Psychoendocrinological assessment of the menstrual cycle: the relationship between hormones, sexuality, and mood

Ovulatory cycle shifts in human motivational prioritisation of sex and food

Previous research on the endogenous effects of ovarian hormones on motivational states in women has focused on sexual motivation. The Motivational Priority Shifts Hypothesis has a broader scope. It predicts a shift from somatic to reproductive motivation when fertile. In a highly powered preregistered online diary study across 40 days, we tested whether 390 women report such an ovulatory shift in sexual and eating motivation and behaviour. We compared 209 naturally cycling women to 181 women taking hormonal contraceptives (HC) to rule out non-ovulatory changes across the cycle as confounders. We found robust ovulatory decreases in food intake and increases in general sexual desire, in-pair sexual desire and initiation of dyadic sexual behaviour. Extra-pair sexual desire increased mid-cycle, but the effect did not differ significantly in HC women, questioning an ovulatory effect. Descriptively, solitary sexual desire and behaviour, dyadic sexual behaviour, appetite, and satiety showed expected mid-cycle changes that were diminished in HC women, but these failed to reach our strict preregistered significance level. Our results provide insight into current theoretical debates about ovulatory cycle shifts while calling for future research to determine motivational mechanisms behind ovulatory changes in food intake and considering romantic partners' motivational states to explain the occurrence of dyadic sexual behaviour.

Relationship Between Steroid Hormone Profile and Premenstrual Syndrome in Women Consulting for Infertility or Recurrent Miscarriage

To determine the relationships between luteal-phase steroidal hormonal profile and PMS for a large number of women attending a dedicated fertility clinic. This was a retrospective cross-sectional study on women attending a hospital-based clinic for fertility concerns and/or recurrent miscarriage. All participants were assessed with a women's health questionnaire which also included evaluation of premenstrual symptoms. Day of ovulation was identified based on the peak mucus symptom assessed by the woman after instruction in a fertility awareness-based method (FABM). This enabled reliable timing of luteal-phase serum hormone levels to be taken and analysed. Between 2011 and 2021, 894 of the 2666 women undertaking the women's health assessment had at least one evaluable serum luteal hormone test. Serum progesterone levels were up to 10 nmol/L lower for symptomatic women compared with asymptomatic women. This difference was statistically significant (p < 0.05) for the majority of PMS symptoms at ≥ 9 days after the peak mucus symptom. A similar trend was observed for oestradiol but differences were generally not statistically significant. ROC curves demonstrated that steroid levels during the luteal phase were not discriminating in identifying the presence of PMS symptoms. Blood levels for progesterone were lower throughout the luteal phase in women with PMS, with the greatest effect seen late in the luteal phase.

Menstrual cycle-driven vs noncyclical daily changes in sexual desire

BACKGROUND

Past research on the association between sexual desire and the menstrual cycle has provided inconclusive results and has not considered the potential influence of psychological and physical changes that are frequently associated with the menstrual cycle.

AIM

To test the strength of association between the menstrual cycle (and associated symptoms) and changes in sexual desire.

METHODS

Prospective daily reports across 2 full menstrual cycles (2 months) from a sample of female university students (n = 213), were analysed. Analyses tested for average effects of the menstrual cycle on sexual desire, individual differences in these effects, and cyclical and noncyclical associations between sexual desire and the 9 menstrual cycle-related changes. Note that data presented in the current article come from a larger study from which other reports have been published.

OUTCOMES

Target variables were (1) daily change in sexual desire and (2) daily reports of 5 psychological changes and 4 physical changes that are commonly associated with the menstrual cycle.

RESULTS

Results showed that when considering average effects across participants, the menstrual cycle was associated with a small midcycle increase in sexual desire. However, multilevel analyses showed large individual differences in how the menstrual cycle influences sexual desire. Specifically, some participants showed a midcycle increase, others a perimenstrual increase, and others no change across the menstrual cycle. Moreover, results demonstrated that psychological changes were more important for predicting sexual desire as compared with physical changes.

CLINICAL IMPLICATIONS

These results suggest that daily measurement of sexual desire across multiple menstrual cycles may be an important tool in the assessment of sexual desire among some females.

STRENGTHS AND LIMITATIONS

Strengths of this study are the daily assessment of sexual desire and all symptoms for 2 menstrual cycles and multilevel analyses that allow the study of individual differences. Limitations include limited measurement of sexual desire based on only 2 questions and the lack of measures of relationship status and sexual orientation.

CONCLUSION

Emphasis is placed on the need to apply more rigorous research methods and to abandon simplistic average-effects models that are based on outdated theories and stereotypes.

Pairing status and stimulus type predict responses to audio playbacks in female titi monkeys

Some paired primates use complex, coordinated vocal signals to communicate within and between family groups. The information encoded within those signals is not well understood, nor is the intricacy of individuals' behavioral and physiological responses to these signals. Considering the conspicuous nature of these vocal signals, it is a priority to better understand paired primates' responses to conspecific calls. Pair-bonded titi monkeys (Plecturocebus cupreus) sing duets comprised of the male and female's long call. Here, we use a playback study to assess female titi monkeys' responses to different vocal stimuli based on the subject's pairing status. Six adult female titi monkeys participated in the study at two timepoints--pre-pairing and post-pairing. At each timepoint, subjects underwent three distinct playbacks--control recording, male solo vocalization, and pair duet. Behaviors such as locomotion and vocalizations were scored during and after the playback, and cortisol and androgen values were assessed via a plasma blood sample. Female titi monkeys attended more to social signals compared to the control, regardless of pairing status. However, in the time immediately following any playback type, female titi monkeys trilled more and spent a greater proportion of time locomoting during pre-pairing timepoints (compared to post-pairing). Female titi monkeys' behavioral responses to social audio stimuli, combined with subjects' increases in cortisol and androgens as paired individuals, imply female titi monkeys attend and respond to social signals territorially.

