ORIGINAL RESEARCH

You have free access to this content

Female Sexual Arousal Disorders

  1. Annamaria Giraldi MD, PhD1,*,
  2. Alessandra H. Rellini PhD2,
  3. James Pfaus PhD3,
  4. Ellen Laan PhD4

Article first published online: 13 SEP 2012

DOI: 10.1111/j.1743-6109.2012.02820.x

Issue

The Journal of Sexual Medicine

The Journal of Sexual Medicine

Volume 10, Issue 1, pages 58–73, January 2013

Additional Information

How to Cite

Giraldi, A., Rellini, A. H., Pfaus, J. and Laan, E. (2013), Female Sexual Arousal Disorders. Journal of Sexual Medicine, 10: 58–73. doi: 10.1111/j.1743-6109.2012.02820.x

Author Information

  1. 1

    Department of Sexological Research, Rigshospitalet 7411, Copenhagen, Denmark

  2. 2

    Department of Psychology, University of Vermont, Burlington, VT, USA

  3. 3

    Department of Psychology, Concordia University, Montreal, QC, Canada

  4. 4

    Department of Sexology and Psychosomatic Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

*Annamaria Giraldi, MD, PhD, Department of Sexological Research, Rigshospitalet 7411, Blegdamsvej 9, 2100 Copenhagen, Denmark. Tel: +45 38 64 71 50; Fax: +45 38 64 71 64; E-mail: annamaria.giraldi@regionh.dk

Publication History

  1. Issue published online: 23 JAN 2013
  2. Article first published online: 13 SEP 2012

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (173K)

