Accepted Manuscript

Title: Higher testosterone levels are associated with unfaithful

behavior in men

Authors: C. Klimas, U. Ehlert, T.J. Lacker, P. Waldvogel, A.

Walther

PII: S0301-0511(18)30700-2
DOI: https://doi.org/10.1016/j.biopsycho.2019.107730
Article Number: 107730

Reference: BIOPSY 107730

To appear in:

Received date: 15 September 2018

Revised date: 22 May 2019
Accepted date: 10 July 2019

Please cite this article as: Klimas C, Ehlert U, Lacker TJ, Waldvogel P, Walther A,
Higher testosterone levels are associated with unfaithful behavior in men, Biological
Psychology (2019), https://doi.org/10.1016/j.biopsycho.2019.107730

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Article Type:
Original research

Higher testosterone levels are associated with unfaithful

behavior in men
Running Head:
Testosterone levels in unfaithful men

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Klimas, C.1, Ehlert, U.2,3, Lacker, T.J.2,3 Waldvogel, P.2 & Walther, A.1,2,3

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1
Biological Psychology, TU Dresden, Dresden, Germany
2
Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
3
Dynamics of Healthy Aging, University Research Priority Program, University of Zurich, Zurich,

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Switzerland

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Submitted to Journal:
Biological Psychology

Correspondence: U
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Dr. Andreas Walther
andreas.walther@tu-dresden.de
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Highlights
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 A robust relation between higher testosterone and increased unfaithful

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behavior was observed.

 Infidelity was measured using direct and sensitive indirect (crosswise)

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questioning.

 In this sample of men aged between 40 and 75 years, 37.5% men

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answered having been unfaithful in the current relationship

 Subsample analysis indicates a positive association between testosterone

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and infidelity to be present primarily in men without sexual dysfunction.

Abstract

Background: Infidelity in romantic relationships is a common, but severe issue often causing

breakup and severe psychological impairment. Higher levels of testosterone are related to
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mating-behavior, sexual desire, and infidelity in men with sexual dysfunctions. Previous

studies, have insufficiently addressed the potential role of testosterone in infidelity in healthy

men.

Methods: A sample of 224 middle-aged self-reporting healthy men being currently in a

relationship completed questionnaires on relationship characteristics, infidelity, and provided

overnight-fasting saliva samples for testosterone quantification.

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Results: In the sample, 37.5% men answered having been unfaithful in the current relationship,

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while 29% were identified as fulfilling criteria for a sexual dysfunction. Adjusting for

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covariates, a significant positive association for the frequency of unfaithful behavior and

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testosterone levels emerged. Subsample analysis indicates a positive association between

testosterone and infidelity only to be present in men without sexual dysfunction.

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Conclusion: Unfaithful behavior in males is associated with higher testosterone levels.
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Key words:
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Infidelity; testosterone; unfaithful behavior; sexual activity; sexuality; men; relationship

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satisfaction; sexual dysfunction

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Introduction

Infidelity is a severe problem in society and may lead to individual complaints like depression,

psychosomatic problems (Plack et al., 2008) and even symptoms of post-traumatic stress

2
disorder (Gordon et al., 2004). Couples who had experienced infidelity before show less

relationship satisfaction and experience greater relationship problems than couples without

history of extrapair sexual activities (Plack et al., 2008). Therefore, infidelity threatens the

continuation of a relationship (Plack et al., 2008), making it one of the primary causes of divorce

(Amato and Previti, 2003; Scott et al., 2013).

Several studies have concluded that unfaithful behavior is more common in men

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compared to women (Allen & Baucom, 2004; Haversath & Kröger, 2014; Laumann, Michael,

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Gagnon, & Michaels, 1995; Wiederman, 1997). While some authors have identified trends for

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infidelity rates becoming increasingly similar over time (Petersen & Hyde, 2010), others

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observed higher rates in women compared to men, when applying a broad construct of

unfaithful behavior, which additionally accounted for kissing or romantic involvement, without
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the necessity of sexual intercourse (Brand, Markey, Mills, & Hodges, 2007). However, when
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examining exclusively sexual infidelity in large cohort studies, up to 15% of women, and 25%
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of men admitted having had at least one sexual extradyadic activity in the current relationship
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(Laumann, 1994; Wiederman, 1997). In a recently examined German sample, lifetime

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prevalence of sexual infidelity even yielded 49% for heterosexual men and 29% for
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heterosexual women, while the substantial gender difference was also present for homosexual

men (34%) and homosexual women (4%) (Haversath & Kröger, 2014).
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From an evolutionary point of view, gender dissimilarities within the tendency of

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extrapair sexual intercourse can be explained through the reproductive benefits for men when

having various short-term matings, potentially leading to a higher number of offspring

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(Symons, 1979). This is supported by the fact, that men’s sperm is plentiful due to generation

of millions per day, which leads to high libido and enables the insemination of many females

(Buss & Schmitt, 1993). It was also shown that the sex hormone testosterone facilitates mating-

related behavior in terms of competitive behavior towards other males (Anestis, 2006; Gould

& Ziegler, 2007). Considering that men have on average six-fold higher testosterone levels than

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women (Clifton et al., 2016), and show considerably higher rates of unfaithful behavior than

women, higher testosterone levels might present an underlying biological parameter related to

more extradyadic sexual activities.

