- Sexualité
- Androgènes et Sexualité
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Rôle des androgènes dans la motivation sexuelle masculine: approche par la neuroanatomie cérébrale fonctionnelle
Role of androgens in male sexual motivation: approach with functional brain imaging techniques
Andrologie volume 14, pages 324–335 (2004)
Resume
Le système nerveux central joue un rôle à toutes les étapes du comportement sexuel, notamment en ce qui concerne le traitement des stimuli externes. Une étape clé consiste en l’attribution à ces signaux externes d’une valeur dite de «récompense» qui conditionnera la mise en place des différentes étapes de l’excitation sexuelle. Ces étapes font intervenir des processus cognitifs complexes, interagissant avec des composantes émotionnelles et physiologiques. Les androgènes, et notamment la testostérone, par leur action au sein du système nerveux central, jouent un rôle fondamental dans la régulation et le maintien du comportement sexuel. Ceci est en particulier mis en évidence dans le cadre de pathologies entraînant un déficit androgénique, tel que l’hypogonadisme, pathologies caractérisées par une diminution significative de la motivation et de l’activité sexuelles.
Les techniques récentes d’imagerie cérébrale fonctionnelle (Tomographie par Emission de Positons, Imagerie par Résonance Magnétique fonctionnelle) ont permis de mettre en évidence un réseau de structures cérébrales impliquées dans le développement et le contrôle de la motivation sexuelle chez l’homme. Ces techniques, associées à l’étude de patients hypogonadiques, peuvent permettre de mieux comprendre la spécificité de ces structures cérébrales dans la fonction sexuelle, ainsi que de préciser les mécanismes d’action des androgènes dans la régulation de la motivation sexuelle.
Abstract
The central nervous system plays a crucial role in all of the successive stages of sexual behaviour, particularly for the processing of external stimuli. One important step consists of the evaluation of these stimuli and the assessment of their potential reward value, which will determine the development of the sexual response. These different stages involve complex cognitive processes interacting with emotional and physiological components.
Androgens, and particularly testosterone, are closely related to the regulation of sexual behaviour. Many of the various effects of testosterone on sexual behaviour have been thought to result from its effects on the central nervous system. Several studies have demonstrated that a minimum concentration of plasma testosterone is necessary to maintain a normal level of sexual desire in human males. Consequently, in normal men, acute and profound androgen deficiency induced by an experimental pharmacological treatment results in decreased sexual desire and fantasies. This reduced sexual desire is also one of the major symptoms observed in male hypogonadism. Conversely, in hypogonadal men, androgen substitution therapy results in increased sexual interest and activity.
Over recent years, the development of brain functional imaging techniques (Positron Emission Tomography, functional Magnetic Resonance Imaging) has demonstrated the brain regions participating in a neural network that controls and regulates sexual arousal. We have proposed a four component neurobehavioural model, comprising cognitive (e.g. orbitofrontal cortex), motivational (e.g. anterior cingulate gyrus), emotional (e.g. somatosensory cortex, insula) and physiological (e.g. hypothalamus) processes, to describe this cerebral control of sexual motivation in human males. This network comprises activating and inhibiting structures that interact with each other.
As testosterone can modulate sexual desire via its action on cerebral function, we decided to perform a brain imaging study in hypogonadal patients (both when they were untreated and when they received hormone replacement therapy), to obtain e better understanding of the specificity of these brain regions in sexual arousal processes. This study could also help describe the brain regions via which testosterone acts to modulate sexual behaviour.
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Redouté, J., Stoléru, S. Rôle des androgènes dans la motivation sexuelle masculine: approche par la neuroanatomie cérébrale fonctionnelle. Androl. 14, 324–335 (2004). https://doi.org/10.1007/BF03034921
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DOI: https://doi.org/10.1007/BF03034921