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Women's sexual experience during the menstrual cycle: Identification of the sexual phase by noninvasive measurement of luteinizing hormone
The Journal of Sex Research
Abstract
Imprecise measures of ovulation obscure the relationship between women's sexuality and the menstrual cycle, as does studying women with different contraceptive goals in different social contexts. Here we present a novel noninvasive method to precisely pinpoint the preovulatory surge of Luteinizing Hormone (LH), demarcating hormonally distinct cycle phases with greater than 95% reliability. Women were more sexually active on days prior to and including the preovulatory (LH) surge. This pattern was evident only when women initiated sexual activity and not when their partners did, indicating an increase in women's sexual motivation rather than attractiveness. A second study replicated the 6-day increase in sexual activity beginning 3 days before the LH surge, accompanied by stronger sexual desire and more sexual fantasies. We propose the term 'sexual phase' of the cycle, since follicular phase is over inclusive and ovulatory phase is not sufficient. These findings are striking because the women were avoiding pregnancy and were kept blind to the hypotheses, preventing expectation bias. The sexual phase was more robust in women with regular sexual partners, although the increase in sexual desire was just as great in nonpartnered women, who also reported feeling less lonely at this time. We use these results to evaluate potential neuroendocrine mechanisms underlying women's sexual motivation and activity.
... One such mechanism is the endogenous endocrine regulation of motivational states across women 1 's ovulatory cycles (Fessler, 2003;Roney, 2016). Previous research has shown that women exhibit increased sexual motivation during the fertile phase of the ovulatory cycle (Arslan, Schilling, et al., 2021;Bullivant et al., 2004;Gangestad et al., 2002;Grebe et al., 2016;Jones et al., 2018a;Marcinkowska et al., 2022;Simmons, 2013, 2016). These findings have given rise to a number of theories on so-called ovulatory cycle shifts in women's sexual motivation. ...
... However, empirical evidence is growing that women show changes during their fertile window that indicate heightened sexual proceptivity (i.e. women show increased sexual motivation and initiate more sexual behaviour; Bullivant et al., 2004), sexual receptivity (e.g. women rate male bodies as more attractive; Jünger, Kordsmeyer, et al., 2018;Stern et al., 2021) and increased attractiveness (women feel more attractive; Schleifenbaum et al., 2021, and men rate female faces as more attractive; for a review see Haselton and Gildersleeve, 2016, but see Catena et al., 2019;Jones, Hahn, Fisher, Wang, Kandrik, Lao, et al., 2018;Marcinkowska et al., 2021;Schleifenbaum et al., 2022;Stern et al., 2023 for contradicting evidence on perceptible changes across the cycle). ...
... The aforementioned studies showing a robust ovulatory increase in general sexual motivation in women provide strong support for the first prediction of the MPSH of an ovulatory increase in general, not specific, sexual motivation, or increases in in-pair and extra-pair desire simultaneously (Arslan, Schilling, et al., 2021;Jones et al., 2018a;Simmons, 2013, 2016;Shirazi, Jones, et al., 2019;Stern et al., 2020). Moreover, several studies reporting ovulatory increases in dyadic (Bullivant et al., 2004;Caruso et al., 2014;Harvey, 1987;van Goozen et al., 1997;Wilcox et al., 2004), female-initiated (Adams et al., 1978;Bullivant et al., 2004;Gangestad et al., 2002;Harvey, 1987), and solitary sexual behaviour (Brown et al., 2011;Burleson et al., 2002;van Goozen et al., 1997) add to this picture. Yet, other studies failed to detect ovulatory changes in sexual behaviour (Brewis and Meyer, 2005;Elaut et al., 2016;Roney and Simmons, 2013). ...