The androgen system across the menstrual cycle: Hormonal, (epi-)genetic and psychometric alterations

The menstrual cycle is characterized by various hormonal alterations and associations with mental and physical conditions have been postulated. Among endocrine factors, the androgen system has been a target of major interest in males and to a lesser extent in females and may influence emotion, cognition, behavior and somatic factors. Only few studies investigated alterations of these parameters throughout the menstrual cycle and there is a lack of studies exploring a link towards epigenetic and genetic regulation. This multisite longitudinal study examines behavioral parameters including affectivity, stress perception and various diary parameters of mental and physical well-being in conjunction with testosterone and LH plasma levels in 87 menstruating women. Additionally, Cysteine-Adenenine-Guanin (CAG) repeat length and methylation of the androgen receptor gene collected at four time points across two cycles comprising the menstrual, pre-ovulatory, mid-luteal and premenstrual phase were assesed. There was a significant increase of LH and testosterone plasma levels during the pre-ovulatory phase as well as a decrease of methylation of the androgen receptor at mid-luteal phase. Subjective ratings of physical condition and sexual interest peaked during the pre-ovulatory phase and the former correlated negatively with the androgen receptor gene methylation level. This longitudinal study shows alterations of the androgen system including epigenetic measurements throughout the menstrual cycle. While a link between peripheral testosterone and sexual activity and between increased physical condition and an upregulation of testosterone receptor protein expression can be assumed, the majority of parameters remained unchanged. These initial findings need validation by subsequent studies.

HPA axis activity across the menstrual cycle - a systematic review and meta-analysis of longitudinal studies

Differential HPA axis function has been proposed to underlie sex-differences in mental disorders; however, the impact of fluctuating sex hormones across the menstrual cycle on HPA axis activity is still unclear. This meta-analysis investigated basal cortisol concentrations as a marker for HPA axis activity across the menstrual cycle. Through a systematic literature search of five databases, 121 longitudinal studies were included, summarizing data of 2641 healthy, cycling participants between the ages of 18 and 45. The meta-analysis showed higher cortisol concentrations in the follicular vs. luteal phase (d_SMC = 0.12, p =.004, [0.04 - 0.20]). Comparisons between more precise cycle phases were mostly insignificant, aside from higher concentrations in the menstrual vs. premenstrual phase (d_SMC = 0.17, [0.02 - 0.33], p =.03). In all included studies, nine samples used established cortisol parameters to indicate HPA axis function, specifically diurnal profiles (k = 4) and the cortisol awakening response (CAR) (k = 5). Therefore, the meta-analysis highlights the need for more rigorous investigation of HPA axis activity and menstrual cycle phase.

Women's Estrus and Extended Sexuality: Reflections on Empirical Patterns and Fundamental Theoretical Issues

How do women's sexual interests change across their ovulatory cycles? This question is one of the most enduring within the human evolutionary behavioral sciences. Yet definitive, agreed-upon answers remain elusive. One empirical pattern appears to be robust: Women experience greater levels of sexual desire and interest when conceptive during their cycles. But this pattern is not straightforward or self-explanatory. We lay out multiple possible, broad explanations for it. Based on selectionist reasoning, we argue that the conditions that give rise to sexual interests during conceptive and non-conceptive phases are likely to differ. Because conceptive and non-conceptive sex have distinct functions, the sexual interests during conceptive and non-conceptive phases are likely to have different strategic ends. We discuss provisional evidence consistent with this perspective. But the exact nature of women's dual sexuality, if it exists, remains unclear. Additional empirical research is needed. But perhaps more crucially, this topic demands additional theory that fruitfully guides and interprets future empirical research.

Are Endogenous Androgens Linked to Female Sexual Function? A Systemic Review and Meta-Analysis

BACKGROUND

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.

AIM

To answer the question: is there an association between endogenous levels of androgens and sexual function in women?

METHODS

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.

OUTCOMES

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).

RESULTS

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.

CLINICAL IMPLICATIONS

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.

STRENGTHS & LIMITATIONS

This represents the first attempt at meta-analyzing data available on the topic. A significant publication bias was found for total T.

CONCLUSION

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.

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.

Circulating steroids and mood disorders in patients with polycystic ovary syndrome

Aberrant androgen metabolism is a characteristic feature of polycystic ovary syndrome (PCOS). Various androgens as well as their precursors and metabolites can accumulate in the blood of PCOS patients. Although these steroids include neuroactive steroids, such as allopregnanolone and androstenedione (Δ4A), it remains unknown whether altered blood steroid levels contribute to the high risk of mood disorders in PCOS. In this study, we measured blood levels of 11 steroids in 25 PCOS patients using liquid chromatography-tandem mass spectrometry and chemiluminescent enzyme immunoassay, and assessed the psychological status of these patients using the Hospital Anxiety and Depression Scale (HADS) questionnaire. We also examined age and the degree of metabolic abnormalities of each patient. Steroid values of the patients were compared to our previous data from 31 eumenorrheic women. As a result, 20 patients exhibited aberrant blood levels of one or more of the 11 tested steroids. In most cases, Δ4A and allopregnanolone levels were within or close to the reference ranges. Levels of four steroids were negatively correlated with patients' age, while no correlation was observed between steroid values and metabolic conditions. Seven patients showed high HADS scores. HADS scores were correlated with blood Δ4A levels even after stratifying by body mass indexes, but not with the levels of other steroids or clinical data. These results indicate that the high frequency of anxiety and depression in PCOS patients cannot be ascribed to altered blood levels of a specific steroid, although there may be a weak association between circulating Δ4A levels and psychological conditions of the patients.