References

  • 1
    Dickinson RL. Human sex anatomy. 2nd edition. London: Balliere, Tindal & Cox; 1949.
  • 2
    Kinsey AC, Pomeroy WB, Martin CE, Gebhard PH. Sexual Behavior in the human female. Philadelphia: W.B. Saunders; 1953.
  • 3
    Masters WH, Johnson VE. Human sexual response. Boston: Little; Brown; 1966.
  • 4
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. DMS-IV-TR. 4th revised edition. Washington, DC: American Psychiatric Press; 2000.
  • 5
    Laan E, Everaerd W, van der Velde J, Geer JH. Determinants of subjective experience of sexual arousal in women: Feedback from genital arousal and erotic stimulus content. Psychophysiology 1995;32:444–51.
    Direct Link:
  • 6
    Chivers ML, Seto MC, Lalumiere ML, Laan E, Grimbos T. Agreement of self-reported and genital measures of sexual arousal in men and women: A meta-analysis. Arch Sex Behav 2010;39:5–56.
  • 7
    Laan E, Janssen E. How do men and women feel? Determinants of subjective experience of sexual arousal. In: Janssen E, ed. The psychophysiology of sex. Bloomington: Indiana University Press; 2007:278–90.
  • 8
    Laan E, van Driel EM, van Lunsen RH. Genital responsiveness in healthy women with and without sexual arousal disorder. J Sex Med 2008;5:1424–35.
    Direct Link:
  • 9
    Palacios S. Managing urogenital atrophy. Maturitas 2009;63:315–8.
  • 10
    Nathan SG. When do we say a woman's sexuality is dysfunctional? In: Levine SB, Risen C, Althof SE, eds. Handbook of clinical sexuality for mental health professionals. New York: Brunner-Routledge; 2003:95–110.
  • 11
    Leiblum S. Classification and diagnosis of female sexual disorders. In: Goldstein I, Meston C, Davis SR, Traish A, eds. Women's sexual function and dysfunction. Study, diagnosis and treatment. 1st edition. London: Taylor & Francis; 2006:323–30.
  • 12
    Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, Graziottin A, Heiman JR, Laan E, Meston C, Schover L, van Lankveld J, Schultz WW. Definitions of women's sexual dysfunction reconsidered: Advocating expansion and revision. J Psychosom Obstet Gynaecol 2003;24:221–9.
  • 13
    Meston CM, Rellini AH, McCall K. The sensitivity of continuous laboratory measures of physiological and subjective sexual arousal for diagnosing women with sexual arousal disorder. J Sex Med 2010;7(2 Pt 2):938–50.
    Direct Link:
  • 14
    Basson R, Brotto LA. Sexual psychophysiology and effects of sildenafil citrate in oestrogenised women with acquired genital arousal disorder and impaired orgasm: A randomised controlled trial. BJOG 2003;110:1014–24.
    Direct Link:
  • 15
    Brotto L, Basson R, Gorzalka BB. Psychophysiological assessment in premenopausal sexual arousal disorder. J Sex Med 2004;1:266–77.
    Direct Link:
  • 16
    Brotto LA, Bitzer J, Laan E, Leiblum S, Luria M. Women's sexual desire and arousal disorders. J Sex Med 2010;7(1 Pt 2):586–614.
    Direct Link:
  • 17
    Derogatis LR, Clayton AH, Rosen RC, Sand M, Pyke RE. Should sexual desire and arousal disorders in women be merged? Arch Sex Behav 2011;40:217–9.
  • 18
    Brotto LA. The DSM diagnostic criteria for hypoactive sexual desire disorder in women. Arch Sex Behav 2010;39:221–39.
  • 19
    Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED, Rellini AH, Segraves T. Definitions/epidemiology/riskfactors for sexual dysfunction. J Sex Med 2010;7:1598–607.
    Direct Link:
  • 20
    Hayes RD, Bennett CM, Fairley CK, Dennerstein L. What can prevalence studies tell us about female sexual difficulty and dysfunction? J Sex Med 2006;3:589–95.
    Direct Link:
  • 21
    Lewis RW, Fugl-Meyer KS, Bosch R, Fugl-Meyer AR, Laumann EO, Lizza E, Martin-Morales A. Definitions, classification, and epidemiology of sexual dysfunction. In: Lue TF, Basson R, Rosen R, Giuliano F, Khoury S, Montorsi F, eds. Sexual medicine. Sexual dysfunctions in men and women. 2nd edition. Paris: Health Publications; 2004:37–72.
  • 22
    Fugl-Meyer AR, Fugl-Meyer KS. Prevalence data in Europe. In: Goldstein I, Meston C, Davis SR, Traish A, eds. Women's sexual function and dysfuncion. Study, diagnosis and treatment. 1st edition. London: Taylor & Francis; 2006:34–41.
