Menstruation and marital sex

Behavioral and biological determinants of fecundability

Our discussion has focused on a set of behavioral and physiological factors which influence fecundability. Some potentially important determinants are notable primarily because of their absence. Foremost among these determinants (as a group) are the male attributes. We have, by and large, ignored the links between male sexual behavior and hormonal profiles and the effects of hormones (or other factors) on sperm function. The fact that we have not reviewed them here does not imply that we believe that they are unimportant. Indeed, the effects of male factors may be particularly important because in some settings men are the predominant, if not the sole, decision-makers regarding reproductive behaviors including initiation of sexual intercourse and use of contraception. Also conspicuous by their absence are the effects of nutrition, consumption of alcohol, exercise, smoking, and behavioral and hormonal correlates of stress, all of which may affect fecundability. We have, though, reviewed a wide range of factors which contribute to fecundability and identified several points of potential interaction between the behavioral and biological determinants. We expect that our future understanding of these processes will be enhanced by empirical work and modeling efforts which also interact to draw upon the insights provided by each.

Pregnancy avoidance and coital behavior

This study proposes a behavioral model that identifies determinants of coital activity in the context of pregnancy avoidance and assesses the relationships using weekly panel data collected on 300 rural married women in Sri Lanka in 1988. We discuss the utility of the design, which is similar to that of an epidemiological surveillance system, for the measurement of coital behavior and pregnancy risk perceptions. Perceptions of pregnancy risk, spousal agreement on sexual relations, menstrual and lactational status, and cycle timing, all measured daily, are found to influence significantly the probability of coitus on that day. The findings suggest that substantial gains in studying fertility regulation are likely from closer investigation of the behavioral connections between motivation for pregnancy avoidance and coital incidence. Comparison of such panel data with those of cross-sectional sample surveys also provides insights into the validity of measures of coital and contraceptive behavior.

Positive perimenstrual changes: toward a new perspective on the menstrual cycle

Although many women report negative symptoms, the perimenstrual phase also is associated with enhanced mood and performance among some women. However, research on perimenstrual concomitants reflects a sterotypic negative bias that does not encompass the complexity of the phenomena. This paper tries to redress that balance by documenting the prevalence of positive perimenstrual changes. Overall, about 5-15% of women experience increased excitement, energy, and well-being in the perimenstrual phase. Many women also report increased activity, heightened sexuality, and improved performance on certain types of tasks during the perimenstrual phase. Future research should examine why some women report positive perimenstrual changes, the extent to which individual variations in hormone levels can account for differences in women's perimenstrual experience, and how much women differ in their responsiveness to changing hormone levels. The influence of menstrual-related beliefs and expectations on the changes a woman reports also needs to be clarified.