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

Abstract

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.

Keywords: Pre-menstrual syndrome; androgens; cyclical mood changes; sex hormone-binding globulin; sexuality.