Prolactin secretory rhythm in women: immediate and long-term alterations after sexual contact

BACKGROUND Prolactin (PRL) is one of the most versatile hormones in the mammalian body, affecting reproductive, sexual and other functions. In rats, mating or vaginocervical stimulation activates a characteristic PRL secretory pattern for several days, which is essential for successful reproduction. Although the underlying mechanisms appear to be different, PRL is also crucial for human fertility. We have detected a PRL increase in women induced by sexual intercourse. Extending these findings, the current study aimed at analyzing the PRL secretory rhythm after sexual contact, in order to elucidate whether human females also show long-term alterations of the PRL secretory pattern. METHODS In a pilot study, serial blood samples were taken from women (n= 7) in mid-cycle to assess changes in PRL secretory rhythm induced by sexual intercourse, during a period of 32 h. RESULTS Compared with control condition, sexual intercourse with orgasm induced not only the well-established immediate PRL increase of ∼300% but also an additional PRL elevation around noon of the next day (P< 0.05). These fluctuations were measured on top of the regular circadian rhythm of PRL, manifested as a surge early in the morning. CONCLUSIONS We are able to demonstrate a long-term change in the PRL secretory rhythm after sexual intercourse with orgasm in females, suggesting memory effects. We hypothesize that the additionally secreted PRL could be beneficial for decidualization and implantation. Further studies with more participants are required to investigate in detail the implications of such effects on reproductive success in human

Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial

In a randomized, controlled trial (n = 30), we showed that botulinum toxin injection to the glabellar region produces a marked improvement in the symptoms of major depression. We hypothesized that the mood-lifting effect was mediated by facial feedback mechanisms. Here we assessed if agitation, which may be associated with increased dynamic psychomotor activity of the facial musculature, can predict response to the treatment. To test this hypothesis, we re-analyzed the data of the scales from our previous study on a single item basis and compared the baseline scores in the agitation item (item 9) of the Hamilton Depression Rating Scale (HAM-D) between responders (n = 9) and participants who did not attain response (n = 6) among the recipients of onabotulinumtoxinA (n = 15). Responders had significantly higher item 9 scores at baseline [1.56 + 0.88 vs. 0.33 + 0.52, t (13) = 3.04, d = 1.7, p = 0.01], while no other single item of the HAM-D or the Beck Depression Inventory was associated with treatment response. The agitation score had an overall precision of 78% in predicting response in a receiver operating characteristic (ROC) analysis (area under the curve, AUC = 0.87). These data provide a link between response to botulinum toxin treatment with a psychomotor manifestation of depression and thereby indirect support of the proposed facial feedback mechanism of action. Moreover, it suggests that patients with agitated depression may particularly benefit from botulinum toxin treatment

Alterations in voxel based morphometry and resting state functional connectivity in men with compulsive sexual behavior disorder in the Sex@Brain study

Aim: Compulsive Sexual Behavior Disorder (CSBD) is a new category in ICD-11. Research examining underlying brain mechanisms is sparse. Research into neurobiological differences can be helpful in advancing the possibilities of new diagnostic approaches and therapeutic methods. The present study aimed to examine brain matter volume and resting state functional connectivity (rs-FC) in CSBD. Methods: Structural and rs-FC magnetic resonance imaging and data from questionnaires were collected in 30 men with CSBD and 32 age- and education-matched controls. Whole brain voxel based morphometry (VBM) and seed based rs-FC in a-priori defined seeds were analyzed. Results: Structural analyses showed that men with CSBD had significantly increased gray matter volume in the right cerebellum, middle occipital and superior frontal lobe. No differences in rs-FC could be detected when using these brain structures as seed regions in rs-FC. In contrast, literature based rs-FC analysis revealed decreased rs-FC between the right orbital middle frontal cortex (mOFC) and the right gyrus rectus, as well as between left pallidum and right post/precentral gyrus in men with CSBD. In the left amygdala we observed increased rs-FC with precuneus in this group. In addition, most of these measures correlated with symptom severity. Conclusion: Structural findings may underscore the idea that the cerebellum plays an important role in sexual arousal and CSBD. Perhaps, a simultaneous activation of the left amygdala and the precuneus reflects a constant sexual occupation of men with CSBD. Furthermore, lower connectivity between mOFC and gyrus rectus in CSBD may support the assumption that sexual stimuli are evaluated more positively because inhibition is decreased

