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Local Genital Arousal: Mechanisms for Vaginal Lubrication

  • Female Sexual Dysfunction and Disorders (A Stanton, Section Editor)
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Abstract

Purpose of Review

There is a growing body of evidence-based research in the area of female sexual arousal that has led to improved understanding of the female sexual arousal response and the development of FDA-approved treatments for female sexual dysfunction. The purpose of this paper is to review the existing literature on female sexual arousal and response with a focus on local genital arousal and the mechanisms underlying vaginal lubrication.

Recent Findings

From May 2000 to May 2020, PubMed and Cochrane databases were reviewed and manuscripts selected, based on keywords, content, references, and relevance to the topic. Vaginal lubrication occurs due to vasodilation of the major branches of iliohypogastric and pudendal arterial beds. The increase in intravascular and vaginal wall pressure forces fluid to pass through the vaginal intraepithelial gap junctions, forming a transudate of plasma. The fluid coalesces to form water-like droplets that lubricate the entire vaginal canal, allowing for ease of penetration during sexual intercourse. Vaginal lubrication is a fundamental component of female sexual arousal and directly correlates with subjective levels of satisfaction and enjoyment.

Summary

The female sexual arousal response is a complex reflex involving multiple organs and bodily functions. There are numerous age-related, metabolic, environmental, hormonal, and other factors that can negatively impact female sexual arousal and vaginal lubrication. As women age, vaginal lubrication declines due to declining genital blood flow and serum hormone levels. Concomitant reduction in physical activity and other medical comorbidities can also negatively impact vaginal blood flow and lubrication. The new and evolving treatment modalities for female sexual arousal disorder are directed toward optimizing vaginal health, function, and lubrication.

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Authors and Affiliations

  1. Department of Surgery, Division of Urology, Cedars Sinai Medical Center, Beverly Hills, CA, USA

    A. Dubinskaya, J. T. Anger & K. S. Eilber

  2. The Berman Women’s Wellness Center, Beverly Hills, CA, USA

    T. Guthrie & J. R. Berman

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  1. A. Dubinskaya
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  2. T. Guthrie
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  4. K. S. Eilber
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  5. J. R. Berman
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Contributions

Alexandra Dubinskaya, MD—project design, data management, and manuscript writing

Teghan Guthrie—data management, manuscript writing, and editorial work

Jennifer T Anger, MD—project design, data management, and manuscript editorial work

Karyn S Eilber, MD—project design and manuscript editorial work

Jennifer R Berman, MD—project design, data management, and manuscript editorial work

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Correspondence to J. R. Berman.

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Dubinskaya, A., Guthrie, T., Anger, J.T. et al. Local Genital Arousal: Mechanisms for Vaginal Lubrication. Curr Sex Health Rep 13, 45–53 (2021). https://doi.org/10.1007/s11930-021-00305-8

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