Implications of hormonal influences on sexual behavior for demographic models of reproduction

Association of PCOS and its clinical signs with sexual function among Iranian women affected by PCOS

INTRODUCTION

Polycystic ovary syndrome (PCOS) and its physiological and psychological changes influence the sexual function of women affected.

AIM

In the present study, we aimed to investigate the association of PCOS and its clinical signs with sexual function among a population of married Iranian women affected by PCOS.

MAIN OUTCOME MEASURE

The impact of clinical signs of PCOS on sexual function of affected women was the main outcome measure in the present study.

METHODS

This cross-sectional study was carried out on 591 married women with PCOS, aged 18-45 years. Data were collected using a questionnaire including information on demographic and reproductive status and the Female Sexual Function Index. Data were analyzed using chi-square test, Mann-Whitney test, and logistic regression analysis.

RESULTS

The participants' mean age was 30.6 years. Among associated manifestations of PCOS, infertility and hair loss have significant adverse effects on female sexual function. Logistic regression analysis showed that PCOS women with infertility have a significantly lower sexual function score compared with those who are fertile. Subgroup analysis demonstrated that compared with their fertile counterparts, PCOS women with infertility had significant sexual dysfunction in all aspects except desire and pain.

CONCLUSION

Among various manifestations of PCOS, infertility mainly disrupts the sexual function of affected women.

Life history theory and the immune system: steps toward a human ecological immunology

Within anthropology and human biology, there is growing interest in immune function and its importance to the ecology of human health and development. Biomedical research currently dominates our understanding of immunology, and this paper seeks to highlight the potential contribution of a population-based, ecological approach to the study of human immune function. Concepts from life-history theory are applied to highlight the major challenges and demands that are likely to shape immune function in a range of ecological contexts. Immune function is a major component of maintenance effort, and since resources are limited, trade-offs are expected between investment in maintenance and other critical life-history functions involving growth and reproduction. An adaptationist, life-history perspective helps make sense of the unusual developmental trajectory of immune tissues, and emphasizes that this complex system is designed to incorporate information from the surrounding ecology to guide its development. As a result, there is substantial population variation in immune development and function that is not considered by current biomedical approaches. In an attempt to construct a framework for understanding this variation, immune development is considered in relation to the competing life-history demands that define gestation, infancy, childhood, adolescence, and adulthood. Each life stage poses a unique set of adaptive challenges, and a series of hypotheses is proposed regarding their implications for immune development and function. Research in human ecological immunology is in its earliest stages, but this is a promising area of exploration, and one in which anthropology is well-positioned to make important contributions.

The impact of testosterone imbalance on depression and women's health

Women suffer more often from depression than males, indicating that hormones might be involved in the etiology of this disease. Low as well as high testosterone (T) levels are related to depression and well-being in women, T plasma levels correlate to depression in a parabolic curve: at about 0.4-0.6 ng/ml plasma free T a minimum of depression is detected. Lower levels are related to depression, osteoporosis, declining libido, dyspareunia and an increase in total body fat mass. Androgen levels in women decrease continuously to about 50% before menopause compared to a 20-year-old women. Androgen levels even decline 70% within 24 h when women undergo surgical removal of the ovaries. Conventional oral contraception or HRT cause a decline in androgens because of higher levels of SHBG. Hyperandrogenic states exist, like hirsutism, acne and polycystic ovary syndrome. Social research suggests high androgen levels cause aggressive behavior in men and women and as a consequence may cause depression. Higher androgen values are more pronounced at young ages and before and after delivery of a baby and might be responsible for the "baby blues". It was found that depression in pubertal girls correlated best with an increase in T levels in contrast to the common belief that "environmental factors" during the time of growing up might be responsible for emotional "up and downs". T replacement therapy might be useful in perimenopausal women suffering from hip obesity, also named gynoid obesity. Abdominal obesity in men and women is linked to type 2 diabetes and coronary heart diseases. Testosterone replacement therapy in hypoandrogenic postmenopausal women might not only protect against obesity but also reduce the risk of developing these diseases. Antiandrogenic progestins might be useful for women suffering from hyperandrogenic state in peri- and postmenopause. Individual dosing schemes balancing side effects and beneficial effects are absolutely necessary. Substantial interindividual variability in T plasma values exists, making it difficult to utilize them for diagnostic purposes. Therefore a "four-level-hormone classification scheme" was developed identifying when estradiol (E) and T levels are out of balance. (1) Low E-low T levels are correlated with osteoporosis, depression, and obesity; (2) high E-low T with obesity, decreased libido; (3) high T-low E levels with aggression, depression, increased libido, and substance abuse; (4) high E-high T with type II diabetes risk, breast cancer and cardiovascular risk. Testosterone delivery systems are needed where beneficial and negative effects can be balanced. Any woman diagnosed for osteoporosis should be questioned for symptoms of depression.

The missing politics and unsettled science of the trend toward earlier puberty

The age of puberty in many populations has declined steeply over recent centuries and may be declining still. Consequently, today's children tend to experience the hormonal stresses of rapid development at younger ages than did their ancestors, around whose later, if not more gradual, maturation traditional behavioral expectations formed. Little has been made of this "rush to puberty" outside the life sciences. This article reviews its historical documentation, scholarly appreciation, epidemiological correlations, putative physiological and environmental explanations, sociological implications, and largely latent politics.

Pain sensitivity and individual differences in self-reported sexual behavior

The relationship between sexual behavior and pain sensitivity was assessed in 27 heterosexual men and 20 heterosexual women. Sexual behavior measures included sexual motivation and ratings of subjective sexual arousal to and enjoyment of an auditory stimulus. Pain sensitivity measures were pain threshold and pain tolerance in a cold pressor task. Participants were tested after exposure to a neutral or a sexual audio stimulus. Exposure to the sexual stimulus increased pain sensitivity in women but not in men. However, sexual behavior measures were correlated with pain threshold for both men and women. Specifically, higher pain thresholds were associated with weaker sexual motivation, lower enjoyment potential for sexual interaction, and increased inhibition during intercourse. These results are consistent with findings in laboratory animals, suggesting that differences in sexual behavior may reflect differences in responsiveness to a variety of stimuli.