Supporting the mating effort hypothesis, research suggests that men who are involved

in a romantic relationship show 21% lower testosterone levels than single men (Burnham et al.,

2003), while fatherhood additionally lowers endogenous testosterone levels (Gettler et al.,

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2011; Perini et al., 2012). Intriguingly, comparable effects were found in women (Barrett et

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al., 2013; Kuzawa, Gettler, Huang, & McDade, 2010; van Anders, Hamilton, & Watson, 2007).

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Men experiencing a reduced testosterone decline during the transition to fatherhood show

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higher sexual activity at 4.5-year follow-up (Gettler, McDade, Agustin, Feranil, & Kuzawa,

2013), while higher testosterone in the phase of early fatherhood is associated with increased
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perceived constraint due to fatherhood (Waldvogel & Ehlert, 2017). Interestingly, paired men
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who still express great interest in extrapair sexual activities have higher testosterone levels than
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those who see their relationship as exclusive (Edelstein, Chopik, & Kean, 2011; McIntyre et
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al., 2006).
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In previous studies, elevated testosterone levels in men and also women were associated
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with higher sex drive in terms of seeking more frequent sexual encounters (Edelstein et al.,

2011; van Anders et al., 2007). For instance, polyamorous individuals show higher levels of
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testosterone than monogamously partnered individuals (Alvergne, Faurie, & Raymond, 2009;
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van Anders et al., 2007). In line with this, testosterone was shown to be positively associated

with sexual desire (Anderson, Bancroft, & Wu, 1992; Edelstein et al., 2011; McIntyre et al.,
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2006).

Moreover, men suffering from hypogonadism show reduced libido and after exogenous

testosterone administration libido levels are significantly increased (e.g. Brock et al., 2016;

Corona et al., 2016; Cunningham et al., 2016, Wu et al., 2016), while the libido increasing

effect of testosterone has also been observed for men with normal testosterone levels (Anderson

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et al., 1992). Further, testosterone is positively linked to ejaculatory reflex (Corona et al., 2008)

and negatively associated with erectile dysfunction (Bandini et al., 2009; Walther et al., 2017).

Likewise, testosterone patches were shown to increase libido in women with hypoactive sexual

desire disorder (Braunstein et al., 2006). Thus, it has been shown that parenthood, sexual desire,

or relationship types are consistently associated with testosterone levels in males, while similar

associations in females are discussed. Besides this, testosterone administration studies

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consistently lead to increased libido and sexual activity (Barrett et al., 2013; Braunstein et al.,

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2006; Kuzawa et al., 2010; van Anders, Hamilton, & Watson, 2007).

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Furthermore, research on personality traits and androgenization indicated positive

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associations of testosterone with histrionic behavior like seductivity, self-centeredness and

sensation seeking (Bandini et al., 2009; Perini et al., 2012). Therefore, it can be assumed that
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individuals with higher testosterone levels are more prone to extrapair sexual activities, as they
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might easier experience monotony in monogamous relationships, but enjoy seduction of and
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admiration by others.
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Prior studies showed a positive association between testosterone and promiscuity, but
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fell short for measuring infidelity with sufficient content validity (Edelstein et al., 2011;
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McIntyre et al., 2006). In the study by Edelstein et al. (2011) examining 132 male and 122

female undergraduate students aged between 18 to 37 years, the infidelity measure consisted of
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a subscale of a questionnaire measuring general promiscuity and degree of unrestricted sexual

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orientation, while not explicitly asking about infidelity in the current relationship. McIntyre et

al. (2006) directly asked male undergraduate students about their history of extrapair sex, but
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subsequently integrated this single item in the broader composite extrapair sexual interest

capturing also participants’ mere willingness to have extrapair sex. Fisher and colleagues

(2009) examining 2,592 heterosexual men reported significantly higher testosterone levels in

unfaithful men compared to faithful men. However, in this study, the sample consisted

exclusively of outpatients with sexual dysfunction, which has previously been shown to be

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negatively related to testosterone levels suggesting overall lower testosterone levels in this

sample than in the general male population. Unfaithful behavior was further identified

employing a face-to-face interview potentially increasing the risk of social desirability bias and

reducing infidelity reports. This is further supported by the relatively low infidelity rate of 17%

identified for this sample.

