Female social and sexual interest across the menstrual cycle: the roles of pain, sleep and hormones

How do phases of the menstrual cycle affect sleep? A polysomnographic study of the EPISONO database

PURPOSE

Our study aimed to evaluate the impact of the menstrual cycle stages, especially menses, on sleep, inflammatory mediators, fatigue, anxiety, depression, and quality of life.

METHODS

We used data from the EPISONO study cohort, selecting 96 women who had undergone one-night polysomnography. The women were distributed in three groups according to the time point of the menstrual cycle on the polysomnography night: menses, mid/late follicular phase, and luteal phase. The volunteers completed questionnaires related to sleep quality, daytime sleepiness, insomnia, fatigue, anxiety, depression, and quality of life. Blood samples were collected to analyze interleukin 6, tumor necrosis factor-alpha, and C-reactive protein.

RESULTS

Sleep efficiency was statistically higher in women in the mid/late follicular group (89.9% ± 9.6) compared to menstrual (83.0% ± 10.8) and luteal (83.7% ± 12.7) groups. The mid/late follicular group presented a statistically significant reduction in sleep onset latency (7.1 ± 7.1 min) compared to the menstrual (22.3 ± 32.4 min) and luteal groups (15.9 ± 14.7 min). No statistical differences among the three groups were observed in other polysomnographic parameters, inflammatory mediators, daytime sleepiness, insomnia, fatigue, anxiety, depression, and quality of life.

CONCLUSIONS

Our findings demonstrate that the mid/late follicular phase might be beneficial for women's sleep, although there were no statistically changes in inflammatory mediators among the groups.

The Effects of Hormonal Contraceptives on the Sleep of Women of Reproductive Age

Research about the effects of hormonal contraceptives on sleep has been performed but is subjected to important levels of methodological heterogeneity. Hormonal contraceptives impact sleep, but the direction of this association is not clear. Most studies describe a negative sleep profile among contraceptive users, including increased sleepiness, insomnia symptoms, decreased sleep efficiency, and a reduced overall sleep quality. Hormonal intrauterine contraceptives are associated with less negative effects. More research on the field, especially randomized controlled trials, is needed to increase the level and certainty of evidence about the effects of hormonal contraceptives on sleep.

The effects of hormonal contraceptive use on sleep in women: A systematic review and meta-analysis

Hormonal contraceptives are some of the most widely used medications worldwide, but studies on their effects on sleep are contradictory, with some reporting a sleep-promoting effect, while others a sleep-inhibiting effect. Our objective was, therefore, to undertake a systematic review and meta-analysis of the literature on this subject to try to clarify their effects. A search was conducted in three databases (PubMed, Scopus and Web of Science). Only studies evaluating hormonal contraception use were considered eligible, and both objective and subjective sleep-related outcomes were considered. Individual effect size was calculated for each article, and meta-analyses were performed using a DerSimonian and Laird random effects method. The initial search identified 2076 articles, of which 13 met the criteria for the study after full text evaluation. A total of 33 meta-analyses were performed, three of them related to subjective measures and 30 considering data from polysomnography. The only statistically significant result between contraceptive users and non-contraceptive users was observed in respect of wake after sleep onset, which was 7 min shorter among contraceptive users (-7.12 [-12.80; -1.44]; I²  = 65%; p = 0.01). In conclusion, hormonal contraceptives are not associated with clinically relevant changes in sleep patterns in women.

Association between mental illness and cycle phases and physical, social, and task attraction in female university students

PURPOSE

To examine the association between menstrual cycle phases and other factors (depression, anxiety, and stress) with social, physical, and task attraction.

METHODS

This cross-sectional study enrolled 662 female university students (December 2019-January 2020).

RESULTS

Higher stress was associated with higher social and task attraction. Higher stress and depression were associated with higher physical attraction, whereas higher anxiety was associated with lower physical attraction. None of the cycle's phases was associated with attraction.

PRACTICAL IMPLICATIONS

This study results showed a lot of contradictory information to what is present in the literature, in addition to new associations that are not tackled enough in the literature. Therefore, there is a crucial need for new firm studies that explore the relationship between women's hormonal levels and attraction levels.

Effects of sex and menstrual cycle phase on cardiac response and alpha- amylase levels in psychosocial stress

The impact of sex and the menstrual cycle phase on the autonomic response to psychosocial stress remains controversial. This study explored autonomic nervous system activity through salivary alpha-amylase, heart rate, and heart rate variability responses to the Trier Social Stress Test (TSST) in healthy young people. The sample was composed of 25 men, 26 women in the luteal phase, and 25 women in the follicular phase, from 18 to 25 years of age. Participants were exposed to the TSST or a control condition. The results indicate that women in their follicular phase showed a blunted alpha-amylase response to stress compared to men and women in the luteal phase. In addition, men showed higher sympatho-vagal activity in the stress condition compared to the two groups of women. These results confirm that sex and the menstrual cycle phase are potential modulators of autonomic nervous system reactivity to psychosocial stress.

