Advertisement

Impact of Testosterone on Aspects of Psychology

  • John A. BarryEmail author
Chapter

Abstract

This chapter explores what we know about the psychological effects of testosterone in women, both with polycystic ovary syndrome (PCOS) and without. Many readers will find this chapter fascinating. The topics include ones that people might think they know about, but are widely misunderstood, such as sexual orientation and aggression. There are other topics in which testosterone has the expected impact on healthy women (such as cognition and libido), but works differently in women with PCOS. There are many surprises in this chapter, not least the evidence that testosterone, a prosocial hormone.

Keywords

Mental rotation Libido Sexual orientation Aggression Prosocial 

References

  1. Agrawal, R., Sharma, S., Bekir, J., Conway, G., Bailey, J., Balen, A. H., & Prelevic, G. (2004). Prevalence of polycystic ovaries and polycystic ovary syndrome in lesbian women compared with heterosexual women. Fertility and Sterility, 82(5), 1352–1357.PubMedPubMedCentralCrossRefGoogle Scholar
  2. Albert, D. J., Walsh, M. L., & Jonik, R. H. (1993). Aggression in humans: What is its biological foundation? Neuroscience & Biobehavioral Reviews, 17(4), 405–425.CrossRefGoogle Scholar
  3. Aleman, A., Bronk, E., Kessels, R. P., Koppeschaar, H. P., & van Honk, J. (2004). A single administration of testosterone improves visuospatial ability in young women. Psychoneuroendocrinology, 29(5), 612–617.PubMedCrossRefPubMedCentralGoogle Scholar
  4. Annagür, B. B., Tazegül, A., Uguz, F., Kerimoglu, Ö. S., Tekinarslan, E., & Celik, Ç. (2013). Biological correlates of major depression and generalized anxiety disorder in women with polycystic ovary syndrome. Journal of Psychosomatic Research, 74(3), 244–247.CrossRefGoogle Scholar
  5. Archer, J., Graham-Kevan, N., & Davies, M. (2005). Testosterone and aggression: A reanalysis of Book, Starzyk, and Quinsey’s (2001) study. Aggression and Violent Behavior, 10(2), 241–261.CrossRefGoogle Scholar
  6. Asik, M., Altinbas, K., Eroglu, M., Karaahmet, E., Erbag, G., Ertekin, H., & Sen, H. (2015). Evaluation of affective temperament and anxiety–depression levels of patients with polycystic ovary syndrome. Journal of Affective Disorders, 185, 214–218.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Astapova, O., Minor, B. M., & Hammes, S. R. (2019). Physiological and pathological androgen actions in the ovary. Endocrinology, 160(5), 1166–1174.PubMedPubMedCentralCrossRefGoogle Scholar
  8. Azziz, R., Carmina, E., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Futterweit, W., … Witchel, S. F. (2009). The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: The complete task force report. Fertility and Sterility, 91(2), 456–488.PubMedPubMedCentralCrossRefGoogle Scholar
  9. Baba, T., Endo, T., Honnma, H., Kitajima, Y., Hayashi, T., Ikeda, H., … Saito, T. (2006). Association between polycystic ovary syndrome and female-to-male transsexuality. Human Reproduction, 22(4), 1011–1016.PubMedCrossRefGoogle Scholar
  10. Balen, A. H., Schachter, M. E., Montgomery, D., Reid, R. W., & Jacobs, H. S. (1993). Polycystic ovaries are a common finding in untreated female to male transsexuals. Clinical Endocrinology, 38(3), 325–329.PubMedCrossRefPubMedCentralGoogle Scholar
