Campbell B C, Udry J R
Carolina Population Center, University of North Carolina, Chapel Hill 27516.
Ann N Y Acad Sci. 1994 Feb 18;709:117-27. doi: 10.1111/j.1749-6632.1994.tb30392.x.
In exploring the implications of hormonal influences on sexual behavior for reproduction, we have focused on androgens because of the convincing evidence for androgenic effects on female sexual motivation. We have been guided by the simple idea, based on clinical findings among hyperandrogenic women, that higher testosterone levels will increase female sexual motivation which in turn will result in increased coital frequency. However, careful consideration of the evidence fails to confirm such a role for testosterone in sexual behavior among normal women at any point in the reproductive span. While some amount of testosterone appears to be important in maintaining female sexual motivation, there is little evidence that variation in testosterone within the normal range is associated with variation in sexual motivation. Reported associations between testosterone and sexual behavior among married women cannot be interpreted as resulting from androgenic effects on sexual motivation. Thus we are left with the task of explaining why testosterone does not appear to play the same role in libido among hyperandrogenic and normal women. As mentioned earlier, some of the difference may attributable to the much higher levels of testosterone among hyperandrogenic women. Sherwin points out that the levels of sexual motivation decline with declining testosterone levels even while testosterone is well above normally occurring levels. It is possible that the brain is simply not sensitive to the variation in testosterone levels found in normal women. Other evidence suggests that the presence of intact ovaries may be equally important. A recent study of androgen replacement in naturally post-menopausal women failed to find a dramatic effect of testosterone on sexual motivation and behavior, despite levels similar to those in studies on surgically menopausal women, pointing to the importance of other factors associated with the presence of ovaries. A similar point can be made with regard to hyperandrogenism related to endogenous sources of testosterone, as in the case of PCOS. High levels of testosterone effectively disrupt ovarian function and interfere with other ovarian processes. Among hyperandrogenic women sexual behavior appears to be related to the direct effects of androgens on motivation, while the indirect effects of estrogen and progesterone are essentially eliminated. Among normal women, on the other hand, there is little evidence for such a dominating role of a direct androgenic effect on sexual behavior. Instead, other ovarian hormones, including estrogen and progesterone may also play a demonstrable role, despite the lack of strong evidence at this point.(ABSTRACT TRUNCATED AT 400 WORDS)
在探究激素对性行为的影响对生殖的意义时，由于有确凿证据表明雄激素对女性性动机有影响，我们将重点放在了雄激素上。我们一直受一个基于高雄激素女性临床研究结果的简单观点所引导，即较高的睾酮水平会增强女性性动机，进而导致性交频率增加。然而，仔细考量证据后发现，在正常女性的整个生殖期内，睾酮在性行为中并未发挥这样的作用。虽然一定量的睾酮对于维持女性性动机似乎很重要，但几乎没有证据表明正常范围内的睾酮变化与性动机变化有关。已婚女性中报道的睾酮与性行为之间的关联不能被解释为雄激素对性动机的影响所致。因此，我们面临着一项任务，即解释为什么睾酮在高雄激素女性和正常女性的性欲中似乎没有发挥相同的作用。如前所述，部分差异可能归因于高雄激素女性体内高得多的睾酮水平。舍温指出，即使睾酮水平远高于正常水平，性动机水平也会随着睾酮水平下降而降低。大脑可能根本对正常女性体内的睾酮水平变化不敏感。其他证据表明，完整卵巢的存在可能同样重要。最近一项针对自然绝经后女性雄激素替代疗法的研究未能发现睾酮对性动机和行为有显著影响，尽管其水平与针对手术绝经女性的研究中的水平相似，这表明与卵巢存在相关的其他因素很重要。对于与内源性睾酮来源相关的高雄激素血症，如多囊卵巢综合征的情况，也可以提出类似观点。高睾酮水平会有效破坏卵巢功能并干扰其他卵巢过程。在高雄激素女性中。性行为似乎与雄激素对动机的直接影响有关，而雌激素和孕激素的间接影响基本被消除。另一方面，在正常女性中，几乎没有证据表明雄激素对性行为有如此主导性的直接影响。相反，尽管目前缺乏有力证据，但包括雌激素和孕激素在内的其他卵巢激素可能也发挥着明显作用。（摘要截选至400词）
