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Hormonal contraceptive use and the objectification of women and men
Abstract
The purpose of this study was to test the influence of combined hormonal contraceptive (CHC) use on women's objectification of other women and men (i.e., the tendency to attribute appearance-related body features rather than competence-related body features). A regression analysis showed that the higher the dose of the synthetic estrogen contained within a CHC, the higher the level of objectification of other women. As for men target, the synthetic estrogen was not a significant predictor, but it showed a positive trend, thus higher levels of estrogen might be, at least in part, associated with higher levels of objectification. There was no relationship between synthetic progesterone and the level of objectification of both women and men. The implications of these results are discussed with respect to the mate-retention strategies and intra-group dynamics.
... Interestingly, the level of synthetic estrogen in combined HCs also positively predicts women's objectification of other women. 4 Collectively, these findings imply that synthetic estrogen administered via HCs changes aspects of women's behavior, which may reflect underlying changes in personality. ...
... Low extraversion and high neuroticism predispose people to experience more negative objective life events 9 and predict low subjective wellbeing, 10 relationship satisfaction, and intimacy, 12 and high anxiety, depression, 13 and jealousy. 14 Together with other research on HCs, [2][3][4]8 this suggests that high levels of synthetic estrogen within HCs may negatively impact personality, which may have downstream consequences on intra-couple and other social behaviors. Still, future research should more explicitly test the relationship between synthetic estrogens and happiness, relationship satisfaction, and sexual satisfaction. ...
... In the Objectification of Others Questionnaire [16], participants are provided with attributes related to physical appearance (e.g., attractiveness, weight) and physical competence (e.g., health, fitness level) and are asked to rank their importance with respect to the body of other women and men. Although these measures have proven useful in research (e.g., [15,17]), they have two major limitations: They require participants' awareness of their own objectifying behaviors and cognitions and their willingness to report them without distortion. For instance, in the Interpersonal Sexual Objectification Perpetration Scale, participants are asked questions such as, "How often have you perpetrated sexual harassment (on the job, in school, etc.)?" Valid responses require that the respondents recognize certain behaviors as sexual harassment and are willing to respond honestly. ...
Objectification occurs when a person is perceived and/or treated like an object. With the present work, we overview the available measures of objectification and present a series of studies aimed at investigating the validity of the task of inverted body recognition proposed by Bernard and colleagues (2012), which might potentially be a useful cognitive measure of objectification. We conducted three studies. Study 1 (N = 101) is a direct replication of Bernard et al.’s study: participants were presented with the same photos of sexualized male and female targets used in the original research. Study 2a (N = 100) is a conceptual replication: we used different images of scantily dressed male and female models. Finally, in Study 2b (N = 100), we investigated a boundary condition by presenting to participants photos of the same models as in Study 2a, but fully dressed and non-sexualized. Using mixed-effects models for completely-crossed classified data structures, we investigated the relationship between the inversion effect and the stimulus’ asymmetry, sexualization and attractiveness, and the perceivers’ self-objectification, sexism, and automatic woman-human association. Study 1 replicated the original results, showing a stronger inversion effect for male photos. However, no difference between male and female stimuli emerged in either Study 2a or 2b. Moreover, the impact of the other variables on the inversion effect was highly unstable across the studies. These aspects together indicate that the inversion effect depends on the specific set of stimuli and limits the generalizability of results collected using this method.
... 37 A regression analysis reported that the higher the dose of the synthetic estrogen contained within a COC, the higher was the level of objectification of other women (a tendency to attribute appearancerelated body features rather than competence-related). 38 In a Czech sample, among women who had engaged in nonmonogamous sexual behavior, HC users reported fewer 1-night affairs than non-users and tended to have fewer partners in general. HC users also showed more frequent dyadic intercourse than non-users, potentially indicating higher commitment to their current relationship. ...
Introduction:
Hormonal contraceptives are among the most popular contraceptives used by women worldwide. Long-term adherence may vary significantly among users because of fear of side effects, unhealthy habits, and lack of knowledge, despite their proven effectiveness.
Aim:
To analyze the psychological, relational, sexual, and cultural factors associated with choice and use of hormonal contraceptives. We highlight the importance of a biopsychosocial approach to contraceptive counseling.
Methods:
A systematic literature review was conducted in September 2018.
Main outcome measures:
99 articles published in Google Scholar, Web of Science, Scopus, EBSCO, and the Cochrane Library about counseling to hormonal contraception and related biopsychosocial factors were reviewed.
Results:
In the current work, we have analyzed a broad range of factors involved in the contraceptive choice among psychological, relational, sexual, and cultural spheres under the umbrella of the biopsychosocial model. The literature has highlighted that counseling provided by a specialized health care professional may help women in selecting a contraceptive method that best suits their personal needs and lifestyles, maximizing compliance and well-being.
Conclusion:
The importance of psychological, relational, sexual and cultural aspects involved in the selection of a contraceptive should be acknowledged by health care professionals and addressed during individualized counseling to ensure that the option selected and offered is tailored to the personal preferences, lifestyle, and practices of each woman. Nimbi FM, Rossi R, Tripodi F, et al. A Biopsychosocial Model for the Counseling of Hormonal Contraceptives: A Review of the Psychological, Relational, Sexual, and Cultural Elements Involved in the Choice of Contraceptive Method. Sex Med Rev 2019;7:587-596.
