[Menopause and depression. Interview by C. Staehr].
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Climacteric↗
Biomedical subjects
B B Sherwin
Publications and source records attributed to B B Sherwin.
No adverse effects of medroxyprogesterone treatment without estrogen in postmenopausal women: double-blind, placebo-controlled, crossover trial.
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Clinical Trials as Topic↗
Sex steroids, psychosocial factors, and lipid metabolism.
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Animals↗
The relationship between mood and sexuality in women using an oral contraceptive as a treatment for premenstrual symptoms.
This study investigated the effects of a triphasic oral contraceptive (OC) on mood and on sexual interest in a group of 45 women with premenstrual complaints. Subjects made daily ratings of mood and sexual interest for one baseline cycle and were then randomly assigned to receive either placebo or OC for 3 mo. Women who received the OC reported decreased sexual interest during the menstrual and postmenstrual phases of the cycle. The predominant effect of both the OC and the placebo on mood was one of improvement, particularly during the premenstrual phase. There was little evidence of co-variation of mood and sexual interest in either group. Although the mechanism for the adverse effects of the OC on levels of sexual interest in unknown, it is clear that this effect was not simply a consequence of pill-induced negative mood change. The findings provide evidence that mood and sexual desire are dissociable and suggest that OCs can have direct effects on women's sexuality.
Adolescent↗
Sex steroids, sexual behavior, and selection attention for erotic stimuli in women using oral contraceptives.
The relationship between sex steroids and sexual behavior was examined in 19 oral contraceptive users. Retrospective assessment of sexual attitudes were obtained and women completed daily ratings of sexual behavior and well-being for 28 days. Plasma levels of free testosterone (T), estradiol, and progesterone were measured at weekly intervals. In addition, women performed a novel selective attention task designed to measure the strength of the tendency to be distracted by sexual stimuli. Multiple regression analyses using average sexual behavior variables as dependent variables, and hormone levels sexual attitudes and well-being as predictor variables, showed that free T was strongly and positively associated with sexual desire, sexual thoughts, and anticipation of sexual activity. A role for T in attention to sexual stimuli was also supported by the positive correlation between free T and the bias for sexual stimuli in a subgroup of women. These results are consistent with the hypothesis that T may enhance cognitive aspects of women's sexual behavior.
Adolescent↗
A prospective treatment study of premenstrual symptoms using a triphasic oral contraceptive.
Eighty-two women with complaints of moderate to severe premenstrual symptoms were recruited for a double-blind, controlled trial of a triphasic oral contraceptive (o.c.). Subjects made daily ratings of symptoms for at least one baseline cycle and were then randomly assigned to receive either placebo or o.c. for three months. Twenty-three women dropped out of the study (18 o.c., 5 placebo), 13 failed to show prospective confirmation of moderate to severe premenstrual symptoms, and one placebo subject had an anovulatory cycle. Forty-five women with prospectively-confirmed premenstrual changes (20 o.c., 25 placebo) completed the study. Premenstrual breast pain and bloating were significantly reduced with active treatment compared to placebo (p less than 0.03) but there were no beneficial effects of the o.c. over placebo for any of the mood symptoms. Women who received o.c.s reported decreased sexual interest after starting treatment and this effect was independent of any adverse influence on mood.
Adult↗
Effects of estrogen on memory function in surgically menopausal women.
The effects of estrogen (E) on memory were assessed in 19 women who required a hysterectomy and bilateral oophorectomy for benign disease. Blood samples were drawn and memory tests were administered before surgery and again after 2 mo of postoperative treatment consisting of either monthly E or placebo (PL) injections. Scores on the immediate and delayed recall of paired-associates stayed at the same level in E-treated women, whereas they decreased significantly pre- to post-operatively in the PL-treated subjects. In the immediate recall of paragraphs, the scores of those given E improved postoperatively compared to baseline; scores remained unchanged in the PL group. No hormonal effects were apparent on the immediate or delayed recall of visual material, delayed recall of paragraphs, or digit span scores. These findings suggest that variations in specific aspects of memory function may occur in surgically menopausal women coincident with changes in plasma estrone and estradiol levels.
Climacteric↗
Variations in memory function and sex steroid hormones across the menstrual cycle.
Memory, mood, and hormone levels were measured in 25 women during the menstrual and luteal phases of their cycles. Significantly lower visual memory (delayed recall) scores were found during the menstrual phase compared to the luteal phase. No phase differences were found on mood measures or on other memory measures including digit span, paired-associate learning, immediate recall of visual material, and immediate or delayed paragraph recall. The visual memory decrease was most prominent in approximately one-half of the sample and was significantly correlated with plasma progesterone in the luteal phase. For all subjects, paragraph recall scores were negatively correlated with free testosterone levels, whereas paired-associate learning was positively correlated with estradiol levels in the luteal phase. These results suggest that changes in memory test performance may be associated with sex steroid levels, particularly in some subgroups of women.
