Subjective Sexual Arousal In Women Research Articles

Understanding Women's Subjective Sexual Arousal Within the Laboratory: Definition, Measurement, and Manipulation.

Subjective sexual arousal (SSA) is positive, cognitive engagement in sexual activity. SSA is considered an important aspect of the sexual experience, as it has been found to facilitate sexual activity and, in situations of chronically low or absent arousal, potentially cause distress. Despite the clinical implications of SSA, a thorough review of how to manipulate SSA has yet to be conducted. To review the state of knowledge about SSA in women, including its definition, measurement, and the outcomes of studies attempting to manipulate SSA within a laboratory setting. A comprehensive search of the electronic databases of PubMed and PsycINFO was conducted. The generated list of articles was reviewed and duplicates were removed. Individual articles were assessed for inclusion and, when appropriate, relevant content was extracted. The potential effects of various manipulations of SSA in a laboratory setting was the main outcome. 44 studies were included in this review. Manipulations were grouped into 3 primary categories: pharmacological (n= 16), cognitive (n= 22), and those based on changes to the autonomic nervous system (n= 6). Results suggest that cognitive manipulation is the most effective method of increasing SSA. Altering the relative balance of the 2 branches of the autonomic nervous system (the sympathetic nervous system and the parasympathetic nervous system) also appears to be a promising avenue for increasing SSA. This review supports the use of cognitive manipulation for increasing women's SSA in a laboratory setting. Avenues for future research and recommendations for clinicians are discussed. Handy AB, Stanton AM, Meston CM. Understanding Women's Subjective Sexual Arousal Within the Laboratory: Definition, Measurement, and Manipulation. Sex Med Rev 2018;6:201-216.

A Single Session of Autogenic Training Increases Acute Subjective and Physiological Sexual Arousal in Sexually Functional Women

Heart rate variability (HRV) has recently been associated with female sexual function (Stanton, Lorenz, Pulverman, & Meston, 2015). Below-average HRV was identified as a possible risk factor for sexual arousal dysfunction and overall sexual dysfunction in women. Based on this newly established relationship between HRV and female sexual function, the present study examined the effect of autogenic training to increase HRV on acute physiological and subjective sexual arousal in women. Specifically, vaginal pulse amplitude (VPA), an index of genital sexual arousal, and subjective sexual arousal were assessed in 33 sexually functional women, aged 18 to 27, before and after a short session of autogenic training. Autogenic training, a relaxation technique that restores the balance between the activity of the sympathetic and the parasympathetic branches of the autonomic nervous system, has been shown to significantly increase HRV (Miu, Heilman, & Miclea, 2009). After autogenic training, significant increases in both VPA (p <.05) and subjective sexual arousal (p <.005) were observed. Moreover, change in HRV from pre- to postmanipulation significantly moderated changes in subjective sexual arousal (p <.05) when it was measured continuously during the presentation of the erotic stimulus. This cost-effective, easy-to-administer behavioral intervention may have important implications for increasing sexual arousal in women.

Investigating Female Sexual Concordance: Do Sexual Excitation and Sexual Inhibition Moderate the Agreement of Genital and Subjective Sexual Arousal in Women?

The agreement of subjective and genital sexual response, also referred to as sexual concordance, shows substantial variability between women. Identifying predictors of sexual arousal and sexual concordance is important to improve our understanding of female sexual response and its relationship to sexual function or dysfunction. The aim of this study was to assess the relevance of sexual excitation and sexual inhibition as predictors of subjective sexual arousal, genital arousal, and sexual concordance. In a laboratory setting, sexual arousal was induced by erotic video stimuli. Subjective sexual arousal was assessed continuously during stimulus presentation and genital arousal was measured with vaginal photoplethysmography. Data of 58 women (Mage=24.95, SD=4.65) were analyzed using multilevel analyses (HLM). This data analytic technique estimates the within-subject associations of subjective and genital arousal, by controlling for between-subject differences. An interaction term of sexual excitation and sexual inhibition significantly predicted genital sexual arousal. In exploratory analyses, two lower order factors of sexual inhibition (Concerns about Sexual Function and Arousal Contingency) were predictive of sexual concordance. Further examination of these associations might increase our knowledge of female sexual function and deepen our understanding of how sexual excitation and sexual inhibition affect sexual arousal and consequently, impact sexual behaviors, in women.