... We found that oestradiol levels in NC women predicted how well they were able to discriminate ovulatory from luteal faces in a setting implying intra-sexual competition (date-enticement). This is in line with studies finding positive associations between oestradiol levels and competitive behaviour among women, such as greater emotional reaction to sexual infidelity [23], or objectification of other women [24]. Our data suggest that in women oestrogen is more related to intra-sexual competition than testosterone. ...
Recent research suggests that men find portraits of ovulatory women more attractive than photographs of the same women taken during the luteal phase. Only few studies have investigated whether the same is true for women. The ovulatory phase matters to men because women around ovulation are most likely to conceive, and might matter to women because fertile women might pose a reproductive threat. In an online study 160 women were shown face pairs, one of which was assimilated to the shape of a late follicular prototype and the other to a luteal prototype, and were asked to indicate which face they found more attractive. A further 60 women were tested in the laboratory using a similar procedure. In addition to choosing the more attractive face, these participants were asked which woman would be more likely to steal their own date. Because gonadal hormones influence competitive behaviour, we also examined whether oestradiol, testosterone and progesterone levels predict women's choices. The women found neither the late follicular nor the luteal version more attractive. However, naturally cycling women with higher oestradiol levels were more likely to choose the ovulatory woman as the one who would entice their date than women with lower oestradiol levels. These results imply a role of oestradiol when evaluating other women who are competing for reproduction.
... We found that oestradiol levels in NC women predicted how well they were able to discriminate ovulatory from luteal faces in a setting implying intra-sexual competition (date-enticement). This is in line with studies finding positive associations between oestradiol levels and competitive behaviour among women, such as greater emotional reaction to sexual infidelity [23], or objectification of other women [24]. Our data suggest that in women oestrogen is more related to intra-sexual competition than testosterone. ...
Recent research suggests that men find portraits of ovulatory women more attractive than photographs of the same women taken during the luteal phase. Only few studies have investigated whether the same is true for women. The ovulatory phase matters to men because women around ovulation are most likely to conceive, and might matter to women because fertile women might pose a reproductive threat. In an online study 160 women were shown face pairs, one of which was assimilated to the shape of a late follicular prototype and the other to a luteal prototype, and were asked to indicate which face they found more attractive. A further 60 women were tested in the laboratory using a similar procedure. In addition to choosing the more attractive face, these participants were asked which woman would be more likely to steal their own date. Because gonadal hormones influence competitive behaviour, we also examined whether oestradiol, testosterone and progesterone levels predict women's choices. The women found neither the late follicular nor the luteal version more attractive. However, naturally cycling women with higher oestradiol levels were more likely to choose the ovulatory woman as the one who would entice their date than women with lower oestradiol levels. These results imply a role of oestradiol when evaluating other women who are competing for reproduction.
... This may again suggest that the context of social dominance should be specified in future research. Although we attempted to control for the type and method of administration of hormonal contraception by conducting subsequent analyses in our sample, future research using larger samples could consider the impact on testosterone levels and dominance of specific hormonal contraceptive doses and variants of synthetic estrogen and progesterone (see Cobey, Pollet, Roberts, and Buunk 2011;Piccoli, Cobey, and Carnaghi 2014;Welling, Puts, Roberts, Little, and Burriss 2012). Likewise, further studies could consider the influence of cycle phase in regularly cycling women, as there is some evidence to suggest that testosterone increases near to ovulation (e.g. ...
How to achieve dominance in a group is a recurrent challenge for individuals
of many species, including humans. Previous research indicates that both relationship
status and contraceptive use appear to moderate women’s testosterone levels. If testosterone
contributes to dominance, this raises the possibility for group differences in
dominance between single and partnered women, and between users and non-users of
hormonal contraception. Here, we examine associations between relationship status and
use/non-use of hormonal contraception and women’s self-reported social dominance. In
a sample of 84 women, we replicate previous research documenting a significant
positive correlation between women’s saliva testosterone levels and their selfreported
dominance. Consistent with other literature, we also find that women using
hormonal contraception have significantly lower testosterone than those who are
regularly cycling and that partnered women have significantly lower testosterone than
single women. Although we do not find a main effect of either relationship status or
hormonal contraceptive use status on women’s reported levels of dominance, the
interaction between these variables predicted reported dominance scores. This interaction
remained significant when participant age and testosterone values were added to
the model as covariates.We discuss these results in the context of the existing literature
on testosterone and women’s dominance behaviour and with respect to the evolutionary
benefits of social dominance in women.
This article offers objectification theory as a framework for understanding the experiential consequences of being female in a culture that sexually objectifies the female body. Objectification theory posits that girls and women are typically acculturated to internalize an observer's perspective as a primary view of their physical selves. This perspective on self can lead to habitual body monitoring, which, in turn, can increase women's opportunities for shame and anxiety, reduce opportunities for peak motivational states, and diminish awareness of internal bodily states. Accumulations of such experiences may help account for an array of mental health risks that disproportionately affect women: unipolar depression, sexual dysfunction, and eating disorders. Objectification theory also illuminates why changes in these mental health risks appear to occur in step with life-course changes in the female body.