Testosterone synthesis in the female songbird brain

Decades of work have established the brain as a source of steroid hormones, termed 'neurosteroids'. The neurosteroid neuroestradiol is produced in discrete brain areas and influences cognition, sensory processing, reproduction, neurotransmission, and disease. A prevailing research focus on neuroestradiol has essentially ignored whether its immediate synthesis precursor - the androgen testosterone - is also dynamically regulated within the brain. Testosterone itself can rapidly influence neurophysiology and behavior, and there is indirect evidence that the female brain may synthesize significant quantities of testosterone to regulate cognition, reproduction, and behavior. In songbirds, acoustic communication is regulated by neuroestrogens. Neuroestrogens are rapidly synthetized in the caudomedial nidopallium (NCM) of the auditory cortex of zebra finches in response to song and can influence auditory processing and song discrimination. Here, we examined the in vivo dynamics of NCM levels of the neuroestrogen synthesis precursor, testosterone. Unlike estradiol, testosterone did not appear to fluctuate in the female NCM during song exposure. However, a substantial song-induced elevation of testosterone was revealed in the left hemisphere NCM of females when local aromatization (i.e., conversion to estrogens) was locally blocked. This elevation was eliminated when local androgen synthesis was concomitantly blocked. Further, no parallel elevation was observed in the circulation in response to song playback, consistent with a local, neural origin of testosterone synthesis. To our knowledge, this study provides the first direct demonstration that testosterone fluctuates rapidly in the brain in response to socially-relevant environmental stimuli. Our findings suggest therefore that locally-derived 'neuroandrogens' can dynamically influence brain function and behavior. SIGNIFICANCE STATEMENT: This study demonstrates that androgen synthesis occurs rapidly in vivo in the brain in response to social cues, in a lateralized manner. Specifically, testosterone synthesis occurs within the left secondary auditory cortex when female zebra finches hear male song. Therefore, testosterone could act as a neuromodulator to rapidly shape sensory processing. Androgens have been linked to functions such as the control of female libido, and many steroidal drugs used for contraception, anti-cancer treatments, and sexual dysfunction likely influence the brain synthesis and action of testosterone. The current findings therefore establish a clear role for androgen synthesis in the female brain with implications for understanding neural circuit function and behavior in animals, including humans.

Gonadotropin-releasing hormone (GnRH) deficiency under treatment: psychological and sexual functioning impacts

OBJECTIVE

GnRH (gonadotropin releasing hormone) is a crucial hormone for sexual development, puberty, and fertility, and its deficiency leads to hypogonadotropic hypogonadism (HH), which causes abnormal secondary sexual development and infertility. The combination of the lack of sense of smell, i.e., anosmia, and HH is a type of GnRH deficiency known as Kallmann syndrome, which affects both men and women. The impact of Kallmann syndrome can be very severe and causes a variety of psychological problems in patients. The aim of the present study was to investigate psychopathology, sexuality, and personality characteristics in patients with GnRH deficiency under hormonal replacement therapy.

DESIGN

A total of 38 patients with GnRH deficiency aged 30.6 ± 10.44 years and 38 healthy matched for age individuals participated in the study and completed a series of questionnaires concerning sexual functioning, ego defense mechanisms, quality of life, personality characteristics, as well as anxiety and depression.

RESULTS

After adjustment for anxiety and depression, no difference in sexuality parameters were reported between men with and without GnRH deficiency, while women with GnRH deficiency had significantly lower sexual desire compared to controls. Concerning quality of life, satisfaction with general health was significantly lower in patients compared to controls, even after adjusting for sex. Furthermore, patients with GnRH deficiency indicated markedly less anxiety and a trend for less depression compared to controls. Finally, defense styles, ego-strength, and hostility did not differ between GnRH deficiency patients and controls.

CONCLUSIONS

Our study is the first to investigate psychological and sexual functioning impacts in patients with GnRH deficiency under hormonal replacement therapy. However, larger studies are needed so as to add further empirical evidence.

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

A robust body of research has demonstrated shifts in women's sexual desire and arousal across the menstrual cycle, with heightened desire and arousal coincident with heightened probability of conception (POC), and it is likely that ovarian hormones modulate these shifts. However, studies in which women are exposed to audiovisual sexual stimuli (AVSS) at high POC (mid-follicular) and low POC (luteal) phases have failed to detect significant differences in genital or subjective arousal patterns based on menstrual cycle phase. Here, we tested whether hormonal responsivity to AVSS differs as a function of cycle phase at testing, and whether phase during which participants were first exposed to AVSS influences hormonal responsivity in subsequent test sessions. Twenty-two naturally cycling heterosexual women were exposed to AVSS during the follicular and luteal phases, with phase at first test session counterbalanced across participants. Salivary samples were collected before and after AVSS exposure. Estradiol increased significantly during both follicular and luteal phase sessions, and increases were higher during the follicular phase. Testosterone (T) increased significantly only during the follicular phase session, while progesterone (P) did not change significantly during either cycle phase. Session order and current cycle phase interacted to predict P and T responses, such that P and T increased during the follicular phase in women who were first tested during the luteal phase. These data suggest that menstrual cycle phase influences hormonal responsivity to AVSS, and contribute to a growing body of clinical and empirical literature on the neuroendocrine modulators of women's sexuality.

