Androgen Status in Healthy Premenopausal Women with Loss of Libido

Abstract

Androgen deficiency may contribute to female sexual dysfunction and loss of libido. The role of the active metabolite of testosterone, dihydrotestosterone (DHT), in these conditions is uncertain. The aim of this study was to determine the role of androgens and DHT in the etiology of loss of libido in healthy women. We studied 29 premenopausal women with reduced libido (subjects) and 12 healthy females (controls). They were aged 18 to 45 years and in a stable heterosexual relationship. At 9 a.m. we took venous blood in the follicular phase for serum estradiol, total testosterone, and DHT, dehydroepiandrosterone sulfate (DHEAS), and SHBG levels. Subjects were interviewed by a psychosexual counsellor. Using the modified Wilson's sexual fantasy questionnaire (Baumgartner, Scalora, & Huss, 2002) and sexual satisfaction by Golombok-Rust Inventory of Sexual Satisfaction (GRISS Rust & Golombok, 1985, 1986) we assessed sexual drive. The total testosterone and DHT levels (mean +/- SD) were respectively 0.97 +/- 0.38 mmol/L and 0.76 +/- 0.37 nmol/L in subjects and 0.97 +/- 0.41 mmol/L and 0.77 +/- 0.15 nmol/L in controls. The SHBG and DHEAS were respectively 65 +/- 42 mmol/L and 3.76 +/- 1.0 umol/L in subjects and 65 +/- 29 mmol/L and 3.67 +/- 2.6 in controls. The scores of the Wilson questionnaire and GRISS were respectively 21 +/- 14.1 and 5 +/- 2.1 in subjects and 35 +/- 14.8 & 2 +/- 1.2 in controls. Subjects were more likely than controls to have low income (48% versus 8%, p < 0.02), a minor illnesses (57% versus 17%, p < 0.02), a history of depression (57% versus 8%, p = 0.025) and to report sexual problems in their partners (24% versus 0%, p = 0.053). Loss of libido in otherwise healthy women may be related to relationship problem, depression, psychosocial factors, and sexual dysfunction in the partner but do not appear to be related to androgen status.

Pharmacologically Induced Hypogonadism and Sexual Function in Healthy Young Women and Men

“…These data suggest (albeit indirectly) that deficiencies of sex hormones could underlie a decrease in sexual function in both men and women. Second, some basal hormone studies have observed correlations between blood levels of sex steroids and sexual functioning, while other studies have observed lower sex hormone levels in subjects with decreased sexual function compared with asymptomatic control groups (Schiavi et al, 1991;Cawood and Bancroft, 1996;Santoro et al, 2005;Basar et al, 2005;Modelska et al, 2004;Travison et al, 2006;Beutel et al, 2005;Kennedy et al, 1997;Nyunt et al, 2005;Dennerstein et al, 1994Dennerstein et al, , 2002Slob et al, 1996;Adams et al, 1978;Bancroft et al, 1980;Meuwissen and Over, 1992;Doering et al, 1974). Finally, several longitudinal studies have demonstrated the reduction of sexual function under the following circumstances: after medical or surgical castration; after the development of hypogonadism secondary to a variety of medical illnesses; after the administration of medications that inhibit sex hormone production (Marberger et al, 2006); and during age-related reproductive senescence (Dennerstein et al, 2002;Koster and Garde, 1993).…”

Female Sexual Function and Dysfunction in the Reproductive Years: The Influence of Endogenous and Exogenous Sex Hormones

“…However, in another case control study, Nyunt et al. measured androgens in 29 premenopausal women with reduced libido and compared them with 12 premenopausal controls [52]. No differences were found in androgens between the case and control group.…”

Sex Hormone Binding Globulin and Aging

“…Given the preclinical evidence that SHBG has direct eff ects in the brains of females on their sexual behavior, there is surprisingly no evidence that SHBG levels in blood are altered under conditions of low sexual libido or varying levels of sexual desire. Nyunt et al [46] found no diff erence in SHBG levels between low libido premenopausal women and controls. Schreiner-Engels and colleagues [47] also found no diff erence in SHBG blood levels in a group of women with hypoactive sexual desire disorder.…”