Previous research on the endogenous effects of ovarian hormones on motivational states in women has focused on sexual motivation. The Motivational Priority Shifts Hypothesis has a broader scope. It predicts a shift from somatic to reproductive motivation when fertile. In a highly powered preregistered online diary study across 40 days, we tested whether 390 women report such an ovulatory shift in sexual and eating motivation and behaviour. We compared 209 naturally cycling women to 181 women taking hormonal contraceptives (HC) to rule out non-ovulatory changes across the cycle as confounders. We found robust ovulatory decreases in food intake and increases in general sexual desire, in-pair sexual desire and initiation of dyadic sexual behaviour. Extra-pair sexual desire increased mid-cycle, but the effect did not differ significantly in HC women, questioning an ovulatory effect. Descriptively, solitary sexual desire and behaviour, dyadic sexual behaviour, appetite, and satiety showed expected mid-cycle changes that were diminished in HC women, but these failed to reach our strict preregistered significance level. Our results provide insight into current theoretical debates about ovulatory cycle shifts while calling for future research to determine motivational mechanisms behind ovulatory changes in food intake and considering romantic partners' motivational states to explain the occurrence of dyadic sexual behaviour.
... Bullivant et al. (7) identifican una fase sexual, en la que las mujeres tienen mayor deseo que se compone de 6 días, desde 3 días antes del pico de LH hasta 2 días después del mismo. Siguiendo con la teoría evolucionista, que la fase sexual no dure únicamente lo que dura la ovulación tiene sentido, porque el esperma puede mantenerse con vida durante varios días (7). ...
Antecedente: La sexualidad femenina se rige mediante neurotransmisores como la dopamina, la noradrenalina o la serotonina, los cuales son influidos por las hormonas esteroideas. Dichas hormonas varían durante el ciclo menstrual siendo probable que la sexualidad femenina también lo haga. Objetivo: Analizar si los componentes de la respuesta sexual varían a lo largo del ciclo menstrual, evaluando si las puntuaciones globales y por dominios del Índice de Función Sexual Femenina (FSFI, Female Sexual Function Index) varían en sus diferentes fases.Métodos: Mujeres cisgénero entre 18 y 45 años con ciclos regulares y naturales, rellanaron el FSFI en cuatro momentos diferentes del ciclo: menstrual o folicular temprana, folicular tardía, ovulatoria y lútea. Los resultados fueron analizados de manera descriptiva, con el test de ANOVA unifactorial (test de corrección de LSD de Fischer) y el test de correlación bivariante (Tau b de Kendall).Resultados: Durante la fase menstrual, cuando los niveles de hormonas ováricas son más bajos, todos los dominios del FSFI obtuvieron peores resultados (menores puntajes). A medida que transcurren las fases, las puntuaciones aumentan. Acorde con la teoría evolucionista, el deseo muestra un pico ovulatorio. Conclusión: Las puntuaciones del FSFI, tanto por dominios como en su puntuación global, varían durante el ciclo menstrual.
... For example, some studies suggest that the frequency of proactive behaviors such as flirtation and female-initiated sexual activity peaks around ovulation [38][39][40][41][42], when circulating estradiol and testosterone levels are highest [43,44]. Around ovulation, some studies report a greater frequency of total and self-initiated sexual encounters [40,45,46] and opportunistic mating (i.e., "trading up" from a primary partner in favor of a more attractive mate with better resources) [47]. ...
The extent to which estradiol, progesterone, and testosterone influence mating behavior across the menstrual cycle is unclear. The Proactive and Responsive Mating Strategies Scales (PARMSS) were developed to separately examine two specific components of sexuality and were used here to test divergent hormonal associations. Preliminary psychometric data (N = 364 females) suggest that both scales consist of one factor and demonstrate strong psychometric properties (internal consistency, test–retest reliability, and construct and convergent validity). The PARMSS were used in a repeated-measures observational study to examine the relationships between changes in endogenous hormone levels and both proactive and responsive mating intentions with potential new short-term or long-term partners in healthy pre-menopausal participants (N = 38). At two points in their cycle, participants provided salivary hormone samples in the laboratory and reported the likelihood of engaging in proactive and responsive behaviors with men in photos and vignettes. Participants reported greater responsive than proactive intentions. Increases in estradiol and testosterone across the cycle were associated with increases in short-term mating intentions, particularly responsivity to potential short-term relationship partners. No associations were found for intentions that were proactive or that involved potential long-term partners or for progesterone. Changes in the three hormones explained changes in short-term responsive mating intentions (22% of the variance). The results suggest (a) cyclical changes in estradiol and testosterone are differentially associated with changes in responsive vs. proactive mating intentions and (b) context-dependent changes (i.e., short-term vs. long-term mating intentions and possibly relationship status). The findings require replication with larger and diverse samples.