Personality dimensions of compulsive sexual behavior in the Sex@Brain study

Background and aims: Hypersexual disorder is characterized by recurrent and intense sexual fantasies, sexual urges, or sexual behaviors that can lead to clinically relevant levels of distress and adverse con- sequences for affected individuals. Earlier research has established a connection between sexual phe- nomena, such as compulsive sexual behavior, and personality features. The aim of the present study was to gain further insights into the associations of personality maladjustment and HD. Methods: The present study applied the dimensional approach of personality maladjustment presented in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to connect compulsive sexual behavior to personality maladjustment. We investigated 47 men suffering from HD (age: M 5 36.51, SD 5 11.47) and 38 matched men without HD (age: M 5 37.92, SD 5 12.33) regarding personality maladjustment using a 100-item version of the Personality Inventory for DSM-5 (PID-5-BF). Results: The men with HD showed higher levels of personality maladjustment regarding all PID-5-BF domains (negative affect, detachment, psychoticism, antagonism, and disinhibition) and significantly differentiated from men without HD in the level of subordinate facets. However, no domain of personality differentiated significantly between groups using a binary stepwise logistic regression analysis. Discussion and conclusions: In sum, the findings of the study underline the extent of personality maladjustment in men with HD. Interpersonal difficulties which men with HD frequently experience can contribute to clinically relevant levels of distress and adverse consequences reported by affected individuals

Same Same but Different: A Clinical Characterization of Men with Hypersexual Disorder in the Sex@Brain Study

Problems arising from hypersexual behavior are often seen in clinical settings. We aimed to extend the knowledge about the clinical characteristics of individuals with hypersexual disorder (HD). A group of people who fulfilled the proposed diagnostic criteria for HD (men with HD, n = 50) was compared to a group of healthy controls (n = 40). We investigated differences in sociodemographic, neurodevelopmental, and family factors based on self-report questionnaires and clinical interviews. Men with HD reported elevated rates of sexual activity, paraphilias, consumption of child abusive images, and sexual coercive behavior compared to healthy controls. Moreover, rates of affective disorders, attachment difficulties, impulsivity, and dysfunctional emotion regulation strategies were higher in men with HD. Men with HD seem to have experienced various forms of adverse childhood experiences, but there were no further differences in sociodemographic, neurodevelopmental factors, and family factors. Regression analyses indicated that attachment-related avoidance and early onset of masturbation differentiated between men with HD and healthy controls. In conclusion, men with HD appear to have the same neurodevelopment, intelligence levels, sociodemographic background, and family factors compared to healthy controls, but they report different and adverse experiences in childhood, problematic sexual behavior, and psychological difficulties

Differential effects of intranasal oxytocin on sexual experiences and partner interactions in couples

Knowledge about the effects of the neuropeptide oxytocin (OXT) on human sexual behaviors and partner interactions remains limited. Based on our previous studies, we hypothesize that OXT should be able to positively influence parameters of sexual function and couple interactions. Employing a naturalistic setting involving 29 healthy heterosexual couples (n = 58 participants), we analyzed the acute effects of intranasally administered OXT (24 IU) on sexual drive, arousal, orgasm and refractory aspects of sexual behavior together with partner interactions. Data were assessed by psychometric instruments (Acute Sexual Experiences Scale, Arizona Sexual Experience Scale) as well as biomarkers, such as cortisol, α-amylase and heart rate. Intranasal OXT administration did not alter “classical” parameters of sexual function, such as sexual drive, arousal or penile erection and lubrication. However, analysis of variance and a hierarchical linear model (HLM) revealed specific effects related to the orgasmic/post-orgasmic interval as well as parameters of partner interactions. According to HLM analysis, OXT increased the intensity of orgasm, contentment after sexual intercourse and the effect of study participation. According to ANOVA analysis, these effects were more pronounced in men. Men additionally indicated higher levels of sexual satiety after sexual intercourse with OXT administration. Women felt more relaxed and subgroups indicated better abilities to share sexual desires or to empathize with their partners. The effect sizes were small to moderate. Biomarkers indicated moderate psychophysiological activation but were not affected by OXT, gender or method of contraception. Using a naturalistic setting, intranasal OXT administration in couples exerted differential effects on parameters of sexual function and partner interactions. These results warrant further investigations, including subjects with sexual and relationship problems

