Genital Arousal In Women Research Articles

(023) The Acute Effect of Caffeine on Genital Arousal in Women: A Pilot Study

Abstract Introduction Genital sexual arousal, a process characterized by increased vaginal lubrication and vasocongestion in females, is facilitated by moderate activation of the sympathetic nervous system (SNS) (for review, see Stanton, Handy, & Meston, 2018). Among the range of factors that impede the female genital arousal response (e.g., disrupted endocrine functioning and vascular and neurological problems), antidepressants have strikingly deleterious effects on genital arousal function that hinder quality of life (Nappi et al., 2016) and jeopardize medication adherence. When patients present with antidepressant-induced sexual side effects, physicians may switch their antidepressant or tack on an additional medication (e.g., bupropion) to counter them. While sometimes effective, this increases patients’ financial burden and often introduces a host of new side effects. Moderate activation of the SNS through exercise has shown promising results for ameliorating antidepressant-induced genital arousal dysfunction (Lorenz & Meston, 2012; 2014). Given that SNS activation prior to sex counteracts the inhibitory effect of antidepressants on genital blood flow, it is feasible that caffeine – an SNS stimulant (Biaggioni et al., 1991; Zahn et al., 1987) – could improve antidepressant-induced genital arousal difficulties if ingested prior to sex. Caffeine could serve as a low-cost, widely accessible intervention with minimal side effects if efficacy is shown. Objective The goal of the present pilot study is to examine whether the acute administration of 300mg of caffeine increases genital arousal (i.e., vaginal pulse amplitude) in women experiencing antidepressant-induced genital arousal difficulties. Methods Women attended two counterbalanced in-laboratory sessions in which they ingested either 300mg caffeine or placebo. Fifteen minutes post-ingestion, they viewed an erotic film while their heart rate and genital sexual arousal were measured. Caffeine consumption was controlled for. Results Preliminary data analyses suggest that compared to placebo, 300mg of caffeine increases vaginal pulse amplitude fifteen minutes post-ingestion among women experiencing antidepressant-induced genital arousal difficulties. Additional pilot subjects are currently being tested; results will be updated with an addendum upon completion. Conclusions If efficacy is demonstrated in our sample, caffeine may serve as a low-cost, widely accessible treatment for women experiencing antidepressant-induced genital arousal dysfunction. While we aim to target genital arousal concerns with caffeine, improvements in genital arousal are likely to positively impact other stages of women’s sexual response given the high degree of overlap between these stages. Disclosure No

037 Perceived Genital Arousal in Women with Sexual Dysfunction

037 Perceived Genital Arousal in Women with Sexual Dysfunction

Interoceptive Awareness Moderates the Relationship Between Perceived and Physiological Genital Arousal in Women

IntroductionIn general, laboratory studies have shown low correlations between subjective (ie, self-report) and physiologic (ie, vaginal pulse amplitude) measurements of sexual arousal in women. One explanation for this presumed low concordance is that women might not be attending to their genital responses and/or might be unable to accurately perceive their genital responses. AimTo examine the extent to which women can perceive their genital arousal sensations, the role that interoceptive awareness plays in this ability, and whether interoceptive awareness influences sexual concordance in women. MethodsTwenty-six sexually functional women viewed an erotic film while their physiologic and perceived genital sexual arousal levels were measured continuously. Self-report measurements of sexual function and bodily awareness also were administered. Main Outcome MeasuresPhysiologic sexual arousal was measured with a vaginal photoplethysmograph, and perception of genital arousal was measured with an arousometer. Degree of bodily awareness was measured with the Multidimensional Assessment of Interoceptive Awareness questionnaire. ResultsWomen exhibited a significant degree of agreement between physiologic and perceived genital arousal (P < .05). Interoceptive awareness was found to significantly moderate this relation (P < 0.05), such that a greater degree of interoceptive awareness facilitated greater agreement between physiologic and perceived genital arousal. Interoceptive awareness also was found to facilitate greater concordance between subjective and physiologic sexual arousal (P < .05). ConclusionWomen can perceive their genital response, and interoceptive awareness influences this ability and the relation between subjective and physiologic sexual arousal. Increasing bodily awareness could be a plausible route for treatment development.