  • 23
    Paik A, Laumann EO. Prevalence of women's sexual problems in the USA. In: Goldstein I, Meston C, Davis SR, Traish A, eds. Women's sexual function and dysfunction. Study, diagnosis and treatment. 1st edition. London: Taylor & Francis; 2006:23–33.
  • 24
    Oberg K, Fugl-Meyer AR, Fugl-Meyer KS. On categorization and quantification of women's sexual dysfunctions: An epidemiological approach. Int J Impot Res 2004;16:261–9.
  • 25
    Dunn KM, Croft PR, Hackett GI. Sexual problems: A study of the prevalence and need for health care in the general population. Fam Pract 1998;15:519–24.
  • 26
    Fugl-Meyer AR, Fugl-Meyer KS. Sexual disabilities, problems and satisfaction in 18–74 year old Swedes. Scand J Sexol 1999;2:79–97.
  • 27
    Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: Prevalence and predictors. JAMA 1999;281:537–44.
  • 28
    Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: Prevalence and correlates. Obstet Gynecol 2008;112:970–8.
  • 29
    Hayes RD, Dennerstein L, Bennett CM, Fairley CK. What is the “true” prevalence of female sexual dysfunctions and does the way we assess these conditions have an impact? J Sex Med 2008;5:777–87.
    Direct Link:
  • 30
    Cain VS, Johannes CB, Avis NE, Mohr B, Schocken M, Skurnick J, Ory M. Sexual functioning and practices in a multi-ethnic study of midlife women: Baseline results from SWAN. J Sex Res 2003;40:266–76.
  • 31
    Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T. Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005;17:39–57.
  • 32
    Salonia A, Giraldi A, Chivers ML, Georgiadis JR, Levin R, Maravilla KR, McCarthy MM. Physiology of women's sexual function: Basic knowledge and new findings. J Sex Med 2010;7:2637–60.
    Direct Link:
  • 33
    Hayes R, Dennerstein L. The impact of aging on sexual function and sexual dysfunction in women: A review of population-based studies. J Sex Med 2005;2:317–30.
    Direct Link:
  • 34
    Graziottin A, Leiblum S. Biological and psychosocial pathophysiology of female sexual dysfunction during the menopausal transition. J Sex Med 2005;2(suppl 3):133–45.
    Direct Link:
  • 35
    Dennerstein L, Hayes R. Confronting the challenges: Epidemiological study of female sexual dysfunction and the menopause. J Sex Med 2005;2(suppl 3):118–32.
    Direct Link:
  • 36
    Ibe C, Simon JA. Vulvovaginal atrophy: Current and future therapies (CME). J Sex Med 2010;7:1042–50.
    Direct Link:
  • 37
    Leiblum S, Bachmann G, Kemmann E, Colburn D, Swartzman L. Vaginal atrophy in the postmenopausal woman. The importance of sexual activity and hormones. JAMA 1983;249:2195–8.
  • 38
    Bachmann GA, Leiblum SR, Kemmann E, Colburn DW, Swartzman L, Shelden R. Sexual expression and its determinants in the post-menopausal woman. Maturitas 1984;6:19–29.
  • 39
    Weber AM, Walters MD, Schover LR, Mitchinson A. Vaginal anatomy and sexual function. Obstet Gynecol 1995;86:946–9.
  • 40
    Wierman ME, Nappi RE, Avis N, Davis SR, Labrie F, Rosner W, Shifren JL. Endocrine aspects of women's sexual function. J Sex Med 2010;7(1 Pt 2):561–85.
    Direct Link:
  • 41
    Laan E, van Lunsen RH. Hormones and sexuality in postmenopausal women: A psychophysiological study. J Psychosom Obstet Gynaecol 1997;18:126–33.
  • 42
    Davison SL, Davis SR. Androgenic hormones and aging—The link with female sexual function. Horm Behav 2011;59:745–53.
  • 43
    Guthrie JR, Dennerstein L, Taffe JR, Lehert P, Burger HG. The menopausal transition: A 9-year prospective population-based study. The Melbourne Women's Midlife Health Project. Climacteric 2004;7:375–89.
  • 44
    Labrie F, Archer D, Bouchard C, Fortier M, Cusan L, Gomez JL, Girard G, Baron M, Ayotte N, Moreau M, Dube R, Cote I, Labrie C, Lavoie L, Berger L, Gilbert L, Martel C, Balser J. Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women. Menopause 2009;16:923–31.
  • 45