BACKGROUND
Combined oral contraceptives (COCs) reduce levels of androgen, especially testosterone (T), by inhibiting ovarian and adrenal androgen synthesis and by increasing levels of sex hormone-binding globulin (SHBG). Although this suppressive effect has been investigated by numerous studies over many years, to our knowledge no systematic review concerning this issue had been performed. This systematic review and meta-analysis was performed to evaluate the effect of COCs on concentrations of total T, free T and SHBG in healthy women and to evaluate differences between the various types of COCs (e.g. estrogen dose, type of progestin) and the assays used to assess total T and free T.METHODSA review of the literature was performed using database searches (MEDLINE, EMBASE and the Cochrane Central Register of Clinical Trials) and all publications (from inception date until July 2012) investigating the effect of COCs on androgen levels in healthy women were considered eligible for selection. Three reviewers were involved in study selection, data extraction and critical appraisal. For the meta-analysis, data on total T, free T and SHBG were extracted and combined using random effects analysis. Additional subgroup analyses were performed to evaluate differences between the various types of COCs (e.g. estrogen dose, type of progestin) and the assays used to assess total T or free T.RESULTSA total of 151 records were identified by systematic review and 42 studies with a total of 1495 healthy young women (age range: 18-40 years) were included in the meta-analysis. All included studies were experimental studies and 21 were non-comparative. Pooling of the results derived from all the included papers showed that total T levels significantly decreased during COC use [mean difference (MD) (95% confidence interval, CI) -0.49 nmol/l (-0.55, -0.42); P < 0.001]. Significantly lower levels of free T were also found [relative change (95% CI) 0.39 (0.35, 0.43); P < 0.001], with a mean decrease of 61%. On the contrary, SHBG concentrations significantly increased during all types of COC use [MD (95% CI) 99.08 nmol/l (86.43, 111.73); P < 0.001]. Subgroup analyses revealed that COCs containing 20-25 µg EE had similar effects on total and free T compared with COCs with 30-35 µg EE. In addition, suppressive effects on T levels were not different when comparing different types of progestins. However, subgroup analyses for the estrogen dose and the progestin type in relation to changes in SHBG levels did show significant differences: COCs containing second generation progestins and/or the lower estrogen doses (20-25 µg EE) were found to have less impact on SHBG concentrations.CONCLUSIONS
The current literature review and meta-analysis demonstrates that COCs decrease circulating levels of total T and free T and increase SBHG concentrations. Due to the SHBG increase, free T levels decrease twice as much as total T. The estrogen dose and progestin type of the COC do not influence the decline of total and free T, but both affect SHBG. The clinical implications of suppressed androgen levels during COC use remain to be elucidated.
Intrasexual competition implies viewing the confrontation with same-sex individuals, especially in the context of contact with the opposite-sex, in competitive terms. After constructing the items for the preliminary scale and after conducting a pilot study, in two studies with a total of 706 participants from The Netherlands and Canada, a 12-item scale for individual differences in intrasexual competition was developed that was sex neutral, and that had a high degree of crossnational equivalence. In The Netherlands, sociosexuality, sex drive and social comparison orientation were independently related to intrasexual competition. In Canada, intrasexual competition was strongly, and independently of the Big Five, related to social comparison orientation, but only among women. There was no effect of birth order, but sibling rivalry did correlate with intrasexual competition. Among men, intrasexual competition was more strongly, and differently, related to the Big Five than among women. Among women, intrasexual competition was predicted by a lack of agreeableness, and among men by a high level of neuroticism and extraversion.
Reports an error in "That swimsuit becomes you: Sex differences in self-objectification, restrained eating, and math performance" by Barbara L. Fredrickson, Tomi-Ann Roberts, Stephanie M. Noll, Diane M. Quinn and Jean M. Twenge (Journal of Personality and Social Psychology, 1998[Jul], Vol 75[1], 269-284). This article contains errors in the Participants sections. The corrected information is included in the erratum. (The following abstract of the original article appeared in record 1998-04530-020.) Objectification theory (B. L. Fredrickson & T Roberts, 1997) posits that American culture socializes women to adopt observers' perspectives on their physical selves. This self-objectification is hypothesized to (a) produce body shame, which in turn leads to restrained eating, and (b) consume attentional resources, which is manifested in diminished mental performance. Two experiments manipulated self-objectification by having participants try on a swimsuit or a sweater. Experiment 1 tested 72 women and found that self-objectification increased body shame, which in turn predicted restrained eating. Experiment 2 tested 42 women and 40 men and found that these effects on body shame and restrained eating replicated for women only. Additionally, self-objectification diminished math performance for women only. Discussion centers on the causes and consequences of objectifying women's bodies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The majority of research examining sex differences in risk-taking behavior focuses on overt physical risk measures in which failed risk attempts may result in serious injury or death. The present research describes sex differences in patterns of risk taking in day-to-day behavior among Dutch cyclists. Through three observational studies we test sex differences in risk taking in situations of financial risk (fines for failing to use bike lights, Study 1), theft risk (bike locking behavior, Study 2) as well as physical risk (risky maneuvers, Study 3). Results corroborate previous findings by showing that across these domains men are more inclined to take risks than women. We discuss how these findings might be used in an applied context.