A longitudinal analysis of salivary testosterone concentrations and competitiveness in elite and non-elite women athletes

BACKGROUND

There is evidence linking women's testosterone (T) to competitive behaviours in sport and exercise. To advance this work, we examined the longitudinal relationships between salivary T (sal-T) and competitiveness in athletic women who differ in training status.

METHODS

Elite (n = 9) and non-elite (n = 21) women athletes were monitored on days 6-8 (follicular phase), 13-15 (ovulatory phase) and 20-22 (Luteal phase) of a menstrual cycle with two repeats. Salivary T levels were assessed before breakfast, followed by two questions (each rated on a 1-7 scale) on competitive desire and training motivation. Using a linear mixed model, we evaluated the menstrual phase and training status effects on each variable, before assessing the within-subject effects of sal-T on competitiveness.

RESULTS

Salivary T concentrations were higher at ovulation (effect size [ES] difference = 0.2-1.4), relative to the follicular and luteal phases, with a more marked response among elite women (p < .01). The competitiveness ratings showed similar menstrual-phase variation (ES difference = 0.6-1.0 at ovulation). A positive effect of sal-T on competitiveness emerged in both groups (p < .001), but with different slope patterns (p < .015). Specifically, the elite sal-T relationships with desire to compete (standardized β = 1.147, SE = 0.132) and training motivation (β = 1.195, SE = 0.124) were stronger compared with non-elite women (β = 0.631, SE = 0.114; β = 0.778, SE = 0.114), respectively.

CONCLUSIONS

Morning sal-T concentrations, competitive desire and training motivation all peaked around ovulation in women athletes. Notably, sal-T availability and its relationship with competitiveness was stronger among high-performing athletes. Our findings confirm menstrual fluctuations in T and competitiveness among naturally-cycling women, with population context as a moderating factor.

Gender-Specificity in Viewing Time Among Heterosexual Women

Measures of sexual interest tend to be more gender-specific in heterosexual men than in heterosexual women. Cognitive measures, such as viewing time to attractive stimuli, may also show similar patterns of gender-specificity or nonspecificity among men and women and thus serve as useful adjuncts to more direct measures of sexual interest. The objectives of the present research were to determine the extent of gender-specificity in women's viewing times for female pictures (varying in their perceived physical attractiveness) and explore the influence of social comparison of physical appearance on these patterns of responses. In Study 1, we recorded only women's viewing times for pictures of both genders, measured self-reported menstrual cycle phase, and manipulated the waist-to-hip ratio of the women in the female pictures. In Study 2, we recorded women's and men's viewing times, self-reported sexual attraction to pictures of males and females, and physical appearance social comparison. Study 1 found that heterosexual women's viewing time toward female pictures was not associated with manipulation of the perceived attractiveness of those pictures. Study 2 found that heterosexual men were more gender-specific than heterosexual women in their viewing time patterns. We also found that reported sexual attraction and physical appearance social comparison were associated with heterosexual women's viewing times for female pictures, while heterosexual men's viewing times were associated with sexual attraction only. Our results are discussed in relation to the utility of viewing time as an indicator of visual attention toward attractive or sexually appealing visual stimuli.

Endocrinology of human female sexuality, mating, and reproductive 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.

Relations Between Self-Reported Adverse Events in Childhood and Hypersexuality in Adult Male Sexual Offenders

Hypersexuality, or extreme normophilic sexual urges and behaviors, is a controversial construct that was recently considered as a candidate disorder for the DSM-5 and was rejected. It was also rejected for inclusion in Section III (Conditions for Further Study). Nonetheless, it has been found to be an important predictor of recidivism among sex offenders, and it continues to be discussed widely in the literature. In the present study, we investigated the developmental roots of this construct in a sample of 529 adult male sexual offenders, who were administered the Multidimensional Assessment of Sex and Aggression. Physical, psychological, and sexual abuse experiences were estimated using several scales of early development. Psychological abuse in childhood and adolescence, especially by a father, was found to be the most prominent predictor of subsequent hypersexual thoughts and behaviors. The accumulation of abuse types, however, was also associated with a monotonic increase in the latent trait of hypersexuality. The consequences of these results for conceptualizations of the construct are discussed.

Is There a Gender Difference in Strength of Sex Drive? Theoretical Views, Conceptual Distinctions, and a Review of Relevant Evidence

The sex drive refers to the strength of sexual motivation. Across many different studies and measures, men have been shown to have more frequent and more intense sexual desires than women, as reflected in spontaneous thoughts about sex, frequency and variety of sexual fantasies, desired frequency of intercourse, desired number of partners, masturbation, liking for various sexual practices, willingness to forego sex, initiating versus refusing sex, making sacrifices for sex, and other measures. No contrary findings (indicating stronger sexual motivation among women) were found. Hence we conclude that the male sex drive is stronger than the female sex drive. The gender difference in sex drive should not be generalized to other constructs such as sexual or orgasmic capacity, enjoyment of sex, or extrinsically motivated sex.

