Sexual arousal is an important factor for the success of sexual behavior, and regulated by the central nervous system, its underlying mechanism is very complicated. Androgen is the most important endocrine hormone in men, which is deeply involved in the whole process of male sexual response, but how it regulates male sexual arousal has not been fully clarified and remains one of the hotspots in current andrological research. Therefore, this paper presents an overview of the advances in the studies of the related role and mechanism of androgen in male sexual arousal. In the central nervous system, androgen regulates the release of dopamine neurotransmitters by binding androgen receptors or metabolizing neurosteroids, thus activating the brain reward system. Besides, androgen regulates the neuronal plasticity and spinous process formation in the neural circuit of sexual arousal to ensure successful activation and conduction of the neural circuit. However, the specific regulating mechanism of sexual arousal remains to be further explored.
Androgens ; Humans ; Male ; Sexual Arousal

OBJECTIVE: To evaluate female sexual function after colpoperineoplasty. METHODS: Women who visited regional clinic for colpoperineoplasty from June. 2004-Aug. 2004. filled in FSFI (The Female Sexual Function Index) questionnarie before and 4 months after surgery. Six weeks after surgery, they start pelvic muscle training with HMT 2000 (Korea, electric stimulator). RESULTS: Frequency of coitus, sexual desire, arousal, lubrication and orgasm was increased after colpoperineoplasty. Percentage of patients who had coitus more than once a week increased from 18% to 63%. In sexual desire, about 18% felt sexual arousal more than or about half the time before surgery, but increased to 45% after surgery. In sexual arousal, percentage of who felt sexually aroused during more than half of sexual activity increased from 34% before surgery to 69% after surgery. In Lubrication, percentage of who became lubricated during more than half of sexual activity increased from 44% before surgery to 82% after surgery. Who reached orgasm more than half of sexual activity increased from 29% before surgery to 70%. CONCLUSION: Colpoperineoplasty increased female sexual activity.
Arousal ; Coitus ; Female* ; Humans ; Lubrication ; Orgasm ; Sexual Behavior

Sexual behavior is crucial in life, yet comparatively little is known about the mechanisms in the sexual response in humans. A lot of theories and models have been developed to explain about the process of the sexual response in humans. The first model of sexual function was described by Masters and Johnson, defined the four-phase model (phases of excitation, plateau, orgasm and resolution). Helen Kaplan proposed a slightly different model of human sexual response by adding the conception of the desire phase. Some years later, a new model of circular sexual response pattern was described by Whipple and Brash-McGreer, who acknowledged the cyclic nature of women's sexual response. Basson presented an alternative model of women's normative sexual function, which featured a responsive form of desire in women's sexual response. Bancroft developed a new theoretical model, the Dual Control Model, which postulates sexual response and arousal is ultimately determined by the balance between the sexual activation or excitation system and the sexual inhibition system. The Sexual Tipping Point is a model created by Perelman, suggesting that a sexual response is determined by a balance between excitatory or inhibitory factors that may be psychological, organic, psychosocial, or cultural. A comprehensive understanding of sexual response and function is of paramount importance for the psychiatrist to study sex, offer counseling to the patient on sex, and practice sex therapy. In this literature, models of sexual response would be reviewed to understand the knowledge of the sexual functioning in humans.
Arousal ; Counseling ; Fertilization ; Humans* ; Models, Theoretical ; Orgasm ; Psychiatry ; Sexual Behavior ; Sexuality

Purpose: Female sexual dysfunction is defined as a disorder of sexual desire, arousal, or orgasm, and/or sexual pain, resulting in personal distress that impacts on the quality of life and interpersonal relationships. It is a compilation of problems that has both biological and psychosocial components and is multifactorial in its etiology. In this study, the female sexual dysfunction in overactive bladder (OAB) patients was evaluated. Materials and Methods: The subjects included 63 female who visited our health care center for health medical examinations without voiding symptoms (control group) and 37 female patients with OAB. All patients were asked to complete the Brief index of sexual functioning for women (BISF-W), which had been translated into Korean. The Beck depression inventory (BDI) and State-Trait anxiety inventory (STAI) were also used to assess the relationship between the sexual dysfunction and anxiety or depression. The results were analyzed statistically by ANCOVA using age as a covariant. Results: The mean ages in the OAB and control groups were 35.47+/-6.76 and 42.70+/-9.68 years, respectively. The mean scores of desire in the OAB and control groups were 3.92+/-3.09 and 8.92+/-4.99, for arousal were 6.78+/-3.85 and 11.06+/-5.60, frequency of sexual activity 3.92+/-5.24 and 8.53+/-4.52, receptivity/initiation 10.08+/-3.71 and 11.47+/-4.91, orgasm 13.19+/-6.97 and 19.72+/-7.36, relationship satisfaction 7.12+/-1.68 and 7.11+/-1.88 and physical problems affecting sexual function 12.14+/-6.17, 11.83+/-5.05, respectively. The OAB group shows decreased sexual desire, arousal, frequency of sexual activity and orgasm compared to the control group (p<0.05). However, there were no differences in anxiety or depression between the two groups and there was no sexual dysfunction due to anxiety or depression in either group. Conclusions: Female sexual dysfunction was more common in OAB patients than the controls. OAB is one of the important factor affecting female sexual dysfunction. Consideration should be given with regard to female sexual dysfunction in patients with OAB.
Anxiety ; Arousal ; Delivery of Health Care ; Depression ; Female* ; Humans ; Orgasm ; Quality of Life ; Sexual Behavior ; Sexuality ; Urinary Bladder ; Urinary Bladder, Overactive*