Contemporary mate preferences can provide important clues to human reproductive history. Little is known about which characteristics people value in potential mates. Five predictions were made about sex differences in human mate preferences based on evolutionary conceptions of parental investment, sexual selection, human reproductive capacity, and sexual asymmetries regarding certainty of paternity versus maternity. The predictions centered on how each sex valued earning capacity, ambition— industriousness, youth, physical attractiveness, and chastity. Predictions were tested in data from 37 samples drawn from 33 countries located on six continents and five islands (total N = 10,047). For 27 countries, demographic data on actual age at marriage provided a validity check on questionnaire data. Females were found to value cues to resource acquisition in potential mates more highly than males. Characteristics signaling reproductive capacity were valued more by males than by females. These sex differences may reflect different evolutionary selection pressures on human males and females; they provide powerful cross-cultural evidence of current sex differences in reproductive strategies. Discussion focuses on proximate mechanisms underlying mate preferences, consequences for human intrasexual competition, and the limitations of this study.
Objectification theory (Fredrickson & Roberts, 1997) holds that American culture coaxes women to develop observers' views of their bodies. The present study was designed to test whether a state of self-objectification can be automatically activated by subtle exposure to objectifying words. A state of self-objectification or of bodily empowerment was primed by the use of a scrambled sentence task. Women's ratings of negative emotions were higher and their ratings of the appeal of physical sex lower when primed with self-objectification than when primed with body competence. Men's ratings were unaffected by the primes. The results of this study suggest that mere exposure to objectifying media can play a significant role in the initiation of a self-objectified state along with its attendant psychological consequences for women.
Objectification theory has linked self-objectification to negative emotional experiences and disordered eating behavior in cultures that sexually objectify the female body. This link has not been empirically tested in a clinical sample of women with eating disorders. In the present effort, 209 women in residential treatment for eating disorders completed self-report measures of self-objectification, body shame, media influence, and drive for thinness on admission to treatment. Results demonstrated that the internalization of appearance ideals from the media predicted self-objectification, whereas using the media as an informational source about appearance and feeling pressured to conform to media ideals did not. Self-objectification partially mediated the relationship between internalized appearance ideals and drive for thinness; internalized appearance ideals continued to be an independent predictor of variance. In accordance with objectification theory, body shame partially mediated the relationship between self-objectification and drive for thinness in women with eating disorders; self-objectification continued to be an independent predictor of variance. These results illustrate the importance of understanding and targeting the experience of self-objectification in women with eating disorders or women at risk for eating disorders.
This study was designed to test the extent to which women who self-objectify also objectify other women. One hundred thirty-two university students and their friends (64 women and 68 men) completed three questionnaires: (1) Noll and Fredrickson’s (1998) Self-Objectification Questionnaire, (2) a modified version of that questionnaire that measured individuals’ objectification of others, and (3) Slade, Dewey, Newton, and Brodie’s (1990) Body Cathexis scale. Women were more likely than men to self-objectify. Self-objectification was negatively related to body satisfaction for women but not for men. Both women and men objectified women more than they objectified men, although women’s objectification of other women was not significantly different than their objectification of men. Men objectified women more than women did, and women objectified men more than men did. Women were more likely to objectify other women than to objectify themselves. Higher self-objectification among both women and men was related to increased objectification of other women and men, but the relationships were stronger for women. Results indicate that women also objectify women, although not to the degree exhibited by men.
Female hormonal contraceptive use has been associated with a variety of physical and psychological side effects. Women who use hormonal contraceptives report more intense affective responses to partner infidelity and greater overall sexual jealousy than women not using hormonal contraceptives. Recently, researchers have found that using hormonal contraceptives with higher levels of synthetic estradiol, but not progestin, is associated with significantly higher levels of self-reported jealousy in women. Here, we extend these findings by examining the relationship between mate retention behavior in heterosexual women and their male partners and women's use of hormonal contraceptives. We find that women using hormonal contraceptives report more frequent use of mate retention tactics, specifically behaviors directed toward their partners (i.e., intersexual manipulations). Men partnered with women using hormonal contraceptives also report more frequent mate retention behavior, although this relationship may be confounded by relationship satisfaction. Additionally, among women using hormonal contraceptives, the dose of synthetic estradiol, but not of synthetic progesterone, positively predicts mate retention behavior frequency. These findings demonstrate how hormonal contraceptive use may influence behavior that directly affects the quality of romantic relationships as perceived by both female and male partners.
The authors report a field experiment with skateboarders that demonstrates that physical risk taking by young men increases in the presence of an attractive female. This increased risk taking leads to more successes but also more crash landings in front of a female observer. Mediational analyses suggest that this increase in risk taking is caused in part by elevated testosterone levels of men who performed in front of the attractive female. In addition, skateboarders' risk taking was predicted by their performance on a reversal-learning task, reversal-learning performance was disrupted by the presence of the attractive female, and the female's presence moderated the observed relationship between risk taking and reversal learning. These results suggest that men use physical risk taking as a sexual display strategy, and they provide suggestive evidence regarding possible hormonal and neural mechanisms.
Female and male mate choice preferences in humans both vary according to the menstrual cycle. Women prefer more masculine, symmetrical and genetically unrelated men during ovulation compared with other phases of their cycle, and recent evidence suggests that men prefer ovulating women to others. Such monthly shifts in mate preference have been suggested to bring evolutionary benefits in terms of reproductive success. New evidence is now emerging that taking the oral contraceptive pill might significantly alter both female and male mate choice by removing the mid-cycle change in preferences. Here, we review support for such conclusions and speculate on the consequences of pill-induced choice of otherwise less-preferred partners for relationship satisfaction, durability and, ultimately, reproductive outcomes.