    Labrie F, Archer D, Bouchard C, Fortier M, Cusan L, Gomez JL, Girard G, Baron M, Ayotte N, Moreau M, Dube R, Cote I, Labrie C, Lavoie L, Berger L, Martel C, Balser J. High internal consistency and efficacy of intravaginal DHEA for vaginal atrophy. Gynecol Endocrinol 2010;26:524–32.
  • 46
    Giraldi A, Kristensen E. Sexual dysfunction in women with diabetes mellitus. J Sex Res 2010;47:199–211.
  • 47
    Basson R. Sexual function of women with chronic illness and cancer. Womens Health (Lond Engl) 2010;6:407–29.
  • 48
    Basson R, Rees P, Wang R, Montejo AL, Incrocci L. Sexual function in chronic illness. J Sex Med 2010;7(1 Pt 2):374–88.
    Direct Link:
  • 49
    Mok K, Juraskova I, Friedlander M. The impact of aromatase inhibitors on sexual functioning: Current knowledge and future research directions. Breast 2008;17:436–40.
  • 50
    Nobre PJ, Pinto-Gouveia J. Cognitive schemas associated with negative sexual events: A comparison of men and women with and without sexual dysfunction. Arch Sex Behav 2009;38:842–51.
  • 51
    Middleton LS, Kuffel SW, Heiman JR. Effects of experimentally adopted sexual schemas on vaginal response and subjective sexual arousal: A comparison between women with sexual arousal disorder and sexually healthy women. Arch Sex Behav 2008;37:950–61.
  • 52
    ter Kuile MM, Both S, van Uden J. The effects of experimentally-induced sad and happy mood on sexual arousal in sexually healthy women. J Sex Med 2010;7:1177–84.
    Direct Link:
  • 53
    Angst J. Sexual problems in healthy and depressed persons. Int Clin Psychopharmacol 1998;13(suppl 6):S1–4.
  • 54
    Kennedy SH, Dickens SE, Eisfeld BS, Bagby RM. Sexual dysfunction before antidepressant therapy in major depression. J Affect Disord 1999;56:201–8.
  • 55
    Peterson ZD, Janssen E. Ambivalent affect and sexual response: The impact of co-occurring positive and negative emotions on subjective and physiological sexual responses to erotic stimuli. Arch Sex Behav 2007;36:793–807.
  • 56
    Kaplan H. The new sex therapy. New York: Brunner Mazel; 1974.
  • 57
    Kalmbach DA, Ciesla JA, Janata JW, Kingsberg SA. Specificity of anhedonic depression and anxious arousal with sexual problems among sexually healthy young adults. J Sex Med 2012;9:505–13.
    Direct Link:
  • 58
    van den Hout M, Barlow D. Attention, arousal and expectancies in anxiety and sexual disorders. J Affect Disord 2000;61:241–56.
  • 59
    Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther 2006;44:1067–77.
  • 60
    Apt C, Hurlbert DF. The sexual attitudes, behavior, and relationships of women with histrionic personality disorder. J Sex Marital Ther 1994;20:125–33.
  • 61
    Rellini A. Review of the empirical evidence for a theoretical model to understand the sexual problems of women with a history of CSA. J Sex Med 2008;5:31–46.
    Direct Link:
  • 62
    Staples J, Rellini AH, Roberts SP. Avoiding experiences: Sexual dysfunction in women with a sexual abuse history in childhood. Arch Sex Behav 2012;41:341–50.
  • 63
    Schloredt KA, Heiman JR. Perceptions of sexuality as related to sexual functioning and sexual risk in women with different types of childhood abuse histories. J Trauma Stress 2003;16:275–84.
    Direct Link:
  • 64
    Rellini AH, Vujanovic AA, Gilbert M, Zwolensky MJ. Childhood maltreatment and difficulties in emotion regulation: Associations with sexual and relationship satisfaction among young adult women. J Sex Res 2011;19:1–9.
  • 65
    Kelly MP, Strassberg DS, Turner CM. Behavioral assessment of couples' communication in female orgasmic disorder. J Sex Marital Ther 2006;32:81–95.
  • 66
    Hayes RD, Dennerstein L, Bennett CM, Sidat M, Gurrin LC, Fairley CK. Risk factors for female sexual dysfunction in the general population: Exploring factors associated with low sexual function and sexual distress. J Sex Med 2008;5:1681–93.
    Direct Link:
  • 67
    Masters WH, Johnson VE. Human sexual inadequacy. Boston: Little; Brown; 1970.
  • 68
    van Lankveld J, Bergh S. The interaction of state and trait aspects of self-focused attention affects genital, but not subjective, sexual arousal in sexually functional women. Behav Res Ther 2008;46:514–28.