We therefore hypothesize that higher testosterone levels are associated with more

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frequent unfaithful behavior and that the group of men reporting having engaged in extradyadic

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sexual activities, shows higher testosterone levels compared to men having never engaged in

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extradyadic sexual activities. In order to replicate and extend previous results, the current study

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is the first to examine the relation between testosterone and infidelity in healthy men and men

identified as having a sexual dysfunction in parallel as well as including both hetero- and
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homosexual men. Furthermore, we tested for infidelity through direct and indirect questioning
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using for indirect questioning the cross-wise model – a questionnaire technique, which is
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advantageous over anonymous self-reports to reduce risk of socially desirable answers –

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thereby increasing the probability of a true and representative report of unfaithful behavior.
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Methods

Participants
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The examined sample represents a subsample of a larger project on men's health described in
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detail elsewhere (Walther, Phillip, Lozza, & Ehlert, 2016). Of 224 men fulfilling the criterion

of being in a romantic relationship recruited via online and newspaper announcements for a
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study on healthy aging, complete data on measures of infidelity and testosterone levels was

available. Since recent studies show no differences between homo- and heterosexual men with

regard to sex hormones (Juster et al., 2016), men of different sexual orientation were included

in the sample. The final sample comprised of 212 self-reporting (94.6%) heterosexual, 2 (0.9%)

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homosexual, 8 (3.6%) bisexual, and 2 (0.9%) asexual men. Sample characteristics for the 224

men aged between 40 and 75 years are represented in Table 1.

Measures and Procedures

After registering for the online platform and providing informed consent, participants

independently completed online psychometric test batteries one week prior to biological

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examination. The psychometric test battery included sociodemographic information, the

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International Index for Erectile Function (IIEF; Wiltink, Hauck, Phädayanon, Weidner, &

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Beutel, 2003), the Relationship Assessment Scale (RAS; Sander & Böcker, 1993), the Brief

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Symptom Inventory subscale on depressive symptoms (Zabora et al., 2001), the German

version of the Short Form Health Survey (SF36; Jenkinson et al., 1993), questions on alcohol
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drinking habits, and questions on relationship characteristics. Further, we directly asked the
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highly delicate question, whether and how often participants had ever engaged in extradyadic
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sexual activities without agreement of the current partner with the following response options
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“never”, “seldom”, “occasionally” and “regularly”. In the following, we classified participants

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having responded either “seldom”, “occasionally”, and “regularly” to this question as

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“unfaithful” and those having responded “never” as “faithful”.

We also used the Crosswise Model (Yu, Tian, & Tang, 2008), a sensitive indirect
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questioning technique in order to reduce social desirability bias by providing an anonymous

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response format (Jann, Jerke, & Krumpal, 2012), when assessing unfaithful behavior in the

past. Within the cross-wise model, participants are asked two simple yes-or-no-questions, a
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non-sensitive one and a sensitive one. Participants then indicate whether the answer is “yes” to

both questions (option A), “no” to both questions (option A) or whether only one of the two

answers is true (option B). When looking at the responses of a single subject, the investigator

cannot conclude which of the two questions was affirmed or denied by the participant. Thus,

the Crosswise Model allows for participants´ anonymity and increases the likelihood of

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admitting norm violations. By considering the observed marginal distributions within the

overall sample, the proportion of subjects, who has responded with “yes” to the sensitive

question, can be estimated. Therefore, it is important that the probability of a potential yes-

answer to the non-sensitive question is known. In the present study participants were asked the

non-sensitive question in the first place: “Is your mother´s birthday in January or February?”.
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The probability, that participants responded positively to the question was = 0.167. The

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12

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sensitive question was asked in order to reveal unfaithful behavior of the participants:

“Considering your current relationship, have you ever had sexual contacts to a person outside

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of this partnership without prior agreement of your partner?”. Subjects then provided a joint

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answer for both questions. They chose option A when responses were identical and option B if

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the answers differed. The proportion of unfaithful behavior was computed using the proposed
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formula by Jann and colleagues (2012) shown below, with the unknown prevalence for
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infidelity , the observed proportion of respondents choosing answer option A, 𝜙̂ , and the
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known prevalence of a yes-answer to the non-sensitive question, p, in our study p = 0.167.

(𝜙̂ + 𝑝 − 1)
𝜋̂ =
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(2𝑝 − 1)
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Procedures of testosterone sampling and quantification are described in detail elsewhere

(Walther et al., 2016). In brief, participants arrived at the biological examination after over-
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night fasting and underwent different biological examinations (e.g. height and weight
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measurement for the calculation of the body mass index). Saliva was sampled in Salicaps at

8:00 am under standardized conditions and testosterone was quantified by enzyme linked
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immunosorbent assay in the biochemical laboratories of the Department of Psychology of the

University of Zurich. For testosterone, intra- and inter-assay coefficients were below 5% and

10%, respectively, while sensitivity was 1.8 pg/ml.

Statistical analyses

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To identify confounding variables being significantly different between the two groups

(unfaithful vs. faithful) two-tailed T-tests or χ2-tests were computed. To examine the relation

between the frequency of unfaithful behavior and testosterone levels one-tailed zero-order

bivariate correlations were calculated. Subsequently, analyses were repeated using one-tailed

partial correlations entering variables differing between the two groups or variables known to

influence salivary testosterone levels as covariates. Multiple linear regression analysis was

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performed, predicting frequency of infidelity by testosterone levels and respective covariates.

