This study examined the effects of the nitric oxide-precursor L-arginine combined with the α2-blocker yohimbine on subjective and physiological sexual arousal in postmenopausal women with Female Sexual Arousal Disorder. Twenty-four women participated in three treatment sessions in which self-report and physiological (vaginal photoplethysmograph) sexual responses to erotic stimuli were measured following treatment with either L-arginine glutamate (6 g) plus yohimbine HCl (6 mg), yohimbine alone (6 mg), or placebo, using a randomized, double-blind, three-way cross-over design. Sexual responses were measured at approximately 30, 60, and 90 min postdrug administration. The combined oral administration of L-arginine glutamate and yohimbine substantially increased vaginal pulse amplitude responses to the erotic film at 60 min postdrug administration compared with placebo. Subjective reports of sexual arousal were significantly increased with exposure to the erotic stimuli but did not differ significantly between treatment groups.
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American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text revision). Washington, DC: Author.
Andersson, K. E., & Wagner, G. (1995). Physiology of penile erection. Physiological Reviews, 75, 191-236.
Ashton, A. K. (1999). Sildenafil treatment of paroxetine-induced anorgasmia in woman [Letter]. American Journal of Psychiatry, 156, 800.
Ashton, A. K., & Bennett, R. G. (1999). Sildenafil treatment of serotonin reuptake inhibitor-induced sexual dysfunction [Letter]. Journal of Clinical Psychiatry, 60, 194-195.
Boolell, M., Allen, M. J., Ballard, S. A., Gepi-Attee, S., Muirhead, G. J., Naylor, A. M., et al. (1996). Sildenafil: An orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. International Journal of Impotence Research, 6, 47-52.
Burnett, A. L. (1995). Role of nitric oxide in the physiology of erection. Biology of Reproduction, 5, 485-489.
Burnett, A. L. (1997). Nitric oxide in the penis: Physiology and pathology. Journal of Urology, 157, 320-324.
Burnett, A. L., Calvin, D. C., Silver, R. I., Peppas, D. S., & Docimo, S. G. (1997). Immunohistochemical description of nitric oxide synthase isoforms in human clitoris. Journal of Urology, 158, 75-78.
Chen, J., Wollman, Y., Chernichovsky, T., Iaina, A., Sofer, M., & Matzkin, H. (1999). Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: Results of a double-blind, randomized, placebo-controlled study. BJU International, 83, 269-273.
Derry, F. A., Dinsmore, W. W., Fraser, M., Gardner, B. P., Glass, C. A., Maytom, M. C., et al. (1998). Efficacy and safety of oral Sildenafil (Viagra) in men with erectile dysfunction caused by spinal cord injury. Neurology, 51, 1629-1633.
Dinsmore, W. W., Hodges, M., Hargreaves, C., Osterloh, I. H., Smith, M. D., & Rosen, R. C. (1999). Sildenafil citrate (Viagra) in erectile dysfunction: Near normalization in men with broad-spectrum erectile dysfunction compared with age-matched healthy control participants. Urology, 53, 800-805.
Ende, N., Gertner, S. B., Hwang, S. G., & Kadi, R. S. (1989). Measurement of postcoital sympathetic activity in females by means of vanillylmandelic acid. Hormones and Behavior, 23, 150-156.
Everaerd, W., & Laan, E. (2000). Drug treatments for women's sexual disorders. Journal of Sex Research, 37, 195-204.
Exton, M. S., Bindert, A., Kruger, T., Scheller, F., Hartmann, U., & Schedlowski, M. (1999). Cardiovascular and endocrine alterations after masturbation-induced orgasm in women. Psychosomatic Medicine, 61, 280-289.
Fugl-Meyer, A. R., & Sjogren Fugl-Meyer, K. (1999). Sexual disabilities, problems, and satisfaction in 18-74 year old Swedes. Scandinavian Journal of Sexology, 3, 79-105.
Giuliano, F., Hultling, C., El Masry, W. S., Smith, M. D., Osterloh, I. H., Orr, H., et al. (1999). Randomized trial of Sildenafil for treatment of erectile dysfunction in spinal cord injury. Annals of Neurology, 46, 15-21.
Goldstein, I., & Berman, J. (1998). Vasculogenic female sexual dysfunction: Vaginal engorgement and clitoral erectile insufficiency syndrome. International Journal of Impotence Research, 8, S84-S90.
Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998). Oral Sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338, 1397-1404.
