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Susan R. Davis, Robin J. Bell, Letter to the Editor: Randolph J, et al. Masturbation Frequency and Sexual Function Domains Are Associated With Serum Reproductive Hormone Levels Across the Menopausal Transition, The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 2, 1 February 2015, Page L25, https://doi.org/10.1210/jc.2014-4264
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We are writing in relation to the recent publication by Randolph et al from the Study of Women Across the Nation (1).
Contrary to the authors reporting that Davis et al “did not document a measurable relationship between any hormone concentration and any domain of sexual activity,” in our past study of androgens and female sexual function (2), we found highly significant associations between dehydroepiandrosterone sulfate and arousal, responsiveness, and pleasure for older women and for desire, arousal, and responsiveness for younger women. When one considers the complexity of female sexual function and the noise in analyses such as these, that both of these two large cross-sectional studies (1, 2) identified significant associations between androgens and measures of female sexual function is important.
Randolph et al have reported only outcomes for total T despite having described the calculation of a free T index in their methods. Considering the impact the concentration of SHBG has on the amount of free T, omission of the findings for calculated free T, or even the free T index in the analysis, is a study limitation that was not discussed. Furthermore, Randolf et al reported the change in sexual function in relation to hormone levels, adjusted for all hormones. Because T is a product of dehydroepiandrosterone sulfate, and estradiol a product of both, we question the analysis in which adjustment is made for measures that are on the putative causal pathway between the exposure and the outcome.
