(162) Sex Steroid Dynamics Within Vaginal Fluid During Arousal

Abstract Introduction While topical (exogenous) estrogens and androgens have been a focus of treatment for vaginal pain, little is known about how the dynamics of vaginal arousal may contribute to activity of endogenous sex steroid hormones within the vaginal environment. Previous research suggests sexual arousal influences the concentration of testosterone within cervicovaginal fluid; however, it is unclear whether estrogens respond similarly. There is reason to expect that vaginal sexual arousal may activate mechanisms within the vaginal tissue that increase absorption of both testosterone and estradiol from the mucosal layer into the tissue beneath. Objective This project aims to characterize the influence of vaginal arousal on the presence of estradiol and testosterone in the cervicovaginal fluid and changes from pre- and post-arousal, and the within-person stability of these effects over time (3 weeks). Methods Analyses are drawn from an ongoing randomized trial in which participants completed 3 in-lab sessions spaced 3 weeks apart, in which they provided samples of cervicovaginal fluid before and after watching a brief (~7 minutes) erotic video. During the erotic video, participants’ vaginal blood flow (ie, physiological sexual arousal) was measured using a vaginal photoplethysmograph (VPP) and then cleaned to assess vaginal pulse amplitude (VPA). For each fluid sample, participants insert a disposable menstrual cup, which sits loosely around the cervix, for about 10 minutes. After the post-arousal menstrual cup was removed, participants complete a survey battery that includes demographics and measures of sexual function and sexual desire. Between in-lab sessions 2 and 3, participants are asked to masturbate at least 4 different days each week for 3 weeks. Results Similar to changes observed in cervicovaginal testosterone, concentrations of cervicovaginal estradiol significantly decreased from pre- to post-arousal concentrations (V = 13248. 0, p. 001). Preliminary analyses examining a subset of available data (n = 51) suggest that different indicies of arousal predict changes in estradiol and testosterone. While no measurements of arousal predicted the change in estradiol (VPA %change (t (54. 40) = -0. 21, p =. 831) ; time at maximum arousal (t (45. 33) = -0. 30, p =. 766) ; time to reach maximum arousal (t (60. 93) = 0. 72, p =. 476), time spent at their maximum arousal was a marginally significant predictor of change in testosterone concentrations (t (45. 42) = -1. 83, p =. 074). Analyses will be presented at the meeting that will determine whether this effect is significant with the final data (117). Overall, sample weight significantly predicted both estradiol and testosterone concentrations (β ^=1. 04, 95% CI 0. 46, 1. 63, t (105. 26) = 3. 48, p. 001; β ^=0. 86, 95% CI 0. 52, 1. 19, t (125. 15) = 5. 01, p. 001, respectively). Conclusions Though further work is needed to confirm the role of sexual arousal in sex steroid hemodynamics within vaginal tissue, it seems the vaginal blood differently impact cervicovaginal estradiol and testosterone. Differentiation among these sex steroids during sexual arousal may be useful for informing exogenous sex steroid application for postmenopausal women. Specifically, if masturbation or sexual activity facilitates absorption of endogenous testosterone absorption into the vaginal tissue, this may function over the longer term as a protective factor for tissue integrity. Disclosure Yes, this is sponsored by industry/sponsor: Sexual Wellness Institute - Vaginal Biome Science. Clarification: Industry funding only - investigator initiated and executed study.