Govier, F. E., McClure, R. D., Weissman, R. M., Gibbons, R. P., Prichett, T. R., & Kramer-Levien, D. (1993). Experience with triple-drug therapy in a pharmacological erection program. Journal of Urology, 150, 1822-1824.
Hackbert, L., Heiman, J. R., & Meston, C. M. (1998, June). The effects of DHEA on sexual arousal in postmenopausal women. Poster session presented at the annual meeting of the International Academy of Sex Research, Stony Brook, NY.
Heiman, J. R., & Rowland, D. L. (1983). Affective and physiological sexual response patterns: The effects of instructions on sexually functional and dysfunctional men. Journal of Psychosomatic Research, 27, 105-116.
Klotz, T., Mathers, M. J., Braun, M., Bloch, W., & Engelmann. U. (1999). Effectiveness of oral L-arginine in first line treatment of erectile dysfunction in a controlled crossover study. Urologia Internationalis, 63, 220-223.
Laan, E., Everaerd, W., & Evers, A. (1995). Assessment of female sexual arousal: Response specificity and construct validity. Psychophysiology, 32, 476-485.
Laan, E., van Lunsen, R. H.W., Everaerd, W., Heiman, J. R., & Hackbert, L. (2000, June). The effects of Sildenafil on women's genital and subjective sexual response. Paper presented at the annual meeting of the International Academy of Sex Research, Paris, France.
Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.
Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. Journal of the American Medical Association, 281, 537-544.
Lebret, T., Herve, J. M., Barre, P., Lugagne, P. M., & Botto, H. (2000). Safety and efficacy of the combination of arginine and yohimbine for the treatment of erectile dysfunction. A controlled human trial. Proceedings from the Third meeting of the European Society for Impotence Research. (ESIR), p. 23.
Levin, R. J. (1991). VIP, vagina, clitoral and periurethral glans:Anupdate on female genital arousal. Experimental and Clinical Endocrinology, 98, 61-69.
Levin, R. J. (1992). The mechanisms of human female sexual arousal. Annual Review of Sex Research, 3, 1-48.
Lindal, E., & Stefansson, J. G. (1993). The lifetime prevalence of psychosexual dysfunction among 55 to 57-year-olds in Iceland. Social Psychiatry and Psychiatric Epidemiology, 28, 91-95.
Marks, L. S., Duda, C., Dorey, F. J., Macairan, M. L., & Santos, P. B. (1999). Treatment of erectile dysfunction with Sildenafil. Urology, 53, 19-24.
Mazer, N. A., Leiblum, S. R., & Rosen, R. C. (2000). The brief index of sexual functioning for women (BISF-W): A new scoring algorithm and comparison of normative and surgically menopausal populations. Menopause, 7, 350-363.
Meston, C. M. (2000). The psychophysiology of female sexual arousal. Journal of Sex Education and Therapy, 25, 6-16.
Meston, C. M., & Gorzalka, B. B. (1995). The effects of sympathetic activation on physiological and subjective sexual arousal inwomen. Behaviour Research and Therapy, 33, 651-664.
Meston, C. M., & Gorzalka, B. B. (1996). The differential effects of sympathetic activation on sexual arousal in sexually functional and dysfunctional women. Journal of Abnormal Psychology, 105, 582-591.
Meston, C. M., Gorzalka, B. B., & Wright, J. M. (1997). Inhibition of subjective and physiological sexual arousal in women by clonidine. Journal of Psychosomatic Medicine, 59, 399-407.
Meston, C. M., & Heiman, J. R. (1998). Ephedrine-activated sexual arousal in women. Archives of General Psychiatry, 55, 652-656.
Meston, C. M., & Heiman, J. R. (2002). Acute dehydroepiandrosterone effects on sexual arousal in premenopausal women. Journal of Sex and Marital Therapy, 28, 53-60.
Meston, C. M., Moe, I. E., & Gorzalka, B. B. (1996). The effects of sympathetic inhibition on sexual behavior in the female rat. Physiology and Behavior, 59, 537-542.
Montorsi, F., McDermott, T. E., Morgan, R., Olsson, A., Schultz, A., Kirkeby, H. J., et al. (1999). Efficacy and safety of fixed-dose oral Sildenafil in the treatment of erectile dysfunction of various etiologies. Urology, 53, 1011-1018.
