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Female Sexual Dysfunction: Epidemiology, Physiology, Evaluation, and Treatment

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Book cover Male Sexual Function

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Female sexual dysfunction (FSD) is a multicausal and multidimensional problem affecting between 30–50% of American women (1,2). Based on the National Health and Social Life Survey of 1749 women, 43% have complaints of sexual dysfunction. Although this study has a large sample size and minority representation, it is limited by the cross-sectional design. In addition, women over age 60 were not included, and neither menopausal nor other medical risk factors were correlated with sexual complaints. Another study, which looked at 448 women over age 60, demonstrated that two-thirds of them were sexually inactive, 12% of married women had difficulty with intercourse, and approx 14% experienced pain with intercourse. Sexual activity was strongly correlated with marital status (3). Women over age 60 were less likely to have sex if their partner was of poor health and if they had low feelings of self-worth (4). Studies of older women have failed to include specific measures of female sexual arousal, orgasm, or satisfaction.

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References

  1. Spector I, Carey M. Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature. Arch Sex Behav 1990; 19: 389–408.

    Article  PubMed  CAS  Google Scholar 

  2. Laumann E, Paik A, Rosen R. Sexual dysfunction in the United States prevalence and predictors. JAMA 1999; 281: 537–544.

    Article  PubMed  CAS  Google Scholar 

  3. Diokno AC, Brown MB, Herzog R. Sexual function in the elderly. Arch Intern Med 1990; 150: 197–200.

    Article  PubMed  CAS  Google Scholar 

  4. Mooradian AD, V Greiff. Sexuality in older women. Arch Int Med 1990; 150: 1033–1038.

    Article  CAS  Google Scholar 

  5. Hsueh WA. Sexual dysfunction with aging and systemic hypertension. Am J Cardiol 1998; 61: 18H 23H.

    Google Scholar 

  6. Masters EH, Johnson VE. Human Sexual Response. Little Brown, Boston, MA 1966.

    Google Scholar 

  7. Kaplan HS. The New Sex Therapy. Bailliere Tindall, London 1974.

    Google Scholar 

  8. Berman JR, Berman L, Goldstein I. Female sexual dysfunction: incidence, pathophysiology, evaluation, and treatment options. Urology 1999; 54: 385–391.

    Article  PubMed  CAS  Google Scholar 

  9. Graziottin A. Libido. In: Studd J. ed. Yearbook of the Royal College of Obstetricians and Gynaecologists, RCOG, Parthenon 1996, pp. 235243.

    Google Scholar 

  10. Berman JR, Berman LA, Werbin T, Leary N, Flaherty E, Goldstein I. Clinical evaluation of female sexual function: effects of age and estrogen status on subjective and physiologic sexual responses. Int J Impot Res 1999; (11): 31–38.

    Google Scholar 

  11. Sjoberg I. The vagina: morphological, functional and etiological aspects. Acta Obstetric Gynecologic Scand 1992; 71: 84.

    Article  CAS  Google Scholar 

  12. Weber M, Walters M, Schover L, Mitchinson A. Vaginal anatomy and sexual function. Obstet Gynecol 1995; 86: 946–949.

    Article  PubMed  CAS  Google Scholar 

  13. Levin RJ. The physiology of sexual function in women. Clin Obstet Gynecol 1981; 7: 213.

    Google Scholar 

  14. Park K, Goldstein I, Andry C, Siroky MB, Krane RJ, Azadzoi KM. Vasculogenic female sexual dysfunction: the hemodynamic basis for vaginal engorgement insufficiency and clitoral erectile insufficiency. Int J Impot Res 1997; 9: 27–37.

    Article  PubMed  CAS  Google Scholar 

  15. O’Connell HE, Hutson FM, Anderson CR, Plenter RJ. Anatomical relationship between urethra and clitoris. J Urol 1998; 159: 1892.

    Article  PubMed  Google Scholar 

  16. Carlson KJ. Outcomes of hysterectomy. Clin Obstet Gynecol 1997; 40: 939–946.

    Article  PubMed  CAS  Google Scholar 

  17. Holye CH, Stones RW, Robson T, Whitley K, Burnstock G. Innervation of vasculature and microvasculature of human vagina by NOS and neuropeptide-containing nerves. J Anat 1996; 188: 633–644.

    Google Scholar 

  18. Park K, Moreland RB, Goldstein I, Atala A, Traish A. Characterization of phosphodiesterase activity inhuman clitoral corpus cavernosum smooth muscle cells in culture. Biochem Biophys Res Com 1998; 617.

    Google Scholar 

  19. Traish AM, Moreland RB, Huang Y-H, Kim NN, Berman J, Goldstein I. Development of human and rabbit vaginal smooth muscle cell cultures: effects of vasoactive agents on intracellular levels of cyclic nucleotides. Mol Cell Biol Res Commun 1999; 2: 131–137.