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Bias corrected and accelerated confidence intervals were reported on a 95%-level (BCa CI95%).

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Binary logistic regression modeling was applied to predict infidelity as dichotomous variable

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by testosterone levels and respective covariates. Analyses have been conducted with IBM SPSS

Statistics, Version 24.0. (Armonk, NY: IBM Corp.) significance level was set at alpha = .05.
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Confounders
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By using T-tests or χ2-tests, potentially differing variables between the self-reporting faithful
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and the unfaithful group were examined (see Table 1). Identified potential confounders were
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age, sexual function (IIEF), relationship satisfaction (RAS), depressive symptoms (BSI-18-D),
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and alcohol consumption. Variables such as relationship duration or BMI were not significantly

different between groups.

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Subsequently, a theoretical approach was used to further include potential variables

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associated with salivary testosterone secretion. To control for the well-described effects of

general health, body composition, tobacco, recent sexual activity, or different medication types
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on salivary testosterone secretion (Dai, Gutai, Kuller, & Cauley, 1988; English et al., 2001;

Walther & Ehlert, 2015), SF36 item 1 (How would you describe your general health status?

With answer options from “poor” to “excellent”), BMI, tobacco consumption, sexual activity

within the last 12 hours, and medication intake were included as covariates. To control for a

potential confounding effect of education, the highest degree of education ranging between “did

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not finish regular school” to “tertiary education” was included as covariate. To account for the

sampling method using saliva to extract testosterone, the potential contamination with blood by

gingival bleeding in the last days was controlled for (Kivlighan, Granger, & Schwartz, 2005).

Finally, to control for sleep restriction and sampling time variations due to participant delay to

examination appointments (Leproult, 2011), waking time of the participant and starting time of

saliva sampling were included as covariates.

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Results

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224 healthy men, who stated to be married or in a relationship at time of data collection, were

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included in the analysis. Participants’ age ranged from 40 to 75 years (M = 58.05, SD = 10.69),

and mean relationship duration was 21.49 years (SD = 16.02). 84 participants (37.5%) reported
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having engaged in extradyadic sexual activities one or more times without consent of the
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current partner during their present relationship. When applying the crosswise model, 128 out
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of 220 respondents (four participants did not agree to answer this specific question) chose
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answer option A (𝜙̂ = 0.58). After having applied the formula for estimated prevalence of
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infidelity, results yielded a percentage of 37.7%, thereby verifying participants’ statements

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about their sexual extrapair activities (see Table 2). By using the IIEF cut-off score for the

identification of sexual dysfunction as recommended by Wiltink et al. (2003), a total of 29%

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men were identified as fulfilling criteria for at least a mild form of sexual dysfunction. Salivary
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testosterone concentration ranged from 7.7 to 163.1 pg/ml (M = 66.42, SD = 26.37) indicating

comparable levels with other large male cohorts in the same age range reporting salivary
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testosterone levels (Clifton et al., 2016).

One-tailed zero-order bivariate correlation between the frequency of unfaithful behavior

and testosterone levels yielded a positive trend (r = 0.095, p = .079). Subsequently conducted

partial correlation analyses, including identified covariates, revealed a significant positive

association between the frequency of unfaithful behavior and testosterone levels (rp = .14, BCa

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CI95% [.012, .280], p = .022). The calculated effect size for Cohen’s d = .28 suggests a small to

moderate effect (Kelley & Preacher, 2012). Point-biserial correlations between testosterone and

the dichotomous variable for infidelity (faithful = 0, unfaithful = 1) revealed a trend for a

positive association (r = .11, p = .057), indicating higher testosterone levels in unfaithful men.

This association became significant after controlling for respective covariates (rp = .17, BCa

CI95% [.030, .336], p = .007).

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Multiple regression analyses were calculated, predicting frequency of extrapair sexual

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activities through testosterone and respective covariates. Using the enter method it was

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observed that the model explained a significant amount of variance in the frequency of

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unfaithful behavior, F15,207 = 2.11, p = .011, R2 = .13, R2adjusted = .07. The effect size of f2 = .27

indicated a medium to large effect (Cohen, 1992). Testosterone significantly predicted the
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frequency of extrapair sexual activities (β = .15, p = .045). The covariates alcohol consumption
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(β = .17, p = .014), depression (β = .16, p = .037) and waking time (β = .14, p = .037) emerged
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as additional significant covariates within the model. Further results as well as bias corrected
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and accelerated confidence intervals are presented in table 3.

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Results of the binary logistic regression analyses revealed that testosterone (b = .016, p
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= .015) significantly predicted, whether participants were faithful or not, with higher

testosterone levels in unfaithful men. Also, alcohol consumption (b = .48; p = .001) and
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depression (b = .48; p = .001) emerged as significant predictors.

