Sexy thoughts: Effects of sexual cognitions on testosterone, cortisol, and arousal in women

Previous research suggests that sexual stimuli increase testosterone (T) in women and shows inconsistent effects of sexual arousal on cortisol (C), but effects of cognitive aspects of arousal, rather than behaviors or sensory stimuli, are unclear. The present study examined whether sexual thoughts affect T or C and whether hormonal contraceptive (HC) use moderated this effect, given mixed findings of HC use confounding hormone responses. Participants (79 women) provided a baseline saliva sample for radioimmunoassay. We created the Imagined Social Situation Exercise (ISSE) to test effects of imagining social interactions on hormones, and participants were assigned to the experimental (sexual) or one of three control (positive, neutral, stressful) conditions. Participants provided a second saliva sample 15 min post-activity. Results indicated that for women not using HCs, the sexual condition increased T compared to the stressful or positive conditions. In contrast, HC using women in the sexual condition had decreased T relative to the stressful condition and similar T to the positive condition. The effect was specific to T, as sexual thoughts did not change C. For participants in the sexual condition, higher baseline T predicted larger increases in sexual arousal but smaller increases in T, likely due to ceiling effects on T. Our results suggest that sexual thoughts change T but not C, baseline T levels and HC use may contribute to variation in the T response to sexual thoughts, and cognitive aspects of sexual arousal affect physiology.

Research Highlights
► Sexual thoughts increase testosterone in women not using hormonal contraceptives.
► Hormonal contraceptive use reverses testosterone responses to sexual thoughts.
► Sexual thoughts do not change cortisol.
► Higher baseline testosterone predicts larger increases in sexual arousal.
► Higher baseline testosterone predicts smaller testosterone increases.