Affective and cognitive determinants of women's sexual response to erotica.

The specific cognitive-affective mechanisms involved in the activation and regulation of the subjective and genital components of sexual arousal are not fully understood yet. The aim of the present study was to investigate the contribution of self-reported thoughts and affect to the prediction of women's subjective and genital responses to erotica. Twenty-eight sexually functional women (mean age = 32, SD = 6.29) were presented with sexually explicit and nonexplicit romantic films. Genital responses, subjective sexual arousal, state affect, and self-reported thoughts were assessed. Vaginal pulse amplitude was measured using a vaginal photoplethysmograph. Subjective sexual arousal, thoughts, and affective responses were assessed through self-report scales. Correlations between subjective and physiological sexual arousal were low (r = -0.05, P > 0.05). Self-reported thoughts and affect were significant predictors of subjective sexual arousal. The strongest single predictor of subjective arousal was sexual arousal thoughts (e.g., "I'm getting excited") (β = 0.63, P < 0.01). None of the cognitive or affective variables predicted women's genital responses. Overall, results support the role of cognitive (self-reported thoughts) and affective dimensions in women's subjective sexual arousal to erotica and, consistent with previous findings, suggest that subjective and physiological sexual arousal may be impacted by different processes.

Sexual Arousal in Women with Provoked Vestibulodynia: The Application of Laser Doppler Imaging to Sexual Pain

Introduction. Women with provoked vestibulodynia (PVD) report lower sexual arousal than nonaffected women, however, laboratory studies of arousal have reported contradictory results about whether group differences exist in genital and subjective arousal. Aim. To examine genital and subjective sexual arousal in women with and without PVD. Methods. Eligible women with and without PVD (N = 42) attended a laboratory session that included an interview, questionnaire completion, and genital imaging. A direct measure of superficial blood flow-laser Doppler imaging-was used to assess vulvar blood flow levels while participants watched three films, including an erotic film. Participants answered questions about their level of sexual arousal before, during, and after the erotic film. Main Outcome Measures. Average vulvar blood flow levels during the baseline and erotic films, numerical ratings of subjective sexual arousal and anxiety, as well as questionnaire measures of arousal. Results. There was a significant group difference in genital arousal, whereby the PVD group showed a lower genital response to the erotic film, as well as a significant interaction between baseline blood flow and group membership. Separate group regression analyses demonstrated that baseline blood flow explained a substantial amount of the variance in erotic film blood flow in the control group (70%), while only 27% was explained by this variable in the PVD group. There were no differences in subjective sexual arousal or anxiety between the groups. Across questionnaire measures, women with PVD reported lower sexual arousal than the control group. Conclusions. The results suggest that women with PVD show lower genital responsiveness than nonaffected women to sexual stimuli in a laboratory setting and that their genital arousal is likely impacted by a number of biopsychosocial factors. Boyer SC, Pukall CF, and Chamberlain SM. Sexual arousal in women with provoked vestibulodynia: The application of laser Doppler imaging to sexual pain. J Sex Med **;**:**-**.

The Effects of Experimentally-Induced Sad and Happy Mood on Sexual Arousal in Sexually Healthy Women