Effects of hormonal contraceptives on sleep - A possible treatment for insomnia in premenopausal women

Due to the changes that took place since the 1970s, women have achieved important socioeconomic positions. Many tasks, including domestic and familiar ones, continue to be under women's responsibility, which leads to an overload work. Additionally, the female organism has its peculiarities due to hormonal changes. Adding all these factors up, women seem to be more vulnerable to stressing factors and consequently, might be prone to present several health problems. Within this scenario, one can point out insomnia as a highly prevalent disease among women, directly affecting performance and quality of life. Progesterone has an important effect over sleep, acting both as a hypnogenic and as a respiratory stimulant. Hormonal contraceptives are largely recognized among the modern society women; however, little is known about the effects of these drugs on sleep. This proposal hypothesizes that the use of hormonal contraceptives, mainly those based on progestagens could be a new therapeutic element for the treatment of insomnia and one more tool to be used to improve women´s sleep pattern and quality of life.

Sex differences in age-related changes in the sleep-wake cycle

Age-related changes in sleep and circadian regulation occur as early as the middle years of life. Research also suggests that sleep and circadian rhythms are regulated differently between women and men. However, does sleep and circadian rhythms regulation age similarly in men and women? In this review, we present the mechanisms underlying age-related differences in sleep and the current state of knowledge on how they interact with sex. We also address how testosterone, estrogens, and progesterone fluctuations across adulthood interact with sleep and circadian regulation. Finally, we will propose research avenues to unravel the mechanisms underlying sex differences in age-related effects on sleep.

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.

Histories of abuse predict stronger within-person covariation of ovarian steroids and mood symptoms in women with menstrually related mood disorder

OBJECTIVE

Individual differences in sensitivity to cyclical changes in ovarian steroids estradiol (E2) and progesterone (P4) have been implicated in the pathophysiology of menstrually related mood disorder (MRMD). However, no prospective studies have investigated psychosocial risk factors for sensitivity to hormone effects on mood in MRMD. Using a repeated measures approach and multilevel models, we tested the hypothesis that a history of abuse provides a context in which within-person elevations of E2 and P4 prospectively predict daily symptoms.

METHOD

66 women with prospectively-confirmed MRMD recruited for a trial of oral contraceptives provided 1 month of baseline hormone and mood data prior to randomization. Lifetime physical and sexual abuse experiences were assessed. Across one cycle, women completed daily measures of symptoms and provided blood samples on 5 days across the menstrual cycle. Current E2 and P4 were centered within person (CWP) such that higher values represented cyclical elevations in hormones.

RESULTS

Rates of physical (27%) and sexual (29%) abuse were high, consistent with previous work documenting a link between trauma and MRMD. In women with a history of physical abuse, cyclical increases in P4 predicted greater mood and interpersonal symptoms on the three days following that sample. In women with a history of sexual abuse, cyclical increases in E2 predicted greater anxiety symptoms on the three days following that sample.

CONCLUSIONS

Results inform further inquiry into the role of severe life stressors and stress response systems in MRMD. We discuss areas for future research on the psychosocial and physiological pathways through which abuse may influence the link between hormones and symptoms.

Individual Differences in the Psychobiological Response to Psychosocial Stress (Trier Social Stress Test): The Relevance of Trait Anxiety and Coping Styles

The main objective of this study was to investigate the contribution of some personality traits to the physiological and psychological response to a standardized laboratory psychosocial stressor (trier social stress test). Cortisol and affective response (anxiety and mood) were analysed in a mixed-sex group composed of 35 young adults who participated in a crossover design (18 men and 17 women). After verifying a statistically significant response to the trier social stress test in all parameters studied in both sex groups, exploratory cluster analyses were carried out to identify sub-groups based on their psychophysiological responses. These analyses showed two different groups: subjects displaying lower psychological response along with higher cortisol response (cluster 1) compared with the group with high affective reactivity along with lower cortisol response (cluster 2). Interestingly, we also found significant differences in trait anxiety and coping styles when the two clusters were compared. Subjects in cluster 1 showed lower scores on trait anxiety and higher scores on active coping, whereas the subjects in the second cluster obtained higher scores on anxiety and on coping focused on emotions and mental disengagement. These findings support the importance of personality traits and coping styles in understanding the overall integrative psychobiological responsiveness to social stress.

