Thursday, January 6, 2022

Testing associations between women’s cycle phase or hormone levels and pathogen disgust or contamination sensitivity, the authors find no compelling evidence for upregulated pathogen disgust in the luteal phase or higher progesterone levels

Hormones, ovulatory cycle phase and pathogen disgust: A longitudinal investigation of the Compensatory Prophylaxis Hypothesis. Julia Stern, Victor Shiramizu. Hormones and Behavior, Volume 138, February 2022, 105103.


• Testing associations between women’s cycle phase or hormone levels and pathogen disgust or contamination sensitivity

• No compelling evidence for upregulated pathogen disgust in the luteal phase or when progesterone levels are higher

• Results in contrast to the Compensatory Prophylaxis Hypothesis

• No differences in results for women with a current infection

Abstract: Multiple studies have argued that disgust, especially pathogen disgust and contamination sensitivity, change across women's ovulatory cycle, with higher levels in the luteal phase due to an increase in progesterone levels. According to the Compensatory Prophylaxis Hypothesis (CPH), women have a higher disgust sensitivity to pathogen cues when in the luteal phase (or when progesterone levels are higher), because progesterone is associated with suppressed immune responses. Evidence for this hypothesis is rather mixed and uncertain, as the largest study conducted so far reported no compelling evidence for an association between progesterone levels and pathogen disgust. Further, ovulatory cycle research has been criticized for methodological shortcomings, such as invalid cycle phase estimates, no direct hormone assessments, small sample sizes or between-subjects studies. To address these issues and to contribute to the literature, we employed a large, within-subjects design (N = 257 with four sessions each), assessments of salivary hormone levels and cycle phase estimates based on luteinizing hormone tests. A variety of multilevel models suggest no compelling evidence that self-reported pathogen disgust or contamination sensitivity is upregulated in the luteal phase or tracks changes in women's hormone levels. We further found no compelling evidence for between-subjects associations of pathogen disgust or contamination sensitivity and hormone levels. Results remain robust across different analytical decisions (e.g. in a subsample of women reporting feeling sick). We discuss explanations for our results, limitations of the current study and provide directions for future research.

Keywords: Pathogen disgustContamination sensitivityProgesteroneHormonesOvulatory cycleCompensatory Prophylaxis Hypothesis

4. Discussion

In the current study, we aimed to test the CPH by employing a longitudinal design, a large sample size, direct hormone assessments and LH-test validated cycle phase estimates. Across a variety of different analyses, we found no compelling evidence that pathogen disgust or contamination sensitivity is related to LH-validated cycle phase or different hormones levels (within-subjects and between-subjects). We further found no significant effects for women who reported feeling sick in our data.

Previous studies testing the CPH yield mixed findings. Our results are in line with the results by Jones et al. (2018) who also reported no compelling evidence that pathogen disgust tracks changes in women's salivary progesterone, estradiol, testosterone, or cortisol. They are further in line with studies not reporting compelling evidence for an association of different cycle phases and increased pathogen disgust (e.g. Fessler and Navarrete, 2003Żelaźniewicz et al., 2016), but in contrast to previous studies reporting significant effects for either (within-subjects or between-subjects) hormone levels or different cycle phases.

