University of British Columbia, Department of Psychiatry, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
University of British Columbia, Department of Counselling Psychology, 2125 Main Mall, Vancouver, BC V6T 1Z4, Canada.
Psychoneuroendocrinology. 2019 Jun;104:259-268. doi: 10.1016/j.psyneuen.2019.03.001. Epub 2019 Mar 8.
Previous research has found lower serum levels of dehydroepiandrosterone (DHEA) or its sulfated form, DHEA-S, in women diagnosed with Hypoactive Sexual Desire Disorder (HSDD). Given that DHEA and DHEA-S have multiple direct actions on the brain as well as anti-glucocorticoid properties, it is possible that lower levels of DHEA directly impact women's sexual functioning. To date, the significance of the lower DHEA levels remains unclear. To our knowledge, there has been no empirical study of stress hormones as markers of HPA dysregulation in women with HSDD. To attend to this gap, the present study utilized several measures of HPA axis function - morning and evening cortisol and DHEA, the cortisol awakening response (CAR), diurnal cortisol slope, and cortisol:DHEA ratio - and examined their relationship with sexual functioning in N = 275 women with (n = 137) and without (n = 138) HSDD. Results demonstrated multiple hormonal markers of HPA dysregulation in women diagnosed with HSDD compared to control participants, specifically, lower AM cortisol and AM DHEA levels, a flatter diurnal cortisol slope, and a lower CAR. Overall, results of the present study indicate that persistently low sexual desire in women is associated with HPA axis dysregulation, with both cortisol and DHEA alterations potentially detrimental to sexual desire.
先前的研究发现，患有性欲低下障碍（HSDD）的女性的血清脱氢表雄酮（DHEA）或其硫酸化形式 DHEA-S 水平较低。鉴于 DHEA 和 DHEA-S 对大脑有多种直接作用，并且具有抗糖皮质激素特性，因此 DHEA 水平较低可能直接影响女性的性功能。迄今为止，DHEA 水平降低的意义仍不清楚。据我们所知，目前还没有关于 HSDD 女性应激激素作为 HPA 失调标志物的实证研究。为了弥补这一空白，本研究利用了几种 HPA 轴功能的测量指标——早晨和晚上的皮质醇和 DHEA、皮质醇觉醒反应（CAR）、日间皮质醇斜率和皮质醇:DHEA 比值，并检查了它们与 275 名 HSDD 女性（n=137）和无 HSDD 女性（n=138）的性功能之间的关系。结果表明，与对照组相比，患有 HSDD 的女性存在多种 HPA 失调的激素标志物，具体表现为早晨皮质醇和早晨 DHEA 水平较低、日间皮质醇斜率较平，以及 CAR 较低。总的来说，本研究的结果表明，女性持续的低性欲与 HPA 轴失调有关，皮质醇和 DHEA 的改变可能对性欲不利。