A Pilot Study on Tamoxifen Sexual Side Effects and Hand Preference in Male Breast Cancer

Recent clinical and imaging studies suggest that sex hormones modulate sexuality according to a psychophysiologic process of lateralization of the brain, with androgens playing a greater role in sexual functioning of left hemibrain/right handedness and estrogens possibly for right hemibrain/left handedness. Based on this perspective, the current study attempted to specify the relationship between hand preference, estrogens, and sexual function in subjects with male breast cancer, taking into account the sexual side effects of tamoxifen as the agent for inhibiting estrogen action. Twenty-eight Romanian men-17 right-handed and 11 left-handed-undergoing treatment with tamoxifen for male breast cancer participated in this study. These men were assessed both prior to and during tamoxifen treatment using the International Index of Erectile Function, a standardized instrument used for the evaluation of various aspects of sexual functioning, including erectile function (EF), orgasmic function (OF), sexual desire (SD), and overall functioning (OF). A main effect for handedness was found on EF, OF, SD, and OS scales, with right-handed men showing higher functioning than left-handed men. Regarding interaction effects, the left-handed group of men showed greater decreased sexual functioning during tamoxifen (on three subscales: OF, SD, OS) compared to right-handed men. Further research should be conducted in order to support and refine this potential lateralized process of sexual neuromodulation within the brain.

Menstrual cycle phase does not predict political conservatism

Recent authors have reported a relationship between women's fertility status, as indexed by menstrual cycle phase, and conservatism in moral, social and political values. We conducted a survey to test for the existence of a relationship between menstrual cycle day and conservatism. 2213 women reporting regular menstrual cycles provided data about their political views. Of these women, 2208 provided information about their cycle date, 1260 provided additional evidence of reliability in self-reported cycle date, and of these, 750 also indicated an absence of hormonal disruptors such as recent hormonal contraception use, breastfeeding or pregnancy. Cycle day was used to estimate day-specific fertility rate (probability of conception); political conservatism was measured via direct self-report and via responses to the "Moral Foundations" questionnaire. We also recorded relationship status, which has been reported to interact with menstrual cycle phase in determining political preferences. We found no evidence of a relationship between estimated cyclical fertility changes and conservatism, and no evidence of an interaction between relationship status and cyclical fertility in determining political attitudes. Our findings were robust to multiple inclusion/exclusion criteria and to different methods of estimating fertility and measuring conservatism. In summary, the relationship between cycle-linked reproductive parameters and conservatism may be weaker or less reliable than previously thought.

Coping with an acute psychosocial challenge: behavioral and physiological responses in young women

Despite the relevance of behavior in understanding individual differences in the strategies used to cope with stressors, behavioral responses and their relationships with psychobiological changes have received little attention. In this study on young women, we aimed at analyzing the associations among different components of the stress response and behavioral coping using a laboratory psychosocial stressor. The Ethological Coding System for Interviews, as well as neuroendocrine, autonomic and mood parameters, were used to measure the stress response in 34 young women (17 free-cycling women in their early follicular phase and 17 oral contraceptive users) subjected to the Trier Social Stress Test (TSST) and a control condition in a crossover design. No significant differences in cardiac autonomic, negative mood and anxiety responses to the stressor were observed between the two groups of women. However, women in the follicular phase showed a higher cortisol response and a larger decrease in positive mood during the social stress episode, as well as greater anxiety overall. Interestingly, the amount of displacement behavior exhibited during the speaking task of the TSST was positively related to anxiety levels preceding the test, but negatively related to baseline and stress response values of heart rate. Moreover, the amount of submissive behavior was negatively related to basal cortisol levels. Finally, eye contact and low-aggressiveness behaviors were associated with a worsening in mood. Overall, these findings emphasize the close relationship between coping behavior and psychobiological reactions, as well as the role of individual variations in the strategy of coping with a psychosocial stressor.

Sexuality and androgens in women with cyclical mood changes and pre-menstrual syndrome

OBJECTIVE

To study the relation between androgen levels and sexual interest in women with different kinds of pre-menstrual syndrome (PMS).

DESIGN

Causal comparative study.

SETTING

Swedish university hospital outpatient clinic.

POPULATION

Seventy women with cyclical mood changes.

METHODS

Pre-menstrual syndrome patients were divided into those with and those without preovulatory symptoms. In 37 women, early follicular phase blood samples were analyzed for androstenedione, testosterone, sex hormone-binding globulin (SHBG), progesterone and estradiol, using radioimmunoassay. The participants were divided into subgroups depending on whether the levels of androgens and SHBG were above or below the median. In 33 of them it was possible to compare the cyclicity in sexual parameters between these subgroups.

MAIN OUTCOME MEASURES

Daily ratings of sexual parameters and hormonal analyses.

RESULTS

Plasma testosterone was significantly lower and SHBG significantly higher in women with luteal phase symptoms compared with those with additional follicular phase symptoms. ANOVA showed significant cyclicity for all sexual parameters consistently. For the "sexual feelings" and "pleasant sexual thoughts" parameters, cyclicity was the same whether or not the hormonal levels were "high" or "low."