In female sexual dysfunction (FSD), psychological and contextual factors significantly influence organic components of sexual response and behavior. The hormonal environment also affects FSD. Therefore, a tailored medical approach to each individual's sexual symptom is inevitable. This paper reviews currently available pharmacological treatment of FSD including the most recent advances and future targets in pharmacotherapy. In hormonal therapies for FSD, efficacy of estrogens and androgens on the treatment of vaginal atrophy, low sexual desire, and small subsets of genital arousal disorder, respectively, have been demonstrated. However, we need more data regarding long-term safety. There are two non-hormonal agents approved by the US Food and Drug Administration. Flibanserin has shown marginal benefit over placebo for the treatment of hypoactive sexual desire disorder. Ospemifen has shown beneficial effect on vulvovaginal pain from hormone related atrophy although it requires a longer period data to assess safety in other female genital organs, such as uterus and ovaries. Controversies still remain regarding hormonal therapies for FSD. Besides, some of the developing drugs still require more reliable safety and efficacy data. However, pharmacologic treatment of FSD is a promising field yet to be explored.
Androgens ; Arousal ; Atrophy ; Drug Therapy ; Estrogens ; Female* ; Genitalia, Female ; Humans ; Ovary ; Sexual Dysfunctions, Psychological ; United States Food and Drug Administration ; Uterus

During the past 10 years, there have been many studies in the field of female sexual function and dysfunction. Studies of genital hemodynamic-related sexual arousal, contractility of the genital tissue, and the effects of sex steroid hormones on sexual function are increasing our understanding of female sexual function and dysfunction, and also are fundamental to the pharmacotherapy of female sexual dysfunction. On the basis of the clinical studies, testosterone is a strongly recommended treatment for women with sexual desire disorder with androgen deficiency. Female sexual arousal disorder with defects in genital hemodynamics is considered as a candidate for drugs that increase genital blood flow, including phentolamine, phosphodiesterase type 5 inhibitors, apomorphine, prostaglandine E1, and VIP derivates. Although many drugs have bee tested in the clinical treatment of sexual symptoms the results of clinical trials with these drugs have not been consistent. Women are largely affected in the initiation of sexual desire and in the process of sexual arousal by psychodynamics like mood or intimacy. However, some of the drugs which have shown inconsistent effects may still offer the promise of significantly improving sexual symptoms, and certainly offer treatment options that go beyond psychological treatment, which has been the only treatment available for many decades. In this review, I will summarize several drugs that have been tried clinically or could be applied theoretically.
Apomorphine ; Arousal ; Bees ; Drug Therapy ; Female* ; Gonadal Steroid Hormones ; Hemodynamics ; Humans ; Phentolamine ; Phosphodiesterase 5 Inhibitors ; Sexual Dysfunctions, Psychological ; Testosterone

Sexual dysfunction affects both men and women, involving organic disorders, psychological problems, or both. Overall, the state of our knowledge is less advanced regarding female sexual physiology in comparison with male sexual function. Female sexual dysfunction has received little clinical and basic research attention and remains a largely untapped field in medicine. The epidemiology of female sexual dysfunction is poorly understood because relatively few studies have been done in community settings. In the United States, female sexual dysfunction has been estimated to affect 40% of women in the general population. Among the elderly, however, it has been reported that up to 87% of women complain of sexual dissatisfaction. Several studies have shown that the prevalence of female sexual arousal disorders correlates significantly with increasing age. These studies have shown that sexual arousal and frequency of coitus in the female decreases with increasing age. The pathophysiology of female sexual dysfunction appears more complex than that of males, involving multidimensional hormonal, neurological, vascular, psychological, and interpersonal aspects. Organic female sexual disorders may include a wide variety of vascular, neural, or neurovascular factors that lead to problems with libido, lubrication, and orgasm. However, the precise etiology and mechanistic pathways of age-related female sexual arousal disorders are yet to be determined. In the past two decades, some advances have been made in exploring the basic hemodynamics and neuroregulation of female sexual function and dysfunction in both animal models and in human studies. In this review, we summarize neural regulation of sexual function and neurological causes of sexual dysfunction in women.
Aged ; Arousal ; Clitoris ; Coitus ; Epidemiology ; Female ; Hemodynamics ; Humans ; Libido ; Lubrication ; Male ; Models, Animal ; Orgasm ; Physiology ; Prevalence ; Sexual Dysfunctions, Psychological ; United States ; Vagina

