THE ROLE OF HORMONES IN HUMAN BEHAVIOR. I. CHANGES IN FEMALE SEXUALITY AFTER ADRENALECTOMY

Abstract

Twenty-nine women, mean age 51 years, who had undergone total bilateral oophorectomy and adrenalectomy for metastatic breast cancer were interviewed about changes in their sexual desire, activity and responsiveness at an average period of twelve months after adrenal ablation. Of the 17 patients reportingsome sexual desire preoperatively, 14 experienced a decrease after surgery, the majority losing all desire. Of the 17 patients sexually active preoperatively, all reduced their frequency of intercourse postoperatively, almosthalf stopping entirety. Of the 12 patients responsive in intercourse preoperatively, 11 experienced a decrease after surgery, almost all becoming completely unresponsive. In each of these categories, the number of patients who lost sexual function entirely was statistically significant. Both sexual feelings and activities declined in all but 2 of the patients not already at zero levels among the 20 who obtained remission of metastatic disease after adrenalectomy, as well asin all but 1 of the 9 patients who did not present objective evidence of benefit from the operation. Neither breast cancer itself nor any previous surgery had as profound an impact on sexual behavior as did adrenalectomy. In agreement with the preponderance of evidence in the literature, changes in a subgroup of 7 patients who had undergone oophorectomy one to five years before their adrenals were removed indicated that ovarian ablation by itself usually does not radically alter sexual behavior. It was concluded that the adrenal glands and, more specifically, the androgens of adrenal origin, play a critical part in maintaining the patterns of sexual behavior in the human female.