Partnered sexual activity moderates menstrual cycle–related changes in inflammation markers in healthy women: an exploratory observational study

Abstract

Objective To examine differences in inflammation markers in sexually active vs. abstinent women, and observe changes in inflammation markers across the menstrual cycle. Cycle-related immune fluctuations may have evolved to reduce interference with conception. If so, reproductively active (i.e., sexually active) women should show the most variability in cytokine expression. Design Participants provided serum samples at menses and ovulation (from which cytokines were assayed) and saliva samples at menses, follicular, ovulation, and luteal phases (from which C-reactive protein was assayed). Participants self-reported intercourse frequency during the study. Setting Academic research laboratory. Participants 32 healthy, naturally cycling premenopausal women (sexually active, N = 15, abstinent, N = 17). Interventions Observational study. Main outcome measures Pro-inflammatory cytokines (Interleukin-6, IL-6; Interferon γ, IFN-γ; Tumor Necrosis Factor α, TNF-α), an anti-inflammatory cytokine (Interleukin-4, IL-4), and a marker of total inflammation (C-reactive protein, CRP). Results Sexually active women had higher levels of all of the immune markers measured, including both pro- and anti-inflammatory cytokines, than abstinent women. Relative to sexually active women, abstinent women had less change across the menstrual cycle in levels of CRP. Among sexually active women, higher intercourse frequency predicted greater mid-cycle decreases in CRP, IL-6, and IFN-γ and mid-cycle increases in IL-4. Conclusions Sexual activity may stimulate a complex interaction between pro- and anti-inflammatory cytokines that subsequently drive mid-cycle declines in inflammation.

Neuroimmunology of the female brain across the lifespan: Plasticity to psychopathology

“…from studies other than with ovariectomy or E2 replacement), and even less work on central cyclical immune changes. Yet there is some human evidence that circulating inflammatory markers change across the menstrual cycle, with C-reactive protein (CRP) being low in the follicular phase (when sex hormones are high) (Gaskins et al, 2012;Lorenz et al, 2017). In rodent models, central cytokines can be differentially sensitive across the ovarian cycle.…”

Physiological predictors of leptin vary during menses and ovulation in healthy women

“…Date of ovulation was confirmed via daily tests for urine LH (Onestep Urine Ovulation Test; BlueCross Biomedical) [18,19]. One of the goals of the parent study was to follow changes in markers of inflammation [20]; given data suggesting that venipuncture may itself influence inflammation [21], serum samples were limited to the two most important defining features of the menstrual cycle, namely, menses and ovulation.…”

Interactions Among Sexual Activity, Menstrual Cycle Phase, and Immune Function in Healthy Women

“…These data are drawn from a larger study of menstrual-cycle-related changes in health-related variables (Lorenz, Demas, & Heiman, 2017; Lorenz, Heiman, & Demas, 2015a, 2015b).…”

“…Although beneficial for conception, this “window of opportunity” may increase infection risk (Wira & Fahey, 2008). Indeed, several studies have suggested that healthy sexually active women show significant cycle-related variation in immune responses while sexually abstinent women do not (Brown, Morrison, Calibuso, & Christiansen, 2008; Lorenz, Demas, & Heiman, 2017; Lorenz, Heiman, & Demas, 2015a, 2015b, 2017); these findings have been replicated in White and Latino samples (Lorenz, Worthman, & Vitzthum, 2015).…”