Heather A. Rupp

Sex differences in viewing sexual stimuli: An eye-tracking study in men and women

Men and women exhibit different neural, genital, and subjective arousal responses to visual sexual stimuli. The source of these sex differences is unknown. We hypothesized that men and women look differently at sexual stimuli, resulting in different responses. We used eye tracking to measure looking by 15 male and 30 female (15 normal cycling (NC) and 15 oral contracepting (OC)) heterosexual adults viewing sexually explicit photos. NC Women were tested during their menstrual, periovulatory, and luteal phases while Men and OC Women were tested at equivalent intervals, producing three test sessions per individual. Men, NC, and OC Women differed in the relative amounts of first looks towards, percent time looking at, and probability of looking at, defined regions of the pictures. Men spent more time, and had a higher probability of, looking at female faces. NC Women had more first looks towards, spent more time, and had a higher probability of, looking at genitals. OC Women spent more time, and had a higher probability of, looking at contextual regions of pictures, those featuring clothing or background. Groups did not differ in looking at the female body. Menstrual cycle phase did not affect womens looking patterns. However, differences between OC and NC groups suggest hormonal influences on attention to sexual stimuli that were unexplained by subject characteristic differences. Our finding that men and women attend to different aspects of the same visual sexual stimuli could reflect pre-existing cognitive biases that possibly contribute to sex differences in neural, subjective, and physiological arousal.

Neural activation in the orbitofrontal cortex in response to male faces increases during the follicular phase

Womens sexual interest changes with hormonal fluctuations across the menstrual cycle. It is unclear how hormones modify womens sexual behavior and desire, but one possibility is that they alter womens positive appraisals of stimuli and thus their sexual interest. Using 3 T fMRI, we measured neural activation in women at two time points in their menstrual cycle (late follicular, luteal) while they evaluated photos of men presented as potential sexual partners. Participants were ten heterosexual women aged 23-28 none of who was using hormonal contraceptives or in a committed relationship. In an event-related design, the women were presented with as series of photos of male faces and asked questions to assess their degree of sexual interest in the men depicted. Results demonstrate an overall effect of menstrual cycle phase on neural activation. During their follicular versus luteal phase, women demonstrated increased activation in the right medial orbitofrontal cortex (OFC), suggesting increased positive appraisal. Activation in the OFC was positively correlated with womens estradiol to progesterone ratios. There were no areas that demonstrated increased activation during the luteal versus follicular phase. The observed increase in activation in the OFC during the follicular phase may reflect a hormonally mediated increase in appetitive motivation and may prime women towards increased sexual interest and behavior around ovulation.

Relationship between testosterone and interest in sexual stimuli: The effect of experience

Testosterone is commonly thought to drive male sexual interest, but little experimental evidence demonstrates a direct relationship between natural variation in testosterone and sexual interest in healthy young men. This study measured young mens testosterone levels and their interest in visual sexual stimuli across three test sessions within 1 month. Fifteen men aged 23-28 viewed pictures of couples engaged in sexually explicit activity. Each session included a unique set of 72 pictures depicting heterosexual oral sex or intercourse presented in randomized order. Participants controlled how long they viewed each picture, with viewing time indicating sexual interest. Mens testosterone (T) levels were assayed from blood spots obtained prior to viewing the pictures. Overall, T and viewing time were positively correlated; however, the strength of this relationship varied by test session. T was marginally correlated with viewing time during the first session (r=0.43) and not significantly correlated with viewing time on the second session (r=0.16). During the final test session, when habituation might influence male interest in the stimuli, T was strongly correlated with viewing time (r=0.80). Thus, the current study demonstrates a direct but context dependent relationship between testosterone and sexual interest in healthy young males.

Sex-Specific Content Preferences for Visual Sexual Stimuli

Although experimental studies support that men generally respond more to visual sexual stimuli than do women, there is substantial variability in this effect. One potential source of variability is the type of stimuli used that may not be of equal interest to both men and women whose preferences may be dependent upon the activities and situations depicted. The current study investigated whether men and women had preferences for certain types of stimuli. We measured the subjective evaluations and viewing times of 15 men and 30 women (15 using hormonal contraception) to sexually explicit photos. Heterosexual participants viewed 216 pictures that were controlled for the sexual activity depicted, gaze of the female actor, and the proportion of the image that the genital region occupied. Men and women did not differ in their overall interest in the stimuli, indicated by equal subjective ratings and viewing times, although there were preferences for specific types of pictures. Pictures of the opposite sex receiving oral sex were rated as least sexually attractive by all participants and they looked longer at pictures showing the female actor’s body. Women rated pictures in which the female actor was looking indirectly at the camera as more attractive, while men did not discriminate by female gaze. Participants did not look as long at close-ups of genitals, and men and women on oral contraceptives rated genital images as less sexually attractive. Together, these data demonstrate sex-specific preferences for specific types of stimuli even when, across stimuli, overall interest was comparable.