Sexual arousal and masculinity-femininity of women.

Studies with volunteers in sexual arousal experiments suggest that women are, on average, physiologically sexually aroused to both male and female sexual stimuli. Lesbians are the exception because they tend to be more aroused to their preferred sex than the other sex, a pattern typically seen in men. A separate research line suggests that lesbians are, on average, more masculine than straight women in their nonsexual behaviors and characteristics. Hence, a common influence could affect the expression of male-typical sexual and nonsexual traits in some women. By integrating these research programs, we tested the hypothesis that male-typical sexual arousal of lesbians relates to their nonsexual masculinity. Moreover, the most masculine-behaving lesbians, in particular, could show the most male-typical sexual responses. Across combined data, Study 1 examined these patterns in women's genital arousal and self-reports of masculine and feminine behaviors. Study 2 examined these patterns with another measure of sexual arousal, pupil dilation to sexual stimuli, and with observer-rated masculinity-femininity in addition to self-reported masculinity-femininity. Although both studies confirmed that lesbians were more male-typical in their sexual arousal and nonsexual characteristics, on average, there were no indications that these 2 patterns were in any way connected. Thus, women's sexual responses and nonsexual traits might be masculinized by independent factors. (PsycINFO Database Record

Uncovering category specificity of genital sexual arousal in women: The critical role of analytic technique.

Based on analytic techniques that collapse data into a single average value, it has been reported that women lack category specificity and show genital sexual arousal to a large range of sexual stimuli including those that both match and do not match their self-reported sexual interests. These findings may be a methodological artifact of the way in which data are analyzed. This study examined whether using an analytic technique that models data over time would yield different results. Across two studies, heterosexual (N = 19) and lesbian (N = 14) women viewed erotic films featuring heterosexual, lesbian, and gay male couples, respectively, as their physiological sexual arousal was assessed with vaginal photoplethysmography. Data analysis with traditional methods comparing average genital arousal between films failed to detect specificity of genital arousal for either group. When data were analyzed with smoothing regression splines and a within-subjects approach, both heterosexual and lesbian women demonstrated different patterns of genital sexual arousal to the different types of erotic films, suggesting that sophisticated statistical techniques may be necessary to more fully understand women's genital sexual arousal response. Heterosexual women showed category-specific genital sexual arousal. Lesbian women showed higher arousal to the heterosexual film than the other films. However, within subjects, lesbian women showed significantly different arousal responses suggesting that lesbian women's genital arousal discriminates between different categories of stimuli at the individual level. Implications for the future use of vaginal photoplethysmography as a diagnostic tool of sexual preferences in clinical and forensic settings are discussed.

Assessment of female sexual arousal in forensic populations.

Sexual offenses cause significant harm to victims, their families, and society as a whole and thus are an important social concern. While it is commonly assumed that sexual offenses are committed solely by males, research has shown that approximately 5% of sex crimes in the USA and Canada are committed by females. Penile plethysmography (PPG) is a method to measure male genital arousal, which is commonly used in the assessment and treatment of male sex offenders and men with paraphilic sexual interests. Similarly, vaginal photoplethysmography (VPP) is a test to measure female genital arousal and is commonly used to assess female sexual dysfunctions. Although VPP is currently the most validated method to measure genital arousal in women, its use with female sex offenders or females with paraphilic sexual interests has been almost nonexistent. One explanation for this is that some research has suggested that female genital arousal may not be category-specific, meaning that women will respond to any sexual cues, not just those involving their preferred sexual interests. However, not all research supports this finding. Due to the potential benefits of using VPP in the assessment and treatment of female sex offenders or females with paraphilic sexual interests, it is important that further research be done before dismissing the use of VPP in forensic populations. The purpose of this article is to review the current research on VPP and its applicability to female sex offenders and females with paraphilic sexual interests.

