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Testosterone (T) is often studied for its role in causally influencing (male) sexual behavior. However, research in females and males from a variety of species also demonstrates evidence for the ‘reverse relationship’, i.e., effects of sexual stimuli and behaviors on T. Although sexuality clearly modulates T, T does not respond the same way in every individual or in every sexual situation. What accounts for this variability in sexually-modulated T is not well-characterized. However, the social context surrounding a sexual interaction, over and above specific sensory modalities or behaviors, seems important in shaping sexual modulation of T. Additionally, in humans, sexual thoughts in the absence of external stimuli or the mere anticipation of sexual activity can increase T. These findings suggest that one source of variability in sexually-modulated T may be how an event is experienced internally (i.e., cognitively, perceptually, and affectively). In this dissertation, I examined how internal experiences shaped sexual modulation of T and bidirectional sexuality-T associations in women. To address my research questions, I employed longitudinal, qualitative, and experimental methods. First, I demonstrated that women’s T was positively associated with solitary sexual behavior (i.e., being sexual alone) but negatively associated with dyadic sexual behavior (i.e., being sexual with a partner). Second, mirroring their differential associations with T, solitary and dyadic sexuality were described as qualitatively different experiences by women themselves. In focus group discussions, women defined solitary sexual pleasure as oriented around autonomy and orgasm, and dyadic sexual pleasure as oriented around nurturant intimacy (among other components). These findings supported theoretical predictions that sexual contexts oriented around genital/erotic pleasure would be linked with higher T, and those oriented around nurturance would be linked with lower T. Finally, I showed that cognitive/emotional experiences predicted women’s acute T responses to visual sexual stimuli. Specifically, identification with stimuli (i.e., taking the perspective of film characters) moderated T responses to self-chosen versus researcher-chosen erotic films. Taken together, my findings highlight (a) the bidirectional and dynamic nature of T-sexuality associations and (b) the power of even subtle internal cues to shape physiology.