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Influence of PDE5 inhibitor on MRI measurement of clitoral volume response in women with FSAD: a feasibility study of a potential technique for evaluating drug response

Abstract

The purpose of this study was to determine if magnetic resonance imaging (MRI) could quantify a difference in clitoral response following administration of a vasoactive medication, in 12 women with female sexual arousal disorder (FSAD). Subjects were entered into a double-blind, randomized two-way crossover study of sildenafil 50 mg vs placebo administered 1 h prior to genital MRI. Each subject underwent two MR studies, performed while subjects viewed alternating segments of nonerotic and erotic video. MR images were analyzed for change in clitoral volume during each session. The mean change in clitoral volume for the entire group was higher in the sildenafil MRI session (1282 mm3) compared with placebo (849 mm3) but did not reach statistical significance (P=0.064). Comparison using analysis of variance between the two sessions for each individual subject revealed a significant increase in clitoral volume following sildenafil compared with placebo in 6 of 12 subjects, no significant change in either imaging session in three subjects and in three subjects, there was a robust clitoral response in both MR sessions. In conclusion, MR measurements of clitoral volume can provide an objective measure of engorgement change following a vasoactive medication in women with FSAD.

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References

  1. Kaneko S, Bradley WE . Evaluation of erectile dysfunction with continuous monitoring of penile rigidity. J Urol 1986; 136: 1026–1029.

    Article  CAS  Google Scholar 

  2. Goldstein I, Berman JR . Vasculogenic female sexual dysfunction: vaginal engorgement and clitoral erectile insufficiency syndromes. Int J Impot Res 1998; 10 (Suppl 2): S84–S90.

    PubMed  Google Scholar 

  3. Heiman JR, Rowland DL, Hatch JP, Gladue BA . Psychophysiological and endocrine responses to sexual arousal in women. Arch Sex Behav 1991; 20: 171–186.

    Article  CAS  Google Scholar 

  4. Henson DE, Rubin HB, Henson C . Consistency of the labial temperature change measure of human female eroticism. Behav Res Ther 1978; 16: 125–129.

    Article  CAS  Google Scholar 

  5. Yilmaz U, Kromm BG, Yang CC . Evaluation of autonomic innervation of the clitoris and bulb. J Urol 2004; 172 (5 Part 1): 1930–1934.

    Article  Google Scholar 

  6. Masters W, Johnson VE . Human Sexual Response. Little, Brown and Company: Boston, 1966.

    Google Scholar 

  7. Basson R, Berman J, Burnett A, Derogatis L, Ferguson D, Fourcroy J et al. Report of the International Consensus Development Conference on Female Sexual Dysfunction: definitions and classifications. J Urol 2000; 163: 888–893.

    Article  CAS  Google Scholar 

  8. Maravilla KR, Cao Y, Heiman JR, Garland PA, Peterson BT, Carter WO et al. Serial MR imaging with MS-325 for evaluating female sexual arousal response: determination of intrasubject reproducibility. J Magn Reson Imaging 2003; 18: 216–224.

    Article  Google Scholar 

  9. Maravilla KR, Cao Y, Heiman JR, Yang CC, Garland PA, Peterson BT et al. Noncontrast dynamic magnetic resonance imaging for quantitative assessment of female sexual arousal. J Urol 2004; 173: 162–166.

    Article  Google Scholar 

  10. Basson R, McInnes R, Smith MD, Hodgson G, Koppiker N . Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with female sexual arousal disorder. J Womens Health Gend Based Med 2002; 11: 367–377.

    Article  Google Scholar 

  11. Suh DD, Yang CC, Cao Y, Heiman JR, Garland PA, Maravilla KR . MRI of female genital and pelvic organs during sexual arousal. J Psychosom Obstet Gynaecol 2004; 25: 153–162.

    Article  CAS  Google Scholar 

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Acknowledgements

Research support for this study was provided by Pfizer Inc.

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Correspondence to K R Maravilla.

Appendix 1. Subjective self-assessment questionnaire of sexual arousal

Appendix 1. Subjective self-assessment questionnaire of sexual arousal

Instructions: Please use the following to evaluate how you felt before or after the tape/film. Please answer honestly and carefully. On the scale, circle any of the numbers from 1 (not at all) to 7 (intensely).Table A1

Table 1 Table a1

(Values from the three questions were averaged to a single arousal score for analysis).

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Yang, C., Cao, Y., Guan, Q. et al. Influence of PDE5 inhibitor on MRI measurement of clitoral volume response in women with FSAD: a feasibility study of a potential technique for evaluating drug response. Int J Impot Res 20, 105–110 (2008). https://doi.org/10.1038/sj.ijir.3901625

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