Table 1.
The Effects of Induced Hypogonadism and Sex Hormone Replacement on DISF Scores in Healthy Adult Women (n = 20) and Men (n = 20)––Mean (SD) (Range)
| Baseline | Lupron alone | Lupron+E | Lupron+P | Lupron+T | |
|---|---|---|---|---|---|
| DISF Total | |||||
| Women | 1179.7 (466.8) | 715.5 (437.1)** | 919.2 (532.6)* | 820.6 (434.9)* | –– |
| (324–2041) | (60–1692) | (97–1833) | –– | –– | |
| Men | 1632.5 (358.5) | 886.8 (333.6)**,‡ | –– | –– | 1506.6 (420.9) |
| (836–2294) | (181–1577) | –– | –– | (689–2128) | |
| DISF Subscales (SS) | |||||
| Cognition no. 1 | |||||
| Women | 226.4 (106.3) | 149.4 (128.0) | 205.1 (132.0) | 178.1 (105.6) | –– |
| Men | 275.9 (98.0) | 140.7 (87.8)**, ‡ | –– | –– | 249.5 (120.7) |
| Arousal no. 2 | |||||
| Women | 191.0 (111.3) | 114.3 (98.2) | 157.3 (110.1) | 137.7 (111.2) | –– |
| Men | 336.8 (91.1) | 150.3 (86.5)**,‡ | –– | –– | 300.9 (112.5) |
| Behavior no. 3 | |||||
| Women | 187.6 (110.9) | 99.6 (83.5) | 139.1 (104.6) | 133.5 (71.8) | –– |
| Men | 208.6 (103.8) | 109.4 (71.9)**,† | –– | –– | 200.9 (91.0) |
| Orgasm no. 4 | |||||
| Women | 343.1 (156.9) | 196.5 (141.7)** | 232.0 (169.2)** | 211.3 (151.3)** | –– |
| Men | 546.1 (88.7) | 327.9 (160.0)**,‡ | –– | –– | 504.2 (135.0) |
| Drive no. 5 | |||||
| Women | 231.7 (88.1) | 155.8 (74.9) | 185.8 (89.8) | 160.0 (75.6) | –– |
| Men | 265.2 (68.1) | 158.5 (80.9)**,‡ | –– | –– | 251.2 (81.6) |
| BDI | |||||
| Women | 2.1 (5.1) | 3.0 (2.9) | 2.0 (3.0) | 2.2 (3.0) | –– |
| Men | 0.4 (1.0) | 2.2 (3.2) | –– | –– | 0.9 (1.6) |
Post hoc comparisons: women and men compared with baseline––
p < 0.05;
p < 0.01.
Men only: Lupron alone vs T replaced––
p < 0.05,
p < 0.01.
Otherwise p = NS.
BDI––all comparisons p = NS.
In women, we observed a significant effect of hormone condition on total DISF scores (ANOVA-R: F3,54 = 5.1, p = 0.009).a Compared with baseline, the total DISF scores were significantly lower during hypogonadism, and remained significantly lower during P (t54 = 3.0, p < 0.05) and lower at a trend level of significance during E administration (t54 = 2.2, p = 0.05). There were no significant differences in the total DISF scores during hypogonadism compared with either E or P (t54 (range) = 0.9–1.7, p = NS). All DISF subscale scores were lower; however, only subscale four (quality of orgasm) showed a significant decrease during hypogonadism, E, and P compared with baseline (t54 (range) = 2.8–3.7, p < 0.05 with six comparisons). DISF subscale scores during hypogonadism, E, and P did not differ significantly.
In men, total DISF scores during hypogonadism were significantly decreased compared with scores during both baseline and T (ANOVA-R: F2,38 = 31.0, p<0.001). All DISF subscale scores significantly decreased during hypogonadism compared with baseline conditions (ANOVA-R: F2,38 (range) = 9.3–32.3, p ≤ 0.001) (t190 (range) = 3.6–7.9, p < 0.01). Additionally, scores were decreased during hypogonadism compared with T (t190 (range) = 3.3–6.4, p < 0.01) in subscale nos. 1, 2, and 4; p < 0.05 in subscale nos. 3 and 5.
Total DISF scores were significantly higher in men compared with women during both baseline and hypogonadism (ANOVA-R: significant effects of sex (F1,38 = 12.2, p = 0.001)); total DISF scores significantly decreased in both men and women during hypogonadism compared with baseline (F1,38 = 44.4, p < 0.001), but there was no significant sex by hormone condition interactions (F1,38 = 2.4, p = 0.13). Total DISF scores remained significantly higher in men after scores in both sexes were standardized (ie, Z-scores) (effect of sex: F1,38 = 6.5, p = 0.02; effect of hormone condition: F1,38 = 48.7, p < 0.001). Individual DISF subscales demonstrated a significant decrease during hypogonadism in both men and women (F1,38 (range) = 18.6–46.4 (range), p < 0.001). Additionally, scores of subscale nos. 2 and 4 (arousal and orgasm, respectively) were significantly greater in men compared with women (effect of sex: F1,38 = 8.9 and 7.9, p < 0.01) and declined to a greater extent in men compared with women (sex by hormone condition interaction: F1,38 = 11.4 and 7.4, p ≤ 0.01).
To avoid violating sphericity assumptions, Greenhouse–Geisser adjustments of the degrees of freedom were employed to calculate the observed p-values, since in some comparisons the variance of the differences in scores between hormone conditions was large.
DISF ratings were not completed by one woman during P replacement and, therefore, her ratings were not included in the analysis comparing DISF scores in women across the four hormone conditions.