Two studies measured self-esteem across the menstrual cycle to test the prediction that self-esteem will vary interindividually as a positive function of mate value and intraindividually as a negative function of fertility status. Study 1 (n = 52) found that self-esteem was positively related to mate value between women but that women experienced a self-esteem decrease nearest to ovulation, when women tend to be more attractive to men. Study 2 (n = 59) replicated these results and demonstrated that the self-esteem decrease at high fertility was positively related to women's reported long-term mating motivation. Additionally, the magnitude of the self-esteem decrease at high fertility was found to be related to increased willingness to spend money on items to enhance attractiveness at high fertility. A self-esteem decrease at high fertility may motivate mate value enhancement efforts when such efforts are most critical.
Darwin's theory of sexual selection suggests that individuals compete with members of their own sex for reproductively relevant resources held by members of the opposite sex. Four empirical studies were conducted to identify tactics of intrasexual mate competition and to test four evolution-based hypotheses. A preliminary study yielded a taxonomy of tactics. Study 1 used close-friend observers to report performance frequencies of 23 tactics to test the hypotheses. Study 2 replicated Study 1's results by using a different data source and subject population. Study 3 provided an independent test of the hypotheses in assessing the perceived effectiveness of each tactic for male and female actors. Although the basic hypotheses were supported across all three studies, there were several predictive failures and unanticipated findings. Discussion centers on the heuristic as well as predictive role of evolutionary theory, and on implications for other arenas of intrasexual competition.
Norms and reliability and validity data are presented for an objectively scored Body Esteem Scale. Factor analysis of the scale revealed that body esteem is a multidimensional construct which differs for males and females. For males, the body esteem dimensions dealt with physical attractiveness, upper body strength, and physical condition. For females, the dimensions dealt with sexual attractiveness, weight concern, and physical condition. The three aspects of males' body esteem were more highly intercorrelated than those of the females, indicating a greater degree of body esteem differentiation for females than for males.
This article proposes a contextual-evolutionary theory of human mating strategies. Both men and women are hypothesized to have evolved distinct psychological mechanisms that underlie short-term and long-term strategies. Men and women confront different adaptive problems in short-term as opposed to long-term mating contexts. Consequently, different mate preferences become activated from their strategic repertoires. Nine key hypotheses and 22 predictions from Sexual Strategies Theory are outlined and tested empirically. Adaptive problems sensitive to context include sexual accessibility, fertility assessment, commitment seeking and avoidance, immediate and enduring resource procurement, paternity certainty, assessment of mate value, and parental investment. Discussion summarizes 6 additional sources of behavioral data, outlines adaptive problems common to both sexes, and suggests additional contexts likely to cause shifts in mating strategy.
Objectification theory (B. L. Fredrickson & T. Roberts, 1997) posits that American culture socializes women to adopt observers' perspectives on their physical selves. This self-objectification is hypothesized to (a) produce body shame, which in turn leads to restrained eating, and (b) consume attentional resources, which is manifested in diminished mental performance. Two experiments manipulated self-objectification by having participants try on a swimsuit or a sweater. Experiment 1 tested 72 women and found that self-objectification increased body shame, which in turn predicted restrained eating. Experiment 2 tested 42 women and 40 men and found that these effects on body shame and restrained eating replicated for women only. Additionally, self-objectification diminished math performance for women only. Discussion centers on the causes and consequences of objectifying women's bodies.
Evolutionary theory predicts that female intrasexual competition will occur when males of high genetic quality are considered to be a resource. It is probable that women compete in terms of attractiveness since this is one of the primary criteria used by men when selecting mates. Furthermore, because hormones influence the mate-selection process, they may also mediate competition. One competitive strategy that women use is derogation--any act intended to decrease a rival's perceived value. To investigate intrasexual competition through derogation, the influence of oestrogen on women's ratings of female facial attractiveness was examined. During periods of high oestrogen, competition, and hence derogation, increased, as evidenced by lower ratings of female facial attractiveness. By contrast, oestrogen levels did not significantly affect ratings of male faces. These findings support the theory of female intrasexual competition with respect to attractiveness.
The objective of this study was to compare cycle control, cycle-related characteristics and bodyweight effects of NuvaRing with those of a combined oral contraceptive (COC) containing 30 microg of ethinyl estradiol and 3 mg of drospirenone.
A randomized, multicentre, open-label trial in which 983 women were treated (intent-to-treat population) with NuvaRing or the COC for 13 cycles.
Breakthrough bleeding or spotting during cycles 2-13 was in general less frequent with NuvaRing than that with the COC (4.7-10.4%) and showed a statistically significant odds ratio of 0.61 (95% confidence interval: 0.46, 0.80) with longitudinal analysis. Intended bleeding was significantly better for all cycles with NuvaRing (55.2-68.5%) than that with the COC (35.6-56.6%) (P < 0.01). Changes from baseline in mean bodyweight and body composition parameters were relatively small for both groups with no notable between-group differences.
NuvaRing was associated with better cycle control than the COC, and there was no clinically relevant difference between the two groups in bodyweight.
