Associations among physiological and subjective sexual response, sexual desire, and salivary steroid hormones in healthy premenopausal women

J Sex Med. 2009 Mar;6(3):739-51. doi: 10.1111/j.1743-6109.2008.01123.x. Epub 2008 Dec 5.


Introduction: Few studies have examined how sexual arousal influences healthy premenopausal women's hormones, limiting our understanding of basic physiology and our ability to transfer knowledge from clinical and nonhuman populations.

Aim: To examine how sexual arousal and steroid hormones (testosterone [T], cortisol [C], estradiol [E]) were linked, to see whether hormone levels influenced and/or changed in response to sexual arousal elicited via visual erotic stimuli in healthy women.

Methods: Participants included 40 healthy premenopausal women not using exogenous hormones.

Main outcome measures: Change in genital sexual arousal (vaginal pulse amplitude), change in subjective sexual arousal, sexual desire (via the Sexual Desire Inventory and Female Sexual Function Index scales), as well as T, C, and E via saliva samples taken before and following viewing of erotic stimuli as genital arousal was recorded via a vaginal photoplethysmograph.

Results: E increased in response to sexual stimuli but this was not statistically associated with genital sexual arousal, whereas C decreased in association with genital sexual arousal, and T showed no statistically significant change. Relationship status was linked to genital but not subjective sexual arousal such that dating women exhibited higher genital sexual arousal than single or partnered women. Results indicated that all three hormones were associated with self-reported genital arousal (via the Detailed Assessment of Sexual Arousal scales) and sexual desire in different domains, and both T and E were associated with self-reported orgasms.

Conclusion: Findings point to the need to examine multiple hormones in multiple ways (e.g., baseline, changes, stimulated) and question using erotic stimuli-induced arousal as a model for women's endocrine responses to sexuality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Erotica
  • Estradiol / analysis*
  • Ethnicity / statistics & numerical data
  • Female
  • Genitalia, Female / physiology
  • Health Status
  • Humans
  • Hydrocortisone / analysis*
  • Orgasm / physiology
  • Premenopause / physiology*
  • Saliva / chemistry*
  • Sexual Behavior / physiology*
  • Surveys and Questionnaires
  • Testosterone / analysis*


  • Testosterone
  • Estradiol
  • Hydrocortisone