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Subsample analysis examining only men with identified sexual dysfunction and men

without sexual dysfunction is presented in the supplementary material. Although the reduction
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of the sample sizes to 65 men (with sexual dysfunction) and 159 men (without sexual

dysfunction) leads to underpowered analyses, it emerges that healthy men are primarily

responsible for the significant positive association between testosterone and infidelity in the

entire sample (see supplementary material table 1a,b for correlational analysis as well as tables

2-5 for regression models).

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Discussion

Analyses revealed a positive association between testosterone levels and the frequency of

unfaithful behavior as well as infidelity operationalized as dichotomous variable (0 = not

unfaithful, 1 = unfaithful) in a self-reporting healthy sample of 224 hetero- und homosexual

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men. This finding is line with previous research identifying for a large sample of 2,592 men

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significantly higher testosterone levels in the 337 men reporting to be unfaithful (Fisher et al.,

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2009). However, the entire sample by Fisher and colleagues (2009) consisted of Italian

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heterosexual male outpatients with sexual dysfunctions, who had consulted a clinic for

andrology, which probably led to a selection bias towards a rather unhealthy sample since male
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sexual dysfunction, particularly erectile dysfunction, has consistently been related to worse
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general health (Guo et al., 2010). The here presented sample, by contrast, consisted only of self-
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reporting healthy men, while it needs to be mentioned that also in the present sample 29% of
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men were identified to have at least a mild form of a sexual dysfunction. Yet, this is a low
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percentage for men in this age-group (Wagle, Carrejo, & Tan, 2012). Moreover, in the Fisher
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et al. (2009) study unfaithful behavior was assessed through a face-to-face interview, which did

not allow for participants’ anonymity and probably led to an underestimation of infidelity in
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the sample with an infidelity rate of 17%. By contrast, our analysis revealed sexual extrapair
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activities in 37.7% for the current relationship (mean relationship duration 22 years), which is

more consistent with a recent anonymous internet survey in Germany reporting for heterosexual
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and homosexual men a lifetime infidelity rate of 49% and 34%, respectively. Therefore, this

study is the first to report in a sample of self-reporting healthy men that increased testosterone

levels are associated with infidelity, while subsample analysis further indicates that this

association is driven by the portion of men of this sample, which were not suffering from any

sexual dysfunction (see supplementary material).

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 Other studies also reported an association of testosterone and infidelity, while the

operationalized variable was often not infidelity but a related construct. For example, Edelstein

et al. (2011) assessed unfaithful behavior via the behavioral subscale of the Sociosexual

Orientation Inventory (SOI; Simpson and Gangestad, 1991), originally conceptualized for

measuring general promiscuity and degree of unrestricted sexual orientation (Penke &

Asendorpf, 2008). McIntyre and colleagues (2006), on the other hand, asked for participants’

T
history of extrapair sexual activities, but integrated this single item in the broader composite

IP
extrapair sexual interest, capturing also participants’ mere willingness to have extrapair sex as

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well as their individual SOI-score. Hence, in both studies, infidelity was confounded by general

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sexual openness, thereby limiting content validity of the measurement. Associations between

higher testosterone and multiple partners are also reported by van Anders, Hamilton and
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Watson (2007). Yet, the authors investigated monogamous vs. polyamorous individuals. The
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latter responded to questions for people with two or more current partners and were mostly
A

recruited from polyamory groups. Subjects in long-term relationships were characterized as

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monogamous, but were not surveyed about potential extradyadic sexual activities. We therefore
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argue, that Anders and colleagues (van Anders et al., 2007) investigated the link between
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testosterone and different types of romantic and sexual relations varying in their degree of

commitment and exclusiveness (i.e. monogamy vs. polygamy). But, there was no examination
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of the relation between testosterone and infidelity per se. However, in line with our findings,
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the studies mentioned above report higher testosterone levels to be associated with greater

desire towards extrapair sexual engagement and more frequent uncommitted sexual behavior
A

(Edelstein et al., 2011; McIntyre et al., 2006; van Anders et al., 2007). The identified association

between higher testosterone levels and increased frequency of unfaithful behavior is small to

moderate in effect size and thus in line with the broad literature. Infidelity is conceptualized as

a multifactorial condition. It was shown that relationship satisfaction (Mark, Janssen, &

Milhausen, 2011), or depressive symptomatology (Gorman & Blow, 2008) influence the risk

13
for infidelity. This was further confirmed in our analysis showing lower levels of relationship

satisfaction and higher levels of depressive symptoms in unfaithful men (see table 1).

Interestingly, relationship satisfaction and depression are also related to testosterone levels

(Almeida et al., 2008; Feldman et al., 2002; Hooper et al., 2011). It is therefore assumed that

circulating testosterone levels in males stand in a mutually influencing relation with multiple

factors, while one such factor assembly consists of infidelity and associated constructs such as

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promiscuity, willingness for extrapair activities, and engaging in polygamous relationships.