  • 69
    Both S, Laan E, Everaerd W. Focusing “hot” or focusing “cool”: Attentional mechanisms in sexual arousal in men and women. J Sex Med 2011;8:167–79.
    Direct Link:
  • 70
    Adams AE III, Haynes SN, Brayer MA. Cognitive distraction in female sexual arousal. Psychophysiology 1985;22:689–96.
    Direct Link:
  • 71
    Dove NL, Wiederman MW. Cognitive distraction and women's sexual functioning. J Sex Marital Ther 2000;26:67–78.
  • 72
    Salemink E, van Lankveld JJ. The effects of increasing neutral distraction on sexual responding of women with and without sexual problems. Arch Sex Behav 2006;35:179–90.
  • 73
    Cranston-Cuebas M, Barlow DH. Cognitive and affective contributions to sexual functioning. Ann Rev Sex Res 1990;1:119–61.
  • 74
    ter Kuile MM, Vigeveno D, Laan E. Preliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women. Behav Res Ther 2007;45:2078–89.
  • 75
    Wiederman MW. Women's body image self-cosciousness during physical intimacy with a partner. J Sex Res 2012;37:60–8.
  • 76
    Seal BN, Meston CM. The impact of body awareness on sexual arousal in women with sexual dysfunction. J Sex Med 2007;4(4 Pt 1):990–1000.
    Direct Link:
  • 77
    Oberg K, Fugl-Meyer K, Fugl-Meyer AR. On Swedish women's distressing sexual dysfunction: Somen concomitant conditions and life satisfaction. J Sex Med 2005;2:169–80.
    Direct Link:
  • 78
    Rubio-Aurioles E, Kim ED, Rosen RC, Porst H, Burns P, Zeigler H, Wong DG. Impact on erectile function and sexual quality of life of couples: A double-blind, randomized, placebo-controlled trial of tadalafil taken once daily. J Sex Med 2009;6:1314–23.
    Direct Link:
  • 79
    Dean J, Rubio-Aurioles E, McCabe M, Eardley I, Speakman M, Buvat J, de Tejada IS, Fisher W. Integrating partners into erectile dysfunction treatment: Improving the sexual experience for the couple. Int J Clin Pract 2008;62:127–33.
    Direct Link:
  • 80
    Askew J, Davey M. Women living with men who use Viagra: An exploratory study. J Couple Relatsh Ther 2012;2004:23–41.
  • 81
    Muller MJ, Ruof J, Graf-Morgenstern M, Porst H, Benkert O. Quality of partnership in patients with erectile dysfunction after sildenafil treatment. Pharmacopsychiatry 2001;34:91–5.
  • 82
    Basson R, Weijmar Schultz WCM, Binik YM, Brotto LA, Eschenbach DA, Laan E, Utian WH, Wesselmann U, Lankveld Van J, Wyatt G, Leiblum S, Althof SE, Redmond G. Woman's sexual desire and arousal disorders and sexual pain. In: Lue TF, Basson R, Rosen R, Giuliano F, Khoury S, Montorsi F, eds. Sexual medicine. Sexual dysfunctions in men and women. 2nd edition. Paris: Health Publications; 2004:851–990.
  • 83
    Brandenburg U, Schwenkhagen A. Sexual history. In: Goldstein I, Meston C, Davis SR, Traish A, eds. Women's sexual function and dysfunction. Study, diagnosis and treatment. 1st edition. London: Taylor and Francis; 2006:343–6.
  • 84
    Perelman MA. Psychosocial history. In: Goldstein I, Meston C, Davis SR, Traish A, eds. Women's sexual function and dysfunction. Study, diagnosis and treatment. 1st edition. London: Taylor & Francis; 2006:336–42.
  • 85
    Stewart EG. Physical examination in female sexual dysfunction. In: Goldstein I, Meston C, Davis SR, Traish A, eds. Female sexual function and dysfunction. 1st edition. London: Taylor & Francis; 2006:347–55.
  • 86
    Sarrel PM. Effects of hormone replacement therapy on sexual psychophysiology and behavior in postmenopause. J Womens Health Gend Based Med 2000;9(suppl 1):S25–32.
  • 87
    Both S, Laan E. Directed masturbation: A treatment of female orgasmic disorder. In: O'Donohue W, Fischer J, Hayes S, eds. General principles and empirically supported techniques of cognitive behavior therapy. New York: John Wiley & Sons; 2009:158–66.
  • 88
    Brotto LA, Basson R, Luria M. A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. J Sex Med 2008;5:1646–59.
    Direct Link:
  • 89
