Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women∗: ∗2016 ISSM Female Sexual Dysfunction Prize

Sarah Wåhlin-Jacobsen; Ellids Kristensen; Anette Tønnes Pedersen; Nanna Cassandra Laessøe; Arieh S. Cohen; David M. Hougaard; Marika Lundqvist; Annamaria Giraldi

doi:10.1016/j.jsxm.2016.12.237

Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women^∗: ^∗2016 ISSM Female Sexual Dysfunction Prize

Sarah Wåhlin-Jacobsen^*, Ellids Kristensen, Anette Tønnes Pedersen, Nanna Cassandra Laessøe, Arieh S. Cohen, David M. Hougaard, Marika Lundqvist, Annamaria Giraldi

^*Corresponding author for this work

Department of Clinical Medicine

13 Citations (Scopus)

Abstract

Introduction The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. Aim To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). Methods The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. Main Outcome Measures Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. Results After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. Conclusion In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A, et al. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. J Sex Med 2017;14:366–379.

Original language	English
Journal	Journal of Sexual Medicine
Volume	14
Issue number	3
Pages (from-to)	366-379
Number of pages	14
ISSN	1743-6095
DOIs	https://doi.org/10.1016/j.jsxm.2016.12.237
Publication status	Published - Mar 2017

Keywords

Androgen
Androstenedione
Depression
Female
Psychosocial Factors
Sexual Desire
Sexual Distress
Sexual Function
Testosterone
Women

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10.1016/j.jsxm.2016.12.237

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Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women^∗: ^∗2016 ISSM Female Sexual Dysfunction Prize. / Wåhlin-Jacobsen, Sarah; Kristensen, Ellids ; Pedersen, Anette Tønnes et al.
In: Journal of Sexual Medicine, Vol. 14, No. 3, 03.2017, p. 366-379.

Research output: Contribution to journal › Journal article › Research › peer-review

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abstract = "Introduction The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. Aim To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). Methods The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. Main Outcome Measures Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. Results After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. Conclusion In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. W{\aa}hlin-Jacobsen S, Kristensen E, T{\o}nnes Pedersen A, et al. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. J Sex Med 2017;14:366–379.",

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author = "Sarah W{\aa}hlin-Jacobsen and Ellids Kristensen and Pedersen, {Anette T{\o}nnes} and Laess{\o}e, {Nanna Cassandra} and Cohen, {Arieh S.} and Hougaard, {David M.} and Marika Lundqvist and Annamaria Giraldi",

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T1 - Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women∗

T2 - ∗2016 ISSM Female Sexual Dysfunction Prize

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AU - Kristensen, Ellids

AU - Pedersen, Anette Tønnes

AU - Laessøe, Nanna Cassandra

AU - Cohen, Arieh S.

AU - Hougaard, David M.

AU - Lundqvist, Marika

AU - Giraldi, Annamaria

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N2 - Introduction The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. Aim To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). Methods The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. Main Outcome Measures Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. Results After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. Conclusion In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A, et al. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. J Sex Med 2017;14:366–379.

AB - Introduction The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive. Aim To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD). Methods The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points. Main Outcome Measures Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry. Results After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses. Conclusion In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A, et al. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. J Sex Med 2017;14:366–379.

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KW - Androstenedione

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KW - Female

KW - Psychosocial Factors

KW - Sexual Desire

KW - Sexual Distress

KW - Sexual Function

KW - Testosterone

KW - Women

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DO - 10.1016/j.jsxm.2016.12.237

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