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Men, naturally high in testosterone, tend to seek more frequent sexual encounters,

R
probably due to evolutionary reproductive benefits of having multiple sexual partners (Symons,

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1979). Likewise, recent research has shown that men with high testosterone levels are perceived

as more attractive by women in terms of short-term mate judgments (O’Connor et al., 2014;
U
Roney et al., 2006). Research on personality traits and androgenization has shown that
N
testosterone levels are associated with histrionic behavior like seductivity (Bandini et al., 2009;
A

Perini et al., 2012) and narcissism (Pfattheicher, 2016). In line with this, high-testosterone
M

participants of our study may find it easier than low-testosterone subjects to approach potential
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female sex partners because of the potentially more appealing impression they make on women.
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In turn, this would offer greater opportunities for extrapair sexual activities.

Alternatively, the observed testosterone-infidelity-link might be mediated through

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socioeconomical status (e.g. working position, income). Associations between higher

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testosterone levels and higher status have been widely supported in previous literature

(Sherman, Lerner, Josephs, Renshon, & Gross, 2016), whereas elevated power in professionals
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was shown to be associated with infidelity in both men and women (Lammers, Stoker, Jordan,

Pollmann, & Stapel, 2011). In turn, one could resume that the experienced power in men with

higher status increases their confidence in attracting potential sex partners. Likewise, men with

higher status and income may easily afford extrapair activities by hiring sex trade workers,

which men with lower income could not. However, statistics within a large sample of almost

14
4,000 Mexican men about categories of extramarital sex partner demonstrated that only 5% had

extramarital sexual intercourse with a prostitute, whereas 54% reported extrapair sexual

activities with a friend, followed by the category mistress (17%), and coworker (14%)

(Pulerwitz, Izazola-Licea, & Gortmaker, 2001).

Positive associations between testosterone and sexual function were previously shown

in a large sample of middle-aged and older men (O’Connor et al., 2011). Interestingly, in the

T
present sample, unfaithful men, exhibiting higher testosterone levels, showed lower sexual

IP
function scores compared to faithful men. Therefore, it is possible that unfaithful partners might

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have experienced greater relationship distress before engaging in unfaithful behavior, which in

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turn reduces relationship satisfaction and intimacy motivation (Allen et al., 2005; Treas &

Giesen, 2000). Both, relationship satisfaction and intimacy motivation, have been shown to be
U
important protective factors against sexual dysfunction in aging men (Walther et al., 2017).
N
Consistent with previous studies in this area (Fincham & May, 2017), in our study
A

relationship satisfaction was significantly different between groups, with lower satisfaction
M

among unfaithful men. Further, group comparisons revealed higher alcohol consumption in
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unfaithful men, which is also in line with previous findings (Atkins, Yi, Baucom, &
TE

Christensen, 2005; Graham, Negash, Lambert, & Fincham, 2016). Alcohol is considered a

testicular toxin (Maneesh, Dutta, Chakrabarti, & Vasudevan, 2006), leading to a decline of
EP

plasma testosterone even in moderate drinkers (Sierksma et al., 2004). However, review articles
CC

summarize that subjective sexual arousal increases after consumption of alcohol (Källmén &

Gustafson, 1998) and fosters sexual risk-taking (George & Stoner, 2000). Moreover, a
A

disinhibiting side effect of alcohol has been widely proposed (George & Stoner, 2000;

Gustafson & Källmén, 1989), while experimental studies show that the loosening of inhibition

through drinking relies on expectancies and self-fulfilling prophecies rather than on actual

pharmacological mechanisms (George, Stoner, Norris, Lopez, & Lehman, 2000). In sum, the

mentioned psychological consequences of alcohol probably makes frequent drinking men

15
showing unfaithful behavior more often. An alternative explanation would be, that unfaithful

men tend to cope with alcohol consumption (Cook & Clark, 2005).

Findings in the present study do not allow for general conclusions about endogenous

testosterone levels predicting men’s disposition for infidelity. Recent research has suggested a

social modulation of androgenization rather than a simple hormonal causation (van Anders &

Watson, 2006). For example, testosterone levels increase as a direct consequence of sexual

T
arousal (Pirke, Kockott, & Dittmar, 1974; Stoléru, Ennaji, Cournot, & Spira, 1993),

IP
masturbation (Purvis, Landgren, Cekan, & Diczfalusy, 1976) and sexual intercourse (Dabbs &

R
Mohammed, 1992). Moreover, findings from longitudinal studies show that masturbation

SC
frequency predicts higher testosterone levels even five years later (Das & Sawin, 2016).