Persistent Genital Arousal in Women With Pelvic and Genital Pain

ObjectivePersistent genital arousal disorder (PGAD) has been identified as a condition of often unprovoked genital arousal associated with a significant level of distress. PGAD is not well understood, and no definitive cause has been determined. The aim of this study was to gain a better understanding of the disorder and to seek commonalities between cases of PGAD encountered in a chronic pain management clinic. MethodWe reviewed a cohort of 15 women with PGAD who presented to a chronic non-cancer pain clinic in a large urban tertiary teaching hospital that provides pelvic and genital pain management. We conducted a series of interviews to examine medical history, history of presenting illness, and management. Descriptive statistics were used to examine the data. ResultsFindings were largely consistent with previous research on PGAD regarding symptomatology and aggravating and alleviating factors. Symptoms of genital pain, depression, and interstitial cystitis were found in over one half of the patients in this cohort. Previous antidepressant use, restless legs syndrome, and pudendal neuralgia were found in a number of cases. Pelvic varices and Tarlov cysts have been previously identified as possible contributors to PGAD, but these were not a common finding in our cohort. ConclusionFurther research is needed to build on the current understanding of PGAD. Patients should be asked about persistent arousal as part of a sexual and reproductive history, especially in the case of common comorbidities.

Gender-Specificity of Solitary and Dyadic Sexual Desire among Gynephilic and Androphilic Women and Men

Incentive motivation theory proposes that sexual desire emerges from sexual arousal, and is triggered by sexually competent stimuli. Research demonstrates gender and sexual orientation differences in the features that contribute to the competency of sexual stimuli. Men's and gynephilic women's genital arousal tends to be gender-specific with preferred gender eliciting significantly greater genital arousal than nonpreferred gender. In contrast, stimuli depicting preferred and nonpreferred gender elicit similar degrees of genital arousal among androphilic women, termed a gender-nonspecific pattern. Given these differences in the features that elicit a sexual response, and that sexual desire is proposed to emerge from sexual arousal, the question remains as to whether sexual desire would emerge only through exposure to preferred stimuli or whether patterns of responsive desire would parallel those observed for genital arousal. The study aims to examine patterns of dyadic and solitary sexual desire in response to stimuli differing in incentive value. Thirty androphilic women, 21 gynephilic women, 21 gynephilic men, and 16 androphilic men participated in a sexual psychophysiological session. Participants viewed sexual stimuli that varied the gender of the actors and the intensity of sexual activities depicted. Participants reported their degree of desire for sex with a partner (dyadic desire) and desire to masturbate (solitary desire), before and after each film. Men and gynephilic women exhibited gender-specific patterns of sexual desire. Androphilic women's dyadic desire showed significantly less differentiation between genders, and their solitary desire did not differentiate at all. No gender difference was observed for either type of desire. All groups reported greater desire as stimulus intensity increased. Gender-nonspecific sexual response is not limited to the sexual arousal patterns of androphilic women, but extends to include responsive sexual desire. Men and gynephilic women, however, show gender-specific responsive sexual desire that parallels their sexual arousal patterns.

Does Menstrual Cycle Phase Influence the Gender Specificity of Heterosexual Women’s Genital and Subjective Sexual Arousal?

Unlike men, heterosexual women's genital arousal is gender nonspecific, such that heterosexual women show relatively similar genital arousal to sexual stimuli depicting men and women but typically report greater subjective arousal to male stimuli. Based on the ovulatory-shift hypothesis-that women show a mid-cycle shift in preferences towards more masculine features during peak fertility-we predicted that heterosexual women's genital and subjective arousal would be gender specific (more arousal towards male stimuli) during peak fertility. Twenty-two naturally-cycling heterosexual women were assessed during the follicular and luteal phases of their menstrual cycle to examine the role of menstrual cycle phase in gender specificity of genital and subjective sexual arousal. Menstrual cycle phase was confirmed with salivary hormone assays; phase at the time of first testing was counterbalanced. Women's genital and subjective sexual arousal patterns were gender nonspecific, irrespective of cycle phase. Cycle phase at first testing session did not influence genital or subjective arousal in the second testing session. Similar to previous research, women's genital and subjective sexual arousal varied with cues of sexual activity, but neither genital nor subjective sexual arousal varied by gender cues, with the exception of masturbation stimuli, where women showed higher genital arousal to the stimuli depicting male compared to female actors. These data suggest that menstrual cycle phase does not influence the gender specificity of heterosexual women's genital and subjective sexual arousal.