Age at Time of Initial Sexual Intercourse and Health of Adolescent Girls

Adolescence is characterized by marked changes in the body, psychology, and sexual behavior due to increasing production of hormones. In this review we aimed to assess the effect of age at the time of first sexual intercourse (sexarche) on the health of adolescent girls, and identify factors that might protect against early initiation of sexual relations in girls. The PubMed, Lilacs, and Google Scholar databases were searched for clinical trials, comparative studies, case-control studies, cross-sectional studies, cohort studies, multicenter studies, observational studies, meta-analyses, and systematic reviews published up to December 2014 on this theme. The search terms were: "sexual debut," "coitarche," "sexarche," and "young people," "adolescent," "unplanned pregnancy," "adolescent contraception," and "STDs." Data were extracted from 28 studies and 41 references were used to introduce the theme and to support the discussion. Sexarche has been occurring in increasingly younger girls. A young age at sexarche can lead to subsequent risky sexual behavior. Girls who have sexarche when they are 14 years old or younger are less likely to use contraception on this occasion, take more time before they start using contraception in subsequent sexual relations, are more likely to have several sex partners, have a higher risk for depression, have lower self-esteem and more episodes of repentance, and have a higher risk for a sexually transmitted disease and cervical cancer. Girls with low educational, socioeconomic, and cultural status, little parental monitoring, parental separation, and absence of religiosity tend to experience sexarche at a younger age. Adolescent girls who postpone sexarche until they are 16 years old are physically and psychologically healthier than those who have sexarche at a younger age. This suggests that providing adolescent girls with appropriate education about sexual relations might reduce the negative effect of sexual relations at a young age.

Sex Differences, Evolutionary Psychology and Biosocial Theory

Biosocial theory claims that evolution did not design human psychological sex differences. It argues that these are the result of the allocation of men and women into different sex roles, based on physical differences. This article argues, however, that biosocial theory is not an alternative to evolutionary psychology in the explanation of human psychological sex differences. Specifically, biosocial theory is incompatible with evolutionary reasoning and it ignores findings of hormonal psychology, developmental psychology and comparative psychology. Moreover, by posing the need for special explanations, it violates the principle of Occam's razor. Finally, it does not provide an explanation as to why sex differences in human partner choice are finely tuned to fitness.

Theoretical frameworks for human behavioral endocrinology

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.

Conscious and Non-conscious Representations of Emotional Faces in Asperger's Syndrome

Several neuroimaging studies have suggested that the low spatial frequency content in an emotional face mainly activates the amygdala, pulvinar, and superior colliculus especially with fearful faces(1-3). These regions constitute the limbic structure in non-conscious perception of emotions and modulate cortical activity either directly or indirectly(2). In contrast, the conscious representation of emotions is more pronounced in the anterior cingulate, prefrontal cortex, and somatosensory cortex for directing voluntary attention to details in faces(3,4). Asperger's syndrome (AS)(5,6) represents an atypical mental disturbance that affects sensory, affective and communicative abilities, without interfering with normal linguistic skills and intellectual ability. Several studies have found that functional deficits in the neural circuitry important for facial emotion recognition can partly explain social communication failure in patients with AS(7-9). In order to clarify the interplay between conscious and non-conscious representations of emotional faces in AS, an EEG experimental protocol is designed with two tasks involving emotionality evaluation of either photograph or line-drawing faces. A pilot study is introduced for selecting face stimuli that minimize the differences in reaction times and scores assigned to facial emotions between the pretested patients with AS and IQ/gender-matched healthy controls. Information from the pretested patients was used to develop the scoring system used for the emotionality evaluation. Research into facial emotions and visual stimuli with different spatial frequency contents has reached discrepant findings depending on the demographic characteristics of participants and task demands(2). The experimental protocol is intended to clarify deficits in patients with AS in processing emotional faces when compared with healthy controls by controlling for factors unrelated to recognition of facial emotions, such as task difficulty, IQ and gender.

Sexual arousal and rhythmic synchronization: A possible effect of vasopressin

Music is ubiquitous. Yet, its biological relevance is still an ongoing debate. Supporting the view that music had an ancestral role in courtship displays, a pilot study presented here provides preliminary evidence on the link between music and sexual selection. The underlying hypothesis is based on the fact that the sexually dimorphic neuropeptide vasopressin has its receptors in the part of the brain involved in music and dance performance (the basal ganglia), and its concentrations rise during sexual arousal in men. In addition, music, dance, and courtship phenotypes seem to be in part regulated by vasopressin and its genes. Hence, to test this hypothesis, a rhythmic synchronization task was employed here on one male subject during sexual arousal. Results revealed a significant effect of sexual arousal on rhythm synchronization. This is the first report that empirically supports the hypothesis on the role of music in sexual selection. Further studies are clearly required.

Within-cycle fluctuations in progesterone negatively predict changes in both in-pair and extra-pair desire among partnered women

Grebe et al. (2016) argued that women's sexual interest in their own partners may be under different hormonal regulation than their sexual desire for other men. They measured partnered women's salivary hormones and reports of attraction to different categories of men at two time points separated by one week. Change in progesterone positively predicted change in women's desire for their own partners, whereas change in estradiol was a negative predictor. These results are opposite to those we previously reported for the hormonal prediction of general sexual desire in a study that employed frequent hormone sampling across multiple menstrual cycles (Roney and Simmons, 2013). Here, to test replication of the Grebe et al. findings, we assessed hormonal predictors of targeted in-pair and extra-pair desire among the subset of the sample from our 2013 paper who reported being in romantic relationships. Contrary to Grebe et al. (2016), we found that within-cycle fluctuations in progesterone were negatively correlated with changes in women's desire for both their own partners and other men. In addition, both in-pair and extra-pair desire were elevated within the fertile window and lowest during the luteal phase. Our findings contradict the idea that partner-specific desire has a unique form of hormonal regulation, and instead support a general elevation of sexual motivation associated with hormonal indices of fecundity. Discussion focuses on possible reasons for the discrepancies in findings between our study and that of Grebe et al. (2016), and on the evolved functions of women's sexual motivation.