  11. Balikci, A., Erdem, M., KESKIN, U., Zincir, S. B., Guelsuen, M., Oezcelik, F., … Erguen, A. (2014). Depression, anxiety, and anger in patients with polycystic ovary syndrome. Nöro Psikiyatri Arşivi, 51(4), 328.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Barnard, L., Ferriday, D., Guenther, N., Strauss, B., Balen, A. H., & Dye, L. (2007). Quality of life and psychological well being in polycystic ovary syndrome. Human Reproduction, 22(8), 2279–2286.PubMedPubMedCentralCrossRefGoogle Scholar
  13. Barry, J. A., & Owens, R. (2019). From fetuses to boys to men: The impact of testosterone on male lifespan development. In The Palgrave handbook of male psychology and mental health (pp. 3–24). Cham: Palgrave Macmillan.CrossRefGoogle Scholar
  14. Barry, J. A., Hardiman, P. J., Saxby, B. K., & Kuczmierczyk, A. (2011a). Testosterone and mood dysfunction in women with polycystic ovarian syndrome compared to subfertile controls. Journal of Psychosomatic Obstetrics and Gynecology, 32(2), 104–111.PubMedPubMedCentralCrossRefGoogle Scholar
  15. Barry, J. A., Hardiman, P. J., Siddiqui, M. R., & Thomas, M. (2011b). Meta-analysis of sex difference in testosterone levels in umbilical cord blood. Journal of Obstetrics and Gynaecology, 31(8), 697–702.CrossRefGoogle Scholar
  16. Barry, J. A., Parekh, H. S. K., & Hardiman, P. J. (2013). Visual-spatial cognition in women with polycystic ovarian syndrome: The role of androgens. Human Reproduction, 28(10), 2832–2837.PubMedPubMedCentralCrossRefGoogle Scholar
  17. Barry, J. A., Leite, N., Sivarajah, N., Keevil, B., Owen, L., Miranda, L. C., … Hardiman, P. (2017). Relaxation and guided imagery significantly reduces androgen levels and distress in polycystic ovary syndrome: Pilot study. Contemporary Hypnosis and Integrative Therapy, 32(1), 21–29.Google Scholar
  18. Barry, J. A., Qu, F., & Hardiman, P. J. (2018). An exploration of the hypothesis that testosterone is implicated in the psychological functioning of women with polycystic ovary syndrome (PCOS). Medical Hypotheses, 110, 42–45.PubMedPubMedCentralCrossRefGoogle Scholar
  19. Batool, S., ul ain Ahmed, F., Ambreen, A., Sheikh, A., & Faryad, N. (2016). Depression and anxiety in women with polycystic ovary syndrome and its biochemical associates. Journal of South Asian Federation of Obstetrics and Gynaecology, 8(1), 44–47.Google Scholar
  20. Bernstein, I. S., Gordon, T. P., & Rose, R. M. (1983). The interaction of hormones, behavior, and social context in nonhuman primates. In Hormones and aggressive behavior (pp. 535–561). Boston: Springer.CrossRefGoogle Scholar
  21. Björkqvist, K., & Niemelä, P. (1992). New trends in the study of female aggression. In K. Björkqvist & P. Niemelä (Eds.), Of mice and women: Aspects of female aggression (pp. 3–16). San Diego, CA, US: Academic Press.CrossRefGoogle Scholar
  22. Boehmer, U., Bowen, D. J., & Bauer, G. R. (2007). Overweight and obesity in sexual-minority women: Evidence from population-based data. American Journal of Public Health, 97(6), 1134–1140.PubMedPubMedCentralCrossRefGoogle Scholar
  23. Book, A. S., Starzyk, K. B., & Quinsey, V. L. (2001). The relationship between testosterone and aggression: A meta-analysis. Aggression and Violent Behavior, 6(6), 579–599.CrossRefGoogle Scholar