Fleischman and Fessler (2018) published three possible explanations for the null results reported by Jones et al. (2018): a) that the CPH might be entirely wrong, b) measurement issues might explain differences in findings, c) progesterone might not be the driving factor. We argue that these three explanations might also pertain to our findings, as they were virtually identical to the findings published by Jones et al. (2018), although Jones et al. (2018) did not specifically assess women's cycle phases. Of course, it is possible that the CPH is wrong and that “changes in immune functioning are too small or not consistent enough to exert selective pressure on mechanisms governing behavior” (Fleischman and Fessler, 2018, p. 468). However, we refrain from such strong conclusions based on our findings, given that there are always limitations in single datasets, that absence of evidence does not equal evidence of absence and that our results might not be generalizable to other contexts or samples (e.g. pregnant women). Nevertheless, we think that our findings further challenge the CPH. We agree that differences in used measures might at least partly explain differences in findings between studies. For example, we did not investigate disgust responses to pictures depicting disease cues, for which some previous studies reported findings in line with the CPH (Fleischman and Fessler, 2011Miłkowska et al., 2021). However, not using pictures in the current study does not explain differences in findings of self-reported pathogen disgust or contamination sensitivity via questionnaires also used by Fleischman and Fessler (2011) or Milkowska et al., 2019Miłkowska et al., 2021. Other differences in methods (besides used stimuli) might be more likely to explain differences in findings. For example, the study by Jones et al. (2018) and the current study are the studies with the largest sample sizes so far, and also the only large-scale within-subject studies with direct hormone assessments. Further, our study used randomized sessions (e.g. not all participants started testing in the same cycle phase), whereas every participant had her first testing session in the fertile phase in the studies by Milkowska et al., 2019Miłkowska et al., 2021. Interestingly, Fleischman and Fessler (2018) also stated that the higher test power in the study by Jones et al. (2018) suggests that the CPH might rather be wrong than differences in results could be explained by measurement issues. Regarding the potential explanation that progesterone is not the driving factor that regulates disgust sensitivity, we agree that other factors related to pregnancy might lead to upregulated disgust sensitivity. To investigate which factors are actually responsible for fluctuations in disgust sensitivity (and higher disgust sensitivity when pregnant), we suggest that future studies should collect data from pregnant women, as only testing pregnant women can answer this research question properly.

4.1. Limitations

We note several limitations regarding our study that might be addressed in subsequent research. First, whereas we investigated whether different self-report questionnaires or different analyses yield different findings regarding our research question, we did not investigate disgust responses to pictures or videos depicting disease cues. Second, we cannot draw strong conclusions on whether having an infection might moderate shifts in disgust sensitivity across the cycle. Although we did not find compelling evidence for this claim, only a very small number of our participants reported feeling sick (potentially as, if they were truly sick, they would not have attended the session). Third, due to ethical constraints, our study was observational, not experimental. Hence, it remains unclear whether progesterone administration might raise disgust, comparably to mice (Bressan and Kramer, 2021).

Although sex hormones play a key role in sex differences in susceptibility, severity, outcomes, and response to therapy of different diseases, sex chromosomes are also increasingly recognized as an important factor

Y chromosome is moving out of sex determination shadow. Raheleh Heydari, Zohreh Jangravi, Samaneh Maleknia, Mehrshad Seresht-Ahmadi, Zahra Bahari, Ghasem Hosseini Salekdeh & Anna Meyfour. Cell & Bioscience volume 12, Article number: 4. January 4 2022.

Abstract: Although sex hormones play a key role in sex differences in susceptibility, severity, outcomes, and response to therapy of different diseases, sex chromosomes are also increasingly recognized as an important factor. Studies demonstrated that the Y chromosome is not a ‘genetic wasteland’ and can be a useful genetic marker for interpreting various male-specific physiological and pathophysiological characteristics. Y chromosome harbors male‑specific genes, which either solely or in cooperation with their X-counterpart, and independent or in conjunction with sex hormones have a considerable impact on basic physiology and disease mechanisms in most or all tissues development. Furthermore, loss of Y chromosome and/or aberrant expression of Y chromosome genes cause sex differences in disease mechanisms. With the launch of the human proteome project (HPP), the association of Y chromosome proteins with pathological conditions has been increasingly explored. In this review, the involvement of Y chromosome genes in male-specific diseases such as prostate cancer and the cases that are more prevalent in men, such as cardiovascular disease, neurological disease, and cancers, has been highlighted. Understanding the molecular mechanisms underlying Y chromosome-related diseases can have a significant impact on the prevention, diagnosis, and treatment of diseases.


Although most sex differences in occurrence and prevalence of diseases have been associated with the function of sex hormones, molecular studies have assigned a hormone-independent role to the differential expression of genes, especially those located on sex chromosomes. Y chromosome genes independently and/or in conjunction with sex hormones, beyond their X-linked collective tasks determine the male-specific characteristics. In this review, we highlighted major recent findings on the contribution of Y chromosome genes to disease susceptibility to various human diseases and showed that how LOY and translation/function failure of Y chromosome genes can affect the pathogenesis of male-specific diseases.

