Females

Oestrogen, progesterone, and androgen

In the female, oestrogen, progesterone, and androgens are involved in differentiating and maintaining genital and breast tissues and in influencing normal sexual function. Fetal genital development, unlike that of the male, does not appear to need hormonal stimulation as the development of female genital structures are the fetal prototype or default programme/36) During puberty, ovarian oestrogen and progesterone together with androgens from the adrenal cortex induce growth and functional changes in the internal and external genitalia, breast, and nipples. Oestrogens induce growth in the fallopian tubes, uterus, vagina, and breasts and lay down subcutaneous fat largely in the breast, hip, and thigh regions to create the rounded contours of the female body that are highly attractive to the male. The fat laid down is enough to supply the energy for a pregnancy and the subseqent lactation. Androgens in the female are responsible for the development of the clitoris, nipples, pubic, and axillary hair, and probably the labia and periurethral glans.

Role of hormones in female sexuality

While over 60 studies have been undertaken to examine whether the changing hormonal levels of the menstrual cycle influence the sexual arousal of the female, (3Z> neither oestrogen or progesterone have been found convincingly to play a direct role in influencing the sexual activity of the human female apart from their indirect functions in the maintenance of the structures and functions of the female genitals, especially the vagina.

Androgens, secreted by the female's adrenal cortex, have a concentration 10 times less than those in the male. The variation of the androgen levels in the plasma during the menstrual cycle is small and it is the free androgen level that must be taken into account. Androgens maintain the adult female pubic and axillary hair, clitoris, and probably labia and periurethral glans. The role of androgens in female sexuality is controversial and not clear cut. (38) Some propose that, as in the male, it is the major hormonal influence on the female libido. Removal of the adrenals has been shown to reduce desire and ability to reach orgasm. Excess androgens stimulates libido but in pharmacological not physiological doses. Such doses affect the structure and sensitivity of the clitoris (an androgen-sensitive tissue), so the effects on sexuality might not be brain mediated.

Sexual behaviour during the menstrual cycle

Despite numerous studies it is still uncertain whether female sexual behaviour is influenced by the hormonal changes in the menstrual cycle. Meuwissen and Over (37> surveyed 64 published studies. A significant number showed a premenstrual peak in sexual desire and activity, others a postmenstrual peak, either at menstruation or ovulation. (The latter studies often used poor methodology to determine the time of ovulation.)

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