Phentolamine Mesylate in Postmenopausal Women with Female Sexual Arousal Disorder: A Psychophysiological Study

Rubio‐Aurioles, Eusebio; López, María Pia; Lipezker, Mirtha; Lara, Claudia; Ramírez, Abraham; Rampazzo, Claudia; Mendoza, María Teresa Hurtado de; Lowrey, F; Loehr, Lean A.; Lammers, Paul

doi:10.1080/00926230252851339

Cited by 44 publications

(19 citation statements)

References 8 publications

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“…With respect to the LIH data, we found a group by LIH interaction such that sexually healthy women showed enhanced VPA to heightened SNS activity, which replicates prior research (Brotto & Gorzalka, 2002;Meston & Gorzalka, 1995, 1996a, 1996bMeston & Heiman, 1998;Meston & Worcel, 2002;Palace & Gorzalka, 1990, 1992Rosen et al, 1999;Rubio-Aurioles et al, 2002). In contrast, heightened SNS activity had no significant effect on physiological arousal in women with heterogeneous SAD.…”

Section: Discussionsupporting

confidence: 86%

“…One study found a facilitatory effect of phentolamine mesylate, a non-selective a 1 -and a 2 -adrenergic antagonist, on VPA in women with SAD diagnosed according to the DSM-IV-TR . In another study, Rubio-Aurioles et al (2002) found a significant facilitatory effect of phentolamine mesylate on VPA in postmenopausal women with DSM-IV-TR defined SAD who were receiving hormone replacement. However, Meston and Worcel (2002) failed to find an effect of the a 2 -adrenergic antagonist, yohimbine, on genital or subjective sexual arousal in a sample of women with Genital SAD, but when yohimbine was combined with the vasodilator, L-arginine glutamate, this SNS-enhancing drug significantly facilitated VPA.…”

Section: Sympathetic Nervous System and Female Sexual Arousal Disordermentioning

confidence: 95%

“…For example, plasma norepinephrine has been shown to correlate with increases in sexual arousal, reaching a peak during orgasm (Exton et al, 1999). Using vaginal photoplethysmography, there were facilitatory effects on sexual arousal of both pharmacological agents (Meston & Heiman, 1998;Rosen, Phillips, Gendrano, & Ferguson, 1999;Rubio-Aurioles et al, 2002) and non-pharmacological interventions (Brotto & Gorzalka, 2002;Meston & Gorzalka, 1995, 1996a, 1996bPalace & Gorzalka, 1990), which increase SNS activity. Meston, Gorzalka, and Wright (1997) found that clonidine, a selective a 2 -adrenergic agonist which inhibits SNS activity, inhibited genital arousal.…”

Section: Sympathetic Nervous System and Female Sexual Arousal Disordermentioning

confidence: 97%

“…Based on the literature that (1) heightened SNS activity significantly facilitates genital arousal in sexually healthy premenopausal women (Brotto & Gorzalka, 2002;Meston & Gorzalka, 1995, 1996b and in premenopausal women with low desire (Meston & Gorzalka, 1996a), (2) pharmacologic agents which enhance SNS activity increase genital arousal in women with SAD diagnosed according to the DSM-IV-TR Rubio-Aurioles et al, 2002), and (3) agents which decrease SNS activity result in inhibited genital arousal in sexually healthy women (Meston et al, 1997), it seems reasonable to explore the effects of heightened SNS activity on genital arousal in women with different subtypes of SAD, diagnosed according to the recently proposed definitions . Laboratory-induced hyperventilation (LIH), a technique that reliably facilitates SNS activity (George et al, 1989;Olsen et al, 1998;St.…”

Section: Objectives Of the Current Studymentioning

confidence: 99%

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Laboratory-Induced Hyperventilation Differentiates Female Sexual Arousal Disorder Subtypes

2008

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The effects of heightened sympathetic nervous system (SNS) activity via laboratory-induced hyperventilation (LIH) on subjective and physiological sexual arousal were examined in a heterogeneous group of women with Sexual Arousal Disorder (SAD; n = 60), as well as across subtypes of SAD, in comparison to a control group of women without sexual difficulties (n = 42). Participants took part in 2 min of rapid breathing, a technique previously found to increase SNS activity, immediately prior to viewing erotic stimuli. Physiological arousal (i.e., vaginal pulse amplitude; VPA) was measured via the vaginal photoplethysmograph and subjective arousal was measured via self-report questionnaires. LIH differentiated women with SAD from those in the control group, with LIH increasing VPA in the latter, but having no significant effect in the heterogeneous SAD group. However, among subtypes of SAD, LIH differentiated women with genital (n = 16) and subjective (n = 16) subtypes of SAD from women with combined SAD (n = 28) and women without sexual difficulties. Specifically, women in the control group and those with combined SAD had a significant increase in VPA whereas women with genital or subjective SAD had a significant decrease in VPA following LIH. There was no significant effect of LIH on any self-report measure of sexual arousal following erotic stimuli. Implications of the results for the conceptualization, diagnosis, and treatment of SAD are discussed.

