Menstrual Cycle-Related Changes in Circulating Androgens in Healthy Women With Self-Reported Normal Sexual Function

Abstract

Introduction There is currently neither a clinically useful, reliable and inexpensive assay to measure circulating levels of free testosterone (T) in the range observed in women, nor is there agreement on the serum free T threshold defining hypoandrogenism that is associated with female-impaired sexual function. Aim Following the Clinical and Laboratory Standards Institute guidelines, we generated clinically applicable ranges for circulating androgens during specific phases of the menstrual cycle in a convenience sample of 120 reproductive-aged, regularly cycling healthy European Caucasian women with self-reported normal sexual function. Methods All participants were asked to complete a semistructured interview and fill out a set of validated questionnaires, including the Female Sexual Function Index, the Female Sexual Distress Scale, and the 21-item Beck's Inventory for Depression. Between 8 am and 10 am, a venous blood sample was drawn from each participant during the midfollicular (day 5 to 8), the ovulatory (day 13 to 15), and the midluteal phase (day 19 to 22) of the same menstrual cycle. Main Outcome Measures Serum levels of total and free testosterone, Δ4-androstenedione, dehydroepiandrosterone sulphate and sex hormone-binding globulin during the midfollicular, ovulatory and midluteal phase of the same menstrual cycle. Results Total and free T levels showed significant fluctuations, peaking during the ovulatory phase. No significant variation during the menstrual cycle were observed for Δ4-androstenedione and dehydroepiandrosterone sulphate. Despite the careful selection of participants that yielded an homogeneous group of women without sexual disorders, we observed a wide range of distribution for each of the circulating androgens measured in this study. Conclusions This report provides clinically applicable ranges for androgens throughout the menstrual cycle in reproductive-aged, regularly cycling, young healthy Caucasian European women with self-reported normal sexual function.

Factors affecting sexual function in premenopausal age women with type 2 diabetes: a comprehensive study

“…The effect of menopause on sexual function is a relatively wellstudied subject in female sexual response compared with the premenopausal period (20)(21)(22)(23)(24) Regarding the relationship between menstruation and sexual function, some investigators found that the phases of the menstrual cycle had an effect on sexual function in women with type 1 diabetes (25,26). Some investigators studied the possible relationship between irregular menstruation and sexual dysfunction in premenopausal women without systemic disease (27,28).…”

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

“…Secondly, both androgens and estrogens play an important role in female sexual arousal, motivation, and activity [12,15]. In most cases, increased androgens such as dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione and/or testosterone favor sexual arousal [29-32], but this relationship may be age, concentration and cycle-phase dependent.…”

“…Specifically, female sexual function has been shown to increase during the ovulatory phase of the menstrual cycle, in congruence with rising free and total testosterone [12]. This is in opposition to the work of Battaglia et al [13], who report no significant variation in androgens across the cycle but mention that additional synthesis and metabolism at the adrenal glands and peripheral tissues make it difficult to accurately correlate a specific androgen to sexual function.…”

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