title: Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women∗:∗2016 ISSM Female Sexual Dysfunction Prize.
abstract: The female sexual response is complex and influenced by several biological, psychological, and social factors. Testosterone is believed to modulate a woman's sexual response and desire, because low levels are considered a risk factor for impaired sexual function, but previous studies have been inconclusive.
  
  
  
  To investigate how androgen levels and psychosocial factors are associated with female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD).
  
  
  
  The cross-sectional study included 428 premenopausal women 19 to 58 years old who completed a questionnaire on psychosocial factors and had blood sampled at days 6 to 10 in their menstrual cycle. Logistic regression models were built to test the association among hormone levels, psychosocial factors, and sexual end points.
  
  
  
  Five different sexual end points were measured using the Female Sexual Function Index and the Female Sexual Distress Scale: impaired sexual function, sexual distress, FSD, low sexual desire, and HSDD. Serum levels of total and free testosterone, androstenedione, dehydroepiandrosterone sulfate, and androsterone glucuronide were analyzed using mass spectrometry.
  
  
  
  After adjusting for psychosocial factors, women with low sexual desire had significantly lower mean levels of free testosterone and androstenedione compared with women without low sexual desire. None of the androgens were associated with FSD in general or with HSDD in particular. Relationship duration longer than 2 years and mild depressive symptoms increased the risk of having all the sexual end points, including FSD in general and HSDD in particular in multivariate analyses.
  
  
  
  In this large cross-sectional study, low sexual desire was significantly associated with levels of free testosterone and androstenedione, but FSD in general and HSDD in particular were not associated with androgen levels. Length of relationship and depression were associated with FSD including HSDD. Wåhlin-Jacobsen S, Kristensen E, Tønnes Pedersen A, et al. Androgens and Psychosocial Factors Related to Sexual Dysfunctions in Premenopausal Women. J Sex Med 2017;14:366-379.
authors.affiliation: Department of Sexological Research, Psychiatric Center Copenhagen, Copenhagen, Denmark. Electronic address: sarah.waahlin@regionh.dk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wåhlin-Jacobsen
authors.affiliation: Department of Sexological Research, Psychiatric Center Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Ellids
authors.initials: E
authors.lastname: Kristensen
authors.affiliation: Department of Gynecology and Fertility Clinic, JMC Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Anette Tønnes
authors.initials: AT
authors.lastname: Pedersen
authors.affiliation: Department of Sexological Research, Psychiatric Center Copenhagen, Copenhagen, Denmark.
authors.forename: Nanna Cassandra
authors.initials: NC
authors.lastname: Laessøe
authors.affiliation: Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark.
authors.forename: Arieh S
authors.initials: AS
authors.lastname: Cohen
authors.affiliation: Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark.
authors.forename: David M
authors.initials: DM
authors.lastname: Hougaard
authors.affiliation: Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark.
authors.forename: Marika
authors.initials: M
authors.lastname: Lundqvist
authors.affiliation: Department of Sexological Research, Psychiatric Center Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Giraldi
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007989:Libido / Q000502:physiology*; D008875:Middle Aged; D017697:Premenopause; D012725:Sexual Behavior / Q000523:psychology*; D012735:Sexual Dysfunction, Physiological / Q000097:blood*; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology*; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D000728:Androgens; D013739:Testosterone; D000735:Androstenedione
keywords: Androgen; Androstenedione; Depression; Female; Psychosocial Factors; Sexual Desire; Sexual Distress; Sexual Function; Testosterone; Women