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Section: Discussionsupporting

confidence: 86%

Section: Sympathetic Nervous System and Female Sexual Arousal Disordermentioning

confidence: 95%

Section: Sympathetic Nervous System and Female Sexual Arousal Disordermentioning

confidence: 97%

Section: Objectives Of the Current Studymentioning

confidence: 99%

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Laboratory-Induced Hyperventilation Differentiates Female Sexual Arousal Disorder Subtypes

2008

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“…Phentolamine has been studied in male patients for the treatment of erectile dysfunction. Some studies on the clinical efficacy of phentolamine in menopausal women showed promising results [80,81] .…”

Section: Phentolaminementioning

confidence: 99%

Progress in Female Sexual Dysfunction

Verit¹,

Yeni²,

Kafalı³

2006

Urol Int

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Introduction: Female sexual dysfunction (FSD) is a significant age-related, progressive and highly prevalent problem that affects a substantial number of women that causes personal distress and has negative effects on quality of life and interpersonal relationships. Definitions: The female sexual response cycle consists of three phases: desire, arousal, and orgasm, and is initiated by non-adrenergic/non-cholinergic, e.g. vasoactive intestinal polypeptide and nitric oxide, neurotransmitters that maintain vascular and non-vascular smooth muscle relaxation resulting in increased pelvic blood flow, vaginal lubrication, and clitoral and labial engorgement. Furthermore, hormonal status may influence female sexual function. For the diagnosis of FSD, a detailed history should be taken initially, followed by a physical examination and laboratory studies. Conclusion: Due to the fact that there has been little research and attention on FSD, our knowledge in this field is quite limited and there is still no approved therapy. Future advances in evaluation and treatment of female sexual problems are forthcoming.

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A 60-Year-Old Woman With Sexual Difficulties

Potter

2007

JAMA

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Ms B is a 60-year-old woman with diabetes, hypertension, hyperlipidemia, and asthma who has noted sexual difficulties since entering menopause. She wonders whether this is normal or whether anything can be done.Ms B had menarche at 12 years of age. She has been happily married for 38 years and has had 3 pregnancies and 3 children. She reports a diagnosis of endometriosis when she was younger but had no difficulty conceiving. She had regular menses until age 58, when she underwent simultaneous bladder suspension surgery for incontinence and hysterectomy for uterine fibroids. Several months postoperatively she began noticing vaginal dryness, decreased sexual desire, and more difficulty achieving an orgasm. She was treated with esterified estrogen (0.625 mg) and methyltestosterone (1.25 mg) at the time with resolution of her symptoms. She continued this regimen for a couple of years, after which it was stopped due to concerns about adverse effects. More recently she has been treated with estradiol vaginal tablets and subsequently switched to an estradiol vaginal ring because of its ease of use. Ms B found that both of these helped with the vaginal dryness but not her other symptoms. She was recently seen by a new primary care physician who suggested trying bupropion (100 mg daily). Her last Papanicolaou test was done a couple months ago and her last mammogram was done about a year ago; results of both were normal.She was recently diagnosed with diabetes and is now treated with metformin (500 mg daily), with a hemoglobin A 1C value of 7.6%. She was also recently noted to have hyperlipidemia and was prescribed pravastatin (40 mg daily) for a total cholesterol level of 307 mg/dL (7.95 mmol/L), high-density lipoprotein (HDL) cholesterol level of 57 mg/dL (1.48 mmol/L), and a calculated low-density lipoprotein (LDL) level of 229 mg/dL (5.93 mmol/L). Her blood pressure has been well controlled with lisinopril (20 mg daily). She has allergic asthma that is well controlled with montelukast (10 mg daily). She notes occasional back pain for which she takes cyclobenzaprine (two 10-mg tablets at bedtime) with good relief. She is allergic to ciprofloxacin with development of a rash.She currently works as a psychologist. She walks 45 minutes daily, has never smoked, and denies any significant alcohol intake. MS B: HER VIEWMy perception of it isn't so much as a dysfunction as an awareness that since menopause, a few years before actual menopause, that it was more of a challenge to really focus on my own sexuality and that upon arousal, when my husband and I would make love, that it takes a little more work now. I just started to feel nowhere near as much desire as I normally did. Things were not as stimulating, and it just became a challenge instead of an adventure.

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Phentolamine Mesylate in Postmenopausal Women with Female Sexual Arousal Disorder: A Psychophysiological Study

Cited by 44 publications

References 8 publications

Laboratory-Induced Hyperventilation Differentiates Female Sexual Arousal Disorder Subtypes

Laboratory-Induced Hyperventilation Differentiates Female Sexual Arousal Disorder Subtypes

Progress in Female Sexual Dysfunction

A 60-Year-Old Woman With Sexual Difficulties

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