... In biology, the display of red on the face, chest, or genitals of non-human female primates during their fertility phase represents a sexual signal designed to attract mates (Dixson, 1983;Deschner et al., 2004;Setchell and Wickings, 2004;Barelli et al., 2007). Similarly, during ovulation, human females may experience reddened skin on their face or body due to increased blood flow velocity (Roberts et al., 2004;Lynn et al., 2007), and are more likely to be sexually aroused (Bullivant et al., 2004), displaying the red flushes of sexual excitation (Katchadourian and Lunde, 1972). After the long process of evolution, men, like other male animals, may have come to subconsciously associate the color red with sexual signals (Elliot and Niesta, 2008;Pazda et al., 2013). ...
Lipstick is one of the most commonly used cosmetics, which is closely associated with female attractiveness and influences people’s perception and behavior. This study aimed to investigate the impact of light sources, lipstick colors, as well as gender on the subjective assessment of lipstick color products from the prospective of color preference, purchase intention and sexual attractiveness. The correlation between color preference evaluations when applying lipstick on lips and on forearms was also explored. Sixty participants completed their visual assessment of 15 lipsticks worn by 3 models under 5 light sources, with uniformly sampled correlated color temperature (CCT) values ranging from 2,500 K to 6,500 K. The results indicated that the light source significantly influenced color preference and purchase intention, while lipstick color significantly impacted on sexual attractiveness. The interactions between gender and other factors were also observed and are discussed. Compared to men, women were found to be more sensitive to different light sources and hold different attitudes toward different lipstick colors under different CCTs. Interestingly, no significant correlation was found between lipstick color preference ratings on the lips and forearm, which conflicted with the commonly recognized way of lipstick color selection. These findings should contribute to a deeper understanding of the consumer attitude toward lipstick colors and provide a useful reference for lighting design in situations where cosmetics are specified, manufactured, retailed and generally used, both professionally and in the home.
... According to evolutionary models, females experience an increase in sexual desire and sexual activity around ovulation, during the most fertile days of their menstrual cycle. 1,2 However, while some studies have provided support for this hypothesis, [3][4][5][6] there is no consistent pattern of results across studies, and conclusions are often limited by methodological weaknesses. For example, although Stanislaw and Rice 7 concluded that around 50% of their participants experienced a peak in sexual desire around ovulation, because the study was conducted in the context of a "family planning" protocol with prescribed days of sexual activity and when the participants were to record their sexual activity and desire, their results may have been more heavily influenced by the family planning and research protocols than the menstrual cycle and ovulation. ...
Background
Past research on the association between sexual desire and the menstrual cycle has provided inconclusive results and has not considered the potential influence of psychological and physical changes that are frequently associated with the menstrual cycle.
Aim
To test the strength of association between the menstrual cycle (and associated symptoms) and changes in sexual desire.
Methods
Prospective daily reports across 2 full menstrual cycles (2 months) from a sample of female university students (n = 213), were analysed. Analyses tested for average effects of the menstrual cycle on sexual desire, individual differences in these effects, and cyclical and noncyclical associations between sexual desire and the 9 menstrual cycle–related changes. Note that data presented in the current article come from a larger study from which other reports have been published.
Outcomes
Target variables were (1) daily change in sexual desire and (2) daily reports of 5 psychological changes and 4 physical changes that are commonly associated with the menstrual cycle.
Results
Results showed that when considering average effects across participants, the menstrual cycle was associated with a small midcycle increase in sexual desire. However, multilevel analyses showed large individual differences in how the menstrual cycle influences sexual desire. Specifically, some participants showed a midcycle increase, others a perimenstrual increase, and others no change across the menstrual cycle. Moreover, results demonstrated that psychological changes were more important for predicting sexual desire as compared with physical changes.
Clinical Implications
These results suggest that daily measurement of sexual desire across multiple menstrual cycles may be an important tool in the assessment of sexual desire among some females.