It is common to summarize statistical comparisons by declarations of statistical significance or nonsignificance. Here we discuss one problem with such declarations, namely that changes in statistical significance are often not themselves statistically significant. By this, we are not merely making the commonplace observation that any particular threshold is arbitrary—for example, only a small change is required to move an estimate from a 5.1% significance level to 4.9%, thus moving it into statistical significance. Rather, we are pointing out that even large changes in significance levels can correspond to small, nonsignificant changes in the underlying quantities.
The error we describe is conceptually different from other oft-cited problems—that statistical significance is not the same as practical importance, that dichotomization into significant and nonsignificant results encourages the dismissal of observed differences in favor of the usually less interesting null hypothesis of no difference, and that any particular threshold for declaring significance is arbitrary. We are troubled by all of these concerns and do not intend to minimize their importance. Rather, our goal is to bring attention to this additional error of interpretation. We illustrate with a theoretical example and two applied examples. The ubiquity of this statistical error leads us to suggest that students and practitioners be made more aware that the difference between “significant” and “not significant” is not itself statistically significant.
Two studies address the role of hormonal shift across menstrual cycle in female dehumanization of other women. In Study 1, normally ovulating women (NOW) and women who use hormonal contraceptives (HCW) are compared in terms of how much they dehumanize other women and two other control targets (men and elderlies). In NOW the level of dehumanization of other women, but not of men and elderlies, increases as the conception risk is enhanced. HCW do not show this pattern of results. In Study 2, we investigate the level of dehumanization of other women and of intra-sexual competition. Findings concerning dehumanization replicate those of Study 1. Intra-sexual competition increases with the raise of conception risk only in NOW. Additionally, dehumanization is significantly associated to intra-sexual competition in NOW but not in HCW. Together these studies demonstrate that dehumanization of women is elicited by menstrual-cycle-related processes and associated to women’s mate attraction goals.
Evolutionary theorists suggest that men engage in risk-taking more than women do in part because, throughout human evolutionary history, men have faced greater sexual selection pressures. We build on this idea by testing the hypothesis that risk-taking reflects a male mating strategy that is sensitive to characteristics of a potential mate. Consistent with this hypothesis, the current experiment demonstrated a positive relationship between mating motivation and risk-taking, but only in men who had been exposed to images of highly attractive females. Moreover, risk-taking in men was associated with enhanced memory for attractive female faces, indicating enhanced processing of their attractive facial characteristics. No relationship between mating motivation and risk-taking was observed in men exposed to images of unattractive women, nor was any such relationship observed in women. This experiment provides evidence that psychological states associated with mating may promote risk-taking, and that these effects are sex specific and are sensitive to situational context.
Objective: To highlight studies that investigated the efficacy, safety, and tolerability of low-dose oral contraceptives (OCs) containing 20 μg of ethinyl estradiol (EE) and to discuss the use of these low-dose contraceptives in women from adolescence to menopause and the noncontraceptive health benefits likely to be afforded by low-dose contraceptives.Design: Relevant literature was identified by searching MEDLINE and EMBASE. Other sources were located by consulting the bibliographies of the material collected from Medline and EMBASE. Sources for additional information included documents from the United States Food and Drug Administration and the Physicians’ Desk Reference (54th ed.).Conclusion(s): The current lowest available dose of EE used for OCs in the United States is 20 μg. Formulations with 20 μg of EE are efficacious and have a low incidence of estrogen-related side effects. Since this lowest effective EE dose inhibits ovarian activity, 20 μg of EE should also provide the noncontraceptive health benefits of OCs. Both contraceptive and noncontraceptive benefits of OCs are available to most women from adolescence to menopause without complications.
The purpose of this study was to test the influence of hormonal contraceptive use on levels of female intrasexual competition. Twenty-eight women completed a scale for intrasexual competition on three occasions: when using hormonal contraceptives and when regularly cycling at a fertile and a non-fertile cycle stage. When using hormonal contraception, pair-bonded, but not single women, reported significantly lower levels of intrasexual competition than when regularly cycling at either fertile or non-fertile cycle stages. This effect remained significant when controlling for age, length of relationship and relationship satisfaction. Neither pair-bonded nor single women reported shifts in intrasexual competition across the menstrual cycle when fertile as compared to non-fertile. This study benefited from a within-subjects design and a more rigorous assessment of fertility status (transvaginal ultrasonography) than which is typical in the field. Results are discussed in consideration of the evolutionary literature on the stability of romantic relationships and fitness advantages associated with intrasexual competition.
This study tests a mediational model of disordered eating derived from objectification theory (Fredrickson & Roberts, 1997). The model proposes that the emotion of body shame mediates the relationship between self-objectification and disordered eating. Two samples of undergraduate women (n= 93, n= 111) completed self-report questionnaires assessing self-objectification, body shame, anorexic and bulimic symptoms, and dietary restraint. Findings in both samples supported the mediational model. Additionally, a direct relationship between self-objectification and disordered eating was also observed. Implications and future research directions are discussed.
