behavior vary as a function of conception risk across the ovarian cycle. These effects are widely believed to be outcomes of hormonal regulation, in particular effects of estrogens (E) and progesterone (P). Increasingly, researchers have sought to test predictions about how psychological processes or behavior vary as a function of conception risk by examining associations with estrogen (e.g., estradiol) and progesterone levels. Yet issues regarding how best to assess these associations arise. Should hormone levels be log-transformed? Do hormone ratios best capture their joint effects? How important are hormone interactions? How should outliers be treated? Across two large datasets, we examined hormonal predictors of conception risk, estimated from day of a luteinizing hormone (LH) surge. Log-transformed E and P levels predicted conception risk better than raw E and P levels did. The raw E/P ratio was a relatively poor predictor, whereas the log-transformed ratio (ln[E/P]) was a relatively good predictor. E × P interactions were detected but weak. Outliers were frequent, especially in distributions of raw hormone levels. Hormone measures predicted two psychological outcomes in these datasets-sexual desire and preferences for strength and muscularity-in parallel to how strongly they predicted conception risk. These results give rise to several recommendations regarding treatment of hormone measures and their use in analyses.

Melanocortin 4 receptor agonism enhances sexual brain processing in women with hypoactive sexual desire disorder

BACKGROUND

Hypoactive sexual desire disorder (HSDD) is characterized by a persistent deficiency of sexual fantasies and desire for sexual activity, causing marked distress and interpersonal difficulty. It is the most prevalent female sexual health problem globally, affecting approximately 10% of women, but has limited treatment options. Melanocortin 4 receptor (MC4R) agonists have emerged as a promising therapy for women with HSDD, through unknown mechanisms. Studying the pathways involved is crucial for our understanding of normal and abnormal sexual behavior.

METHODS

Using psychometric, functional neuroimaging, and hormonal analyses, we conducted a randomized, double-blinded, placebo-controlled, crossover clinical study to assess the effects of MC4R agonism compared with placebo on sexual brain processing in 31 premenopausal heterosexual women with HSDD.

RESULTS

MC4R agonism significantly increased sexual desire for up to 24 hours after administration compared with placebo. During functional neuroimaging, MC4R agonism enhanced cerebellar and supplementary motor area activity and deactivated the secondary somatosensory cortex, specifically in response to visual erotic stimuli, compared with placebo. In addition, MC4R agonism enhanced functional connectivity between the amygdala and the insula during visual erotic stimuli compared with placebo.

CONCLUSION

These data suggest that MC4R agonism enhanced sexual brain processing by reducing self-consciousness, increasing sexual imagery, and sensitizing women with HSDD to erotic stimuli. These findings provide mechanistic insight into the action of MC4R agonism in sexual behavior and are relevant to the ongoing development of HSDD therapies and MC4R agonist development more widely.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04179734.

FUNDING

This is an investigator-sponsored study funded by AMAG Pharmaceuticals Inc., the Medical Research Council (MRC) (MR/T006242/1), and the National Institute for Health Research (NIHR) (CS-2018-18-ST2-002 and RP-2014-05-001).

Effects of Kisspeptin Administration in Women With Hypoactive Sexual Desire Disorder: A Randomized Clinical Trial

IMPORTANCE

Despite being the most common female sexual health complaint worldwide, current treatment options for hypoactive sexual desire disorder (HSDD) are limited in their safety and effectiveness. The hormone kisspeptin is a key endogenous activator of the reproductive hormonal axis with additional emerging roles in sexual and emotional behavior; however, its effects in women with HSDD are unknown.

OBJECTIVE

To test the hypothesis that kisspeptin enhances sexual and attraction brain processing in women with HSDD.

DESIGN, SETTING, AND PARTICIPANTS

This randomized clinical trial was double-masked and placebo controlled with a 2-way crossover. The trial was conducted in a university research setting in the UK from October 2020 to April 2021. Eligible participants were premenopausal women with HSDD. Functional neuroimaging, psychometric, and hormonal analyses were employed to investigate the effects of kisspeptin administration on brain processing, in response to erotic stimuli (erotic videos) and facial attraction (face images of varying attractiveness). Data were analyzed from May to December 2021.

INTERVENTIONS

A 75-minute intravenous infusion of kisspeptin-54 (1 nmol/kg/h) vs equivalent-rate placebo infusion.

MAIN OUTCOMES AND MEASURES

Blood oxygen level-dependent responses across the whole brain and regions of interest during kisspeptin vs placebo administration in response to erotic and facial attraction stimuli.