Despite the vast investigation, little knowledge exists on the molecular mechanisms involved in these sex disparities. This might have been originated from the biological limitations and/or experimental issues such as low expression of MSY genes in rare organs or cell types, high similarity with their X counterparts, hormone effects on intracellular processes, and the absence of mixed-sex experimental groups in cellular, animal, and human studies. In the human Y chromosome proteome project, as a part of the Chromosome-Centric Human Proteome Project (C-HPP), the function of MSY proteins was explored in organ development by taking advantage of PSCs, which are capable of differentiation into all cell types of the human body [171]. We believe that hormone-free systems like PSC and their derivatives as well as organoids, which are in vitro generated copies of human organs, can facilitate the mechanistic studies to explore the role of Y chromosome genes in health and disease and provide novel insights into gender disparity and sex-specific therapeutic strategies for diseases.


Loss of Faith and Decrease in Trust in a Higher Source During COVID-19 in Germany: Developments were observed in both Catholics & Protestants, and in both younger & older persons

Loss of Faith and Decrease in Trust in a Higher Source During COVID-19 in Germany. Arndt Büssing, Klaus Baumann & Janusz Surzykiewicz. Journal of Religion and Health, Jan 5 2022.

Abstract: Many people relied on their faith as one resource in order to cope during the COVID-19 pandemic. In Germany, between the eighteen months from June 2020 to November 2021, different participants at different times were assessed during different phases of the COVID-19 pandemic. The total sample of this continuous cross-sectional survey consisted of 4,693 participants. Analyses revealed that with the 2nd wave of the infection and its 2nd lockdown, trust in a Higher Source, along with praying and meditation decreased. Also, the sharp increase in corona-related stressors was associated with a decline of wellbeing and a continuing loss of faith. These developments were observed in both Catholics and Protestants, and in both younger and older persons. In addition, the long phases of insecurity and social isolation lacking the significant support usually given by religious communities may have likewise challenged the religious-coping capacities of religious/spiritual people themselves.


This cross-sectional survey of different participants at different times during the different phases of the pandemic found that stressor scores rose sharply while wellbeing decreased during the 2nd wave of the pandemic (Table 1). In accord with this, trust in a supporting “Higher Source” declined parallel to the decline of wellbeing, and numerous people stated that they had lost their faith (increasing from 3 to 22%) because of the COVID-19 pandemic. The respective pattern of decline persisted during the first half of 2021, and only started to improve slightly during the 4th wave. These changes cannot be solely explained by differences in the cohorts with respect to non-religious persons or younger participants who may not have held strong bounds to institutional religiosity. This loss of faith and decrease in trust was observed not only in both Catholics and Protestants, but also in those who are not religiously affiliated but may have other sources of spiritual trust. These non-religiously affiliated persons were not necessarily lacking spiritual sources, but rather may have distanced themselves from institutional religiosity. In fact, 17% stated that have faith which is a strong hold in difficult times and 24% stated that they have confidence in a higher power that is sustaining them. Further, a small fraction of these non-religiously affiliated is still praying or practicing meditation, and therefore this small fraction (some of which may have lost what they may call their ‘faith’) may rely on their personal spiritual resources -, resources which were not or no longer institutionally organized.