A New Medical Treatment With Botulinum Toxin in Persistent Genital Arousal Disorder: Successful Treatment of Two Cases

Persistent genital arousal disorder is described in a spontaneous, persistent, and uncontrollable genital arousal in women, with or without orgasm or genital engorgement, unrelated to any feelings of sexual desire. This study aimed to argue that application of Botulinum toxin in the periclitoral region in order to block the dorsal nerve of the clitoris might decrease symptoms of persistent genital arousal disorder. The authors presented 2 cases, in which application of Botulinum toxin resulted in improvement of the symptoms of persistent genital arousal disorder. Botulinum toxin type A treatment protocol is seen as a promising application for the persistent genital arousal disorder. However, further controlled studies in large samples are needed.

Acute exercise improves physical sexual arousal in women taking antidepressants.

Antidepressants can impair sexual arousal. Exercise increases genital arousal in healthy women, likely due to increasing sympathetic nervous system (SNS) activity. Test if exercise increases genital arousal in women taking antidepressants, including selective serotonin reuptake inhibitors (SSRIs), which suppress SNS activity, and selective serotonin and norepinephrine reuptake inhibitors (SNRIs), which suppress the SNS less. Women reporting antidepressant-related sexual arousal problems (N = 47) participated in three counterbalanced sessions where they watched an erotic film while we recorded genital and SNS arousal. In two sessions, women exercised for 20 min, either 5 or 15 min prior to the films. During the no-exercise condition, women taking SSRIs showed significantly less genital response than women taking SNRIs. Exercise prior to sexual stimuli increased genital arousal in both groups. Women reporting greater sexual dysfunction had larger increases in genital arousal post-exercise. For women taking SSRIs, genital arousal was linked to SNS activity. Exercise may improve antidepressant-related genital arousal problems.

Evidence for a curvilinear relationship between sympathetic nervous system activation and women's physiological sexual arousal

There is increasing evidence that women's physiological sexual arousal is facilitated by moderate sympathetic nervous system (SNS) activation. Literature also suggests that the level of SNS activation may play a role in the degree to which SNS activity affects sexual arousal. We provide the first empirical examination of a possible curvilinear relationship between SNS activity and women's genital arousal using a direct measure of SNS activation in 52 sexually functional women. The relationship between heart rate variability (HRV), a specific and sensitive marker of SNS activation, and vaginal pulse amplitude (VPA), a measure of genital arousal, was analyzed. Moderate increases in SNS activity were associated with higher genital arousal, while very low or very high SNS activation was associated with lower genital arousal. These findings imply that there is an optimal level of SNS activation for women's physiological sexual arousal.

The Sensitivity of Continuous Laboratory Measures of Physiological and Subjective Sexual Arousal for Diagnosing Women with Sexual Arousal Disorder