Adolescent↗
Oral contraceptives, androgens, and the sexuality of young women: I. A comparison of sexual experience, sexual attitudes, and gender role in oral contraceptive users and nonusers.
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.
Adult↗
Oral contraceptives, androgens, and the sexuality of young women: II. The role of androgens.
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.
Adult↗
The association between testosterone, sexual arousal, and selective attention for erotic stimuli in men.
Twenty-six, eugonadal men between the ages of 18 and 27 participated in this investigation of the relationship between sexual arousal, testosterone (T) levels, and the processing of sexual information. At each of the two test sessions, subjects gave a blood sample, listened to an erotic or neutral priming audiotape, and completed a dichotic listening task designed to assess selective attention for sexual stimuli. Subjective levels of sexual arousal to the audiotape and sexual attitudes and sexual experience were assessed by self-report measures. Contrary to our hypothesis, there was no relationship between levels of free T and the strength of the selective attention bias for sexual stimuli. However, men who were more distracted by the sexual material in the task reported higher levels of sexual arousal to erotic imagery than men who were less distracted by the sexual material in the task (P less than 0.01). Moreover, men who were more sexually aroused by the erotic audiotape made significantly less shadowing errors in the erotic prime condition then they did during the neutral prime condition (P less than 0.05). There was a negative association between T and shadowing errors in the erotic prime condition (P less than 0.05). These results suggest that lower thresholds for sexual arousal are associated with a greater bias to attend to sexual information and that T may have effects on cognitive-motivational aspects of sexual behavior by enhancing attention to relevant stimuli.
Adolescent↗
The impact of different doses of estrogen and progestin on mood and sexual behavior in postmenopausal women.
This study investigated the effects of various doses of estrogen and progestin on psychological functioning and sexual behavior of 48 healthy, naturally menopausal women. Subjects were tested before treatment and then randomly assigned to 1 of 4 cyclic sequential hormone regimens for 1 yr. Groups A and C received 0.625 or 1.25 mg conjugated equine estrogen (CEE), respectively, for days 1-25 and 5 mg medroxyprogesterone acetate from days 15-25. Groups B and D were given 0.625 or 1.25 mg CEE, respectively, from days 1-25 and placebo from days 15-25. The higher dose of CEE induced supraphysiological levels of plasma estrone. Plasma testosterone levels were lower in group A when blood was sampled during days 18-20 at a time when they were ingesting both 0.625 mg CEE and 5 mg medroxyprogesterone acetate (P less than 0.05), although these decreases were perhaps too trivial to have affected sexual behavior as was hypothesized. Women in group A also had more negative moods and more psychological symptomatology during treatment compared to those in group D who were receiving 1.25 mg CEE and placebo (P less than 0.01). Regardless of group, sexual desire and arousal were higher during the first 2 weeks of the treatment cycle than during week 4 when no hormones were being ingested (P less than 0.05). These findings demonstrate that the effects of progestin on the central nervous system are reflected by an increase in psychological, exclusive of sexual, symptomatology and are attenuated by a higher estrogen/progestin dose ratio.
Affect↗
Up-regulatory effect of estrogen on platelet 3H-imipramine binding sites in surgically menopausal women.
Although depressive symptoms occur in a considerable number of women following a decrease in circulating estrogen levels, a biological correlate of these mood changes has not been identified. In a prospective, double-blind, cross-over investigation of surgically menopausal women, an increase in the number of tritiated imipramine binding sites on platelets and an improvement of mood occurred with estrogen treatment and were reversed when placebo was administered. In vitro studies indicated that this effect was not due to a direct interaction of the steroid with the imipramine binding site at the same concentrations of estradiol induced in the in vivo study. Together with other evidence, these findings suggest that pharmacological but not physiological doses of estrogen can enhance the density of tritiated imipramine binding sites on platelets in women.
Affect↗
Testosterone and sexual behavior in oral contraceptive users and nonusers: a prospective study.