A lack of consistent evidence for cortisol dysregulation in premenstrual syndrome/premenstrual dysphoric disorder

Although decades of research has examined the association between cortisol regulation and premenstrual syndrome/premenstrual dysphoric disorder (PMS/PMDD), no review exists to provide a general set of conclusions from the extant research. In the present review we summarize and interpret research that has tested for associations between PMS/PMDD and cortisol levels and reactivity (n=38 original research articles). Three types of studies are examined: correlational studies, environmental-challenge studies, and pharmacological-challenge studies. Overall, there was very little evidence that women with and without PMS/PMDD demonstrate systematic and predictable mean-level differences in cortisol, or differences in cortisol response/reactivity to challenges. Methodological differences in sample size, the types of symptoms used for diagnosis (physical and psychological vs. only affective), or the type of cortisol measure used (serum vs. salivary), did not account for differences between studies that did and did not find significant effects. Caution is recommended before accepting the conclusion of null effects, and recommendations are made that more rigorous research be conducted, considering symptom-specificity, within-person analyses, and multiple parameters of cortisol regulation, before final conclusions are drawn.

Increasing women's sexual desire: The comparative effectiveness of estrogens and androgens

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.

Duration of oral contraceptive use predicts women's initial and subsequent subjective responses to sexual stimuli

Recent work suggests that a woman's hormonal state when first exposed to visual sexual stimuli (VSS) modulates her initial and subsequent responses to VSS. The present study investigated whether women's initial hormonal state was related to their subjective ratings of VSS, and whether this relationship differed with VSS content. We reanalyzed previously collected data from 14 naturally cycling (NC) women and 14 women taking oral contraceptives (OCs), who subjectively rated VSS at three hormonal time-points. NC women's ratings of 216 unique sexual images were collected during the menstrual, periovulatory, and luteal phases of their menstrual cycles, and OC women's ratings were collected at comparable time-points across their pill-cycles. NC women's initial hormonal state was not related to their ratings of VSS. OC women's initial hormonal state predicted their ratings of VSS with minimal contextual information and of images depicting female-to-male oral sex. Specifically, women who entered the study in the third week of their pill-cycle (OC-3 women) rated such images as less attractive at all testing sessions than did all other women. OC-3 women were also the only women to rate decontextualized VSS as unattractive at all testing sessions. These results corroborate previous studies in which women's initial hormonal state was found to predict subsequent interest in sexual stimuli. Future work, with larger samples, should more directly investigate whether OC-3 women's negative assessment of specific types of VSS reflects a reaction to the laboratory environment or a broader mechanism, wherein OC women's sexual interests decrease late in their pill-cycle.

Is Hypersexuality Dimensional or Categorical? Evidence From Male and Female College Samples

The recent attempt to introduce hypersexual disorder into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has increased empirical scrutiny of the construct. Consensus on its definition and underlying structure remains elusive. Whereas some conceptualizations favor a categorical latent structure, others speculate that hypersexual behavior is dimensional. Research on the latent structure of hypersexual behavior, however, has been sparse. This is unfortunate, because determination of the latent structure can contribute to more accurate assessment, diagnosis, and understanding of etiological process. To date the only study on hypersexuality's latent structure found consistent evidence of a dimensional structure for males but less clear results for females. In the present study the Multidimensional Inventory of Development, Sex, and Aggression (MIDSA), a self-report, contingency-based inventory, was administered to 1,146 college students. Four indices of hypersexual behavior and six indices of sexual compulsivity were analyzed, using three taxometric methods (mean above minus below a cut [MAMBAC], maximum covariance [MAXCOV], and latent mode factor analysis [L-Mode]). Evidence supported a dimensional latent structure for hypersexuality in male and female samples. Future assessments of hypersexuality must focus on adequate reliability and discriminant validity across the continuum of sexual behavior rather than on attempts to differentiate between arbitrarily developed diagnostic categorizations.

Sexual activity, endogenous reproductive hormones and ovulation in premenopausal women

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 44years 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 8times/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.

Do hormones influence women's sex? Sexual activity over the menstrual cycle

INTRODUCTION

In mammals, the effects of ovarian steroids influence sexual behavior. In humans, there are a few studies that take into account if ovulation occurs.

AIM

The study aims to investigate if a woman's sexuality changes during the week and over the menstrual cycle, and if so, in what way.

METHODS

This is a prospective cohort study; 1,957 heterosexual women were involved over the period January 2004-December 2011. Two subgroups were taken into consideration, women having a partner and singles.

MAIN OUTCOME MEASURE

Sexual interview and the Female Sexual Function Index and Female Sexual Distress Scale questionnaires were used to exclude women with sexual dysfunction. Women with ovulation confirmed by sonography were enrolled. Women were given diary cards on which to report their daily sexual activity. Serum concentrations of estradiol, progesterone, total testosterone, sex hormone binding globulin, and free androgen index were measured during the follicular, periovular, and luteal phase of the menstrual cycle.

RESULTS

One thousand one hundred eighty women (age range 18-40 years) were included in the analyses. Of them, 925 had a heterosexual relationship and 255 were single. Women with a partner had more sexual activity during the weekend, while the singles had a constant sexual activity over the week. The sexual activity of singles was higher during the ovulatory phase and lower during menses than that of the women with a partner. A linear correlation between sexual activity and androgenic hormonal profile during the menstrual cycle in women with and without a partner was observed.

