Winnifred B. Cutler

Relationships among sexual behavior, hot flashes, and hormone levels in perimenopausal women

Forty-three perimenopausal women kept daily records of menstrual cycles and sexual activity. Data on hot flashes and plasma estradiol and testosterone levels were obtained at two points during the menopausal transition. The prospective data yielded a significant negative association between hot flash ratings and regularity of sexual intercourse at both time points. A significant negative correlation was found between estradiol (in the early part of the cycle) and hot flashes ratings at the first data point only, and positive correlations were found between hot flashes and ratio of testosterone to estradiol (T/E) at both. Frequency of sexual intercourse and level of plasma estradiol were higher, and T/E and hot flash ratings were lower in “early” perimenopausal women who were still having cycles at least once every 30 days, as compared with “late” perimenopausal women who were cycling less often. It was concluded that a close association exists between increasing irregularity of menstrual cycles, hot flashes, declining estradiol levels, and declining frequency of intercourse during the perimenopause. Causal relationships remain to be established.

Sexual behavior frequency and menstrual cycle length in mature premenopausal women

Abstract (1) Women who had regular weekly sexual intercourse with men had menstrual cycles, the average duration of which was 29 days (range 26–33), while women with less frequent behavioral interactions tended to have more extreme cycle lengths, as shown in 3 different studies in which prospective double blind measurements of data were used. (2) The effect was noted consistently in college women but also occurred in infertile patients. Sexual behavior and consistent menstrual cycle length were associated in all women studied. (3) The mechanism appeared to be related to the regularity with which sexual activity occurred during all the non-menstruating days of the cycle.

Preservation of the ovary: a reevaluation

The incidence of routine ovariectomy approximates 20% to 30% of all women at hysterectomy. The propriety of this practice is evaluated from three perspectives: the review of the longevity of ovarian hormonal function throughout life, the review of the low risk of subsequent disease in the retained ovary, and the review of epidemiologic considerations. Because oophorectomy and the loss of its steroid contribution has such a profound influence on many body functions, with the most devastating relation to osteoporosis, and because there are no meaningful data in the literature to support the value of routine oophorectomy, removal of ovaries should only be performed when the ovaries are diseased.

Sexual behavior and steroid levels among gynecologically mature premenopausal women

Twenty-seven gynecologically mature young women who participated in a 14-week study prospectively recorded daily sexual behavior and basal body temperature data. In addition, they supplied plasma three times during the last cycle of participation. Plasma was analyzed for estradiol (E2), testosterone (T), and progesterone (P) by radioimmunoassay. The levels of circulating sex steroid hormones during the luteal phase were examined in relation to measures of menstrual cycle length, sexual frequency, and coital total. The results indicated the following: (1) women who had weekly sex with men had higher levels of estrogen than women who did not; (2) total amount of coital behavior was not related to any of the hormones assayed; (3) neither T nor P were distinguished by the consistency of sexual behavior or by coital total; and (4) women with aberrant-length cycles tended to have lower levels of E2. Thus, E2 consistently showed relationships to sexual behavior and cycle length, whereas P and T did not.

The psychoneuroendocrinology of the ovulatory cycle of woman: A review

This review has as its objective to show that the mammalian, specifically human, ovulatory cycle is subject to many influences which can alter its inherent rhythmicity. This cyclicity is, in essence, a displaying of a pattern that is endogenously driven but which is also subjected to, and subject to, exogenous influences that alter the basic endogenous rhythm. This literature review is in 2 sections. The first discusses 7 major aspects of the endogenous nature of the primate ovulatory cycle: 1) natural rhythmicity of the ovaries; 2) steroid production and control; 3) gonadotropin production and control; 4) prolactin production, effects, and control; 5) monoamine control of the gonadotropins; 6) autonomic innervation of ovarian tissue; and 7) metabolic influence on ovarian cyclicity. This section concludes with a summary of the endogenous aspects of the ovulatory rhythm. Secton 2 reviews 3 exogenous influences of fertility: 1) nutritional influences; 2) geophysical influences; and 3) childbearing and lactation influences on subsequent ovulation.

Luteal phase defects: a possible relationship between short hyperthermic phase and sporadic sexual behavior in women.

Abstract Sporadic (less than regular weekly) coital activity is associated with a particular type of infertility—the short hyperthermic (luteal) phase. This preliminary report is the first suggestion that a reduced frequency of human sexual activity might, itself, be associated with subfertile reproductive function.

The impact of hysterectomy on sexual life of women

Abstract Objective: To analyze the impact of hysterectomy on frequency and quality of sexual life. Design: Questionnaire results from four groups were compared: 155 women’s wellness patients (132 intact; 23 posthysterectomy), 37 patients with myomata uteri, and recently published (JAMA) reference data about preoperative and postoperative hysterectomy patients. Results: 1) Women scheduled for hysterectomy showed the lowest incidence of regular sexual activity (31%) and the lowest incidence of frequent orgasms during coitus (46%) compared with all other groups. 2) The table shows that the impact of clitoral stimulation on sexual arousal and orgasm was not compromised by hysterectomy, whereas a significant reduction in vaginal sensation and in deep (cervical) sources of arousal and orgasm is reported. Frequent Contribution to Orgasm by Stimulation at Specified Genital Sites Clitoral Vaginal Cervical Intact patients 82% 39% 17% Myomata patients 74% 48% 33% Posthysterectomy patients 86% 19% 10% Conclusions: 1) Sexual life is suppressed in women scheduled for hysterectomy. The current practice of using sex life just before surgery as a baseline should be avoided. 2) Hysterectomy impaired genital sensations vaginally and at the cervical region. 3) Myomata uteri were associated with enhanced genital sensations both vaginally and cervically.