Neural processing associated with cognitive empathy in pedophilia and child sexual offending

Behavioral studies found evidence for superior cognitive empathy (CE) in pedophilic men without a history of child sexual offending (P - CSO) compared to pedophilic men with a history of child sexual offending (P + CSO). Functional magnetic resonance imaging (fMRI) studies also point to differences between P - CSO and P + CSO. Neural processing associated with CE has not yet been investigated. Therefore, the present study aimed to explore the neural correlates of CE in subjects with pedophilia with (P + CSO) and without (P - CSO) child sexual offending. 15 P + CSO, 15 P - CSO and 24 teleiophilic male controls (TC) performed a CE task during fMRI. We observed reduced activation in the left precuneus (Pcu) and increased activation in the left anterior cingulate cortex (ACC) in P - CSO compared to P + CSO. P - CSO also showed stronger connectivity between these regions, which might reflect a top-down modulation of the Pcu by the ACC toward an increased self-focused emotional reaction in social situations. There was also evidence for increased right superior temporal gyrus activation in P - CSO that might constitute a potentially compensatory recruitment due to the dampened Pcu activation. These findings provide first evidence for altered neural processing of CE in P - CSO and underline the importance of addressing CE in pedophilia and CSO in order to uncover processes relevant to effective prevention of child sexual abuse

The Quality of Sexual Experience in Women Correlates with Post‐Orgasmic Prolactin Surges: Results from an Experimental Prototype Study

INTRODUCTION: Sexual intercourse, orgasm, and sexual satisfaction are associated with well-being and improved quality of life. The pituitary hormone prolactin (PRL) may have an important role in regulating (and thus indexing) sexual satiety and satisfaction. AIM: Physiological indices to quantify the quality and resulting satisfaction from female orgasm would be valuable. Therefore we aim to validate associations of orgasm-induced PRL surges with women's orgasm quality and subsequent sexual satisfaction. METHODS: In a prospective study, with a pre-post, single-blinded, cross-over design in a naturalistic field setting, we analyzed the correlation of women's post-orgasmic serum PRL surges following sexual intercourse with women's perceived quality of orgasm and resulting sexual satisfaction, as measured by a questionnaire. MAIN OUTCOME MEASURES: PRL levels prior to and following penile-vaginal intercourse with and without orgasm, and scores from the Acute Sexual Experience Scale (ASES) on quality of orgasm and sexual satisfaction. RESULTS: An analysis of variance of the blood samples in nine women indicated large magnitude, significant effects of intercourse orgasm on PRL levels (P = 0.004, eta squared = 0.78), as well as an interaction with the effect of multiple orgasms (P = 0.008, eta squared = 0.80). PRL post/pre ratios and arithmetic difference correlated strongly with orgasm quality (r = 0.85, P = 0.016, and r = 0.69, P = 0.08) and sexual satisfaction (r = 0.75, P = 0.05 and r = 0.77, P = 0.045). CONCLUSION: Women's intercourse orgasm induced PRL surges are strongly related to the quality of orgasm and subsequent sexual satisfaction. This implies that post-orgasmic PRL surges are an objective index of orgasm and orgasm quality. PRL might be used in future studies on basic research as well as a treatment target in sexual disorders in women

Diminished fronto-limbic functional connectivity in child sexual offenders

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