  24. Booth, A., Shelley, G., Mazur, A., Tharp, G., & Kittok, R. (1989). Testosterone, and winning and losing in human competition. Hormones and Behavior, 23, 556–571.PubMedCrossRefGoogle Scholar
  25. Booth, A., Granger, D. A., Mazur, A., & Kivlighan, K. T. (2006). Testosterone and social behavior. Social Forces, 85(1), 167–191.CrossRefGoogle Scholar
  26. Borghi, L., Leone, D., Vegni, E., Galiano, V., Lepadatu, C., Sulpizio, P., & Garzia, E. (2018). Psychological distress, anger and quality of life in polycystic ovary syndrome: Associations with biochemical, phenotypical and socio-demographic factors. Journal of Psychosomatic Obstetrics and Gynecology, 39(2), 128–137.PubMedPubMedCentralCrossRefGoogle Scholar
  27. Bosinski, H. A., Peter, M., Bonatz, G., Arndt, R., Heidenreich, M., Sippell, W. G., & Wille, R. (1997). A higher rate of hyperandrogenic disorders in female-to-male transsexuals. Psychoneuroendocrinology, 22(5), 361–380.PubMedCrossRefPubMedCentralGoogle Scholar
  28. Cesta, C. E., Månsson, M., Palm, C., Lichtenstein, P., Iliadou, A. N., & Landén, M. (2016). Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort. Psychoneuroendocrinology, 73, 196–203.PubMedPubMedCentralCrossRefGoogle Scholar
  29. Chen, C. H., Wang, P. H., Hsieh, M. T., Tzeng, C. R., Wu, Y. H., Lee, C. S., … Chang, H. Y. (2014). Sexual orientations of women with polycystic ovary syndrome: Clinical observation in Taiwan. Taiwanese Journal of Obstetrics and Gynecology, 53(4), 542–546.PubMedCrossRefPubMedCentralGoogle Scholar
  30. Cooney, L. G., Lee, I., Sammel, M. D., & Dokras, A. (2017). High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: A systematic review and meta-analysis. Human Reproduction, 32(5), 1075–1091.PubMedPubMedCentralCrossRefGoogle Scholar
  31. Dabbs, J. M., Jr., Strong, R., & Milun, R. (1997). Exploring the mind of testosterone: A beeper study. Journal of Research in Personality, 31(4), 577–587.CrossRefGoogle Scholar
  32. Davis, S. (2001). Testosterone treatment: Psychological and physical effects in postmenopausal women. American Society for Reproductive Medicine: Menopausal Medicine, 9(2).Google Scholar
  33. De Sutter, P., Dutré, T., Vanden Meerschaut, F., Stuyver, I., Van Maele, G., & Dhont, M. (2008). PCOS in lesbian and heterosexual women treated with artificial donor insemination. Reproductive Biomedicine Online, 17(3), 398–402.PubMedPubMedCentralCrossRefGoogle Scholar
  34. Defreyne, J., Kreukels, B., T’Sjoen, G., Stahporsius, A., Den Heijer, M., Heylens, G., & Elaut, E. (2019). No correlation between serum testosterone levels and state-level anger intensity in transgender people: Results from the European Network for the Investigation of Gender Incongruence. Hormones and Behavior, 110, 29–39.CrossRefGoogle Scholar
  35. Dittman, R. W., Kappes, M. E., & Kappes, M. H. (1992). Sexual behaviour and adolescent and adult females with congenital adrenal hyperplasia. Psychoneuroendocrinology, 17, 153–170.CrossRefGoogle Scholar
  36. Dunphy, L. (2018, January 18). Lesbian mum who viciously beat bride walks free after telling court she has high levels of “male hormones”. Retrieved from https://www.mirror.co.uk/news/uk-news/lesbian-mum-who-viciously-beat-11872183#ICID=sharebar_twitter.