The age differences within cohorts cannot fully explain the observed changes either, as Loss of faith and decline of trust in a Higher Source are observed in both younger persons (< = 40 years of age) and older persons > 40 years of age. While Loss of faith showed no significant gender-related effect, trust in a Higher Source was stronger in women than men. Regression analyses confirmed that (for participants´ Loss of faith) the recruiting time prior and after the 2nd wave was the best predictor of the increase in stressors and the decline of wellbeing. Thus, the 2nd lockdown (with a much stronger increase in infected persons and hospitalized patients after the all-too-confident summer months that followed the shock of the 1st lockdown) was associated with a rise of perceived stressors such as restrictions in daily life, of being under pressure/stressed, of anxiety/insecurity, of loneliness/social isolation, and of financial-economic difficulties due to the corona pandemic (these are the topics of the 5NRS addressing the “Stressors”). While a considerable part of respondents reported that they had found hope in their faith to cope with the outcomes of the pandemic in the first phase, later with the months-long continuation of the pandemic and its strict distance recommendations, many of these faithful may have lost some of their courage and faith. Similarly, we observed a decline of praying and meditation during the pandemic, and a decrease in participants´ satisfaction with the support of their local religious/spiritual communities. This was found not only in both Catholics and Protestants, but also in those who stated they are not religiously affiliated (but may nevertheless have interest in religious and spiritual resources). However, in Germany the first vaccinations of older persons and groups-at-risk started at the end of December 2020, and a year later in December 2021 all those who were willing to be vaccinated had received it (about 2/3 of the population). This seems to have reduced some of the fears of a complicated course of COVID-19 in many participants, and could be the reason why participants´ wellbeing was starting to improve slightly during the 4th wave of the pandemic (which so far affects predominantly, but not exclusively, non-vaccinated people). Nevertheless, Loss of faith is still increasing, and religious trust and confidence are still rather low.

International studies and statements from the first phase of the pandemic would assume that faith/religiosity is an important resource to cope with the pandemic (Asadzandi et al., 2020; Barmania & Reiss 2020; Edara et al., 2021; Koenig 2020; Kowalczyk et al., 2020; Peteet 2020; Pirutinsky et al., 2020). A study from Poland assumed a “protective influence” of a person´s faith (Kowalczyk et al., 2020). In that study, 72% of Catholics from Poland agreed that their faith was important to cope with the pandemic, and more women than men stated that their faith was strengthened because of the hazard. Further, particularly young women from Poland assumed that their “faith will protect them from the coronavirus infection, probably because they may assume that God as the ‘merciful father’ will save them from all evil and suffering (Kowalczyk et al., 2020). In American Orthodox Jews, trust in God and related positive religious coping was related to less stress, while struggles with God and negative religious coping was related to more stress and other negative impacts related to the pandemic (Pirutinsky et al., 2020). Among Muslims from Iran, phases of spiritual dryness (related to the perception that God is not responding and not helping) were reported during the pandemic, although most would still regard themselves as religious (Büssing et al., 2021b). Both the view of God as a helping one, and positive expectations that God will intervene have been expressed particularly in the first phase of the pandemic when hope was prevailing predominantly in religious societies and specific faith groups. However, for both Catholics and Protestants in rather secular Germany, there was an obvious decline of religious trust and confidence associated with the sharp rise of infection rates during the 2nd wave of the pandemic, which seems to persist during the next waves. This would indicate that their expectations of a helping God may have declined during the course of the pandemic as death rates increased (that those who died were not ‘rescued’ or protected from the virus by God). Whether this can be interpreted in terms of magic beliefs, or of fideism, or of the theodicy question, or as a matter of (passive) resignation, is open to discussion and probably differs individually.

The observed decrease in participants’ trust in a Higher Source (whatever may support them during the pandemic) along with the 2nd and the following waves was predicted best by the levels of a person’s religious affiliation, increased age, strong wellbeing, and time of recruitment before the 2nd lockdown. It can be expected that religious trust can best be explained by a person´s religiosity, and religious people are more often older. However, the corona-related burden affected both religious and non-religious people, and both groups showed a loss of confidence. While there are several studies that underline the idea that religious coping is helpful to deal with stressful life events, this study would indicate that long phases of insecurity and social isolation with the lack of support by religious/spiritual communities (and thus declining satisfaction with their support) may have likewise challenged the religious coping capacities of religious persons themselves. This could be seen in the context of ‘defeat stress’ resulting in feelings of loneliness and social isolation on the one hand (Büssing 2022), and ‘spiritual exclusion’ on the other hand. All in terms of pandemic-related social exclusion due to the required restrictions imposed in order to protect people at risk.