Strengths and Limitations
Strengths of this study are the daily assessment of sexual desire and all symptoms for 2 menstrual cycles and multilevel analyses that allow the study of individual differences. Limitations include limited measurement of sexual desire based on only 2 questions and the lack of measures of relationship status and sexual orientation.
Conclusion
Emphasis is placed on the need to apply more rigorous research methods and to abandon simplistic average-effects models that are based on outdated theories and stereotypes.
Endometriosis is a major health concern in women who have it. Unfortunately, there is no definitive cure except panhysterectomy with its sequelae including induction of premature menopause due to loss of ovaries. Therefore, revealing the causes of this puzzling disease is necessary to avoid contracting it, and to spare women the health disorders resulting from it and the difficulties of treating it. We aimed to study endometriosis with a focus on its theoretical causes. Its classification reports and theories of pathogenesis were identified and studied from available database searches. The causes of endometriosis remain mysterious. Many theories have been proposed to explain the etiology, but retrograde menstruation (RM) remains the closest in this regard. Although this theory is the most accepted in the pathogenesis of endometriosis, its causes are still a matter of debate, especially in women who do not suffer from obstructions to menstrual outflows, such as cases of congenital cervical stenosis and imperforate hymen. It is suggested in some studies that there may be a relationship between women who engage in sexual activity during menstruation and the development of endometriosis. It is concluded that endometriosis is a painful and debilitating disease. Identifying its causes is essential to control the disease and avoid any burdens on health. RM is the main theory for its pathogenesis but its causes are still uncertain. Sexual activity during menstruation may be a possible cause of RM but needs more evidence. Future studies are recommended to reveal all aspects of the pathogenesis of endometriosis. Production and Hosting by Knowledge E Hegazy et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are
Female Arousal and Orgasm: Anatomy, Physiology, Behaviour and Evolution is the first comprehensive and accessible work on all aspects of human female sexual desire, arousal and orgasm. The book attempts to answer basic questions about the female orgasm and questions contradictory information on the topic. The book starts with a summary of important early research on human sex before providing detailed descriptions of female sexual anatomy, histology and neuromuscular biology. It concludes with a discussion of the high heritability of female orgasmicity and evidence for and against female orgasm providing an evolutionary advantage.
The author has attempted to gather as much information on the subject as possible, including medical images, anonymized survey data and previously unreported trends. The groundbreaking book gives a scientific perspective on sexual arousal in women, and helps to uncover information gaps about this fascinating yet complex phenomenon.
In this chapter, we review the literature on attractiveness by explaining the multifaceted nature of attractiveness and then focusing on physical attractiveness as it has a predominant impact on attractiveness.
How attractive we find ourselves decides who we target as potential partners and influences our reproductive fitness. Self-perceptions on women's fertile days could be particularly important. However, results on how self-perceived attractiveness changes across women's ovulatory cycles are inconsistent and research has seldomly assessed multiple attractiveness-related constructs simultaneously. Here, we give an overview of ovulatory cycle shifts in self-perceived attractiveness, sexual desirability, grooming, self-esteem and positive mood. We addressed previous methodological shortcomings by conducting a large, preregistered online diary study of 872 women (580 naturally cycling) across 70 consecutive days, applying several robustness analyses and comparing naturally cycling women with women using hormonal contraceptives. As expected, we found robust evidence for ovulatory increases in self-perceived attractiveness and sexual desirability in naturally cycling women. Unexpectedly, we found moderately robust evidence for smaller ovulatory increases in self-esteem and positive mood. Although grooming showed an ovulatory increase descriptively, the effect was small, failed to reach our strict significance level of .01 and was not robust to model variations. We discuss how these results could follow an ovulatory increase in sexual motivation while calling for more theoretical and causally informative research to uncover the nature of ovulatory cycle shifts in the future.