RESULTS

Of the 40 participants who were randomized, 32 women completed both kisspeptin and placebo visits, with a mean (SE) age of 29.2 (1.2) years. Kisspeptin administration resulted in modulations in sexual and facial attraction brain processing (deactivation of the left inferior frontal gyrus: Z max, 3.76; P = .01; activation of the right postcentral and supramarginal gyrus: Z max, 3.73; P < .001; deactivation of the right temporoparietal junction: Z max 4.08; P = .02). Furthermore, positive correlations were observed between kisspeptin-enhanced hippocampal activity in response to erotic videos, and baseline distress relating to sexual function (r = 0.469; P = .007). Kisspeptin's enhancement of posterior cingulate cortex activity in response to attractive male faces also correlated with reduced sexual aversion, providing additional functional significance (r = 0.476, P = .005). Kisspeptin was well-tolerated with no reported adverse effects.

CONCLUSIONS AND RELEVANCE

These findings lay the foundations for clinical applications for kisspeptin in women with HSDD.

TRIAL REGISTRATION

ISRCTN trial registry identifier: ISRCTN17271094.

Sexual incentive motivation, sexual behavior, and general arousal: Do rats and humans tell the same story?

Sexual incentive stimuli activate sexual motivation and heighten the level of general arousal. The sexual motive may induce the individual to approach the incentive, and eventually to initiate sexual acts. Both approach and the ensuing copulatory interaction further enhance general arousal. We present data from rodents and humans in support of these assertions. We then suggest that orgasm is experienced when the combined level of excitation surpasses a threshold. In order to analyze the neurobiological bases of sexual motivation, we employ the concept of a central motive state. We then discuss the mechanisms involved in the long- and short-term control of that state as well as those mediating the momentaneous actions of sexual incentive stimuli. This leads to an analysis of the neurobiology behind the interindividual differences in responsivity of the sexual central motive state. Knowledge is still fragmentary, and many contradictory observations have been made. Nevertheless, we conclude that the basic mechanisms of sexual motivation and the role of general arousal are similar in rodents and humans.

Sexual dysfunction with major depressive disorder and antidepressant treatments: impact, assessment, and management

INTRODUCTION

Sexual dysfunction (SD) is a symptom of depression in ≈70% of patients presenting with major depressive disorder (MDD). Antidepressant medications (AD) and adjunctive treatments may further contribute to SD and complicate evaluation and management.

AREAS COVERED

A systematic literature search of PubMed, Ovid MEDLINE and Cochrane databases for MDD, SD, classes of antidepressants, etc. was performed with a focus on 2014 to June 2021. SSRIs are associated with 70% treatment-emergent sexual dysfunction (TESD), SNRIs and tricyclics have rates of TESD of 40 - 45%, and antidepressant medications without SRI effects or with additional unique mechanisms of action have rates similar to placebo (<10%). Appropriate assessment at baseline and throughout treatment, consideration of patient preferences in prescribing, addressing modifiable factors (comorbid medical/psychiatric conditions, substances, relationship difficulties), and utilizing management strategies of switching to an AD with less SD, adding an antidote/adjunctive therapy or lowering the dose are discussed.

EXPERT OPINION

MDD and antidepressant treatment contribute to SD in a high percentage of patients. Treating to remission reduces SD as a symptom of depression. Frequent assessment and targeted management strategies may be effective in preventing or addressing SD. Secondary outcomes like impact on adherence, relationships and self-image should also be considered.

Stability and validity of steroid hormones in hair and saliva across two ovulatory cycles

Steroid hormones are often assessed via saliva samples, as they are noninvasive and easy to collect. However, hormone levels in saliva can fluctuate from moment-to-moment, are influenced by factors such as momentary emotional states and food intake, and some vary strongly across women's ovulatory cycle. In contrast, hormone levels in hair seem to be more robust against these influences and were previously suggested to be a good alternative to obtain women's baseline hormone levels. In the current study, we investigated whether hormone levels are stable across multiple assays and whether hormone levels from saliva and hair samples correlate. We collected saliva and hair samples from N = 155 naturally cycling women across two ovulatory cycles. All samples were analyzed for progesterone, testosterone and cortisol levels via mass spectrometry (LC-MS/MS). Results showed that both averaged saliva and hair hormone levels were moderately stable across cycles. Hair progesterone levels showed higher stability than the respective levels from saliva. Saliva and hair levels for progesterone and testosterone were moderately correlated, whereas cortisol levels from saliva and hair were only weakly correlated. Results suggest that the type of sample from which baseline hormone levels are assessed and the cycle phase in which saliva samples are collected may have a high impact on the obtained results. Implications for future studies are suggested.

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Testosterone, progesterone, and cortisol were analyzed from repeated saliva and hair samples via LC-MS/MS.