Particularly during the pandemic, circumstances arose that put religious institutions at trouble and constituted a challenge to the personal religiosity and religious commitment of believers. As a result, the important functions of religion as revealed in its integrative and meaning-making role were severely curtailed. Likewise, the ritual and communal performance of religious practices had been limited (due to the restrictions) and subsequently transferred online and to private living. Religious activities had temporarily changed from the prevailing congregational forms of faith to more individual and private ones, e.g., realized in the family at home. In our study, we have observed a decline parallel to the course of the pandemic in the frequency of praying and meditation in Catholics and Protestants. It seems as if the pandemic did not generally encourage people to rely more strongly on traditional religiosity. Instead, more flexible forms of religiosity were practiced in private and according to one's own preferences. This could also explain the observation that the non-religiously affiliated participants, (who nevertheless may have interest in religious and spiritual issues), stated that they have confidence in a higher supporting source and are more active in meditation than they are in praying.

The challenge for the communities and institutions will be to re-attract and re-integrate into their liturgies and services all those who have experienced that their religiosity can be practiced even without the religious institutions or the communal forms of worship services. A study from Ireland explored how the Christian clergy have framed their adoption of online ministries during the COVID-19 pandemic as opportunities for the churches to retain some significance (Ganiel 2021). During the first phase of the pandemic, older Seventh-day Adventists from Germany benefited from the free church´s digital media resources and experienced a positive impact on their wellbeing in spite of the lockdown restrictions (Büssing et al., 2021c). A study from Italy showed that people who reported a COVID-19 contagion in their family were more frequently using digital religious services (via web, radio and television) and prayer during the pandemic. Whether these short-term coping strategies have changed their religious behavior and faith in the long run is unclear. Under difficult circumstances, a short-term religious revival might take place, even in contexts where the process of secularization is in progress (Molteni et al., 2021). In fact, the increase in existential insecurity can result in needs for religious reassurance (Höllinger & Muckenhuber 2019; Molteni et al., 2021), and thus religious beliefs and behaviors can indeed play a beneficial role when experiencing such insecurity or anxiety (Davis et al., 2021; Narimani & Eyni 2021; Prazeres et al., 2020). Yet, as shown in this study, in some societies this might not be true on a larger scale.

It seems that, due to the long course of social distancing and related restrictions, more or less vital social and religious bonds between people and local religious communities were affected and even disrupted. In Germany, the satisfaction with the support from the local religious communities during the first phases of the pandemic was rather low (33% persons with a religious affiliation stated satisfaction, as compared to 74% of religious brothers and sisters) (Büssing 2021). Here we underline a constant decline of such satisfaction with support from the local communities. Further, when sacred spaces (i.e., the churches) are not easily accessible, people may lose access to the center of their public religious life, and thus they may either develop new forms of spiritual practices in privacy or simply get used to the loss. Counted et al., (2020) described that the pandemic has affected the connections with other people not only in the direct neighborhood and in the faith community, but also in places of work and of worship – and this may have resulted in spiritual struggles which can be indicated by the loss of faith as seen in this study.


This study refers to data collected from different participants recruited via snowball sampling. We have no control over who has participated nor over whom we did not reach with this approach, and therefore we do not assume that the findings are representative of the general Germany society. Due to the fact that we relied on an online survey tool, people without internet access could not participate, and therefore we certainly have not reached all social groups in a comparable manner.

The compositions of the different ‘time cohorts’ of persons continuously recruited during the course of the pandemic are quite similar, but nevertheless differ in specific details. It seems that participants who stated that they have no (or not any longer) religious affiliation may have increased with the later phases of the pandemic. To overcome this potential bias, we also differentiated the responses of a) persons with and without a religious affiliation, b) those specifically with a Catholic and a Protestant background (the group of other religious affiliations was too small to rely on), and c) those with lower age (< = 40 years) and higher age (> 40 years). Religious persons living in monastic structures (brothers and sisters, monks and nuns) who were participating predominantly directly after the first lockdown were excluded from the analyses to avoid a bias due to the responses of these highly religious persons. However, the addressed effects were observed in all the remaining sub-groups.