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Handy AB, McMahon LN, Goldstein I, Meston CM. Reduction in genital sexual arousal varies by type of oral contraceptive pill. J Sex Med 2023; 20:1094-1102. [PMID: 37295939 DOI: 10.1093/jsxmed/qdad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/27/2023] [Accepted: 04/25/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although oral contraceptive pills (OCPs) have been associated with decrements in self-reported genital arousal and vaginal lubrication, 1,2 little is known about how these outcomes vary across types of OCPs. AIM The present study examined differences in physiological lubrication and vaginal blood flow, as well as rates of self-reported vulvovaginal atrophy and female sexual arousal disorder, among women using OCPs with varying androgenic properties. METHODS Participants in this study were 130 women: 59 naturally cycling control women, 50 women taking androgenic OCPs, and 21 women taking antiandrogenic OCPs. Participants watched sexual films while their sexual arousal responses were measured, completed questionnaires, and participated in a clinical interview. OUTCOMES Vaginal blood flow, vaginal lubrication, self-reported vulvovaginal atrophy, and female sexual arousal disorder were assessed. RESULTS Results indicated deficits in vaginal pulse amplitude and lubrication for women taking either form of OCP, with marked inhibitory effects found in women taking antiandrogenic OCPs. Rates of self-reported vulvovaginal atrophy and female sexual arousal disorder were also significantly greater in the antiandrogenic group compared with the control group. CLINICAL IMPLICATIONS It is recommended that prescribing clinicians consult patients on such physiological effects of OCPs. STRENGTHS AND LIMITATIONS To our knowledge, this was the first study to compare multiple measures of physiological sexual arousal across groups of women taking OCPs with varying hormonal profiles. Because all OCPs included in this study contained low doses of ethinylestradiol, we were able to identify the specific effects of the androgenic properties on women's sexual arousal responses. However, the self-administered lubrication test strip was subject to user error. Additionally, the generalizability of findings is limited by the largely heterosexual and college-aged sample. CONCLUSION Compared with naturally cycling women, women taking OCPs that contain antiandrogenic progestins experienced decreased vaginal blood flow and lubrication as well as higher rates of self-reported vaginal bleeding and female sexual arousal disorder.
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Affiliation(s)
- Ariel B Handy
- Department of Psychology, McLean Hospital, Belmont, MA 02478, United States
| | - Leah N McMahon
- Department of Psychology, University of Texas at Austin, Austin, TX 78712, United States
| | - Irwin Goldstein
- Department of Sexual Medicine, Alvarado Hospital, San Diego, CA 92120, United States
| | - Cindy M Meston
- Department of Psychology, University of Texas at Austin, Austin, TX 78712, United States
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2
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Kiesner J, Bittoni C, Eisenlohr-Moul T, Komisaruk B, Pastore M. Menstrual cycle-driven vs noncyclical daily changes in sexual desire. J Sex Med 2023; 20:756-765. [PMID: 37037659 DOI: 10.1093/jsxmed/qdad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 04/12/2023]
Abstract
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.
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Affiliation(s)
- Jeff Kiesner
- Department of Psychology, Università Degli Studi di Padova, Padova 35131, Italy
| | - Celeste Bittoni
- Department of Psychology, Università Degli Studi di Padova, Padova 35131, Italy
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, United States
| | - Barry Komisaruk
- Psychology Department, Rutgers University, Newark, NJ 07102, United States
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3
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Conzatti M, Maciel RF, Perez AV, De Castro DH, Sbaraini M, Wender MCO. Premenstrual Syndrome and Female Sexual Function. JOURNAL OF SEX & MARITAL THERAPY 2020; 47:186-196. [PMID: 33302813 DOI: 10.1080/0092623x.2020.1856988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To examine the relationship between Premenstrual Syndrome (PMS) and female sexual function (FSF) with the luteal (LP) and follicular phases (FP). METHOD We performed a cross-sectional survey using the Female Sexual Function Index (FSFI) questionnaire in the LP and FP. We used the Brazilian's version of the Premenstrual Symptoms Screen Tool (PSST) and the Daily Record of Severity of Problems (DRSP) for diagnosis of PMS. RESULTS There was no difference in the FSF between groups in both cycle phases. We found an association between LP and worst scores on FSFI. CONCLUSION PMS does not affect FSF.