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Hormone levels are moderately stable in both saliva and hair samples.

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Progesterone levels are significantly more stable in hair samples as compared to saliva samples.

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Hair and saliva hormone samples correlate moderately for progesterone and testosterone, but only weakly for cortisol.

Putative Mental, Physical, and Social Mechanisms of Hormonal Influences on Postpartum Sexuality

Purpose of Review

Much research has documented changes in postpartum sexuality, including changes in sexual functioning and satisfaction for both the birthing parent and their partner(s). These changes are often linked to postpartum changes in hormonal and immune responses, which can have both direct and indirect effects on sexuality.

Recent Findings

Here, we review how postpartum sexuality may be changed via mental, physical, and social/relationship effects of a variety of hormones, including estrogens, progestogens, androgens, cortisol, and oxytocin. We also review the ways in which inflammation may act alongside hormones to influence postpartum sexuality.

Summary

We argue that, as each of these factors strongly influence the action of others, the next phase of research in postpartum sexuality must examine the bidirectional interactions of hormones and their effects on behavior, cognition, and social relationships.

Measurement of Sexual Interests with Pupillary Responses: A Meta-Analysis

Objective measures of sexual interest are important for research on human sexuality. There has been a resurgence in research examining pupil dilation as a potential index of sexual orientation. We carried out a meta-analytic review of studies published between 1965 and 2020 (Mdn year = 2016) measuring pupil responses to visual stimuli of adult men and women to assess sexual interest. Separate meta-analyses were performed for six sexual orientation categories. In the final analysis, 15 studies were included for heterosexual men (N = 550), 5 studies for gay men (N = 65), 4 studies for bisexual men (N = 124), 13 studies for heterosexual women (N = 403), and 3 studies for lesbian women (N = 132). Only heterosexual and gay men demonstrated discrimination in pupillary responses that was clearly in line with their sexual orientation, with greater pupil dilation to female and male stimuli, respectively. Bisexual men showed greater pupil dilation to male stimuli. Although heterosexual women exhibited larger pupils to male stimuli compared to female stimuli, the magnitude of the effect was small and non-significant. Finally, lesbian women displayed greater pupil dilation to male stimuli. Three methodological moderators were identified-the sexual explicitness of stimulus materials, the measurement technique of pupillary response, and inclusion of self-report measures of sexual interest. These meta-analyses are based on a limited number of studies and are therefore preliminary. However, the results suggest that pupillary measurement of sexual interest is promising for men and that standardization is essential to gain a better understanding of the validity of this measurement technique for sexual interest.

Impaired Sexual Function in Young Women With PCOS: The Detrimental Effect of Anovulation

BACKGROUND

Even though polycystic ovary syndrome (PCOS) is a common reproductive disorder affecting young women, its impact on their sexual health is not well known.

AIM

To examine the different aspects of female sexuality in young women with PCOS and attempt to associate hormonal changes and ovulatory status with their sexual function.

METHODS

Anthropometric characteristics, hormonal levels and sexual function based on the Female Sexual Function Index (FSFI) questionnaire were assessed in 76 young women with PCOS and 133 matched controls.

OUTCOMES

Sexual function is significantly impaired in young women with PCOS.

RESULTS

Women with PCOS demonstrated lower scores than controls in arousal (5.04 ± 1.19 vs 4.48 ± 1.44, P < .001), lubrication (5.29 ± 1.17 vs 4.69 ± 1.54, P < .001), orgasm (4.78 ± 1.40 vs 4.11 ± 1.61, P = .001), satisfaction (5.22 ± 1.10 vs 4.78 ± 1.31, P = .016), and total score of the FSFI (29.51 ± 5.83 vs 26.76 ± 6.81, P < .001), even after correction for BMI. When corrected for total testosterone, the domains of lubrication, satisfaction, and total score of FSFI remained significantly impaired in women with PCOS (P values .037, .024, & .044 respectively). In multivariate logistic regression analysis, after adjusting for the effect of BMI and hormone levels, dysfunction in orgasm, satisfaction and the total FSFI score were still 3-4 times more common in PCOS (adjusted OR [95% CI]: 3.54, P = .020; 2.96, P = .050; 3.87, P = .027). Even though no statistically significant differences were observed between women with ovulatory PCOS and controls, we detected statistically significant differences in all domains of sexual function apart from pain between controls and PCOS women with anovulation (desire P value .04, arousal P value <.001, lubrication P value <.001, orgasm P value .001, satisfaction P value .001 and FSFI total score P value <.001).

CLINICAL IMPLICATIONS

Women with PCOS have compromised sexual function, which is independent of their BMI and highly dependent on their ovulatory status.

