SEX HORMONES IN HUMAN EROTICISM 



1387 



to be the critical period for optimal, all- 

 round adolescent development. 



The behavioral immaturity that matches 

 sexual immaturity is not necessarily reversi- 

 ble. It may establish itself as a chronic 

 handicap, especially if puberty is too long 

 delayed into and beyond the late teens. 

 Chronic behavioral immaturity then defeats 

 the success of hormonal substitution therapy 

 by militating against success in mating and 

 in adult erotic relationships. 



Androgens and estrogens both mature 

 the body, the one in a virilizing, the other 

 in a feminizing way. Androgens, in addition, 

 have a strong positive influence on nitrogen 

 metabolism and so on muscular strength and 

 energy. This muscular effect was particu- 

 larly noted by two hypogonadal males in 

 the series who worked as manual laborers. 

 Before treatment began they made euphe- 

 mistic statements about their fatigue 

 threshold. After treatment they were able 

 to make a comparison and so to realize how 

 easily they had tired formerly. The con- 

 verse effect of androgen suppression pro- 

 ducing a diminution of muscular strength 

 and energy is well observed in hyperadreno- 

 cortical females when their androgen ex- 

 cesses are first suppressed by cortisone ther- 

 apy. Two patients have remarked on this 

 phenomenon. 



The androgenic effect of stepped-up ni- 

 trogen metabolism and increased general 

 muscular size and strength (Kochakian, 

 1946; Kochakian and Tillotson, 1957) does 

 not seem to have any direct effect on eroti- 

 cism. The hypogonadal men (Table 22.1) on 

 androgen-substitution therapy became sexu- 

 ally more active and participative, but not 

 because they had formerly been in^'alids too 

 weak to participate. They did not become 

 more violent, assaultive, or aggressive, even 

 though they had more muscle power at their 

 disposal. 



Rather than being spread generally over 

 the nervous system and musculature, the 

 specifically erotic action of androgen, inso- 

 far as it can be identified, seems to be ana- 

 tomically localized. In particular, the unde- 

 veloped penis or clitoris responds to initial 

 androgen administration with extensive di- 

 lation of its vasculature and with growth in 

 size. Thereafter, maintenance of an erection 

 by complete engorgement of the organ with 



blood is facilitated by androgen. Tumes- 

 cence of the penis can occur in the absence 

 of androgen, but the erection is generally 

 not complete and long lasting. 



The seminal vesicles and prostate remain 

 immature in a male until they are stimu- 

 lated into growth by androgen. Thereafter, 

 their fluids, which form the medium of 

 sperm conveyance and nourishment, are 

 secreted only so long as there is sufficient 

 androgen in the body. 



IV. Eroticism and the Supply 

 of Sex Hormone 



A. PREPUBERTAL AND POSTPUBERTAL 

 CASTRATION 



Much of the literature bearing on this 

 subject was reviewed by Kinsey, Pomeroy, 

 ]\Iartin and Gebhard (1953). Their sum- 

 mary of the effects of gonadectomy per- 

 formed prepubertally, as well as the sum- 

 maries of their predecessors (Lipschiitz, 

 1924; Commins and Stone, 1932; Beach, 

 1948), contains abundant evidence for the 

 importance of gonadal hormones in the de- 

 velopment of sexual responsiveness in man. 

 The repeated emphasis by Kinsey, Pome- 

 roy, Martin and Gebhard that damage to 

 other endocrine glands such as the pitui- 

 tary, thyroid, adrenals, and islands of Lan- 

 gerhans, may have similar disastrous ef- 

 fects on the development of the capacity to 

 respond sexually does not weaken the case 

 for the specific role of the gonadal hor- 

 mones in such development. Debilitating 

 effects on vital functions including repro- 

 duction do follow ablation of these other 

 glands, but when the gonads are removed 

 the damaging effects, although general, are 

 nevertheless most sharply focused on repro- 

 ductive function. The damage is clearly 

 evident in the chronic infantilism that fol- 

 lows prepubertal castration. 



The results of postpubertal castration are 

 more variable as Bremer's excellent study 

 (1959) and the reviews by Tauber (1940), 

 Engle (1942), Beach (1948), and Kinsey, 

 Pomeroy, Martin and Gebhard (1953) in- 

 dicate, some males and females report that 

 the retention of sexual capacities and re- 

 sponsiveness is ostensibly complete follow- 

 ing castration, others that decrease or total 

 loss occurs. The most serious obstacle to 