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Affiliation(s)
- Maiara Conzatti
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
- Faculdade de Medicina, Universidade do Vale do Taquari (UNIVATES), Rio Grande do Sul, Brasil
| | - Rossana Figini Maciel
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Amanda Vilaverde Perez
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | | - Mariana Sbaraini
- Programa de Pós-graduação em Cardiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | - Maria Celeste Osório Wender
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
- Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
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Crowley PH. Self-Deception about Fecundity in Women : Modeling the Burley Hypothesis. HUMAN NATURE (HAWTHORNE, N.Y.) 2020; 31:421-442. [PMID: 33538980 DOI: 10.1007/s12110-020-09384-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
Concealed fecundity and extended female sexual receptivity have evolved in some primates, including humans, conferring advantages both within primarily monogamous relationships (e.g., benefits from paternity assurance) and from extrapair liaisons (e.g., better access to good genes). As humans evolved the intellectual capacity for decision-making, women became capable of altering their own fertility. In some circumstances, they may choose to ameliorate risks and responsibilities associated with pregnancy by reducing sexual motivation near the perceived most fecund time of their menstrual cycle. But three findings-a general inability of women to accurately recognize their own intervals of fecundity, high variability in ovulation timing, and unconscious transmission and reception of cues associated with fecundity-constitute a physiological and behavioral syndrome that can be considered self-deception. In this study, I develop a descriptive model to determine implications of the hypothesis that these features of female and male physiology and behavior have been shaped by natural selection in response to female decision-making. My analysis shows that consensus motivation for coitus between partners influences both the importance of variable ovulation date and the probability of conception, under the influence of self-deception. It also identifies priorities for future empirical work.
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Affiliation(s)
- Philip H Crowley
- Department of Biology, University of Kentucky, Lexington, KY, 40506, USA.
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5
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Çetin S, Aslan E. The analysis of female sexual functions, sexual satisfaction and depressive symptoms according to menstrual cycle phases. SEXUAL AND RELATIONSHIP THERAPY 2020. [DOI: 10.1080/14681994.2020.1792875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Serpil Çetin
- Faculty of Health Sciences, Department of Nursing, Izmir Bakırçay University, Menemen, İzmir
| | - Ergül Aslan
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpaşa, Sişli, Istanbul, Turkey
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6
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Derogatis LR, Revicki DA, Clayton AH. Instruments for Screening, Diagnosis, and Management of Patients with Generalized Acquired Hypoactive Sexual Desire Disorder. J Womens Health (Larchmt) 2020; 29:806-814. [PMID: 32096691 DOI: 10.1089/jwh.2019.7917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Screening, diagnosis, and management of hypoactive sexual desire disorder (HSDD) and research into the condition have been challenging due to its biopsychosocial complexity and lack of consensus on relevant measures. Although physician interviews yield much clinically valid information, self-reported questionnaires appear more acceptable to patients and physicians. Consequently, validated patient-reported outcome (PRO) tools are essential for evaluation and management of HSDD, including any therapeutic intervention. The US Food and Drug Administration (FDA) has issued guidance on the use of appropriate endpoints and associated measures for female sexual dysfunction, including HSDD. Although many of the available measures were not designed specifically for HSDD assessment, as per FDA guidelines, most clinical studies have used individual domains or items from established tools, such as the Female Sexual Function Index-desire domain and Item 13 of the revised Female Sexual Distress Scale. For clinical practice, several professional societies recommend the Decreased Sexual Desire Screener and/or a sexual history as tools to diagnose HSDD. This review discusses frequently used PRO tools as well as the newly developed and validated Elements of Desire Questionnaire, which may be appropriate for clinical trials or clinical practice.
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Affiliation(s)
| | | | - Anita H Clayton
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, Virginia
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8
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Motta-Mena NV, Puts DA. Endocrinology of human female sexuality, mating, and reproductive behavior. Horm Behav 2017; 91:19-35. [PMID: 27866819 DOI: 10.1016/j.yhbeh.2016.11.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 11/02/2016] [Accepted: 11/12/2016] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- Natalie V Motta-Mena
- Department of Psychology, Pennsylvania State University, University Park, PA 16802, United States
| | - David A Puts
- Department of Anthropology, Center for Brain, Behavior, and Cognition, Center for Human Evolution and Diversity, Pennsylvania State University, University Park, PA 16802¸ United States.
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9
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Abstract
Women experience multiple changes in social and reproductive statuses across the life span which can affect sexual functioning. Various phases of the sexual response cycle may be impacted and can lead to sexual dysfunction. Screening for sexual problems and consideration of contributing factors such as neurobiology, reproductive life events, medical problems, medication use, and depression can help guide appropriate treatment and thereby improve the sexual functioning and quality of life of affected women. Treatment options include psychotropic medications, hormone therapy, and psychotherapy.
