Is Vaginal Sexual Intercourse Permitted during Menstruation? A Biblical (Christian) and Medical Approach

Discounting for Money, Food, and Sex, over the Menstrual Cycle

Sexual desire, physical activity, economic choices and other behaviours fluctuate over the menstrual cycle. However, we have an incomplete understanding of how preferences for smaller sooner or larger later rewards (known as delay discounting) change over the menstrual cycle. In this pre-registered, cross-sectional study, Bayesian linear and quadratic binomial regression analyses provide compelling evidence that delay discounting does change over the menstrual cycle. Data from 203 naturally cycling women show increased discounting (preference for more immediate rewards) mid-cycle, which is at least partially driven by changes in fertility. This study provides evidence for a robust and broad-spectrum increase in delay discounting (Cohen’s h ranging from 0.1 to 0.4) around the fertile point in the menstrual cycle across multiple commodities (money, food, and sex). We also show, for the first time, that discounting changes over the menstrual cycle in a pseudo-control group of 99 women on hormonal contraception. Interestingly, such women increase their discounting of sex toward the end of the menstrual phase — possibly reflecting a prioritisation of bonding-related sexual activity before menstrual onset.

Behavioral effects of different contraceptive methods and HIV acquisition: an ancillary study of the ECHO randomized trial

BACKGROUND

The ECHO trial randomised 7829 women to depot medroxyprogesterone acetate (DMPA-IM), the copper intrauterine device (IUD) and the levonorgestrel (LNG) implant (1:1:1) and found no clear difference in HIV incidence between these three groups. We have previously hypothesized that oligo-amenorrhoea induced by DMPA-IM may have a protective effect on HIV acquisition. The aim of this ancillary study was to assess the effects of DMPA-IM, the IUD and the LNG implant on menstrual symptoms and sexual behavior and to correlate these with HIV acquisition.

METHODS

At the Effective Care Research Unit (ECRU) in South Africa, of 615 women already randomised to DMPA-IM, the copper IUD and the LNG implant (1:1:1) 552 agreed to participate. Participants completed a 28-day symptom and behavior diary following their one-month ECHO trial visit and returning it at their 3-month follow-up visit. HIV acquisition data were retrieved from ECHO trial records.

RESULTS

Of 552 women enrolled on the ancillary study, 390 (70.6%) completed their daily diary; 130, 133, and 127 received DMPA-IM, IUD, and LNG implant, respectively. Thirty-three (5.9%) of these women acquired HIV. Women on the progestin-only contraceptives were more likely to experience amenorrhoea, as expected, and were less likely to have intra-menstrual coitus than IUD users (p < 0.001 for DMPA-IM vs IUD and p = 0.002 for implant vs IUD). Overall coital frequency was highest and condom usage lowest among DMPA-IM users. Intra-menstrual coitus correlated positively, and duration of menstruation correlated negatively, with HIV acquisition, although these effects were not statistically significant (p = 0.09 and p = 0.079, respectively).

CONCLUSIONS

Findings support the hypothesis that oligo-amenorrhoea and the associated reduced intra-menstrual coitus may mitigate the potential for an increased biological risk of HIV acquisition with DMPA-IM but more evidence is needed. Study registration number PACTR201706001651380.

The relationship between gender role and attitude toward menstruation with female sexual function: A cross-sectional study

Background

Although female sexual function can be affected by many psychological, interpersonal, and sociocultural factors, limited studies have focused on the relationships between this construct with some concepts such as women's attitudes toward menstruation and perception from their gender role.

Objective

To investigate the association between gender roles and attitude toward menstruation with sexual function among Iranian reproductive women.

Materials and Methods

An observational cross-sectional study was carried out on a group of 164 Iranian women referred to the health centers of Torbat Heydariyeh, between August and December 2018. All eligible women filled the female sexual function index (FSFI), Bem Sex Role Inventory, and Menstrual Attitude Questionnaire.

Results

The result showed that the total FSFI score was significantly higher in masculine and androgynous gender role groups than women with undifferentiated gender role (p = 0.014, and p = 0.012, respectively). Nevertheless, androgynous women had better sexual arousal than undifferentiated women (p = 0.013). Significant reverse correlations were observed between the perception of menstruation as a debilitating, bothersome, and predictable event with a total score of FSFI and all subscales except lubrication (p = 0.001). In contrast, there was a positive relationship between denial of any effects of menstruation with total FSFI and all its sub-scores except lubrication (p = 0.001).

Conclusion

This study highlighted the role of masculinity and androgyny gender role stereotypes and menstrual attitude in the sexual function of heterosexual women. Future studies are needed to explain how these psychological contexts contribute to different aspects of women's sexuality.