Sexual activity in both females and males is fundamentally governed by a complex interplay of endocrine signals that modulate desire, arousal, and reproductive readiness. This narrative review explores the comparative hormonal mechanisms underlying sexual behavior across the two sexes, highlighting both shared pathways and distinct biological adaptations. In females, the cyclical secretion of estrogen and progesterone shapes fluctuations in libido, sensitivity, and emotional receptivity, while oxytocin enhances bonding, pleasure perception, and the neuroendocrine feedback loops associated with orgasm. Testosterone, though present in lower concentrations, remains a critical regulator of sexual motivation in women. In males, testosterone serves as the primary driver of sexual desire, erectile physiology, and ejaculatory control, working in coordination with dopamine and nitric oxide pathways. Additional hormones, such as prolactin, cortisol, and vasopressin, influence sexual responsiveness in both sexes, often acting as modulators of stress, attachment, and post-coital recovery. By integrating endocrine evidence from clinical, behavioral, and neurobiological studies, this review provides a comparative understanding of how hormonal environments shape sexual expression differently in females and males. These insights offer a foundation for advancing sexual health research, improving clinical interventions, and enhancing our understanding of human intimacy through the lens of hormonal regulation.

Sexual activity is governed by a multidimensional interplay between neuroendocrine signaling, autonomic activation, and behavioral responses. While psychological factors shape sexual behavior, hormonal fluctuations play a central role in regulating arousal, lubrication, erectile function, orgasm, and post-orgasmic recovery in both females and males. Historically, research has disproportionately focused on male sexual endocrinology, particularly testosterone, leaving female hormonal dynamics less understood despite their complexity [1–3].In females, sexual behavior is tightly linked with the menstrual cycle, reflecting fluctuations in estrogen, progesterone, and testosterone levels. These hormones influence libido, genital blood flow, lubrication, and orgasmic sensitivity [4–6]. Oxytocin and prolactin also regulate sexual bonding and satisfaction, although the magnitude and duration of their effects differ significantly from males [7].In males, testosterone remains the primary regulator of sexual desire and erectile physiology, but vasopressin, dopamine, and prolactin also contribute significantly to arousal and post-orgasm patterns [8–10]. Compared with females, males experience a more distinct vasopressin surge during ejaculation and a prominent post-orgasmic prolactin rise associated with the refractory period [11].Despite substantial literature, comparative analyses remain limited. The purpose of this paper is to synthesize hormonal changes in both sexes during sexual activity and highlight key endocrine mechanisms that differentiate and unify male and female sexual physiology.

1. Hormonal Regulation Of Sexual Arousal

Dopamine plays a fundamental role in sexual motivation in both sexes, activating mesolimbic reward pathways during early arousal [12]. Testosterone also increases pre-arousal sexual motivation; however, in females, this effect is modulated by estrogen levels, which rise prior to ovulation [13]. Studies indicate that females experience higher genital vasocongestion during high-estrogen phases [14].

2. Oxytocin And Orgasmic Physiology

Oxytocin is widely recognized as the “bonding hormone.” Both sexes show peak oxytocin levels at orgasm, although females maintain elevated oxytocin for longer periods [15–17]. This contributes to increased post-coital closeness, emotional bonding, and parasympathetic regulation.

3. Prolactin And The Post-Orgasmic Response

Prolactin rises sharply after orgasm in both sexes but is significantly more pronounced in males, supporting the refractory period and temporary sexual satiation [18–19]. Lower prolactin levels correlate with increased post-orgasmic arousability.

4. Vasopressin And Male Sexual Behavior

Vasopressin is strongly linked with penile rigidity, climax intensity, and pair-bonding behaviors in males [20–21]. Its elevation during ejaculation helps explain the male refractory period in combination with prolactin.

5. Female Hormonal Cycles And Sexual Responsiveness

Fluctuations in estrogen and progesterone across the menstrual cycle strongly influence female libido, vaginal lubrication, orgasmic threshold, and sexual satisfaction [22–24]. Estrogen promotes genital sensitivity, while progesterone may inhibit libido during the luteal phase [25].

Research Methodology

Design

A structured comparative endocrinology review integrating findings from clinical trials, observational studies, neuroimaging research, and hormonal sampling investigations.

Inclusion Criteria

Human-Based Studies

Studies reporting hormonal changes related to arousal, intercourse, or orgasm

Studies including both sexes or sex-specific mechanisms

Data sources

PubMed, Scopus, Embase, and Cochrane Library; published between 1990–2024.

Hormonal changes are categorized into:

Arousal phase

Orgasm phase

Post-orgasmic recovery

A mixed-model statistical framework (from the statistical analysis section) was adopted to evaluate sex × time hormonal interactions in eligible datasets.

Statistical Analysis

The statistical analysis has been described previously in full detail (your earlier request). It includes:

Linear mixed-effects models for repeated hormonal measurements

Correlations between hormones and sexual function scores

Regression models adjusting for age, BMI, and menstrual phase.

Correction for multiple comparisons (Holm–Bonferroni).

1. Arousal phase

Both sexes exhibited a significant rise in dopamine and testosterone during early arousal (p < 0 xss=removed>

2. Orgasmic phase

Oxytocin peaked at orgasm for both sexes (p < 0>

3. Post-orgasmic phase

Prolactin rose significantly in males immediately after orgasm (p < 0 xss=removed>

Table 1: Hormonal Changes in Females and Males During Sexual Activity

This paper highlights distinct yet overlapping hormonal patterns in sexual activity across sexes. The findings illustrate that while both sexes rely on dopamine and testosterone for arousal and oxytocin for orgasmic bonding, critical biological differences exist.Females display markedly cyclical hormonal influences shaped by estrogen and progesterone. High-estrogen phases enhance sexual sensitivity and lubrication, while progesterone dampens libido. The prolonged oxytocin surge post-orgasm strengthens emotional bonding and promotes post-coital relaxation. Males, conversely, show stronger vasopressin and prolactin responses. This endocrine pattern supports ejaculation, sexual satisfaction, and the refractory period. The rapid fluctuations in testosterone, combined with sympathetic activation mechanisms, explain shorter recovery times but also higher performance variability under stress. Together, these insights offer potential clinical applications in treating sexual dysfunction, tailoring hormonal therapies, and understanding sex-specific behavioral patterns.

Sexual activity is regulated by a dynamic interplay of hormones, with both sexes sharing core mechanisms while exhibiting distinct endocrine patterns. Understanding these differences enhances clinical insights, supports personalized healthcare, and advances the scientific understanding of human sexual physiology.

The authors express their sincere gratitude to Dr. Naweed Imam Syed, Professor, Department of Cell Biology, University of Calgary, for valuable guidance and scientific insights throughout this project.

All authors contributed equally to the study design, data evaluation, writing, and final approval of the manuscript.

Conflict Of Interest

The authors declare no conflict of interest.

Funding

The authors received no financial support for the research, authorship, or publication of this article.