Twenty-five married women who were not using contraceptives provided daily urine specimens and coital reports for at least 90 days. The authors used urinary luteinizing hormone (LH) as a hormonal marker to determine ovulatory phase, onset of LH surge day, and LH peak day. Coital rate was elevated during the ovulatory phase of the menstrual cycle. Peak coital rate (0.72) occurred on onset of LH surge day, and was significantly greater ( P
The authors studied 740 consecutive in vitro fertilization (IVF) cycles over a 3-year period to compare the results of cycles in which an endogenous luteinizing hormone (LH) surge occurred with cycles in which human chorionic gonadotropin (hCG) was administered for induction of follicular maturation. Clomiphene citrate (100 to 150 mg daily on cycle days 5 to 9) and human menopausal gonadotropin (hMG; 75 to 150 IU daily from cycle day 6) were used for stimulation. Embryo transfer (ET) occurred in 164 (81.2%) of the LH surge cycles and 452 (84%; P = not significant [NS] of the hCG cycles. The first urinary rise in LH was detected in the 6 or 9 A.M. collections in 78 (47.3%) of the LH surge cycles, a greater number (P less than 0.01) than expected if LH surge onset was random. A total of 107 pregnancies was achieved, for an overall pregnancy rate of 17.4% per ET. The pregnancy rate in the hCG-stimulated cycles was 13.9% per ET (63/452) and, in spontaneous LH surge cycles, was 28.8% (44/166; P less than 0.001). The spontaneous abortion rate was 9.1% in LH surge cycles, compared with 25.4% in hCG-triggered cycles (P less than 0.001). The result was a 2.4 times increase in live births for LH surge cycles compared with cycles in which hCG was administered. In this program, occurrence of an LH surge is a favorable event, associated with higher pregnancy and live birth rates than hCG-stimulated cycles, and usually occurring in the early morning, allowing oocyte retrieval during normal working hours.
Occurrence of ovulation was detected by laparoscopy between 22 and 47 hours following the onset of the luteinizing hormone (LH) surge in plasma (61 patients) or human chorionic gonadotropin (hCG) administration (76 patients). None of 22 patients had ovulated before the 34th hour following LH surge or hCG, as compared with 3.4% (3 of 89) and 50.0% (11 of 22) laparoscoped after 34 to 37 hours or 37 to 39 hours, respectively. Whether measured with respect to the initial rise of LH or the injection of hCG, the time lapse before ovulation was comparable. Ovulation was more frequently established at 37 to 39 hours in spontaneous cycles (10/13) than in clomiphene-treated cycles (1/9, P
Using a balanced experimental design, 30 regularly cycling woman not using oral contraceptives, aged 20 to 30 years, were assessed in a laboratory setting during the follicular, ovulatory, and luteal phases. Sexual arousal was measured by self-report and by photoplethysmographic recordings of vaginal vasocongestion. Plasma estradiol, progesterone, and testosterone were determined by radioimmunoassay. There were marked and consistent individual differences among the women in their sexual arousability. Subjective reports of sexual arousal did not differ among menstrual cycle phases, by physiologic arousal did vary with significantly higher mean levels of arousal occurring during the follicular and luteal phases than during the ovulation phase. While hormones fluctuated predictably with menstrual cycle phase, there were wide individual differences in absolute values among women. The correlations between estradiol, progesterone and testosterone and the subjective and objective assessments of arousability were mainly low and insignificant. Some evidence suggestive of a relation between testosterone and sexual arousability was observed with three subgroups of woman were formed on the basis of relative average testosterone concentrations.
In an attempt to analyze the multiple changes and interactions in circulating steroid levels in the peri-ovulatory and peri-menstrual periods, the plasma levels of immunoreactive luteinizing hormone (LH), progesterone and unconjugated pregnenolone, dehydroepiandrosterone, testosterone, oestradiol and oestrone were assayed daily during a complete cycle in 17 normally menstruating women. In 14 of the 17 subjects studied androstenedione and unconjugated dihydrotestosterone were also estimated. The day of the LH-peak and the first day of menstruation, respectively, were used to synchronize the peri-ovulatory and peri-menstrual plasma levels of the various steroids.
With the exception of dehydroepiandrosterone and dihydrotestosterone, the plasma levels of all steroids exhibited significant, but different changes during the cycle. Testosterone levels showed a slight but significant increase around the LH-peak, whereas the levels of pregnenolone and androstenedione were higher in the post-ovulatory than in the pre-ovulatory periods. The levels of oestradiol and oestrone, as well as the ratios of oestradiol to oestrone gradually increased from the low values observed in the early proliferative phase to pre-ovulatory peak values. The relationship between peaks of oestradiol and oestrone and that of LH exhibited great individual variation. The same was true for the individual oestradiol to oestrone ratios. The combination of several steroidal signals did not improve the predictive value of the analyses. However, an increase of individual progesterone values by at least 0.35 ng/ml from the day preceding the LH-peak to the day of the LH-peak was observed in 13 of the 17 subjects. It is suggested that for the early detection of the LH surge and prediction of the subsequent ovulation daily assays of plasma progesterone are of more value than the assay of the other steroids investigated.