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Affiliation(s)
- Anita H Clayton
- University of Virginia Department of Psychiatry and Neurobehavioral Sciences, 2955 Ivy Rd, Suite 210, Charlottesville, VA, 22903, USA.
| | - Veronica Harsh
- University of Virginia Department of Psychiatry and Neurobehavioral Sciences, 2955 Ivy Rd, Suite 210, Charlottesville, VA, 22903, USA.
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10
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Ussher JM, Perz J, May E. Pathology or source of power? The construction and experience of premenstrual syndrome within two contrasting cases. FEMINISM & PSYCHOLOGY 2014. [DOI: 10.1177/0959353514539650] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This research examines the construction and experience of premenstrual syndrome (PMS) in the context of intimate couple relationships, through examination of two contrasting cases analysed using thematic decomposition of narrative interviews. Judith and her male partner pathologised premenstrual change, constructing the premenstrual self as out of control, and the epitome of the ‘monstrous feminine’. Judith reported feeling over-burdened and uncontrollably angry premenstrually, associated with relationship issues and absence of partner recognition or support. In contrast, Sophia normalised premenstrual change, challenging the association between PMS and the construction of woman as deviant or dysfunctional. Sophia reported heightened energy and creativity premenstrually, and engaged in self-care supported by her woman partner. These cases demonstrate that premenstrual distress is an intersubjective experience, with constructions and material practices within relationships providing the context for premenstrual women being positioned as pathological and needing to be contained, or conversely, as sensitive and needing support.
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Affiliation(s)
- Jane M Ussher
- Centre for Health Research, School of Medicine, University of Western Sydney, Australia
| | - Janette Perz
- Centre for Health Research, School of Medicine, University of Western Sydney, Australia
| | - Emily May
- Centre for Health Research, School of Medicine, University of Western Sydney, Australia
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11
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Ussher JM, Perz J. PMS as a process of negotiation: Women’s experience and management of premenstrual distress. Psychol Health 2013; 28:909-27. [DOI: 10.1080/08870446.2013.765004] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Bloch M, Meiboom H, Zaig I, Schreiber S, Abramov L. The use of dehydroepiandrosterone in the treatment of hypoactive sexual desire disorder: a report of gender differences. Eur Neuropsychopharmacol 2013; 23:910-8. [PMID: 23084789 DOI: 10.1016/j.euroneuro.2012.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 07/12/2012] [Accepted: 09/13/2012] [Indexed: 01/23/2023]
Abstract
Data regarding the efficacy of dehydroepiandrosterone (DHEA) in the treatment of hypoactive sexual desire disorder (HSDD) are scarce and inconsistent. We aimed to determine possible gender differences in the efficacy of DHEA as a treatment for HDSS. Postmenopausal women (n=27), and men (n=21) with HSDD, were randomized to receive either DHEA 100 mg daily or placebo for 6 weeks in a controlled, double blind study. Primary outcome measures were sexual function questionnaires. Hormone serum levels of DHEAS, total and bioavailable testosterone, estradiol, and urine levels of DHEA and androsterone were also measured. Participants on active treatment showed a significant increase in circulating serum levels of DHEAS, while bioavailable testosterone levels increased in women only. In women only, significant interaction effects were observed for sexual arousal (p<0.05), satisfaction (p<0.05), and cognition (trend; p=0.06). For arousal, a significant improvement was observed for the DHEA treated group at 6 weeks (p=0.001). Significant correlations were observed between bioavailable T and sexual cognitions, arousal and orgasm, while DHEAS was correlated with satisfaction. In the men, significant correlations were observed between testosterone and arousal (r=.45), sexual drive (r=.50) and orgasm (r=.55). In women with HSDD, DHEA treatment had a significant beneficial effect on arousal, whereas no efficacy was demonstrated in men, indicating a possible gender difference. This improvement seems to be mediated via DHEA's metabolism to testosterone. Our positive results suggest that the neurosteroid DHEA may be effective as a treatment for women with HSDD if administered at a dose of at least 100 mg per day.
