Reproductive Hormones Have Limited Role in Women's Sexual Function

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Reproductive Hormones Have Limited Role in Women’s Sexual Function
Reproductive Hormones Have Limited Role in Women’s Sexual Function

Levels of testosterone and other naturally-occurring reproductive hormones are only modestly linked to menopausal women's interest in sex and their sexual function, according to data published in the Journal of Clinical Endocrinology & Metabolism.

“While levels of testosterone and other reproductive hormones were linked to women's feelings of desire and frequency of masturbation, our large-scale study suggests psychosocial factors influence many aspects of sexual function,” study author John F. Randolph Jr., MD, of the University of Michigan Medical School in Ann Arbor, said in a press release. “A woman's emotional well-being and quality of her intimate relationship are tremendously important contributors to sexual health.” 

Testosterone is the main sex hormone in men, but women's ovaries also naturally produce small amounts. Further, previous research has demonstrated small associations between testosterone or estradiol and sexual function in women. Results from studies on these associations, however, remain mixed.

To assess the relationship between reproductive hormones and sexual function during the menopausal transition, the researchers conducted a longitudinal cohort study including data from 3,302 participants, aged 42 to 52 years at baseline, in the decade-long Study of Women's Health Around the Nation (SWAN).

Over the course of 10 follow-up visits, women answered questionnaires on their interest in sex and sexual activity. Levels of testosterone, dehydroepiandrosterone sulfate (DHEAS), estradiol and follicle-stimulating hormone (FSH) were assessed at each visit via blood test.

Women with naturally higher levels of testosterone reported feeling sexual desire more often than women with low levels, according to the study results. Likewise, those with high levels of DHEAS — a precursor to testosterone — also tended to feel sexual desire more frequently than women with low levels.

Results also demonstrated an association between higher testosterone levels and more frequent masturbation among study participants. A similar association was noted for women with higher levels of DHEAS vs. low levels.

Data also showed that masturbation, arousal and orgasm were negatively associated with FSH.

The link between hormone levels and sexual function, however, remained “fairly subtle,” according to Randolph.

Instead, the researchers found that women who reported fewer sad moods and higher levels of satisfaction in their relationships reported better sexual function, suggesting that a woman's relationship status and other psychosocial factors may be more of a factor than hormones.

“Women's relationships and day-to-day reality are intricately linked to sexual function,” Randolph said. “Our findings suggest menopausal women who are dissatisfied with their sexual function should consider whether these non-hormonal factors are playing a role when discussing treatment with a qualified health care provider.”

Some studies indicate that testosterone therapy may be effective for improving sexual function in women, but a recently updated clinical practice guideline from the Endocrine Society on the use of androgens in women recommends against prescribing testosterone to healthy women.


  1. Randolph JF et al. J Clin Endocrinol Metab. 2014;doi:10.1210/jc.2014-1725.
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