Past findings on the diagnostic sensitivity of vaginal photoplethysmography are limited by testing among women with heterogeneous sexual dysfunctions and by the use of statistical techniques that are unable to assess how changes in subjective arousal are associated with changes in physiological arousal. The aims of this study were to: (i) test the sensitivity of vaginal photoplethysmography and continuous measures of subjective sexual arousal in differentiating between women with and without sexual arousal or orgasm dysfunction; and (ii) examine the diagnostic utility of measuring the synchrony between genital and subjective sexual responses. Sexual arousal was assessed in sexually healthy women (n = 12), women with orgasm disorder (OD; n = 12), and 38 women who met the criteria for the three subcategories of sexual arousal dysfunction described by Basson et al. (i.e., genital sexual arousal disorder [GAD; n = 9], subjective sexual arousal disorder [SAD; n = 13], and combined genital and subjective arousal disorder [CAD; n = 16]). Physiological sexual arousal was assessed using vaginal photoplethysmography, and subjective sexual arousal was measured continuously and using a Likert-scale in response to sexual videos. Women with GAD showed the lowest and women with CAD showed the highest levels of vaginal pulse amplitude response to erotic stimuli. Women with sexual arousal disorder showed significantly lower levels of subjective sexual arousal to erotic stimuli than did sexually healthy women. Relations between subjective and physiological measures of sexual arousal were significantly weaker among women with sexual arousal disorder than sexually healthy women or women with OD. Preliminary support was provided for the diagnostic utility of measuring the synchrony between subjective and genital arousal in women with sexual arousal disorder. Findings do not support the sensitivity of using vaginal photoplethysmography, or continuous or Likert-scale measures of subjective arousal for differentiating between subtypes of women with sexual arousal disorder.

New Insights into Restless Genital Syndrome: Static Mechanical Hyperesthesia and Neuropathy of the Nervus Dorsalis Clitoridis

Systematic study of dysesthetic and paresthetic regions contributing to persistent genital arousal in women with restless genital syndrome (ReGS) is needed for its clinical management. To investigate distinct localizations of ReGS. Twenty-three women, fulfilling all five criteria of persistent genital arousal disorder were included into the study. In-depth interviews, routine and hormonal investigations, electroencephalographs, and magnetic resonance imaging (MRI) of brain and pelvis were performed in all women. The localizations of genital sensations were investigated by physical examination of the ramus inferior of the pubic bone (RIPB) and by sensory testing of the skin of the genital area with a cotton swab (genital tactile mapping test or GTM test). Sensitivity of RIPB, GTM test. Of 23 women included in the study, 18(78%), 16(69%), and 12(52%) reported restless legs syndrome, overactive bladder syndrome, and urethra hypersensitivity. Intolerance of tight clothes and underwear (allodynia or hyperpathia) was reported by 19 (83%) women. All women were diagnosed with ReGS. Sitting aggravated ReGS in 20(87%) women. In all women, MRI showed pelvic varices of different degree in the vagina (91%), labia minora and/or majora (35%), and uterus (30%). Finger touch investigation of the dorsal nerve of the clitoris (DNC) along the RIPB provoked ReGS in all women. Sensory testing showed unilateral and bilateral static mechanical Hyperesthesia on various trigger points in the dermatome of the pudendal nerve, particularly in the part innervated by DNC, including pelvic bone. In three women, sensory testing induced an uninhibited orgasm during physical examination. ReGS is highly associated with pelvic varices and with sensory neuropathy of the pudendal nerve and DNC, whose symptoms are suggestive for small fiber neuropathy (SFN). Physical examination for static mechanical Hyperesthesia is a diagnostic test for ReGS and is recommended for all individuals with complaints of persistent restless genital arousal in absence of sexual desire.

Report of spontaneous and persistent genital arousal in women attending a sexual health clinic

The frequency of spontaneous genital arousal (GA) and persistent genital arousal disorder (PGAD) in women is unknown. The aim of this study was to conduct an anonymous survey to assess the frequency and nature of spontaneous GA and PGAD in women attending a walk-in sexual health clinic in London. Female patients completed a questionnaire, which included demographic information, medical, psychiatric and gynaecology history, the hospital anxiety and depression scale, and a somatization scale. Patients were then asked to complete three questions regarding spontaneous and persistent GA. Any patient with one or more symptoms then answered questions about the distress, intensity and duration of sensations. Ninety-six subjects participated. The mean age was 28.97 years. Thirty-two women (33.3%) answered 'yes' to at least one question regarding spontaneous or persistent GA and six women (6.3%) women answered 'yes' to all three questions. Only one subject fulfilled all five diagnostic criteria for PGAD. In conclusion, women report a high rate of spontaneous GA in the absence of desire or excitement. This has not been well described previously. A small proportion of women report multiple features of spontaneous and persistent GA, with chronicity over years, but without distress in most cases. Larger studies are needed.