Munarriz, R., Talakoub, L., Garcia, S. P., Sarkissian, E., Gioia, L., Hoag, M., et al. (2001, October). Dehydroepiandrosterone (DHEA) treatment for female androgen insufficiency sexual dysfunction: Baseline and post-treatment sexual questionnaire outcome data in those patients with restored androgen values. Presented at the annual meeting of the Female Sexual Function Forum, Boston, MA, Poster.
Nurnberg, H. G., Hensley, P. L., Lauriello, J., Parker, L. M., & Keith, S. J. (1999). Sildenafil for women patients with antidepressant-induced sexual dysfunction. Psychiatric Services, 50, 1076-1078.
Padma-Nathan, H. (2000, July). Hemodynamic effects of the oral administration of a combination of arginine and yohimbine measured by color duplex ultrasonography in men with erectile dysfunction. Presented at the annual meeting of the European Society for Impotence Research, Poster.
Padma-Nathan, H., Steers, W. D., & Wicker, P. A. (1998). Efficacy and safety of oral Sildenafil in the treatment of erectile dysfunction: A double-blind, placebo-controlled study of 329 patients. International Journal of Clinical Practice, 52, 375-379.
Park, K., Moreland, R. B., Goldstein, I., Anthony, A., & Traish, A. (1998). Sildenafil inhibits phosphodiesterase type 5 in human clitoral corpus cavernosum smooth muscle. Biochemical and Biophysical Research Communications, 249, 612-617.
Rosen, R. C., Taylor, J. F., Leiblum, S. R., & Bachmann, G. A. (1993). Prevalence of sexual dysfunction in women: Results of a survey of 329 women in an outpatient gynecological clinic. Journal of Sex and Marital Therapy, 19, 171-188.
Saenz de Tejada, I., Garvey, D. S., Schroeder, J. D., Shelekhin, R., Lettss, L. G., Fernandez, A., et al. (1999). Design and evaluation of nitrosylated alpha-adrenergic receptor antagonists as potential agents for the treatment of impotence. Journal of Pharmacology and Experimental Therapeutics, 290, 121-128.
Schiavi, R. C., & Segraves, R. T. (1995). The biology of sexual function. Psychiatric Clinics of North America, 18, 7-23.
Sherwin, B. B., Gelfand, M. M., & Brender, W. (1985). Androgen enhances sexual motivation in females:Aprospective, crossover study of sex steroid administration in the surgical menopause. Psychosomatic Medicine, 47, 339-351.
Shifren, J. L., Braunstein, G. D., Simon, J. A., Casson, P. R., Buster, J. E., Redmond, G. P., et al. (2000). Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. New England Journal of Medicine, 343, 682-688.
Simonsen, U., Prieto, D., Hernandez, M., de Tejada, I., & Garcia-Sacristan, A. (1997). Prejunctional alpha sub 2-adrenoceptors inhibit nitrergic neurotransmission in horse penile resistance arteries. Journal of Urology, 157, 2356-2360.
Sintchak, G., & Geer, J. H. (1975). A vaginal plethysmograph system. Psychophysiology, 5, 113-115.
Tam, S. W., Worcel, M., & Wyllie, M. (2001). Yohimbine: A clinical review. Pharmacology and Therapeutics, 91, 1-29.
Taylor, J. F., Rosen, R. C., & Leiblum, S. R. (1994). Self-report assessment of female sexual function: Psychometric evaluation of the Brief Index of Sexual Functioning for Women. Archives of Sexual Behavior, 23,627-643.
Toesca, A., Stolfi, V. M., & Cocchia, D. (1996). Immunohistochemical study of the corpora cavernosa of the human clitoris. Journal of Anatomy, 3, 513-520.
Wiedeking, C., Ziegler, M. G., & Lake, C. R. (1979). Plasma noradrenaline and dopamine-beta-hydroxylase during human sexual activity. Journal of Psychiatric Research, 15, 139-145.
Worcel, M. (2000). [The pharmacokinetic profile of L-arginine glutamate plus yohimbine]. Unpublished raw data.
Zorgniotti, A., & Lizza, E. (1994). Effect of large doses of the nitric oxide precursor, L-arginine, on erectile dysfunction. International Journal of Impotence Research, 6, 33-36.
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Meston, C.M., Worcel, M. The Effects of Yohimbine Plus L-arginine Glutamate on Sexual Arousal in Postmenopausal Women with Sexual Arousal Disorder. Arch Sex Behav 31, 323–332 (2002). https://doi.org/10.1023/A:1016220225392
- female sexual arousal
- nitric oxide