    Article  PubMed  CAS  Google Scholar 

  20. Helm G, Ottesen B, Fahrenkrug J. Vasoactive intestinal polypeptide in the human female reproductive tract: distribution and motor effects. Biol Reproduc 1981; 25: 227–234.

    Article  CAS  Google Scholar 

  21. Meston CM, Heiman JR. Ephedrine-activated physiological sexual arousal in women. Arch Gen Psych 1998; 55: 652–656.

    Article  CAS  Google Scholar 

  22. Sarrell PM. Sexuality and menopause. Obstet Gynecol 1990; 75: 26s.

    Google Scholar 

  23. Berman JR, McCarthy MM, Kyprianou N. Effect of estrogen withdrawal on nitric oxide synthase expression and apoptosis in the rat vagina. Urology 1998; 51 (4): 650–656.

    Article  PubMed  CAS  Google Scholar 

  24. Sarrell PM. Ovarian hormones and vaginal blood flow: using laser Doppler velocimetry to measure effects in a clinical trial of post-menopausal women. Int J Impot Res 1998; 10: S91–93.

    Google Scholar 

  25. Matthews KA, Meilahn E, Kuller LH, Kelsey SF, Caggiula AW. Menopause and risk factors for coronary heart disease. N Engl J Med 1989; 321: 641–664.

    Article  PubMed  CAS  Google Scholar 

  26. Greendale GA, Lee NP, Arriola ER. The menopause. Lancet 1999; 353: 571–580.

    Article  CAS  Google Scholar 

  27. Westendrop IC, Bots ML, Broggee DE, et al. Menopausal status and distensibility of the common carotid artery. Arterio Throm Vasc Biol 1999; 19: 713–717.

    Article  Google Scholar 

  28. Sitruk-Ware R. Cardiovascular risk at the menopause–role of the sexual steroids. Horm Res 1995; 43: 58–63.

    Article  PubMed  CAS  Google Scholar 

  29. Nabulsi AA, Folsom AR, White A, et al. Association of hormone replacement therapy with various cardiovascular risk factors in postmenopausal women: the Atherosclerosis Risk in Community Study. N Engl J Med 1993; 328: 1069–1075.

    Article  PubMed  CAS  Google Scholar 

  30. Goldstein I, Berman J. Vasculogenic female sexual dysfunction. Int J Impot Res 1998; 10 (2): s84–290.

    PubMed  Google Scholar 

  31. Sherwin BB, Gelfand MM, Brender W. Androgen enhances sexual motivation in females: a prospective, crossover study of sex steroid administration in the surgical postmenopausal. Psychosom Med 1985; 47: 339–335.

    PubMed  CAS  Google Scholar 

  32. Rako S. Testosterone deficiency and supplementation for women: matters of sexual health. Psychiatr Ann 1999; 29(1): 23 26.

    Google Scholar 

  33. Tarcan T, Park K, Goldstein I, Maio G, Fassina A, Krane RJ, et al. Histomorphometric analysis of age-related structural changes in human clitoral cavernosal tissue. J Urol 1999; 161: 940–944.

    Article  PubMed  CAS  Google Scholar 

  34. Sipski ML, Alexander CJ, Rosen RC. Orgasm in women with spinal cord injuries: A laboratory-based assessment. Arch Phys Med Rehabil 1995; 75: 1097–1102.

    Article  Google Scholar 

  35. Shen WW, Urosevich Z, Clayton DO. Sildenafil in the treatment of female sexual dysfunction induced by selective serotonin reuptake inhibitors. J Reprod Med 1999; 44: 535–542.

    PubMed  CAS  Google Scholar 

  36. Heimann JR. Psychophysiological models of female sexual response. Int J Impot Res 1998; 10: S94.

    Google Scholar 

  37. Berman JR, Berman LA, Lin H, Cantey-Kiser J, Flaherty E, Lahey N, et al. Effect of sildenafil on subjective and physiologic parameters of the female sexual response in women with sexual arousal disorder. Journal of Sex and Marital Therapy, in press.

    Google Scholar 

  38. Rosen RC, Phillips NA, Gendrano N. Oral phentolamine and female sexual arousal disorder: a pilot study. J Sex Marital Ther 1999; 25: 137–144.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Jennifer R. Berman MD
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  2. Laura A. Berman PhD
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  3. Hugh Lin MA
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  4. Irwin Goldstein MD
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Editor information

Editors and Affiliations

  1. Indiana University Medical Center, Indianapolis, Indiana, USA

    John J. Mulcahy MD, PhD

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© 2001 Springer Science+Business Media New York

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Berman, J.R., Berman, L.A., Lin, H., Goldstein, I. (2001). Female Sexual Dysfunction: Epidemiology, Physiology, Evaluation, and Treatment. In: Mulcahy, J.J. (eds) Male Sexual Function. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-098-8_7

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  • DOI: https://doi.org/10.1007/978-1-59259-098-8_7

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-5701-9

  • Online ISBN: 978-1-59259-098-8

  • eBook Packages: Springer Book Archive

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