  37. Eisenegger, C., Naef, M., Snozzi, R., Heinrichs, M., & Fehr, E. (2010). Prejudice and truth about the effect of testosterone on human bargaining behaviour. Nature, 463(7279), 356.PubMedCrossRefGoogle Scholar
  38. Eisenegger, C., Haushofer, J., & Fehr, E. (2011). The role of testosterone in social interaction. Trends in Cognitive Sciences, 15(6), 263–271.PubMedCrossRefGoogle Scholar
  39. Elsenbruch, S., Hahn, S., Kowalsky, D., Offner, A. H., Schedlowski, M., Mann, K., & Janssen, O. E. (2003). Quality of life, psychosocial well-being, and sexual satisfaction in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology and Metabolism, 88, 5801–5807.PubMedPubMedCentralCrossRefGoogle Scholar
  40. Enjezab, B., Eftekhar, M., & Ghadiri-Anari, A. (2017). Association between severity of depression and clinico-biochemical markers of polycystic ovary syndrome. Electronic Physician, 9(11), 5820.PubMedPubMedCentralCrossRefGoogle Scholar
  41. Ercan, C. M., Coksuer, H., Aydogan, U., Alanbay, I., Keskin, U., Karasahin, K. E., & Baser, I. (2013). Sexual dysfunction assessment and hormonal correlations in patients with polycystic ovary syndrome. International Journal of Impotence Research, 25, 127–132.PubMedCrossRefGoogle Scholar
  42. Eriksson, E., Sundblad, C., Lisjö, P., Modigh, K., & Andersch, B. (1992). Serum levels of androgens are higher in women with premenstrual irritability and dysphoria than in controls. Psychoneuroendocrinology, 17(2–3), 195–204.PubMedCrossRefGoogle Scholar
  43. Futterweit, W., Weiss, R. A., & Fagerstrom, R. M. (1986). Endocrine evaluation of forty female-to-male transsexuals: Increased frequency of polycystic ovarian disease in female transsexualism. Archives of Sexual Behavior, 15(1), 69–78.PubMedCrossRefGoogle Scholar
  44. Gallinelli, A., Matteo, M. L., Volpe, A., & Facchinetti, F. (2000). Autonomic and neuroendocrine responses to stress in patients with functional hypothalamic secondary amenorrhea. Fertility and Sterility, 73(4), 812–816.CrossRefGoogle Scholar
  45. Gul, A., Gul, H., Ergur, A. T., & Ozen, N. E. (2018). Anxiety-anger relationship in hyperandrogenemia: A comparative study with polycystic ovary syndrome (PCOS) and healthy control adolescents. Journal of Mood Disorders, 8(1), 26–31.Google Scholar
  46. Hahn, S., Janssen, O. E., Tan, S., Pleger, K., Mann, K., Schedlowski, M., … Elsenbruch, S. (2005). Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome. European Journal of Endocrinology, 153, 853–860.PubMedPubMedCentralCrossRefGoogle Scholar
  47. Himelein, M. J., & Thatcher, S. S. (2006). Depression and body image among women with polycystic ovary syndrome. Journal of Health Psychology, 11(4), 613–625.PubMedPubMedCentralCrossRefGoogle Scholar
  48. Klimczak, D., Szlendak-Sauer, K., & Radowicki, S. (2015). Depression in relation to biochemical parameters and age in women with polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology, 184, 43–47.CrossRefGoogle Scholar
  49. Legro, R. S., Schlaff, W. D., Diamond, M. P., Coutifaris, C., Casson, P. R., Brzyski, R. G., … Ohl, D. (2010). Total testosterone assays in women with polycystic ovary syndrome: Precision and correlation with hirsutism. The Journal of Clinical Endocrinology & Metabolism, 95(12), 5305–5313.CrossRefGoogle Scholar
  50. Lujan, M. E., & Mergler, R. J. (2015). Cognitive function in women with polycystic ovary syndrome (PCOS): Impact of reproductive and metabolic factors. Fertility and Sterility, 104(3), e129.CrossRefGoogle Scholar
  51. Manlove, A. H., Guillermo, C., & Gray, P. B. (2008). Do women with polycystic ovary syndrome (PCOS) report differences in sex-typed behavior as children and adolescents?: Results of a pilot study. Annals of Human Biology, 35(6), 584–595.PubMedPubMedCentralCrossRefGoogle Scholar