Sexual dysfunction affects both men and women, involving organic disorders, psychological problems, or both. Overall, the state of our knowledge is less advanced regarding female sexual physiology in comparison with male sexual function. Female sexual dysfunction has received little clinical and basic research attention and remains a largely untapped field in medicine. The epidemiology of female sexual dysfunction is poorly understood because relatively few studies have been done in community settings. In the United States, female sexual dysfunction has been estimated to affect 40% of women in the general population. Among the elderly, however, it has been reported that up to 87% of women complain of sexual dissatisfaction. Several studies have shown that the prevalence of female sexual arousal disorders correlates significantly with increasing age. These studies have shown that sexual arousal and frequency of coitus in the female decreases with increasing age. The pathophysiology of female sexual dysfunction appears more complex than that of males, involving multidimensional hormonal, neurological, vascular, psychological, and interpersonal aspects. Organic female sexual disorders may include a wide variety of vascular, neural, or neurovascular factors that lead to problems with libido, lubrication, and orgasm. However, the precise etiology and mechanistic pathways of age-related female sexual arousal disorders are yet to be determined. In the past two decades, some advances have been made in exploring the basic hemodynamics and neuroregulation of female sexual function and dysfunction in both animal models and in human studies. In this review, we summarize neural regulation of sexual function and neurological causes of sexual dysfunction in women.
Aged ; Arousal ; Clitoris ; Coitus ; Epidemiology ; Female ; Hemodynamics ; Humans ; Libido ; Lubrication ; Male ; Models, Animal ; Orgasm ; Physiology ; Prevalence ; Sexual Dysfunctions, Psychological ; United States ; Vagina

PURPOSE: The purpose of this study is to compare quality of life (QoL) and sexual functioning between sexually active cervical cancer survivors and healthy women. MATERIALS AND METHODS: In this cross-sectional study, propensity-score-matched cervical cancer survivors (n=104) and healthy women (n=104) were compared. All women had engaged in sexual activity within the previous 3 months, and cervical cancer survivors showed no evidence of disease after primary treatment. QoL and sexual functioning were assessed using three questionnaires; the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), Cervical Cancer Module (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI). RESULTS: Significantly higher scores for lymphedema were observed in the cervical cancer survivors group compared with the healthy women group (mean, 20.2 vs. 12.2; p < 0.05). Sexuality, both in terms of sexual activity, sexual enjoyment, and sexual worry (EORTC QLQ-CX24), and in terms of desire, arousal, lubrication, orgasm, satisfaction, and pain (FSFI) were similar between the groups. When the scale of sexual/vaginal functioning in EORTC QLQ-CX24 was divided into individual questions, cervical cancer survivors reported shorter vaginal length than the control group, but without statistical significance (mean, 80.6 vs. 85.4; p=0.077). CONCLUSION: Compared with healthy women, sexuality was not impaired in cervical cancer survivors who showed no evidence of disease after primary treatment and engaging in sexual activity. Further prospective cohort studies are warranted to confirm this finding.
Arousal ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Lubrication ; Lymphedema ; Orgasm ; Prospective Studies ; Quality of Life* ; Sexual Behavior ; Sexuality* ; Survivors* ; Uterine Cervical Neoplasms*

PURPOSE: This study was done to identify psychosocial factors that might be predictive of sexual desire, arousal, lubrication, orgasm, satisfaction, and pain in women with gynecologic cancer. METHODS: Two hundred and twelve women with cervical, ovarian, or endometrial cancer completed questionnaires on the Female Sexual Function Index including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain, and data on their psychosocial factors including body image, sexual attitude, sexual information, depression, and marital intimacy. Stepwise multivariable regression analysis was performed to explore psychosocial predictors of women's sexual function domains. RESULTS: Predictors were identified as sexual attitude, depression, sexual information, and body image for sexual desire; sexual information, depression, and sexual attitude for sexual arousal; sexual information, marital intimacy, and depression for lubrication; sexual information, marital intimacy, depression, and body image for orgasm; marital intimacy, sexual information, sexual attitude, and depression for satisfaction; sexual information, depression, and marital intimacy for pain. CONCLUSION: The results indicate that women's sexual function needs to be approached to domains of female sexual function psychosocially as well as to general sexual function. These factors should be considered in future interventions to positively promote sexual function in women with gynecologic cancer.
Adult ; *Arousal ; Body Image ; Depression/psychology ; Female ; Genital Neoplasms, Female/*psychology ; Humans ; Libido ; Middle Aged ; *Orgasm ; *Pain ; *Personal Satisfaction ; Questionnaires ; *Sexual Behavior