Abstract
IntroductionSexual desire, arousal, and orgasm are mediated by complex, yet still not fully understood, interactions of the somatic and autonomic nervous systems operating at the central and peripheral levels. Disruption of endocrine, neural, or vascular response, caused by aging, medical illness, neurological diseases, surgery, or drugs, can lead to sexual dysfunctions, thus significantly affecting patients' quality of life.PurposeThis narrative review aims at characterizing the involvement of the central nervous system in human sexual behavior.MethodsA literature search was conducted using PubMed in its entirety up to June 2018, analyzing the studies dealing with the neurobiological and neurophysiological basis of human sexuality.ResultsSexual behavior is regulated by both subcortical structures, such as the hypothalamus, brainstem, and spinal cord, and several cortical brain areas acting as an orchestra to finely adjust this primitive, complex, and versatile behavior. At the central level, dopaminergic and serotonergic systems appear to play a significant role in various factors of sexual response, although adrenergic, cholinergic, and other neuropeptide transmitter systems may contribute as well.ConclusionsProviding healthcare professionals with information concerning sexual behavior may overcome useless and sometimes dangerous barriers and improve patient management, since sexual well‐being is considered one of the most important aspects of one's quality of life.
Highlights
Sexual desire, arousal, and orgasm are mediated by complex, yet still not fully understood, interactions of the somatic and autonomic nervous systems operating at the central and peripheral levels
The study of sexuality in animals is a complex topic that could be approached from different per‐ spectives, given that it relies on the interplay between nervous, endocrine, and genetic factors
From an evolu‐ tionary point of view, this is a fundamental behavior, as it supports the interactions aimed at reproduction, which is critical for biologi‐ cal adaptation and species self‐preservation
Summary
Arousal, and orgasm are mediated by complex, yet still not fully understood, interactions of the somatic and autonomic nervous systems operating at the central and peripheral levels. Several studies pointed out dopamine (DA) as the main actor in triggering sexual motivation, suggesting that the increase of DA levels in structures belonging to the reward system would lead the behavioral shift toward hypersexuality.
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