CONCLUSIONS

Ovarian steroids modulate a woman's sexual activity. This aspect was more evident in singles than in women having a partner, in which a variety of nonhormonal factors can have a role.

The influence of steroid sex hormones on the cognitive and emotional processing of visual stimuli in humans

Steroid sex hormones are responsible for some of the differences between men and women. In this article, I review evidence that steroid sex hormones impact on visual processing. Given prominent sex-differences, I focus on three topics for sex hormone effects for which there is most research available: 1. Preference and mate choice, 2. Emotion and recognition, and 3. Cerebral/perceptual asymmetries and visual-spatial abilities. For each topic, researchers have examined sex hormones and visual processing using various methods. I review indirect evidence addressing variation according to: menstrual cycle phase, pregnancy, puberty, and menopause. I further address studies of variation in testosterone and a measure of prenatal testosterone, 2D:4D, on visual processing. The most conclusive evidence, however, comes from experiments. Studies in which hormones are administrated are discussed. Overall, many studies demonstrate that sex steroids are associated with visual processing. However, findings are sometimes inconsistent, differences in methodology make strong comparisons between studies difficult, and we generally know more about activational than organizational effects.

Disentangling desire and arousal: a classificatory conundrum

A controversial proposal to collapse sexual disorders of desire and arousal is forthcoming in the diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5). Yet, no study has attempted to empirically distinguish these disorders by using explicit criteria to recruit and compare distinct groups of low desire and arousal sufferers. The goal of the current study was to test the feasibility of finding medically healthy men and women meeting clearly operationalized DSM-IV-TR criteria for disorders of desire and/or arousal and compare them to matched controls. To assess operational criteria, participants completed a comprehensive telephone screening interview assessing DSM-IV-TR and DSM-5 criteria, as well as standardized self-report measures of sexual functioning. The use of operationalized DSM-IV-TR criteria to recruit participants led to the exclusion of over 75% of those reporting sexual difficulties, with the primary reason for exclusion being failure to meet at least one central diagnostic criterion. The application of the DSM-5 criteria was even more restrictive and led to the exclusion of all but four men and one woman using the original four-symptom criteria, and four men and five women using the revised three-symptom criteria. Cluster analyses supported the distinction between desire and genital arousal difficulties, and suggest that different groups with distinct clusters of symptoms may exist, two of which are consistent with the DSM-5 criteria. Overall, results highlight the need for revisions to the diagnostic criteria, which, as they stand, do not capture the full range of many people's sexual difficulties.

Hormonal predictors of sexual motivation in natural menstrual cycles

Little is known regarding which hormonal signals may best predict within- and between-women variance in sexual motivation among naturally cycling women. To address this, we collected daily saliva samples across 1-2 menstrual cycles from a sample of young women; assayed samples for estradiol, progesterone, and testosterone; and also collected daily diary reports of women's sexual behavior and subjective sexual desire. With respect to within-cycle, day-to-day fluctuations in subjective desire, we found evidence for positive effects of estradiol and negative effects of progesterone. Desire exhibited a mid-cycle peak, similar to previous findings; measured progesterone concentrations statistically mediated the fall in desire from mid-cycle to the luteal phase, but no combination of hormone measures substantially mediated the follicular phase rise in desire, which suggests that other signals may be implicated in this effect. Hormonal predictors of within-cycle fluctuations in sexual behavior generally reached only trend levels of statistical significance, though the patterns again suggested positive effects of estradiol and negative effects of progesterone. Between-women and within-women, between-cycle effects of hormone concentrations were generally absent, although statistical power was more limited at these higher levels of analysis. There were no significant effects of testosterone concentrations when controlling for the effects of estradiol and progesterone, which raises questions regarding the importance of this hormone for the regulation of sexual motivation in natural cycles. Our study is among the first to identify hormonal predictors of within-cycle fluctuations in sexual motivation, and thus adds novel evidence regarding the endocrine correlates of human sexuality.

Darwin's legacy: an evolutionary view of women's reproductive and sexual functioning

On the Origin of species, published just over 150 years ago, has deeply influenced thinking in both scientific and wider communities. Darwin's legacy includes recognition of the fact that all organisms evolve; that variation within and between species is natural and normal; and that an evolutionary approach to understanding the sources and consequences of this variation comprises theoretical frameworks, testable hypotheses, and rigorously collected evidence. With an eye toward facilitating communication and productive collaboration among researchers from different intellectual traditions who nonetheless share a common interest in women's reproductive and sexual functioning, we discuss evolutionary concepts and models, summarize the known variability in ovarian functioning and consider the implications of this variability for conducting sex research, and evaluate the relative merits of various biomarkers that serve as proxy measurements of a woman's reproductive and hormonal status. With these perspectives and methods from reproductive ecology at hand, we examine several contentious issues: the links between hormones and sexuality in premenopausal and perimenopausal women, the causes of premenstrual syndrome, and the existence (or not) of menstrual synchrony. In none of these cases is as much known as is often claimed. In each, there are abundant opportunities for innovative, albeit challenging, research.