In depressed women, common sexual difficulties include decreased sexual desire, sexual arousal and orgasmic difficulties, reduced sexual satisfaction, and reduced sexual pleasure. Experimental research on the influence of depressed mood on genital and subjective sexual arousal in women is scarce. To investigate the effects of sad mood on genital and subjective sexual arousal in sexually healthy women, using a mood induction procedure. Thirty-two subjects received a sad mood and a happy mood induction, on two different days, using a within subjects design. The mood induction procedure was a combination of the Velten procedure and music. In the Velten procedure, the subject is asked to read sad or happy self-referent sentences and to experience the mood suggested by these sentences. Immediately following mood induction, the subjects were exposed to an erotic film clip. Genital arousal was assessed using vaginal photoplethysmography. Self-report ratings of sad and happy mood, subjective sexual arousal and affective reactions were collected before and after the erotic clip. The sad and happy mood ratings indicated that the mood inductions affected mood as intended. No difference in genital sexual arousal was found between the sad and happy mood conditions. Subjects reported significantly less subjective sexual arousal and positive affect and marginally significant fewer genital sensations and more negative affect in the sad mood condition than in the happy mood condition. The results provide empirical support for the idea that mood can impact on subjective sexual arousal in women.

CS05-04 - Reconsidering the definitions of sexual disorders in DSM-V

The research of neurobiology and treatment of various disorders requires certain degree of homogeneity of the studied entities. In an ideal word, common etiology and/or pathogenesis would help to define homogenous entities. As our understanding of etiology and/or pathogenesis of mental disorders and diseases is lacking, we rely on various diagnostic systems to help us reach some degree of homogeneity.The diagnostic criteria of sexual dysfunction(s) in the DSM-IV are rather vague and imprecise. Interestingly, we are not even clear when a sexual problem becomes a sexual dysfunction. As the new versions of the diagnostic systems (e.g., DSM-V) are being prepared, the classification and definitions of sexual disorders/dysfunctions are being considered.The general classification issues that need to be and are addressed are specific duration of sexual dysfunctions, use of distress s a diagnostic criterion and quantification of severity and frequency. Strengthening and clarifying these three classification issues would probably help in defining more homogenous entities.The broader yet more specific issues to be considered are inclusions of new diagnostic entities (persistent genital arousal disorder in women; adjustment disorder with disturbed sexual functioning; coercive paraphilic disorder), possible removal or reclassification of some sexual dysfunctions (e.g., sexual aversion disorder - remove or reclassify as specific phobia); collapsing some entities into one (dyspareunia and vaginismus into genitor-pelvic pain/penetration disorder) changing the names of some dysfunctions (premature ejaculation to rapid ejaculation); and redefining some dysfunctions (e.g. sexual desire and subjective sexual arousal in women).

Psychophysiological Sexual Arousal in Women with a History of Child Sexual Abuse

On the basis of literature that suggests that child sexual abuse (CSA) survivors with post traumatic stress disorder (PTSD) have higher baseline sympathetic nervous system (SNS) activity than healthy controls and research that suggests that the SNS plays a critical role in female physiological sexual arousal, we examined the impact of SNS activation through intense exercise on sexual arousal in women with CSA and PTSD. We measured physiological and subjective sexual arousal in women with CSA (n = 8), women with CSA and PTSD (n = 10), and healthy controls (n = 10) during exposure to nonerotic and erotic videos. After exercise, women with CSA and women with CSA and PTSD showed no significant differences in the physiological sexual response compared with no exercise, which was different from the increased physiological sexual response after exercise observed in control women.

ORIGINAL RESEARCH—WOMEN'S SEXUAL DYSFUNCTIONS: Assessment and Management of Women's Sexual Dysfunctions: Problematic Desire and Arousal

