Reproductive Endocrinology Ovarian Hormones

Sexual activity, endogenous reproductive hormones and ovulation in premenopausal women

Prasad A, Mumford SL, Buck Louis GM, Ahrens KA, Sjaarda LA, Schliep KC, Perkins NJ, Kissell KA, Wactawski-Wende J, Schisterman EF

Published July 2014 Hormones and Behavior, 66(2), 330-338
DOI 10.1016/j.yhbeh.2014.06.012 PMID 24954690 PMC PMC4127088

RRM Academy Synopsis

Sexually Active Women Had Fewer Cycles Without Ovulation

Sexually inactive women skipped ovulation more often than sexually active women, in a cohort of 259 women over one or two cycles. None were using hormonal contraceptives or trying to get pregnant. Sexually active women also had higher levels of key reproductive hormones.

Key Findings

  • Sexually inactive women skipped ovulation in 22 of 117 cycles (19%); sexually active women skipped it in 19 of 391 cycles (5%), P<.01.
  • After adjustment, sexually active women were less likely than inactive women to skip ovulation (odds ratio 0.34, 95% CI 0.16 to 0.73).
  • Sexually active women showed higher estrogen, mid-cycle LH, and luteal progesterone than inactive women, all P<.01; FSH and testosterone showed no difference.
  • How often sexually active women had sex made no difference to their hormone levels or their chance of skipping ovulation (all P>.23).
  • Higher mid-cycle LH was associated with 28 percent greater odds of having sex the next day (odds ratio 1.28, 95% CI 1.04 to 1.57, P=.02).

Interpretation

The BioCycle Study is a prospective cohort study. Researchers followed 259 women who were not using hormonal contraceptives and not trying to get pregnant. Each woman was tracked for one or two cycles, with blood drawn up to eight times per cycle, while she reported her sexual activity every day. The study linked a history of sexual activity to higher reproductive hormone levels and a lower chance of skipping ovulation. The authors note that 23 percent of the women had no history of sexual activity, a higher share than expected for this age group, which may limit how broadly the findings apply.

RRM Context

The BioCycle Study timed its blood draws using a home urinary hormone monitor. This is the same type of device the Marquette Model uses for fertility awareness-based (FABM) charting. In this study, having ever been sexually active mattered more to ovulation and hormone levels than how often a woman had sex. The finding fits a core FABM principle: a regularly menstruating woman does not ovulate in every cycle. Cycle charting is how a woman or her clinician can see that, cycle by cycle.

Abstract

We investigated whether sexual activity was associated with reproductive function in the BioCycle Study, a prospective cohort study that followed 259 regularly menstruating women aged 18 to 44years for one (n=9) or two (n=250) menstrual cycles in 2005-2007. Women were not attempting pregnancy nor using hormonal contraceptives. History of ever having been sexually active was assessed at baseline and frequency of sexual activity, defined as vaginal-penile intercourse, was self-reported daily throughout the study. Serum concentrations of estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, and testosterone were measured up to 8times/cycle. Sporadic anovulation was identified using peak progesterone concentration. Linear mixed models were used to estimate associations between sexual activity and reproductive hormone concentrations and generalized linear models were used to estimate associations with sporadic anovulation. Models were adjusted for age, race, body mass index, perceived stress, and alcohol consumption and accounted for repeated measures within women. Elevated concentrations of estrogen (+14.6%, P<.01), luteal progesterone (+41.0%, P<.01) and mid-cycle LH (+23.4%, P<.01), but not FSH (P=.33) or testosterone (P=.37), were observed in sexually active women compared with sexually inactive women (no prior and no study-period sexual activity); sexually active women had lower odds of sporadic anovulation (adjusted odds ratio=0.34, 95% confidence interval: 0.16-0.73). Among sexually active women, frequency of sexual activity was not associated with hormones or sporadic anovulation (all P>.23). Findings from our study suggest that ever having been sexually active is associated with improved reproductive function, even after controlling for factors such as age.

Topics

By this author

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Reproductive Endocrinology › Ovarian Hormones › Progesterone · Menstrual Cycle › Cycle Physiology › Hormonal Regulation
Ankita Prasad, Sunni L Mumford, Germaine M Buck Louis, Katherine A Ahrens, Lindsey A Sjaarda, Karen C Schliep, Neil J Perkins, Kerri A Kissell, Jean Wactawski-Wende, Enrique F Schisterman
A Prasad, S Mumford, G Louis, Kathy Ahrens, Kate Ahrens, Katie Ahrens, K Ahrens, L Sjaarda, K Schliep, N Perkins, K Kissell, J Wactawski-Wende, E Schisterman
PMID 24954690 24954690 DOI 10.1016/j.yhbeh.2014.06.012 10.1016/j.yhbeh.2014.06.012 Prasad et al. 2014, Prasad 2014