Women's sexual function and dysfunction: current uncertainties, future directions

Abstract

There is increasing evidence that women at the outset of sexual activity do not need to have sexual desire, as in 'drive', and that many do not distinguish desire from arousal. Multiple modes of investigation confirm poor correlation between women's subjective arousal and measured genital congestion. Suggested revisions to the DSM-IV definitions of sexual disorder have been published: there is now need to align interview assessments and screening questionnaires with contemporary understanding of women's sexual response. Whereas the psychological factors associated with women's sexual function and resilience to biological insults and external stressors are well documented, the role of biological factors is less clear. Variations in the rate of decline of adrenal and ovarian pro-hormones, activity of converting enzymes in peripheral cells, sensitivity of androgen and estrogen receptors and cerebral production of sex steroids may all be involved. Thus there is great complexity underlying the question of sex hormone supplementation, and in particular, little clarity as to which women have decreased brain and/or peripheral androgen activity. When psychosexual etiological factors appear to be minimal and investigational testosterone supplementation is considered, it would be appropriate to target women with disordered arousal and desire in keeping with the recently recommended revised definitions.

An Evolutionary Approach Offers a Fresh Perspective on the Relationship Between Oral Contraception and Sexual Desire

“…First, more care is needed in interpreting how other facets of female sexual experience might relate to desire (Basson, 2008;Levine, 2003). While arousal, lubrication, frequency of sex/orgasm, and satisfaction may be motivationally interlinked and underpinned by the degree of current attraction to the woman's partner, autosexual behavior may be motivationally distinct and perhaps inversely related with partner attraction.…”

The impact of hemorrhoidectomy on sexual function in women: a preliminary study

“…Some of the literature has suggested that diagnostic frameworks that rely on direct physical measurement of sexual dysfunction are not very reliable, which has led to the use of self-report scales. These inventories have become indispensable tools in clinical and research programs, 19,20 which is why we relied on a self-report questionnaire for this study. We also explored whether any demographic variables were associated with sexual functioning among women post-hemorrhoidectomy.…”

Função sexual e qualidade de vida em gestantes de baixo risco

“…A mulher vivencia sua sexualidade de forma peculiar nos diversos períodos de sua vida 1 , especialmente durante a gestação, quando pode ter sua função sexual e qualidade de vida comprometidas. Somente o fato de tomar conhecimento da gravidez, logo nas primeiras semanas, parece afetar a atividade sexual feminina, diminuindo o número de coitos 2 .…”