Lower sexual interest in postpartum women: relationship to amygdala activation and intranasal oxytocin

During the postpartum period, women experience significant changes in their neuroendocrine profiles and social behavior compared to before pregnancy. A common experience with motherhood is a decrease in sexual desire. Although the lifestyle and peripheral physiological changes associated with parturition might decrease a womans sexual interest, we hypothesized that there are also hormone-mediated changes in womens neural response to sexual and infant stimuli with altered reproductive priorities. We predicted that amygdala activation to sexually arousing stimuli would be suppressed in postpartum versus nulliparous women, and altered with intranasal oxytocin administration. To test this, we measured amygdala activation using fMRI in response to sexually arousing pictures, infant pictures, and neutral pictures in 29 postpartum and 30 nulliparous women. Half of the women received a dose of exogenous oxytocin before scanning. As predicted, nulliparous women subjectively rated sexual pictures to be more arousing, and infant pictures to be less arousing, than did postpartum women. However, nulliparous women receiving the nasal oxytocin spray rated the infant photos as arousing as did postpartum women. Right amygdala activation was lower in postpartum versus nulliparous women in response to sexual, infant, and neutral images, suggesting a generalized decrease in right amygdala responsiveness to arousing images with parturition. There was no difference in right amygdala activation with nasal spray application. Postpartum women therefore appear to experience a decrease in sexual interest possibly as a feature of a more generalized decrease in amygdala responsiveness to arousing stimuli.

Oxytocin increases VTA activation to infant and sexual stimuli in nulliparous and postpartum women

After giving birth, women typically experience decreased sexual desire and increased responsiveness to infant stimuli. These postpartum changes may be viewed as a trade-off in reproductive interests, which could be due to alterations in brain activity including areas associated with reward. The goal of this study was to describe the roles of oxytocin and parity on reward area activation in response to reproductive stimuli, specifically infant and sexual images. Because they have been shown to be associated with reward, the ventral tegmental area (VTA) and nucleus accumbens (NAc) were targeted as areas of expected alterations in activity. Oxytocin was chosen as a potential mediator of reproductive trade-offs because of its relationship to both mother-infant interactions, including breastfeeding and bonding, and sexual responses. We predicted that postpartum women would show higher reward area activation to infant stimuli and nulliparous women would show higher activation to sexual stimuli and that oxytocin would increase activation to infant stimuli in nulliparous women. To test this, we measured VTA and NAc activation using fMRI in response to infant photos, sexual photos, and neutral photos in 29 postpartum and 30 nulliparous women. Participants completed the Sexual Inhibition (SIS) and Sexual Excitation (SES) Scales and the Brief Index of Sexual Function for Women (BISF-W), which includes a sexual desire dimension, and received either oxytocin or placebo nasal spray before viewing crying and smiling infant and sexual images in an fMRI scanner. For both groups of women, intranasal oxytocin administration increased VTA activation to both crying infant and sexual images but not to smiling infant images. We found that postpartum women showed lower SES, higher SIS, and lower sexual desire compared to nulliparous women. Across parity groups, SES scores were correlated with VTA activation and subjective arousal ratings to sexual images. In postpartum women, sexual desire was positively correlated with VTA activation to sexual images and with SES. Our findings show that postpartum decreases in sexual desire may in part be mediated by VTA activation, and oxytocin increased activation of the VTA but not NAc in response to sexual and infant stimuli. Oxytocin may contribute to the altered reproductive priorities in postpartum women by increasing VTA activation to salient infant stimuli.

Women's interest in visual sexual stimuli varies with menstrual cycle phase at first exposure and predicts later interest

This study investigated whether womens interest in visual sexual stimuli varied with their hormonal state. Viewing times of 30 women, 15 normal cycling (NC) and 15 oral contracepting (OC), to sexually explicit photos were measured at three different times. NC women were tested during their menstrual, periovulatory, and luteal phases, and OC women were tested at equivalent temporal intervals. Subjects viewed stimuli as long as desired, thus viewing time measured subject interest. Subjective ratings of stimulus sexual attractiveness were obtained on each test. There was no overall relationship between menstrual cycle phase and viewing time. However the participants menstrual cycle phase during first exposure to sexual stimuli predicted subsequent interest in sexual stimuli during the next two tests. NC women who first viewed stimuli during their periovulatory phase looked longer at the sexual stimuli across all sessions than did women first tested in their luteal phase. OC women first exposed to the sexual stimuli during menstruation looked longer at the stimuli across all sessions than did OC women first exposed at other test phases. Neither current test phase nor initial cycle phase influenced subjective ratings. Women had increased interest in sexual stimuli across all sessions if first exposed to sexual stimuli when endogenous estrogens were most likely highest. These data suggest that womens interest in visual sexual stimuli is modulated by hormones such that the hormonal condition at first exposure possibly determines the stimulis emotional valence, markedly affecting subsequent interest in sexual stimuli.