  52. McCook, J. G. (2002). The influence of hyperandrogenism, obesity and infertility on the psychosocial health and wellbeing of women with polycystic ovary syndrome. Unpublished doctoral dissertation, University of Michigan.Google Scholar
  53. Monzani, F., Pucci, F., Caraccio, N., Bagnolesi, A., Molli, D., Fenu, A., & Prunetti, C. (1994). Psychological and psychopathological correlates in the polycystic ovary syndrome (PCOS). Medicina Psicosomatica, 39, 225–236.Google Scholar
  54. Moran, L. J., Deeks, A. A., Gibson-Helm, M. E., & Teede, H. J. (2012). Psychological parameters in the reproductive phenotypes of polycystic ovary syndrome. Human Reproduction, 27, 2082–2088.PubMedPubMedCentralCrossRefGoogle Scholar
  55. Nathorst-Böös, J., Flöter, A., Jarkander-Rolff, M., Carlström, K., & Von Schoultz, B. (2006). Treatment with percutaneous testosterone gel in postmenopausal women with decreased libido–effects on sexuality and psychological general well-being. Maturitas, 53(1), 11–18.PubMedCrossRefPubMedCentralGoogle Scholar
  56. Nordqvist, S., Sydsjö, G., Lampic, C., Åkerud, H., Elenis, E., & Skoog Svanberg, A. (2014). Sexual orientation of women does not affect outcome of fertility treatment with donated sperm. Human Reproduction, 29(4), 704–711.PubMedCrossRefGoogle Scholar
  57. Pastore, L. M., Patrie, J. T., Morris, W. L., Dalal, P., & Bray, M. J. (2011). Depression symptoms and body dissatisfaction association among polycystic ovary syndrome women. Journal of Psychosomatic Research, 71(4), 270–276.PubMedPubMedCentralCrossRefGoogle Scholar
  58. Peters, M., Laeng, B., Latham, K., Jackson, M., Zaiyouna, R., & Richardson, C. (1995). A redrawn Vandenberg and Kuse mental rotations test-different versions and factors that affect performance. Brain and Cognition, 28(1), 39–58.PubMedCrossRefGoogle Scholar
  59. Pintzka, C. W., Evensmoen, H. R., Lehn, H., & Håberg, A. K. (2016). Changes in spatial cognition and brain activity after a single dose of testosterone in healthy women. Behavioural Brain Research, 298, 78–90.PubMedCrossRefPubMedCentralGoogle Scholar
  60. Rahiminejad, M. E., Moaddab, A., Rabiee, S., Esna-Ashari, F., Borzouei, S., & Hosseini, S. M. (2014). The relationship between clinicobiochemical markers and depression in women with polycystic ovary syndrome. Iranian Journal of Reproductive Medicine, 12(12), 811.PubMedPubMedCentralGoogle Scholar
  61. Rasgon, N. L., Rao, R. C., Hwang, S., Altshuler, L. L., Elman, S., Zuckerbrow-Miller, J., & Korenman, S. G. (2003). Depression in women with polycystic ovary syndrome: Clinical and biochemical correlates. Journal of Affective Disorders, 74(3), 299–304.PubMedPubMedCentralCrossRefGoogle Scholar
  62. Rellini, A. H., Stratton, N., Tonani, S., Santamaria, V., Brambilla, E., & Nappi, R. E. (2013). Differences in sexual desire between women with clinical versus biochemical signs of hyperandrogenism in polycystic ovarian syndrome. Hormones and Behavior, 63, 65–71.PubMedCrossRefGoogle Scholar
  63. Roberts, G. (1998). Competitive altruism: From reciprocity to the handicap principle. Proceedings of the Royal Society of London B: Biological Sciences, 265(1394), 427–431.CrossRefGoogle Scholar
  64. Robinson, K., Galloway, K. Y., Bewley, S., & Meads, C. (2017). Lesbian and bisexual women’s gynaecological conditions: A systematic review and exploratory meta-analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 124(3), 381–392.CrossRefGoogle Scholar
  65. Roche Diagnostics. (2000). Elecsys Testosterone Product Information. Retrieved May 5, 2010, from http://www.roche-diagnostics.ch/resource.php?id=Resourcefile-37084379e9754cf58.