STRENGTHS AND LIMITATIONS

This is the first study in women with PCOS that implicates anovulation as a risk factor for sexual impairment in PCOS. Further studies are needed to elucidate the mechanisms implicated and to examine the effect of PCOS therapy on the patients' sexual function.

CONCLUSION

The adverse effect of PCOS status on the female sexual function is independent of BMI and only partially dependent on hormonal changes characterizing the syndrome. Anovulation appears to be the major determinant of sexual impairment among women with PCOS. Mantzou D, Stamou MI, Armeni AK, et al. Impaired Sexual Function in Young Women With PCOS: The Detrimental Effect of Anovulation. J Sex Med 2021;18:1872-1879.

Specific factors and methodological decisions influencing brain responses to sexual stimuli in women

Most of the neuroimaging studies on sexual behavior have been conducted with male participants, leading to men-based models of sexual arousal. Here, possible factors and methodological decisions that might influence brain responses to sexual stimuli, specifically for the inclusion of women, will be reviewed. Based on this review, we suggest that future studies consider the following factors: menstrual phase, hormonal contraception use, history of sexual or psychiatric disorders or diseases, and medication use. Moreover, when researching sexual arousal, we suggest future studies assess sexual orientation and preferences, that women should select visual sexual stimuli, and a longer duration than commonly used. This review is thought to represent a useful guideline for future research in sexual arousal, which hopefully will lead to a higher inclusion of women and therefore more accurate neurobiological models of sexual arousal.

The role of androgens in women's health and wellbeing

Androgens in women, as well as in men, are intrinsic to maintenance of (i) reproductive competency, (ii) cardiac health, (iii) appropriate bone remodeling and mass retention, (iii) muscle tone and mass, and (iv) brain function, in part, through their mitigation of neurodegenerative disease effects. In recognition of the pluripotency of endogenous androgens, exogenous androgens, and selected congeners, have been prescribed off-label for several decades to treat low libido and sexual dysfunction in menopausal women, as well as, to improve physical performance. However, long-term safety and efficacy of androgen administration has yet to be fully elucidated. Side effects often observed include (i) hirsutism, (ii) acne, (iii) deepening of the voice, and (iv) weight gain but are associated most frequently with supra-physiological doses. By contrast, short-term clinical trials suggest that the use of low-dose testosterone therapy in women appears to be effective, safe and economical. There are, however, few clinical studies, which have focused on effects of androgen therapy on pre- and post-menopausal women; moreover, androgen mechanisms of action have not yet been thoroughly explained in these subjects. This review considers clinical effects of androgens on women's health in order to prevent chronic diseases and reduce cancer risk in gynecological tissues.

Using Anthropological Principles to Transform the Teaching of Human "Difference" and Genetic Variation in College Classrooms

Exposure to information about genetics is at an all-time high, while a full understanding of the biocultural complexity of human difference is low. This paper demonstrates the value of an "anthropological approach" to enhance genetics education in biology, anthropology, and other related disciplines, when teaching about human differences such as race/ethnicity, sex/gender, and disability. As part of this approach, we challenge educators across social and natural sciences to critically examine and dismantle the tacit cultural assumptions that shape our understanding of genetics and inform the way we perceive (and teach about) human differences. It calls on educators from both social and natural science disciplines to "de-silo" their classrooms and uses examples from our biological anthropology and sociocultural anthropology classrooms, to demonstrate how educators can better contextualize the "genetics" of human difference in their own teaching. Numerous opportunities to transform our teaching exist, and we are doing a disservice to our students by not taking these critical steps.

Sexual Chemosignals: Evidence that Men Process Olfactory Signals of Women's Sexual Arousal

Research suggests that humans can communicate emotional states (e.g., fear, sadness) via chemosignals. However, thus far little is known about whether sexual arousal can also be conveyed through chemosignals and how these signals might influence the receiver. In three experiments, and a subsequent mini meta-analysis, support was found for the hypothesis that men can process the scent of sexually aroused women and that exposure to these sexual chemosignals affect the subsequent perceptions and sexual motivation of men. Specifically, Experiment 1 revealed that men evaluate the axillary sweat of sexually aroused women as more attractive, compared to the scent of the same women when not sexually aroused. In addition, Experiment 2 showed that exposure to sexual chemosignals increased the men's sexual arousal. Experiment 3 found support for the thesis that exposure to sexual chemosignals would increase sexual motivation. As predicted, men devoted greater attention to and showed greater interest in mating with women who displayed sexual cues (e.g., scantily dressed, in seductive poses). By contrast, exposure to the sexual chemosignals did not alter males' attention and mating interest toward women who displayed no sexual cues. It is discussed how sexual chemosignals may function as an additional channel in the communication of sexual interest and how contextual factors can influence the dynamics of human sexual communication.