Effects of SNS Activation on SSRI-Induced Sexual Side Effects Differ by SSRI

Selective serotonin reuptake inhibitors (SSRIs) are associated with significant sexual side effects. By definition, all SSRIs increase overall serotonin (5HT) by binding to serotonin autoreceptors (5HTIA); however, each SSRI has a unique portfolio of secondary binding properties to other neurotransmitters such as norepinephrine (NE). As 5HTIA receptors mediate NE neurotransmission, SSRIs that are highly selective for 5HTIA are more likely to reduce NE efficiency; however, in SSRIs that are less selective for 5HTIA, this could be counteracted by secondary binding to NE. Norepinephrine is the major neurotransmitter of the sympathetic nervous system (SNS), which has been shown to mediate genital arousal in women; thus, it is possible that increasing SNS activity in women taking SSRIs that are highly selective for 5HTIA may counteract sexual side effects in those women. To test this hypothesis, we conducted a reanalysis of Meston (2004)'s 8-week, double-blind, cross-over, placebo-controlled study of the effects of ephedrine (50 mg taken 1 h prior to sexual activity) on self-reported sexual functioning of women taking paroxetine (N = 5), sertraline (N = 7), or fluoxetine (N = 7). As predicted, women taking SSRIs, which are highly selective for 5HTIA (sertraline, paroxetine), showed improvement in sexual arousal and orgasm. By contrast, women taking SSRIs, which are less selective for 5HTIA relative to NE (fluoxetine), showed no change or decrease in sexual functioning. These findings have implications for treating certain SSRI-induced sexual side effects.

The Clitoral Photoplethysmograph: A New Way of Assessing Genital Arousal in Women

In the present study, we introduce clitoral photoplethysmography as an instrument to assess clitoral blood volume (CBV). In research on female sexual functioning, vaginal pulse amplitude (VPA), as measured using vaginal photoplethysmography, has been used extensively as a measure of vaginal vasocongestion. Measurement of clitoral blood flow has thus far been problematic, mainly because of methodological constraints. To demonstrate that CBV is a valuable, easy to use complementary measure for the female sexual response, offering additional information to the VPA. Thirty women with and without female sexual dysfunction (FSD) watched neutral and erotic film clips. At the end of the erotic clip, the session was interrupted to induce inhibition of the sexual response. Another neutral clip followed the interruption. VPA and CBV were measured simultaneously, as well as skin conductance levels (SCLs), to assess the amount of sympathetic activity. VPA, CBV, SCL. For both FSD and non-FSD women, VPA and CBV increased when sexually explicit material was presented. Changes in skin conductance significantly predicted changes in CBV (b = -0.61, t[27] = -3.88, P < 0.001), but not in VPA. A large increase in sympathetic activity was accompanied by a large decrease in CBV. Furthermore, a large increase in CBV at the end of the erotic film clip presentation, as compared with the neutral clip, was accompanied by a relatively small increase in VPA (b = -0.39, t[29] = -2.25, P < 0.033). CBV is a valid and sensitive tool to measure the female genital response. In the present study, it was particularly useful in investigating sexual inhibition, when used in combination with SCL. Furthermore, high CBV appeared to inhibit VPA, suggesting that VPA reflects an automatic preparatory response rather than genital arousal per se.