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Affiliation(s)
- Miki Bloch
- Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
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13
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Puts DA, Dawood K, Welling LLM. Why women have orgasms: an evolutionary analysis. ARCHIVES OF SEXUAL BEHAVIOR 2012; 41:1127-1143. [PMID: 22733154 DOI: 10.1007/s10508-012-9967-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 11/08/2011] [Accepted: 02/19/2012] [Indexed: 06/01/2023]
Abstract
Whether women's orgasm is an adaptation is arguably the most contentious question in the study of the evolution of human sexuality. Indeed, this question is a veritable litmus test for adaptationism, separating those profoundly impressed with the pervasive and myriad correspondences between organisms' phenotypes and their conditions of life from those who apply the "onerous concept" of adaptation with more caution, skepticism or suspicion. Yet, the adaptedness of female orgasm is a question whose answer will elucidate mating dynamics in humans and nonhuman primates. There are two broad competing explanations for the evolution of orgasm in women: (1) the mate-choice hypothesis, which states that female orgasm has evolved to function in mate selection and (2) the byproduct hypothesis, which states that female orgasm has no evolutionary function, existing only because women share some early ontogeny with men, in whom orgasm is an adaptation. We review evidence for these hypotheses and identify areas where relevant evidence is lacking. Although additional research is needed before firm conclusions can be drawn, we find that the mate-choice hypothesis receives more support. Specifically, female orgasm appears to have evolved to increase the probability of fertilization from males whose genes would improve offspring fitness.
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Affiliation(s)
- David A Puts
- Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA.
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14
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Georgiadis JR, Kringelbach ML. The human sexual response cycle: brain imaging evidence linking sex to other pleasures. Prog Neurobiol 2012; 98:49-81. [PMID: 22609047 DOI: 10.1016/j.pneurobio.2012.05.004] [Citation(s) in RCA: 190] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 04/21/2012] [Accepted: 05/08/2012] [Indexed: 12/30/2022]
Abstract
Sexual behavior is critical to species survival, yet comparatively little is known about the neural mechanisms in the human brain. Here we systematically review the existing human brain imaging literature on sexual behavior and show that the functional neuroanatomy of sexual behavior is comparable to that involved in processing other rewarding stimuli. Sexual behavior clearly follows the established principles and phases for wanting, liking and satiety involved in the pleasure cycle of other rewards. The studies have uncovered the brain networks involved in sexual wanting or motivation/anticipation, as well as sexual liking or arousal/consummation, while there is very little data on sexual satiety or post-orgasmic refractory period. Human sexual behavior also interacts with other pleasures, most notably social interaction and high arousal states. We discuss the changes in the underlying brain networks supporting sexual behavior in the context of the pleasure cycle, the changes to this cycle over the individual's life-time and the interactions between them. Overall, it is clear from the data that the functional neuroanatomy of sex is very similar to that of other pleasures and that it is unlikely that there is anything special about the brain mechanisms and networks underlying sex.
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Affiliation(s)
- J R Georgiadis
- Department of Neuroscience/Section Anatomy, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
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15
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PMS as a Gendered Illness Linked to the Construction and Relational Experience of Hetero-Femininity. SEX ROLES 2011. [DOI: 10.1007/s11199-011-9977-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Salonia A, Giraldi A, Chivers ML, Georgiadis JR, Levin R, Maravilla KR, McCarthy MM. Physiology of Women's Sexual Function: Basic Knowledge and New Findings. J Sex Med 2010; 7:2637-60. [DOI: 10.1111/j.1743-6109.2010.01810.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Pillsworth EG, Haselton MG. Male sexual attractiveness predicts differential ovulatory shifts in female extra-pair attraction and male mate retention. EVOL HUM BEHAV 2006. [DOI: 10.1016/j.evolhumbehav.2005.10.002] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Brewis A, Meyer M. Demographic Evidence That Human Ovulation Is Undetectable (At Least in Pair Bonds). CURRENT ANTHROPOLOGY 2005. [DOI: 10.1086/430016] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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19
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20
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Steiner M, MacDougall M, Berger C, Carter D, Reid R, Steinberg S, Stewart D. Assessment of sexual drive and desire in women with premenstrual dysphoric disorder who have been treated with fluoxetine. Int J Psychiatry Clin Pract 2005; 9:120-3. [PMID: 24930793 DOI: 10.1080/13651500510029002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective To explore the impact of treatment with fluoxetine on sexual drive and desire (SDD) in women with premenstrual dysphoric disorder (PMDD). Methods Data were collected during a randomised, controlled, double-blind trial evaluating the efficacy of fluoxetine 20 or 60 mg/day versus placebo in the treatment of women with PMDD. Study subjects rated their SDD on the Premenstrual Tension Scale, Self Rating (PMTS-SR) during their follicular and luteal phases of the placebo run in cycles and the double-blind treatment cycles. Data were analyzed using chi-square test. Results Data were available for 184 subjects who rated their SDD during the follicular and luteal phases of two baseline (placebo) cycles and the following two treatment cycles. There was a trend for more women on fluoxetine to report improvement in luteal phase SDD compared to women on placebo (P=0.057). Conclusions Our data, contrary to expectations, suggest that fluoxetine treatment may restore SDD in women who experience decreased SDD as part of a cluster of symptoms associated with PMDD. Future trials with SSRIs should include specific measures of sexual functioning to further examine the potential beneficial versus side effects of these medications as they relate to phases of the menstrual cycle.