ABSTRACT Introduction Women frequently report low sexual desire or interest. An associated lack of subjective arousal during sexual activity is clinically highly apparent but has not been the focus of traditional sexual inquiry, definitions of dysfunction, or management. The frequent poor correlation of women's subjective sexual arousal and observable increases in genital congestion in response to sexual stimulation has not been reflected in assessment, diagnosis, or management. Aim To provide recommendations/guidelines for the assessment and management of women's sexual dysfunctions focusing on low desire, low interest, and lack of arousal. Methods An international consultation, in collaboration with major sexual medicine associations, assembled over 200 multidisciplinary experts from 60 countries into 17 committees. One subcommittee of five members focused on women's sexual desire and arousal, developing over a 2-year period various recommendations. Main Outcome Measure Expert opinion was based on grading of evidence-based scientific literature, widespread internal committee discussion, public presentation, and debate. Results Women's sexual response in health can be reconceptualized as a circular model of overlapping phases of variable order influenced by psychological, societal, and biological factors. Subsequent revisions to definitions of arousal and desire disorder are given. Recommendations regarding assessment and management focus on factors reducing arousability and satisfaction. These include women's mental health and feelings for their partner, generally and at the time of sexual activity. Recommendations reflect the poor correlation of subjective arousal and increases in genital vasocongestion. Conclusion Further outcome research of management based on new conceptualization of sexual response and revised definitions of dysfunction is needed. The basis of the variable correlation between genital vasocongestion and subjective arousal needs clarification as do the biological underpinnings of sexual response and their changes with age and life cycle.

The relationship between women's subjective and physiological sexual arousal

Previous literature presents discordant results on the relationship between physiological and subjective sexual arousal in women. In this study, the use of hierarchical linear modeling (HLM) revealed a significant concordance between continuous measures of physiological and subjective sexual arousal as assessed during exposure to erotic stimuli in a laboratory setting. We propose that past studies that have found little or no association between the two measures may have been in part limited by the methodology and statistical analyses employed.

Review: Female sexual dysfunctions — the new models

A new model of women's sexual response reflects their various motivations to be sexual and the fact that psychological and biological factors strongly influence their arousability. Examples of factors stemming from diabetes are included. To increase emotional intimacy with their partner, women will deliberately find or be receptive to sexual stimuli that can potentially be sexually arousing. Only later do they sense specifically sexual need to continue for the sake of sexual sensations, sexual tension and possible orgasmic release. A model of women's subjective sexual arousal reflects the ongoing modulation from her emotions and cognitions as well as highly variable genital feedback.

Habituation of female sexual arousal to slides and film

The habituation of genital and subjective sexual arousal in women was assessed. In a first experiment 32 women were randomly assigned to either a constant stimulus condition in which subjects were exposed to the same erotic slide on repeated trials within one session, or to a varied stimuli condition in which subjects were exposed to various erotic slides. A second experiment assessed habituation of sexual responses of 42 women to erotic film excerpts. In both experiments repeated erotic stimulation was followed by a novel erotic stimulus to study the effect of novel stimulation to a sequence of uniform stimulation. In the first experiment a floor effect was found in response to the first three trials that prevented a valid interpretation of responding on subsequent trials. We conclude that slides yield too little sexual arousal in female subjects. In the second experiment only a slight decline in genital responding was observed. Women sustained considerable levels of genital arousal even after 21 trials of uniform stimulation. Facial EMG was used as a physiological marker of emotional experience. Zygomatic activity decreased over trials, suggesting decreasing positive affect as a result of uniform stimulation. Results are discussed in the context of selective attention, characteristics of the habituation stimulus, and novelty.

The effects of sympathetic activation on physiological and subjective sexual arousal in women

This investigation was designed to examine the effects of acute exercise on physiological and subjective sexual arousal in women. In Experiment 1, Ss participated in two experimental sessions in which they viewed a neutral film followed by an erotic film. In one of these sessions, Ss were exposed to 20 min of intense exercise prior to viewing the films. Subjective sexual arousal was measured with a self-report rating scale and physiological sexual arousal was measured with a vaginal photoplethysmograph. Acute exercise significantly decreased vaginal pulse amplitude responses to a neutral stimulus and significantly increased vaginal pulse amplitude responses to an erotic stimulus. Exercise marginally increased vaginal blood volume responses to an erotic film but had no significant effect on subjective perceptions of sexual arousal. In Experiment 2, Ss viewed two consecutive neutral stimuli preceded by 20 min of intense exercise. There were no significant differences in either vaginal blood volume or vaginal pulse amplitude between the two neutral films. Together, the data from Experiments 1 and 2 provide indirect support for a facilitatory role of sympathetic activation in female sexual arousal.