Avoidance Learning Across the Menstrual Cycle: A Conceptual Replication

Hormonal transitions across the menstrual cycle may modulate human reward processing and reinforcement learning, but previous results were contradictory. Studies assessed relatively small samples (n < 30) and exclusively used within-subject designs to compare women in hormonally distinct menstrual cycle phases. This increased the risk of sporadic findings and results may have been disproportionally affected by expectancy effects. Also, replication studies are widely missing, which currently precludes any reliable inferences. The present study was intended as a conceptual replication of a previous study [(1), Neuropsychologia 84; n = 15]. There, we had observed a reduction in avoidance learning capacity when women were in the high estradiol state of the late follicular phase as compared to the mid luteal phase with enhanced progesterone influence. These results conformed to the idea that estradiol and progesterone may antagonistically modulate dopaminergic transmission as a dopamine agonist and antagonist, respectively. Heightened progesterone in the luteal phase thereby supported the ability to learn from the negative outcomes of one's actions, while the follicular rise in estradiol interfered with this capacity. Here, we re-examined the above described within-subject difference between the follicular and the luteal phase in a between-subjects design. Seventy-five women were tested once with a probabilistic feedback learning task, while being either in the follicular (36 women) or luteal phase (39 women), and were compared for phase-related differences in behavior. Secondly, we combined the new data with data from three previous studies from our laboratory that used the same task and menstrual cycle phases. This meta-analysis included only data from the first test day, free of any biasing expectancy effects. Both analyses demonstrated the consistency of the decline in avoidance learning in the follicular relative to the luteal phase. We also showed that this decline reliably occurred in all of the included samples. Altogether, these results provide evidence for the consistency of a behavioral difference and its apparent association with a transient change in hormonal state that occurs in the natural menstrual cycle. Our findings may also open new avenues for the development of reliable between-subjects test protocols in menstrual cycle research.

Attentional bias toward and distractibility by sexual cues: A meta-analytic integration

From an evolutionary perspective, sexual stimuli are highly salient and are assumed to be processed with high priority. Hence, attentional processing of sexual cues is expected to not only bias attention but to also distract from other cognitive (foreground) tasks. It is, however, unclear to what extent these stimuli capture attention and whether there are differences between men and women. This meta-analysis combined the results of 32 studies employing experiments of attentional bias toward and distraction by sexual stimuli. From these, 13 studies provided data to examine gender differences. Overall, attentional bias and distractibility was lower than anticipated (g_z = 0.43, p < .001) and there was support for the assumption of higher attention bias/interference in men (g_s = 0.29, p = .031). Importantly, there was evidence for the presence of publication bias. With this in mind, findings are discussed in the context of stimulus features, the impact of provoked sexual arousal and motivational state, and gender-specific and -nonspecific neural processing of sexual stimuli which influence attention toward them.

Influence of androgen levels on conception probability in patients undergoing fertility treatment: a retrospective cohort study

PURPOSE

Primary and secondary sterility have become an issue of increasing importance due to demographic and social changes in society. Data regarding the association between female androgen levels and the probability of successful conception after fertility treatment are sparse and contradictive. This study was designed to assess this clinical question.

METHODS

In this retrospective single-center cohort study concentrations of androgens androstenedione, dehydroepiandrosteronsulfat (DHEAS) and testosterone (ng/ml) were investigated in the serum of patients presenting for sterility at the department of reproductive medicine of Saarland University hospital Homburg between January 2015 and December 2017. Androgen levels were correlated with reproductive outcomes. Statistical analysis was performed with the aid of SPSS version 24. Significance for conception rates in dependence of androgen concentration was assessed using Kruskal-Wallis test (significance was estimated with p < 0.05).

RESULTS

The laboratory values of a total of 301 patients were examined (64% primary, 36% secondary sterility). Median age at first visit at the fertility department was 32.7 years (range 20-47 years). 64 pregnancies were observed during the study period (conception rate 21.3%). 23 out of 301 patients (7.6%) suffered from hypoandrogenaemia, 248 (82.4%) had normal androgen levels and 30 (10%) showed hyperandrogenaemia (p = 0.25). Regarding patients in whom fertility treatment was successful 3 (4.7%) showed hypoandrogenaemia, 54 (84.4%) were normoandrogenaemic and 7 (10.9%) had hyperandrogenaemia (p = 0.40 Kruskal-Wallis test).

CONCLUSIONS

We found no association between female androgen levels and sterility and reproductive outcomes.