  66. Rosner, W., Auchus, R. J., Azziz, R., Sluss, P. M., & Raff, H. (2007). Position statement: Utility, limitations, and pitfalls in measuring testosterone: An endocrine society position statement. Journal of Clinical Endocrinology & Metabolism, 92, 405–413.CrossRefGoogle Scholar
  67. Rubinow, D. R., & Schmidt, P. J. (1989). Models for the development and expression of symptoms in premenstrual syndrome. Psychiatric Clinics, 12(1), 53–68.PubMedPubMedCentralGoogle Scholar
  68. Salvador, A., Suay, F., Gonzalez-Bono, E., & Serrano, M. A. (2003). Anticipatory cortisol, testosterone and psychological responses to judo competition in young men. Psychoneuroendocrinology, 28(3), 364–375.PubMedCrossRefPubMedCentralGoogle Scholar
  69. Schattmann, L., & Sherwin, B. B. (2007). Testosterone levels and cognitive functioning in women with polycystic ovary syndrome and in healthy young women. Hormones and Behavior, 51(5), 587–596.CrossRefGoogle Scholar
  70. Schüring, A. N., Nolte, S., Fobker, M., Kannenberg, F., & Nofer, J. R. (2016). Head-to-head assessment of diagnostic performance of testosterone immunoassays in patients with polycystic ovary syndrome. Journal of Clinical Laboratory Analysis, 30(5), 479–484.PubMedCrossRefPubMedCentralGoogle Scholar
  71. Shepard, R. N., & Metzler, J. (1971). Mental rotation of three-dimensional objects. Science, 171(3972), 701–703.PubMedPubMedCentralCrossRefGoogle Scholar
  72. Sills, E. S., Perloe, M., Tucker, M. J., Kaplan, C. R., Genton, M. G., & Schattman, G. L. (2001). Diagnostic and treatment characteristics of polycystic ovary syndrome: Descriptive measurements of patient perception and awareness from 657 confidential self-reports. BMC Women’s Health, 1(1), 3.PubMedPubMedCentralCrossRefGoogle Scholar
  73. Smith, A. M., Rissel, C. E., Richters, J., Grulich, A. E., & de Visser, R. O. (2003). Sex in Australia: Sexual identity, sexual attraction and sexual experience among a representative sample of adults. Australian and New Zealand Journal of Public Health, 27(2), 138–145.Google Scholar
  74. Smith, H. A., Markovic, N., Matthews, A. K., Danielson, M. E., Kalro, B. N., Youk, A. O., & Talbott, E. O. (2011). A comparison of polycystic ovary syndrome and related factors between lesbian and heterosexual women. Women’s Health Issues, 21(3), 191–198.PubMedCrossRefGoogle Scholar
  75. Taher, S., Rothon, C., & Panay, N. (2008). Testosterone gel and improvement in libido, psychological state and general wellbeing in natural and surgical post-menopausal women: P3. 24. Bjog: An International Journal of Obstetrics and Gynaecology, 115(187).Google Scholar
  76. Udiawar, M. (2017). Cardiometabolic and neuroimaging correlates of cognitive function in polycystic ovary syndrome. Doctoral dissertation, Cardiff University.Google Scholar
  77. Weiner, C. L., Primeau, M., & Ehrmann, D. A. (2004). Androgens and mood dysfunction in women: Comparison of women with polycystic ovarian syndrome to healthy controls. Psychosomatic Medicine, 66(3), 356–362.PubMedPubMedCentralGoogle Scholar
  78. Wibral, M., Dohmen, T., Klingmüller, D., Weber, B., & Falk, A. (2012). Testosterone administration reduces lying in men. PLoS One, 7(10), e46774.PubMedPubMedCentralCrossRefGoogle Scholar
  79. Zucker, K. J., Bradley, S. J., Oliver, G., Blake, J., Fleming, S., & Hood, J. (1996). Psychosexual development of women with congenital adrenal hyperplasia. Hormones and Behavior, 30(4), 300–318.PubMedCrossRefPubMedCentralGoogle Scholar
  80. Zung, W. W. (1965). A self-rating depression scale. Archives of General Psychiatry, 12(1), 63–70.CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  1. 1.University College LondonLondonUK

Personalised recommendations