The Role of Testosterone in Sexuality and Paraphilia—A Neurobiological Approach. Part I: Testosterone and Sexuality

Abstract

Using the data presented, we combine the two models and present a new integrated approach to understand the role of testosterone in the excitation and inhibition of sexual function, at the neurochemical, neuroanatomical, and behavioral levels. This knowledge will help us to gain a better understanding of the few and inconsistent data that are currently available concerning (i) the association between testosterone and paraphilic behavior; and (ii) the highly variable effects of antiandrogen therapy, discussed in Part II of this review.

Understanding service users’ and therapists’ experiences of pharmacological treatment for sexual preoccupation and/or hypersexuality in incarcerated sex offenders

“…CPA reduces sexual arousal through the reduction of testosterone levels (by approximately 30-40%, Bancroft, 1989) and SSRIs increase serotonin, which has been evidenced to inhibit sexual desire, psychological and physiological arousal and physiological orgasm (Jordan, Fromberger, Stolpmann, & Müller, 2011;Meston & Frohlich, 2000). Research thus far has tentatively indicated positive results of both these treatments with sexual offenders, although the findings are currently considered inconclusive, and with further research needed (Beech & Mitchell, 2005;Grubin, 2007;Guay, 2009).…”

Changed processing of visual sexual stimuli under GnRH-therapy – a single case study in pedophilia using eye tracking and fMRI

“…Accordingly, a decrease of sexual motivation, intensity and frequency of deviant sexual fantasies as well as a decrease of the masturbation rate has been described in paraphilic patients and sex offenders treated with antiandrogens [3,4]. Despite a large number of studies, the efficiency of ADT aiming at a reduction of the sex drive and a reduced risk of recidivism is still under debate.…”

Ethical and Medical Considerations of Androgen Deprivation Treatment of Sex Offenders

“…In men, androgens are fundamental to normal sexual behavior (9) and are primarily directed at sexual interest or desire (5,10,11). In all people, including persons with a paraphilia, testosterone codetermines the threshold at which erotosexual imagery and sexual activity occurs.…”