Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Physiology of female sexual function and dysfunction

Abstract

Female sexual dysfunction is age-related, progressive, and highly prevalent, affecting 30–50% of American women. While there are emotional and relational elements to female sexual function and response, female sexual dysfunction can occur secondary to medical problems and have an organic basis. This paper addresses anatomy and physiology of normal female sexual function as well as the pathophysiology of female sexual dysfunction. Although the female sexual response is inherently difficult to evaluate in the clinical setting, a variety of instruments have been developed for assessing subjective measures of sexual arousal and function. Objective measurements used in conjunction with the subjective assessment help diagnose potential physiologic/organic abnormalities. Therapeutic options for the treatment of female sexual dysfunction, including hormonal, and pharmacological, are also addressed.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

References

  1. Laumann E, Paik A, Rosen R . Sexual dysfunction in the United States prevalence and predictors. JAMA 1999; 281: 537–544.

    Article  CAS  PubMed  Google Scholar 

  2. Spector IP, Carey MP . Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature. Arch Sex Behav 1990; 19: 389–408.

    Article  CAS  PubMed  Google Scholar 

  3. Sarrel PM . Ovarian hormones and vaginal blood flow: using laser Doppler velocimetry to measure effects in a clinical trial of post-menopausal women. Int J Impot Res 1998; 10 (Suppl 2): S91–S93; discussion S98–S101.

    PubMed  Google Scholar 

  4. Basson R et al. Report on the international consensus development conference of female sexual dysfunction: definitions and classifications. J Urol 2000; 163: 888–893.

    Article  CAS  PubMed  Google Scholar 

  5. Masters EH, Johnson VE . Human Sexual Response. Little Brown & Co.: Boston, 1966.

    Google Scholar 

  6. Kaplan HS . The New Sex Therapy. Bailliere Tindall: London, 1974.

    Google Scholar 

  7. Graziottin A . Libido. In: John S (ed). Yearbook of the Royal College of Obstetricians and Gynaecologists. RCOG Press-Parthenon Publishing Group, 1996, pp 235–243.

    Google Scholar 

  8. Levin RJ . The physiology of sexual function in women. Clin Obstet Gynecol 1981; 7: 213.

    Google Scholar 

  9. Park K et al. Sildenafil inhibits phosphodiesterase type 5 in human clitoral corpus cavernosum smooth muscle. Biochem Biophys Res Commun 1998; 249: 612–617.

    Article  CAS  PubMed  Google Scholar 

  10. Rosen RC, Phillips NA, Gendrano N . Oral phentolamine and female sexual arousal disorder: A pilot study. J Sex Marital Ther 1999; 25: 137–144.

    Article  CAS  PubMed  Google Scholar 

  11. Hoyle CH et al. Innervation of vasculature and microvasculature of human vagina by NOS and neuropeptide-containing nerves. J Anat 1996; 188: 633–644.

    PubMed  PubMed Central  Google Scholar 

  12. Hsueh WA . Sexual dysfunction with aging and systemic hypertension. Am J Cardiol 1998; 61: 18H–123H.

    Article  Google Scholar 

  13. Traish AM et al. Development of human and rabbit vaginal smooth muscle cell cultures: Effects of vasoactive agents on intracellular levels of cyclic nucleotides. Mol Cell Biol Res Commun 1999; 2: 131–137.

    Article  CAS  PubMed  Google Scholar 

  14. Helm G, Ottesen B, Fahrenkrug J . Vasoactive intestinal polypeptide in the human female reproductive tract: distribution and motor effects. Biol Reprod 1981; 25: 227–234.

    Article  CAS  PubMed  Google Scholar 

  15. Shen WW, Urosevich Z, Clayton DO . Sildenafil in the treatment of female sexual dysfunction induced by selective serotonin reuptake inhibitors. J Reprod Med 1999; 44: 535–542.

    CAS  PubMed  Google Scholar 

  16. Sherwin BB, Gelfand MM, Brender W . Androgen enhances sexual motivation in females: a prospective, crossover study of sex steroid administration in the surgical postmenopausal. Psychosom Med 1985; 47: 339–345.

    Article  CAS  PubMed  Google Scholar 

  17. O'Connell HE, Hutson FM, Anderson CR, Plenter RJ . Anatomical relationship between urethra and clitoris. J Urol 1998; 159: 1892.

    Article  CAS  PubMed  Google Scholar 

  18. Davis SR . Androgens and female sexuality. J Gender Specific Med 2000; 3: 36–40.

    CAS  Google Scholar 

  19. Tarcan T et al. Histomorphometric analysis of age-related structural changes in human clitoral cavernosal tissue. J Urol 1999; 161: 940–944.

    Article  CAS  PubMed  Google Scholar 

  20. Sarrell PM . Sexuality and menopause. Obstet and Gynecol 1990; 75: 26s.

    Article  Google Scholar 

  21. Goldstein I, Berman J . Vasculogenic female sexual dysfunction. Int J Impot Res 1998; 10: 84.

    Google Scholar 

  22. Traish AM et al. Development of human and rabbit vaginal smooth muscle cell cultures: effects of vasoactive agents on intracellular levels of cyclic nucleotides. Mol Cell Biol Res Commun 1999; 2: 131–137.

    Article  CAS  PubMed  Google Scholar 

  23. Sjoberg I . The vagina: morphological, functional and etiological aspects. Acta Obstet Gynecologic Scand 1992; 71: 84.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J R Berman.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Berman, J. Physiology of female sexual function and dysfunction. Int J Impot Res 17 (Suppl 1), S44–S51 (2005). https://doi.org/10.1038/sj.ijir.3901428

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901428

Keywords

  • female sexual dysfunction
  • anatomy
  • physiology
  • pathophysiology
  • evaluation
  • treatment

This article is cited by

Search

Quick links