Rhesus monkeys in seminatural environments exhibit a distinct seasonal mating cycle with conceptions restricted to the fall and winter months. In the present study, the characteristics of menstrual cycles were examined during a 1-year period in twelve rhesus monkeys in whom pregnancy was prevented. Menses occurred throughout the year, but ovulations were observed only in the fall and winter months. Menses in the spring and summer months occurred irregularly and were associated exclusively with anovulatory cycles. The total number of ovulations exhibited by these females during the breeding season ranged from two to six and was positively related to body weight, mean luteal phase progesterone (P) levels of normal cycles and social dominance rank. Ovulations with a short luteal phase were exhibited by four females (seven cycles), with the likelihood of occurrence increasing as the breeding season progressed. The incidence of abnormal cycles was predicted from the linear combination of parity, body weight and luteal phase P of normal ovulatory cycles. These results suggest that during the seasonally delimited period of ovulation, females exhibit a range in the quality and quantity of ovulations which may be predicted by certain idiosyncratic physical and behavioral traits.
The relationships between plasma free testosterone (FT) and measures of sexual attitude, sexual behavior, and gender role behavior were assessed in 55 oral contraceptive-using and 53 nonusing female undergraduates. Plasma FT and other measures of androgenicity were substantially lower in the oral contraceptive (OC) group. Correlations between FT and certain behavioral and attitudinal measures were found in the OC users but not the nonusers. In the OC users, FT was positively associated with frequency of sexual intercourse but not with frequency of masturbation. It was negatively associated with restrictive sexual morality. Correlations between FT and measures of gender role behavior were negligible, and FT was unrelated to proceptivity, homosexual interest, or the use of sexual fantasy. The occurrence of some predicted correlations among pill-using women but not the nonusers requires explanation, particularly in view of the substantially lower levels of FT in the pill-using group. It is suggested that androgen—behavior relationships in women are easily obscured by psychosocial influences and in this sample of young women such influences may have been more powerful among those not using OCs. Such psychosocial influences are likely to differ at different stages of women's life cycles. The importance of controlling for such influences in any study of hormone—sexual behavior relationships in women is emphasized, and the need for prospective studies of women before and after starting on steroidal contraception is recognized.
Female undergraduates (108) volunteered for a study of hormones and sexuality, 55 of whom were oral contraceptive (OC) users. In this paper, OC users and nonusers are compared on measures of sexual attitudes and behavior, use of erotic fantasy, and gender role. In the second paper, the effects of OC on androgen levels and the relationship between androgens and behavioral measures within each group are reported. OC users were more likely to have a current sexual partner and less likely to be virgins. The two groups did not differ in frequency of masturbation or use of erotic fantasies. OC users reported less restrictive sexual morality and more interest in erotic images. These differences persisted when women without current partners were excluded. Among those in active sexual relationships, OC users reported more frequent sexual intercourse, higher psychosexual motivation and enjoyment, and were more positive in their evaluation of their partners than OC nonusers.
4112 women completed a retrospective questionnaire indicating when during their last menstrual cycle they felt their well-being and sexual interest to be at their best and worst. The commonest pattern was for well-being to be lowest during the premenstrual and highest during the postmenstrual week. Sexual interest was strongly associated with well-being, suggesting that variations of well-being have a powerful effect on sexuality in the majority of women. Oral contraceptive users, though broadly similar in their reported pattern, were less likely to show peaks and troughs of well-being and highs and lows of sexual interest. This was most evident in the subgroup of monophasic pill users who showed the least tendency to variations in both well-being and sexual interest, and a greater tendency to show either peaks or troughs of well-being during menstruation. Triphasic pill users were intermediate between monophasic and non-pill users.