The relationship between plasma testosterone (T) secretion and patterns of sexual behavior was examined in 18 women using oral contraceptives (OCs) and 13 nonusers matched for partner availability. Retrospective assessments of perimenstrual symptoms, sexual attitudes, and sexual experience were obtained and women completed daily ratings of the frequency of sexual activities and the level of well-being for 1 month. Plasma levels of sex hormone binding globulin (SHBG), progesterone, Total T, Free T, and non-SHBG bound T were determined by radioimmunoassay at four phases of the pill or menstrual cycle. Overall, women not using OCs had higher plasma levels of Total, Free, and non-SHBG bound T and lower plasma levels of SHBG than those of OC users. Further, only nonusers had perimenstrual decreases in plasma levels of Total and Free T. The two groups were comparable on most retrospective measures. However, OC users reported more satisfaction with their sexual partners than did nonusers and prospective monitoring revealed that they engaged in sexual interactions more frequently than did nonusers across the cycle. In contrast, both groups reported a similar frequency of autosexual activities across the cycle. There were no correlations between average levels of T and levels of sexual desire, sexual interactions, or autosexuality. Moreover, only nonusers reported a decrease in levels of sexual desire during the perimenstrual period that was associated with the changes in Free T over the menstrual cycle.
Adolescent↗
A prospective one-year study of estrogen and progestin in postmenopausal women: effects on clinical symptoms and lipoprotein lipids.
Ninety-five healthy women who had been amenorrheic for at least 6 months were randomly assigned to one of four cyclic, sequential hormone regimens for 1 year. Groups A and C received 0.625 or 1.25 mg conjugated equine estrogen (Premarin), respectively, from days 1-25 and 5 mg medroxyprogesterone acetate (Provera) from days 15-25. Groups B and D were given 0.625 or 1.25 mg conjugated equine estrogen, respectively, from days 1-25 and placebo from days 15-25. Plasma estrone levels were physiologic after the lower dose of conjugated equine estrogen and supraphysiologic after ingestion of the higher dose. All four treatment regimens successfully controlled hot flushes, but patients who received 1.25 mg conjugated equine estrogen with or without medroxyprogesterone acetate had a higher energy level and a more enhanced sense of well-being (P less than .05). The four treatments all had favorable effects on lipid metabolism, albeit in a dose-related manner: After 1 year of treatment, high-density lipoprotein levels increased 4.3, 13.7, 13.4, and 19% in groups A, B, C, and D, respectively, compared with pre-treatment values. The high-density lipoprotein/low-density lipoprotein ratios, an antiatherogenic index, increased by 7.3, 13.6, 24, and 43% in groups A, B, C, and D, respectively. The findings of this study on the relative effects of different doses of oral estrogen and progestin, administered sequentially, on clinical symptoms and lipid metabolism provide guidelines for the treatment of postmenopausal women.
Affect↗
Estrogen and/or androgen replacement therapy and cognitive functioning in surgically menopausal women.
The effect of estrogen and/or androgen replacement therapy on several aspects of cognitive functioning in surgically menopausal women was tested in a prospective, crossover design. Women who received either a combined estrogen-androgen preparation, estrogen alone, or androgen alone had scores on two tests of short-term memory, a test of long-term memory and a test of logical reasoning that were not different during the postoperative treatment phase compared to their preoperative performance. However, oophorectomized women who received placebo had lower scores on all four measures of cognitive functioning postoperatively, coincident with their significantly lower concentrations of plasma estradiol and testosterone. Patients who had a hysterectomy but whose ovaries were retained showed stability both in cognitive performance and in circulating sex steroid concentrations. These findings suggest that the drastic change in endocrine milieu following surgical menopause may have a direct, albeit modest, effect on aspects of cognitive functioning. Possible mechanisms of action of the sex hormones on cognitive functioning in women are discussed.
Adult↗
Effect of hormone implants on psychological disorders in the climacteric.
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Climacteric↗
Postmenopausal estrogen and androgen replacement and lipoprotein lipid concentrations.
The effect of a combined estrogen-androgen drug on the lipoprotein lipid profile of women who received it parenterally as long-term postmenopausal replacement therapy was compared to that of women who had been receiving estrogen alone parenterally and to untreated surgically menopausal women. Plasma estradiol, testosterone, total cholesterol, triglycerides, high-density lipoproteins, and low-density lipoproteins were measured at baseline (55 days after injection) and then on days 2, 4, 8, 15, 21, and 28 after injection. The plasma estradiol levels were greater in the two hormone-treated groups compared with the control group (p less than 0.01), and plasma testosterone levels of the combined group exceeded those of the other two groups (p less than 0.01) and remained above the normal female range for the duration of the study. There were no between-group differences in total cholesterol, triglycerides, high-density lipoprotein, or low-density lipoprotein values. Neither was the low-density/high-density lipoprotein ratio significantly different between groups at any of the test times. Therefore, the addition of testosterone to a long-term parenteral estrogen replacement regimen did not induce an increased atherogenic lipid profile compared with that produced by the parenteral administration of estrogen alone.
Cholesterol↗