CONCLUSIONS

The "Pure-PMS" group and the "pre-menstrual-exacerbation" groups differed in their androgen and SHBG levels. Women suffering from PMS with higher neuroticism Eysenck Personality Inventory scores or "low" levels of androgens and SHBG would be more likely to have a decreased sexual interest pre-menstrually than would women with a high level.

Psychobehavioral effects of hormonal contraceptive use

Although female use of hormonal contraceptives (HCs) has been associated with a variety of physical side effects, the psychological and behavioral side effects have received comparatively little attention until recently. Indeed, the long-term impact of HC use on human psychology has been vastly under-researched and has only recently become a focus for mainstream scholars. Women who use HCs report higher rates of depression, reduced sexual functioning, and higher interest in short-term sexual relationships compared to their naturally-cycling counterparts. Also, HC use may alter women's ability to attract a mate, as well as the mate retention behaviors in both users and their romantic partners. Some evidence even suggests that HC use alters mate choice and may negatively affect sexual satisfaction in parous women, with potential effects on future offspring. Interestingly, HCs have become a standard method of population control for captive nonhuman primates, opening up exciting avenues for potential comparative research. Here, the existing literature on the psychobehavioral effects of HCs in humans and nonhuman primates is reviewed and discussed. The potential resulting downstream consequences for the path of human evolution and recommendations for how future research could tease apart the underlying causes of these psychobehavioral effects of HC use are discussed, including suggestions for research involving nonhuman primates.

Psychobehavioral Effects of Hormonal Contraceptive Use

Although female use of hormonal contraceptives (HCs) has been associated with a variety of physical side effects, the psychological and behavioral side effects have received comparatively little attention until recently. Indeed, the long-term impact of HC use on human psychology has been vastly under-researched and has only recently become a focus for mainstream scholars. Women who use HCs report higher rates of depression, reduced sexual functioning, and higher interest in short-term sexual relationships compared to their naturally-cycling counterparts. Also, HC use may alter women's ability to attract a mate, as well as the mate retention behaviors in both users and their romantic partners. Some evidence even suggests that HC use alters mate choice and may negatively affect sexual satisfaction in parous women, with potential effects on future offspring. Interestingly, HCs have become a standard method of population control for captive nonhuman primates, opening up exciting avenues for potential comparative research. Here, the existing literature on the psychobehavioral effects of HCs in humans and nonhuman primates is reviewed and discussed. The potential resulting downstream consequences for the path of human evolution and recommendations for how future research could tease apart the underlying causes of these psychobehavioral effects of HC use are discussed, including suggestions for research involving nonhuman primates.

Do men's faces really signal heritable immunocompetence?

In the literature on human mate choice, masculine facial morphology is often proposed to be an intersexual signal of heritable immunocompetence, and hence an important component of men's attractiveness. This hypothesis has received considerable research attention, and is increasingly treated as plausible and well supported. In this article, we propose that the strength of the evidence for the immunocompetence hypothesis is somewhat overstated, and that a number of difficulties have been under-acknowledged. Such difficulties include (1) the tentative nature of the evidence regarding masculinity and disease in humans, (2) the complex and uncertain picture emerging from the animal literature on sexual ornaments and immunity, (3) the absence of consistent, cross-cultural support for the predictions of the immunocompetence hypothesis regarding preferences for masculinized stimuli, and (4) evidence that facial masculinity contributes very little, if anything, to overall attractiveness in real men. Furthermore, alternative explanations for patterns of preferences, in particular the proposal that masculinity is primarily an intrasexual signal, have been neglected. We suggest that immunocompetence perspectives on masculinity, whilst appealing in many ways, should still be regarded as speculative, and that other perspectives-and other traits-should be the subject of greater attention for researchers studying human mate preferences.

Hormonal contraceptive use and mate retention behavior in women and their male partners

Female hormonal contraceptive use has been associated with a variety of physical and psychological side effects. Women who use hormonal contraceptives report more intense affective responses to partner infidelity and greater overall sexual jealousy than women not using hormonal contraceptives. Recently, researchers have found that using hormonal contraceptives with higher levels of synthetic estradiol, but not progestin, is associated with significantly higher levels of self-reported jealousy in women. Here, we extend these findings by examining the relationship between mate retention behavior in heterosexual women and their male partners and women's use of hormonal contraceptives. We find that women using hormonal contraceptives report more frequent use of mate retention tactics, specifically behaviors directed toward their partners (i.e., intersexual manipulations). Men partnered with women using hormonal contraceptives also report more frequent mate retention behavior, although this relationship may be confounded by relationship satisfaction. Additionally, among women using hormonal contraceptives, the dose of synthetic estradiol, but not of synthetic progesterone, positively predicts mate retention behavior frequency. These findings demonstrate how hormonal contraceptive use may influence behavior that directly affects the quality of romantic relationships as perceived by both female and male partners.