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Affiliation(s)
- Meir Steiner
- McMaster University, St. Joseph's Healthcare, Hamilton, Ontario
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21
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Fessler DM. Rape is not less frequent during the ovulatory phase of the menstrual cycle. ACTA ACUST UNITED AC 2003. [DOI: 10.1080/14616660410001662361] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Fessler DM, Navarrete C. Domain-specific variation in disgust sensitivity across the menstrual cycle. EVOL HUM BEHAV 2003. [DOI: 10.1016/s1090-5138(03)00054-0] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Serra A, Maiolino L, Agnello C, Messina A, Caruso S. Auditory brain stem response throughout the menstrual cycle. Ann Otol Rhinol Laryngol 2003; 112:549-53. [PMID: 12834125 DOI: 10.1177/000348940311200612] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A prospective study was performed to evaluate the changes in the auditory brain stem response (ABR) that occur in healthy premenopausal women throughout the menstrual cycle. Ninety-four women with ovulatory menstrual cycles underwent ABR testing by auditory evoked potentials for wave I, III, and V latencies and for interpeak I-III, I-V, and III-V intervals during the follicular, periovular, and luteal phases of the menstrual cycle. The wave latencies and the interpeak intervals showed shorter values during the periovular phase than during the luteal phase (p < .05) and shorter values during the follicular phase for wave I (p < .05) and interpeak interval I-V (p < .05). The ABR seems to be influenced by the variations of ovarian steroids that occur during the menstrual cycle.
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Affiliation(s)
- Agostino Serra
- Department of Otorhinolaryngology, School of Medicine, University of Catania, Catania, Italy
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Abstract
Are reproductive life events in women associated with an increased risk of sexual dysfunction? Female sexual dysfunction effects up to 40% of women in the United States between 18 and 59 years of age. Sexual dysfunction may be accompanied by fluctuations in gonadal hormone secretion, making women more vulnerable to sexual symptoms, especially during times of reproductive life events. Reproductive life events, such as the use of birth control pills, various phases of the menstrual cycles, postpartum and lactation states, and perimenopause, are highly correlated with changes in sex steroids. As an understanding of the role of sex steroids on sexual functioning is elucidated, clinicians will be able to offer more specific and effective treatment options for women during various phases of reproductive life. Several case studies are presented to illustrate the unique clinical considerations that a clinician must consider when treating the biologic component of female sexual dysfunction.
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Affiliation(s)
- Julia K Warnock
- Department of Psychiatry, University of Oklahoma, Tulsa, Oklahoma 74135, USA.
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25
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Fessler DMT. No time to eat: an adaptationist account of periovulatory behavioral changes. THE QUARTERLY REVIEW OF BIOLOGY 2003; 78:3-21. [PMID: 12661507 DOI: 10.1086/367579] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A comprehensive review of women's dietary behavior across the menstrual cycle suggests a drop in caloric intake around the time of ovulation; similar patterns occur in many other mammals. The periovulatory nadir is puzzling, as it is not explicable in terms of changes in the energy budget. Existing explanations in the animal literature operate wholly at the proximate level of analysis and hence do not address this puzzle. In this paper, I offer an ultimate explanation for the periovulatory feeding nadir, arguing that the decrease in the set point for satiation during the fertile period of the female cycle is an adaptation produced by natural selection in order to reduce the motivational salience of goals that compete with those directly or indirectly pertaining to mating. In support of this explanation, I adduce evidence of: a) periovulatory reductions in other ingestive behaviors, and b) periovulatory increases in motor activity and the psychological concomitants thereof.
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Affiliation(s)
- Daniel M T Fessler
- Department of Anthropology, University of California at Los Angeles, Los Angeles, California 90095-1553, USA.
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