Genital arousal in women: Problem, Pathology or Normative Response

Interest in women's sexual functioning has increased in recent years although the primary emphasis has been on deficits in both genital and subjective sexual response. Clinically, it is not uncommon for women of all ages to present with complaints of difficulty becoming or remaining sexually aroused. While hormonal deficits or pharmacological agents are often implicated etiologically in the genital arousal and lubrication problems of peri or postmenopausal women, psychological and interpersonal factors usually play a significant role as well. Given the high prevalence of sexual complaints generally in women, and the co-morbidity of desire and arousal disorders, it is, perhaps, not surprising, that there exists a common assumption that women's genital responsivity is less reliable and robust than that of males. Recent sexual psychophysiology research suggests that this is not the case and that, in fact, women are capable of greater sexual responsiveness than previously assumed. There are also women who complain of excessive genital arousal. This condition, originally named persistent sexual arousal syndrome (PSAS) was renamed persistent genital arousal disorder (PGAD, Leiblum, 2006) because the problem appeared to be primarily one of unwanted and intrusive sensations of genital, rather than sexual, arousal. PGAD is characterized by five features: (1) involuntary genital and clitoral arousal that persists for an extended period of time; (2) persistent genital arousal that feels intrusive and unwanted; (3) persistent genital arousal that does not completely resolve following one or more orgasms; (4) persistent genital arousal that appears to be unrelated to conscious feelings of sexual desire; and (5) persistent genital arousal that is experienced as moderately distressing. In 2003, it was included as a provisional diagnosis by an international committee of experts convened to recommend revisions in the nomenclature of women's sexual dysfunctions. While there are women at either extreme of the genital arousal continuum, that is, too little or too much arousal, there is a third group of women- women who report genital arousal that appears unsolicited but which may be experienced as relatively persistent, pleasurable and nondistressing. Today's talk will review the findings of the most recent research on PGAD and non-PGAD women and will present case illustrations of the four kinds of arousal complaints in women. We will suggest that what appears to be spontaneous genital arousal in some women may be the result of either subconscious processing of sexual stimuli in the environment - stimuli that are either consciously unacceptable or not noticed- and that are negatively evaluated. This negative evaluation of genital sensations may result in heightened vigilance, increased anxiety, pelvic tension and increased sensations which reinforces the condition. Psychological interventions may be helpful in treating this problem for a subset of women without an identifiable organic basis for their complaint.

T09-P-14 Persistent genital arousal in women: about two case reports

Female sexual psychophysiology research suggests that women are capable of greater sexual responsiveness than previously thought and can experience genital response in the absence of a subjective experience of sexual arousal. There are some women who report persistent genital arousal, both with and without accompanying distress, providing an idea for dissociation between genital and psychological sexual response. In this article, the authors describe two case reports of women with unprovoked genital arousal, intrusive and troubling genital sensations that did not dissipate with one or many orgasms and persisted for many hours or days. These two women assessed at the Clinical Sexology Department of the Coimbra University Hospital had average age of about thirty years old and were married. They both described a bad relationship with their husbands, refusing to have sex because the arousal triggered by sexual activity, persist after several orgasms in unpleasant way.

Sex Differences in Patterns of Genital Sexual Arousal: Measurement Artifacts or True Phenomena?

Sex differences in patterns of sexual arousal have been reported recently. Men's genital arousal is typically more category-specific than women's, such that men experience their greatest genital arousal to stimuli depicting their preferred sex partners whereas women experience significant genital arousal to stimuli depicting both their preferred and non-preferred sex partners. In addition, men's genital and subjective sexual arousal patterns are more concordant than women's: The correlation between genital and subjective sexual arousal is much larger in men than in women. These sex differences could be due to low response-specificity in the measurement of genital arousal in women. The most commonly used measure of female sexual arousal, vaginal photoplethysmography, has not been fully validated and may not measure sexual arousal specifically. A total of 20 men and 20 women were presented with various sexual and non-sexual emotionally laden short film clips while their genital and subjective sexual arousal were measured. Results suggest that vaginal photoplethysmography is a measure of sexual arousal exclusively. Women's genital responses were highest during sexual stimuli and absent during all non-sexual stimuli. Sex differences in degree of category-specificity and concordance were replicated: Men's genital responses were more category-specific than women's and men's genital and subjective sexual arousal were more strongly correlated than women's. The results from the current study support the continued use of vaginal photoplethysmography in investigating sex differences in patterns of sexual arousal.