Furthermore, testosterone supplementation – being used by more and more men – increases
U
sexual desire and activity (Cunningham et al., 2016). This leads to the assumption that higher
N
testosterone levels in the unfaithful group might reflect a general effect of basal endogenous as
A

well as stimulated testosterone levels increasing the overall sexual desire and activity in males.
M

Moreover, unfaithful men in the present study showed lower relationship satisfaction,
D

which is often accompanied by diminished intimacy and lowered commitment to the long-term
TE

partner. This may increase the urge to receive sexual satisfaction elsewhere. In line with this,

there is consistent evidence that those men still (or again) seeking potential partners, have
EP

higher testosterone levels than men in a committed relationship (Alvergne, Faurie, & Raymond,
CC

2009; Burnham et al., 2003; Gettler et al., 2013; van Anders et al., 2007). This underlines the

supporting effect of testosterone on male´s mating efforts and indicates that these efforts may
A

include short-term sexual activities namely extrapair sexual encounters.

Limitations

When interpreting these results, one needs to consider several limitations of this study. First,

although a relatively large sample of a homogenous group of men was examined post hoc power

16
analysis based on identified effect size suggest that the present study was slightly

underpowered. Further, the cross-sectional nature of the study limits causal inferences. This

should be addressed in future studies applying experimental-longitudinal study designs

potentially examining the association between testosterone levels and infidelity prospectively

in men undergoing testosterone treatment. Further, although under standardized conditions, the

testosterone measurement was obtained at a single time-point being susceptible for short-term

T
fluctuations. Repeated sampling or long-term measurement of testosterone provided by

IP
cumulative measures (e.g. hair testosterone) might be more adequate to reflect an individual’s

R
hormonal state. Though significant effects were identified, effect sizes are small to moderate

SC
and a multi-factorial biopsychosocial model is suggested to underlie infidelity. Although there

are many findings that support an evolutionary explanation between testosterone and mating
U
effort (infidelity), we acknowledge that there are as many psychological and social theories that
N
explain a greater prevalence of infidelity in men. Due to our focus on the possible hormonal
A

component of infidelity in men, we have mainly discussed the evolutionary-biological

M

perspective, but do not deny the relevance of parallel psychological and social theories. Finally,
D

although infidelity was asked directly and calculated via the cross-wise measurement, the topic
TE

is highly sensitive and skeptical participants still may have answered in a socially desirable

way.
EP
CC

Conclusion

Our findings indicate that males with higher testosterone levels show increased extrapair sexual
A

activity. Men identified as not having a sexual dysfunction are mainly responsible for this

significant association in the present sample. Data about unfaithful behavior of participants

have shown high reliability after verifying direct statements about frequency of extrapair sexual

activities via the Crosswise Model. Direct and indirect prevalence of infidelity among subjects

17
were nearly equally high, indicating a low level of underreporting of infidelity in the present

study.

Although, dedicating to various sexual partners once had evolutionary benefits, in

today´s monogamous societies extrapair sexual activities often lead to severe relationship

conflicts thereby threatening not only the mental health and life quality of the betrayed partner,

but also that of the unfaithful partner. Higher testosterone levels may therefore be regarded as

T
potential risk factor for unfaithful behavior. This is especially important considering that

IP
testosterone supplementation in men has received substantial attention for treating sexual

R
dysfunction or depression (Elliott et al., 2017; Walther et al., 2019) and an increasing number

SC
of men worldwide is using testosterone products. Medical practitioners may thus consider to

inform men prior to using testosterone products about the possibility of an increased sex drive
U
due to an elevated basal testosterone level. This might be important to anticipate in exclusive
N
romantic relationships.
A
M
D

Author contributions
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AW and UE designed the concept of the study. AW organized and conducted the study and

collected the data. CK and AW analyzed the data and wrote the first draft of the manuscript.
EP

UE, TL, and PW contributed with important intellectual content and edited subsequent versions
CC

of the manuscript.
A

Funding

This research was fully funded by the University Research Priority Program – Dynamics of

Healthy Aging of the University of Zurich.

Conflict of interest

18
None declared.

Acknowledgements

We would like to thank all study participants for contributing to the study. Furthermore, we

would like to thank Thomas Bernauer for his support in implementing the crosswise

questioning procedure in the study design.

T
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Figure caption

Figure 1. Testosterone levels of faithful and unfaithful men. Values are presented as mean and
95% confidence intervals.

T
R IP
SC
U
N
A
M
D
TE
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CC
A

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Table 1. Descriptive statistics of the sample (N=224)
unfaithful faithful
(N=84) (N=140)
Characteristics M SD M SD T p
Age 59.80 10.62 57.01 10.62 1.903 .058
BMI 25.13 3.16 25.60 2.90 -1.126 .262
Sexual function (IIEF) 42.21 16.76 46.77 15.62 -2.057 .041
Health status (SF-36) 2.44 .61 2.39 .71 -.59 .555

T
Relationship duration 23.64 16.41 20.20 15.69 1.563 .120

IP
Relationship
4.05 .70 4.27 .67 2.241 .026
satisfaction (RAS)

R
Depressive symptoms
1.87 2.87 1.13 2.34 -2.101 .037
(BSI-18-D)