In two related studies we examined women's perceptions of each other. In the first study we hypothesized that subjects' perceptions of two women would be a function of their relative physical attractiveness, and the extent to which a male was interacting with them. Female subjects were randomly assigned to one of four groups; each group saw one photograph, and subjects were asked to describe what was occuring in it, and then completed a questionnaire. The “other woman” in the photos was alone, was either provocatively made-up or not, and was either conversing or not conversing with a man in the presence of his female companion. When the “other woman” was dressed provocatively, she was more disliked than when she was dressed casually, especially if she was depicted talking to another woman's companion.In the second study women and men were asked about their responses to the film “Fatal Attraction,” in which a single woman sought to take a married man away from his wife. Single women who were concerned about a “male shortage” were more likely to have seen the film. Both women and men disliked the “other woman” and identified with the wife, and women frequently disliked the husband.
Humans in societies around the world discriminate between potential mates on the basis of attractiveness in ways that can dramatically affect their lives. From an evolutionary perspective, a reasonable working hypothesis is that the psychological mechanisms underlying attractiveness judgments are adaptations that have evolved in the service of choosing a mate so as to increase gene propagation throughout evolutionary history. The main hypothesis that has directed evolutionary psychology research into facial attractiveness is that these judgments reflect information about what can be broadly defined as an individual’s health. This has been investigated by examining whether attractiveness judgments show special design for detecting cues that allow us to make assessments of overall phenotypic condition. This review examines the three major lines of research that have been pursued in order to answer the question of whether attractiveness reflects non-obvious indicators of phenotypic condition. These are studies that have examined facial symmetry, averageness, and secondary sex characteristics as hormone markers.
Women who use hormonal contraceptives have been shown to report higher levels of jealousy than women who are regularly cycling. Here, we extend these findings by examining if self reported levels of jealousy vary with the dose of synthetic estrogen and progestin found in combined oral contraceptives in a sample of 275 women. A univariate ANOVA analysis revealed that higher levels of ethinyl estradiol were associated with significantly higher levels of self-reported jealousy. There was, however, no relationship between combined oral contraceptive progestin dose and reported jealousy levels. When controlling for age, relationship status, mood, and combined oral contraceptive progestin dose the results for ethinyl estradiol were maintained. A test for the interaction between the jealousy sub-scale items (reactive, possessive, and anxious jealousy) was however non-significant: ethinyl estradiol dose thus does not affect one type of jealousy more than another but rather affects overall jealousy. The implications of these findings are discussed in the context of their evolutionary consequences on mate choice and relationship dynamics. (C) 2010 Elsevier Ltd. All rights reserved.
Patterns in the data on human sexuality support the hypothesis that the bases of sexual emotions are products of natural selection. Most generally, the universal existence of laws, rules, and gossip about sex, the pervasive interest in other people's sex lives, the widespread seeking of privacy for sexual intercourse, and the secrecy that normally permeates sexual conduct imply a history of reproductive competition. More specifically, the typical differences between men and women in sexual feelings can be explained most parsimoniously as resulting from the extraordinarily different reproductive opportunities and constraints males and females normally encountered during the course of evolutionary history. Men are more likely than women to desire multiple mates; to desire a variety of sexual partners; to experience sexual jealousy of a spouse irrespective of specific circumstances; to be sexually aroused by the sight of a member of the other sex; to experience an autonomous desire for sexual intercourse; and to evaluate sexual desirability primarily on the bases of physical appearance and youth.
The evolutionary causes of human sexuality have been obscured by attempts to find harmony in natural creative processes and human social life and to view sex differences as complementary. The human female's capacity for orgasm and the loss of estrus, for example, have been persistently interpreted as marriage-maintaining adaptations. Available evidence is more consistent with the view that few sex differences in sexuality are complementary, that many aspects of sexuality undermine marriage, and that sexuality is less a unifying than a divisive force in human affairs.
Objectification Theory (Fredrickson & Roberts, 1997) posits that viewing one's body as an object - i.e., self-objectification - increases depressive symptomatology. Though a handful of studies to date have found self-objectification and depressive symptoms correlated among White American women, few studies have examined whether this finding generalizes to other social groups. We examine whether self-objectification and depressive symptoms are associated among Asian Americans and White Americans in a college sample of women and men (N=169). Self-objectification and depressive symptoms were positively associated among White American women but not among White American men or Asian American men or women. These data suggest the parameters of Objectification Theory are circumscribed by both race/ethnicity and gender and self-objectification may put White women, in particular, at risk for depressive symptoms.
Clinicians have suggested that the core pathology of the eating disorders is an extreme body focus in self-evaluation. This study investigated whether women who focus on their own bodies place a similar focus on body shape when evaluating others and expect others to have a strong body focus in their self-evaluations.
Eighty-four undergraduate women completed the Eating Attitudes Test (EAT-26), which largely measures body focus in self-evaluation. Each was also shown a series of photographs of women and asked what aspects of the photos they first noticed and how the depicted women felt about themselves. Finally, each responded to scenarios in which they or a hypothetical woman overate or dieted.
High EAT-26 scores were associated with an elevated number of "fat" or "thin" feelings attributed to women in the slides and a marginally greater number of body-related observations made about the slides. High EAT-26 scores were also associated with inferred negative feelings of others after overeating and positive feelings of others after dieting. In fact, the relationships between EAT-26 scores and feelings in response to hypothetical overeating and dieting situations were no stronger when applied to the self than when applied to others. However, when presented with a situation in which they overate, participants showed stronger relationships between their EAT-26 scores and their expected weight change and dieting behavior than they predicted would occur for others after an identical period of overeating.