Amygdala response to negative images in postpartum vs nulliparous women and intranasal oxytocin

The neuroendocrine state of new mothers may alter their neural processing of stressors in the environment through modulatory actions of oxytocin on the limbic system. We predicted that amygdala sensitivity to negatively arousing stimuli would be suppressed in postpartum compared to nulliparous women and that this suppression would be modulated by administration of oxytocin nasal spray. We measured brain activation (fMRI) and subjective arousal in response to negatively arousing pictures in 29 postpartum and 30 nulliparous women who received either oxytocin nasal spray or placebo before scanning. Pre- and post-exposure urinary cortisol levels were also measured. Postpartum women (placebo) demonstrated lower right amygdala activation in response to negative images, lower cortisol and lower negative photo arousal ratings to nulliparous women. Nulliparous women receiving oxytocin had lower right amygdala activation compared to placebo. Cortisol levels in the placebo group, and ratings of arousal across all women, were positively associated with right amygdala activation. Together, these findings demonstrate reductions in both amygdala activation and subjective negative arousal in untreated postpartum vs nulliparous women, supporting the hypothesis of an attenuated neural response to arousing stimuli in postpartum women. A causal role of oxytocin and the timing of potential effects require future investigation.

Sexual desire, sexual arousal and hormonal differences in premenopausal US and Dutch women with and without low sexual desire

The interaction between womens hormonal condition and subjective, physiological, and behavioral indices of desire or arousal remains only partially explored, in spite of frequent reports from women about problems with a lack of sexual desire. The present study recruited premenopausal women at two sites, one in the United States and the other in the Netherlands, and incorporated various measures of acute changes in sexual desire and arousal. A sample of 46 women who met criteria for Hypoactive Sexual Desire Disorder (HSDD) was compared to 47 women who experienced no sexual problems (SF). Half of each group used oral contraceptives (OCs). The specific goal was to investigate whether there is a relationship between womens hormone levels and their genital and subjective sexual responsiveness. Background demographics and health variables, including oral contraceptive (OC) use, were recorded and hormones (total testosterone (T), free testosterone (FT), SHBG, and estradiol) were analyzed along with vaginal pulse amplitude and self-report measures of desire and arousal in response to sexual fantasy, visual sexual stimuli, and photos of mens faces. Self-reported arousal and desire were lower in the HSDD than the SF group, but only for women who were not using oral contraceptives. Relationships between hormones and sexual function differed depending on whether a woman was HSDD or not. In line with prior literature, FT was positively associated with physiological and subjective sexual arousal in the SF group. The HSDD women demonstrated the opposite pattern, in that FT was negatively associated with subjective sexual responsiveness. The findings suggest a possible alternative relationship between hormones and sexual responsiveness in women with HSDD who have characteristics similar to those in the present study.

The role of the anterior cingulate cortex in women's sexual decision making.

Womens sexual decision making is a complex process balancing the potential rewards of conception and pleasure against the risks of possible low paternal care or sexually transmitted infection. Although neural processes underlying social decision making are suggested to overlap with those involved in economic decision making, the neural systems associated with womens sexual decision making are unknown. Using fMRI, we measured the brain activation of 12 women while they viewed photos of mens faces. Face stimuli were accompanied by information regarding each mans potential risk as a sexual partner, indicated by a written description of the mans number of previous sexual partners and frequency of condom use. Participants were asked to evaluate how likely they would be to have sex with the man depicted. Women reported that they would be more likely to have sex with low compared to high risk men. Stimuli depicting low risk men also elicited stronger activation in the anterior cingulate cortex (ACC), midbrain, and intraparietal sulcus, possibly reflecting an influence of sexual risk on womens attraction, arousal, and attention during their sexual decision making. Activation in the ACC was positively correlated with womens subjective evaluations of sex likelihood and response times during their evaluations of high, but not low risk men. These findings provide evidence that neural systems involved in sexual decision making in women overlap with those described previously to underlie nonsexual decision making.