SC
Sexual activity (last
2.00 .00 1.99 .12 -1.42 .158
12 hours)
χ2 p
Education level 5.25 1.17 5.21 U 1.36 6.883 .142
N
Tobacco consumption 1.40 .971 1.31 .897 3.164 .531
A
Alcohol consumption 3.94 1.09 3.34 1.09 18.813 .002
Medication intake 1.63 .485 1.68 .469 .531 .466
M

Note: BMI: body mass index; IIEF: International Index of Erectile Function; SF-36: Short Form Health Survey;
relationship duration in years; RAS: Relationship Assessment Scale; BSI-18-D: Brief Symptom Inventory 18 Items
Depression Subscale, tobacco consumption assessed by an item with a 5-point likert scale from “non-smoker” to
D

“smoking 10 or more cigarettes per day”, alcohol consumption on a 6-point likert scale from “I never drink
alcohol” to “2 or more alcoholic drinks per day; Medication intake assessed with “yes” or “no”.
TE
EP
CC
A

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Table 2. Prevalence in % of infidelity via direct questioning and Crosswise-Model.
Direct Questioning Crosswise-Model Difference
(DQ) (CM) (CM-DQ)
37.5 37.7 0.2
infidelity
224 220
observations

T
IP
Table 3. Linear model predicting frequency of extrapair sexual activity during the current
relationship y multiple predictors.

R
b SE b ß p

SC
Constant term -.194 5.384 NA .930

Testosterone levels (pg/mg) .004 [.001, .007] .002 .146 .045

Age .007 [-.003, .017] .006 .108 .213
Education level -.020 [-.092, .053]
U .036 -.038 .571
N
BMI -.001 [-.034, .036] .016 -.005 .943
Medication .023 [-.166, .232] .113 .016 .837
A
Cigarette consumption .028 [-.054, .114] .051 .038 .584
Alcohol consumption .105 [.019, .203] .042 .171 .014
M

General health status (SF36-1) -.043 [-.194, .123] .072 -.042 .552
Sexual function (IIEF-SF) -.002 [-.009, .003] .003 -.057 .458
Sexual activity .488 .077 .251
D

.561 [.211, .960]

Depression (BSI-D) .042 [-006, .093] .020 .156 .037
TE

Relationship satisfaction (RAS) -.093 [-.276, .076] .077 -.094 .225

Gingival bleeding .105 [-.315, .499] .187 .038 .574
Awakening time .002 [.001, .003] .001 .144 .037
EP

Starting time of saliva sampling -.117 [-1.284, .115] .217 -.036 .589
Note. NA: not available. 95% bias corrected and accelerated confidence intervals reported in parentheses. Confidence
intervals and standard errors based on 1000 bootstrap samples. Explained variance of the frequency of extrapair sexual
activity by the model was 13% (R2 = .13). BMI: body mass index, IIEF-SF: International Index of Erectile Function
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– Sexual Function Scale; SF-36-1: Short Form Health Survey – Item 1; RAS: Relationship Assessment Scale; BSI-
18-D: Brief Symptom Inventory 18 Items Depression Subscale.
A

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Table 4. Binary logistic regression model predicting unfaithful vs. faithful men by multiple
predictors
95% CI for Odds Ratio
b SE b Lower Odds Upper p
Constant term -26.523 54413.032 NA NA NA <.001

Testosterone levels .016 .006 1.01 1.02 1.03 .015

(pg/mg)
Age 0.33 .019 .99 1.03 1.07 .081
Education level .015 .123 .797 1.015 1.29 .904

T
BMI -.014 .054 .89 .986 1.10 .801

IP
Medication .197 .372 .59 1.22 2.52 .597
Cigarette consumption .097 .170 .79 1.10 1.54 .570
Alcohol consumption .476 .146 1.21 1.61 2.14 .001

R
General health status .000 .242 .62 1.00 1.61 .999

SC
(SF36-1)
Sexual function (IIEF-SF) -.014 .011 .97 .986 1.01 .212
Sexual activity 21.19 .511 NA NA NA .999
Depression (BSI-D)
Relationship satisfaction
.112
-.186
.068
.250 U.98
.51
1.12
.83
1.28
1.35
.100
.456
N
(RAS)
Gingival bleeding .490 .636 .47 1.63 5.68 .441
A
Awakening time .003 .003 .99 1.00 1.01 .188
Starting time of saliva -2.86 .4.037 .001 .058 157.02 .479
M

sampling
Note. NA: not available. 95% confidence intervals for odds ratio. Explained variance of the frequency of extrapair sexual
activity by the model was 21% (R2 = .21). BMI: body mass index, IIEF-SF: International Index of Erectile Function – Sexual
D

Function Scale; SF-36-1: Short Form Health Survey – Item 1; RAS: Relationship Assessment Scale; BSI-18-D: Brief
Symptom Inventory 18 Items Depression Subscale.
TE
EP
CC
A

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