Extrapolating findings to a clinical population, women with eating disorders may focus on others' body shapes as well as their own. These women may also expect others to be as emotionally invested in their own body shapes as they are themselves, but may not expect others to be as prone to gain weight or to diet as strictly as they do. Treatment for this somewhat recalcitrant belief system is discussed, as are directions for future research.
To highlight studies that investigated the efficacy, safety, and tolerability of low-dose oral contraceptives (OCs) containing 20 microg of ethinyl estradiol (EE) and to discuss the use of these low-dose contraceptives in women from adolescence to menopause and the noncontraceptive health benefits likely to be afforded by low-dose contraceptives.
Relevant literature was identified by searching MEDLINE and EMBASE. Other sources were located by consulting the bibliographies of the material collected from Medline and EMBASE. Sources for additional information included documents from the United States Food and Drug Administration and the Physicians' Desk Reference (54th ed.).
The current lowest available dose of EE used for OCs in the United States is 20 microg. Formulations with 20 microg of EE are efficacious and have a low incidence of estrogen-related side effects. Since this lowest effective EE dose inhibits ovarian activity, 20 microg of EE should also provide the noncontraceptive health benefits of OCs. Both contraceptive and noncontraceptive benefits of OCs are available to most women from adolescence to menopause without complications.
Hormonal contraception is available in oral contraceptive pills and in newer formulations, including the transdermal patch, the vaginal ring, subcutaneous implants, and IM injections. Prevention of pregnancy is achieved by inhibiting ovulation, fertilization, and/or implantation of an egg. Hormonal contraception provides effective, tolerable, and reversible prevention of pregnancy. Efficacy and safety profiles are similar for different formulations and administration routes. Lowest expected failure (i.e., method failure) rates for hormonal contraceptives, regardless of formulation, are <2%. Typical failure rates for oral formulations range from <3% to 5% due to failures in compliance. The most commonly reported adverse effects are weight gain, nausea, variations in menstrual flow, breast changes such as tenderness, discomfort, or swelling, depression or mood disturbances, decreased sexual desire or response, and acne. Rare but serious potential effects include cardiovascular diseases, such as stroke, and an increased risk for breast cancer, liver tumors, and gallbladder disease. Hormonal contraceptive use should be avoided in women at risk for blood clots, by heavy smokers, and in women with breast or other cancers. Use of hormonal contraception in adolescents requires special consideration, in part because of decreased compliance.
This randomized multicenter, open-label, trial compared efficacy, acceptability, tolerability and compliance of NuvaRing with a combined oral contraceptive (COC), containing 30 microg of ethinyl estradiol (EE) and 3 mg of drospirenone.
In this 13-cycle study, 983 women were randomized and treated (intent-to-treat population) with NuvaRing or COC.
One in-treatment pregnancy occurred with NuvaRing (Pearl Index=0.25) (95% confidence interval [CI]: 0.006, 1.363) and four with the COC (Pearl Index=0.99) (95% CI: 0.269, 2.530). For both groups, compliance (89.2% NuvaRing, 85.5% COC) and satisfaction (84% NuvaRing; 87% COC) were high; the vast majority of women found NuvaRing easy to insert (96%) and remove (97%). Tolerability was similar; the most frequent adverse events with NuvaRing were related to ring use, whereas estrogen-related events were more common with the COC.
NuvaRing has comparable efficacy and tolerability to a COC containing 30 microg of EE and 3 mg drospirenone. User acceptability of both methods was high.
Body dissatisfaction was studied in 123 predominately European-American college women. Desired changes in body characteristics were associated with scores on the Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ-3) and the Objectified Body Consciousness Scale (OBCS). All SATAQ-3 measures were associated with desired changes in bust size and height, but were not related to desired upper body size. In contrast, the OBCS Surveillance and Body Shame Scales were related to desired upper body size, but were not related to desired bust size or height. As hypothesized, the SATAQ-3 Pressure and Internalization-General Scales and the OBCS Surveillance and Body Shame Scales were related to desired weight and lower body size. Results indicate body dissatisfaction is a complex construct and different aspects of this construct are related to different dispositional measures. Results also indicate that the OBCS is a more narrowly focused measure than the SATAQ-3.
Laboratory experiments and surveys show that self-objectification increases body shame, disrupts attention, and negatively predicts well-being. Using experience sampling methodology, the authors investigated self-objectification in the daily lives of 49 female college students. Building on the predictions of objectification theory, they examined associations between internalizing an observer's perspective on the self and psychological well-being, and examined the moderating roles of trait self-esteem and appearance-contingent self-worth. Within-person increases in self-objectification predicted decreased well-being, but this association was moderated by trait self-esteem and trait appearance-contingent self-worth; high self-esteem, highly appearance-contingent participants reported increased well-being when they self-objectified. Furthermore, perceived unattractiveness partially mediated the main effect and the three-way interaction: high self-esteem, highly contingent participants experienced smaller drops in well-being when they self-objectified, in part because they felt less unattractive. These results suggest that in daily life, some women receive a boost from self-objectification, although most women experience decreases in well-being when self-objectifying.
Current diagnosis & treatment in family medicine
- J E South-Paul
- E L Lewis
- S C Matheny
South-Paul, J. E., Lewis, E. L., & Matheny, S. C. (2008). Current diagnosis & treatment in
family medicine (2nd ed.). McGraw-Hill.