Momentary affective states surrounding sexual intercourse in depressed adolescents and young adults

Depressed young people may have sexual intercourse (sex) to regulate their disordered affective states. This study sought to determine how momentary positive and negative affect relate to subsequent sex events in depressed adolescents and young adults. Fifty-four outpatients (87% female) 15-22 years who reported clinically significant depressive symptoms and having sex at least once a week completed a baseline survey, then reported momentary affective states and the occurrence of sex events on a handheld computer in response to 4-6 random signals per day for 2 weeks. Participants identified 387 unique sex events (median, 3.5/participant/week) on 3,159 reports (median, signal response rate 80%). Most (86-96%) reported low burden of participation on questions asked at study completion. Similar to what has been reported in non-depressed young people, momentary positive and negative affect were both improved beginning approximately 6 h before until approximately 6 h after a sex event. Positive affect was lower in the 24 h before this pericoital period, compared to other times. Negative affect did not significantly differ between before the pericoital period and other times. The findings suggest that depressed youth may have sex to regulate their positive affect and have implications for provision of their mental and physical health care.

The role of ovarian steroid hormones in mood

Fluctuations in ovarian hormones across the menstrual cycle have long been considered a determinant of mood in women. The majority of studies, however, use menstrual cycle phase as proxy for hormone levels. We measured ovarian hormone levels directly in order to examine the relationship between daily hormone levels and mood in non-help-seeking women. Participants (n=19) provided daily information about their positive and negative moods, and collected their first morning-voided urine for 42days, which was analyzed for estrogen and progesterone metabolites (E1G and PdG). The independent contributions of daily E1G, PdG, stress, physical health, and weekly social support, were calculated for 12 daily mood items, and composite measures of positive and negative mood items, using linear mixed models. E1G or PdG contributed to few mood items: E1G measured 2days prior contributed negatively to the model for Motivation, while E1G measured 3days prior contributed negatively to Getting Along with Others, and E1G measured 4days prior contributed negatively to Anxiety. PdG, measured the same day and 1day prior, contributed positively to the models of Irritability, and PdG measured 5days prior contributed positively to Difficulty Coping. By contrast, the variables stress and physical health contributed significantly to all the mood items, as well as both composite positive and negative mood measures. These findings demonstrate that, compared to stress and physical health, ovarian hormones make only a small contribution to daily mood. Thus, fluctuations in ovarian hormones do not contribute significantly to daily mood in healthy women.

Women's sexuality, well-being, and the menstrual cycle: methodological issues and their interrelationships

Although many studies report that women's sexual behavior varies across their menstrual cycles, the research findings remain inconsistent. In this study, we addressed two methodological issues in research on the menstrual cycle: how ovulation is measured/inferred and whether data using menstrual cycles or participants' scores averaged across cycles as units of analysis yield similar results. We also employed an abstinent comparison group in addition to examining how emotional well-being was related to libido and sexual behavior through factor and regression analysis. Data were obtained from 97 participants. There were no significant differences in the results of analyses performed using cycles with known LH surges to determine ovulation versus cycles based on backward counts. However, we concluded that statistical power might be compromised when the known timing of ovulation was less accurate. Likewise, we found few overall differences in the results when we analyzed data using cycles with known LH surges compared to participants' averaged data across cycles. Women, including those in the abstinent group, reported increased sexual behavior prior to ovulation. Allosexual behavior was positively related to libido, and negatively related to positive and "premenstrual" emotional factors. Autosexual behavior was predicted by libido and an energetic/creative emotional factor. Our findings support hypotheses that women's sexual behavior is related to both mating and pair-bond formation.

Sexual desire, sexual arousal and hormonal differences in premenopausal US and Dutch women with and without low sexual desire

The interaction between women's hormonal condition and subjective, physiological, and behavioral indices of desire or arousal remains only partially explored, in spite of frequent reports from women about problems with a lack of sexual desire. The present study recruited premenopausal women at two sites, one in the United States and the other in the Netherlands, and incorporated various measures of acute changes in sexual desire and arousal. A sample of 46 women who met criteria for Hypoactive Sexual Desire Disorder (HSDD) was compared to 47 women who experienced no sexual problems (SF). Half of each group used oral contraceptives (OCs). The specific goal was to investigate whether there is a relationship between women's hormone levels and their genital and subjective sexual responsiveness. Background demographics and health variables, including oral contraceptive (OC) use, were recorded and hormones (total testosterone (T), free testosterone (FT), SHBG, and estradiol) were analyzed along with vaginal pulse amplitude and self-report measures of desire and arousal in response to sexual fantasy, visual sexual stimuli, and photos of men's faces. Self-reported arousal and desire were lower in the HSDD than the SF group, but only for women who were not using oral contraceptives. Relationships between hormones and sexual function differed depending on whether a woman was HSDD or not. In line with prior literature, FT was positively associated with physiological and subjective sexual arousal in the SF group. The HSDD women demonstrated the opposite pattern, in that FT was negatively associated with subjective sexual responsiveness. The findings suggest a possible alternative relationship between hormones and sexual responsiveness in women with HSDD who have characteristics similar to those in the present study.

Androgenic hormones and aging--the link with female sexual function

In women, sexual function, hormones and aging are inextricably related. Sexual activity in women involves interest and motivation, the ability to become aroused and achieve orgasm, the pleasure of the experience and subsequent personal satisfaction. Androgens, as endogenous hormones or given as a therapy, potentially influence female sexual function, with research into the effects of exogenous androgens in women mostly devoted to effects on sexual desire. Some studies have been conducted to delineate the effects of testosterone on arousal, however arousal determined by laboratory measures does not always correlate with subjective reporting of a sensation of arousal. Overall large randomised controlled trials of exogenous testosterone show benefits over placebo on sexual desire, arousal, orgasm, pleasure and satisfaction. The aspects of consideration of androgen therapy for women that continue to stimulate debate in this therapeutic area include whether female sexual dysfunction is a condition that merits pharmacotherapy, how effective is such treatment and whether testosterone therapy is safe.