    Brotto L, Seal BN, Rellini A. Pilot study of a brief cognitive bahavioral versus mindfulness-based intervention for women with sexual distress and a history of childhood sexual abuse. J Sex Marital Ther 2012;38:1–27.
  • 90
    Basson R. Pharmacotherapy for women's sexual dysfunction. Expert Opin Pharmacother 2009;10:1631–48.
  • 91
    Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2003;(4):CD001500.
  • 92
    Dennerstein L, Burrows GD, Wood C, Hyman G. Hormones and sexuality: Effect of estrogen and progestogen. Obstet Gynecol 1980;56:316–22.
  • 93
    Kovalevsky G. Female sexual dysfunction and use of hormone therapy in postmenopausal women. Semin Reprod Med 2005;23:180–7.
  • 94
    Nathorst-Boos J, Wiklund I, Mattsson LA, Sandin K, von Schoultz B. Is sexual life influenced by transdermal estrogen therapy? A double blind placebo controlled study in postmenopausal women. Acta Obstet Gynecol Scand 1993;72:656–60.
    Direct Link:
  • 95
    Wu MH, Pan HA, Wang ST, Hsu CC, Chang FM, Huang KE. Quality of life and sexuality changes in postmenopausal women receiving tibolone therapy. Climacteric 2001;4:314–9.
  • 96
    Kokcu A, Cetinkaya MB, Yanik F, Alper T, Malatyalioglu E. The comparison of effects of tibolone and conjugated estrogen-medroxyprogesterone acetate therapy on sexual performance in postmenopausal women. Maturitas 2000;36:75–80.
  • 97
    Nathorst-Boos J, Hammar M. Effect on sexual life—A comparison between tibolone and a continuous estradiol-norethisterone acetate regimen. Maturitas 1997;26:15–20.
  • 98
    Labrie F, Archer D, Bouchard C, Fortier M, Cusan L, Gomez JL, Girard G, Baron M, Ayotte N, Moreau M, Dube R, Cote I, Labrie C, Lavoie L, Berger L, Gilbert L, Martel C, Balser J. Intravaginal dehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy. Menopause 2009;16:907–22.
  • 99
    Basson R, McInnes R, Smith MD, Hodgson G, Koppiker N. Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with female sexual arousal disorder. J Womens Health Gend Based Med 2002;11:367–77.
  • 100
    Berman JR, Berman LA, Toler SM, Gill J, Haughie S. Safety and efficacy of sildenafil citrate for the treatment of female sexual arousal disorder: A double-blind, placebo controlled study. J Urol 2003;170(6 Pt 1):2333–8.
  • 101
    Caruso S, Intelisano G, Lupo L, Agnello C. Premenopausal women affected by sexual arousal disorder treated with sildenafil: A double-blind, cross-over, placebo-controlled study. BJOG 2001;108:623–8.
  • 102
    Bygdeman M, Swahn ML. Replens versus dienoestrol cream in the symptomatic treatment of vaginal atrophy in postmenopausal women. Maturitas 1996;23:259–63.
  • 103
    Nachtigall LE. Comparative study: Replens versus local estrogen in menopausal women. Fertil Steril 1994;61:178–80.
  • 104
    Billups KL, Berman L, Berman J, Metz ME, Glennon ME, Goldstein I. A new non-pharmacological vacuum therapy for female sexual dysfunction. J Sex Marital Ther 2001;27:435–41.
  • 105
    Billups KL. The role of mechanical devices in treating female sexual dysfunction and enhancing the female sexual response. World J Urol 2002;20:137–41.
  • 106
    Munarriz R, Maitland S, Garcia SP, Talakoub L, Goldstein I. A prospective duplex Doppler ultrasonographic study in women with sexual arousal disorder to objectively assess genital engorgement induced by EROS therapy. J Sex Marital Ther 2003;29(suppl 1):85–94.
  • 107
    Schroder M, Mell LK, Hurteau JA, Collins YC, Rotmensch J, Waggoner SE, Yamada SD, Small W Jr, Mundt AJ. Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients. Int J Radiat Oncol Biol Phys 2005;61:1078–86.
  • 108
    Waldinger MD, Venema PL, van Gils AP, Schweitzer DH. New insights into restless genital syndrome: Static mechanical hyperesthesia and neuropathy of the nervus dorsalis clitoridis. J Sex Med 2009;6:2778–87.
    Direct Link:
  • 109
    Amsterdam A, bu-Rustum N, Carter J, Krychman M. Persistent sexual arousal syndrome associated with increased soy intake. J Sex Med 2005;2:338–40.
    Direct Link:
  • 110
    Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, Graziottin A, Heiman JR, Laan E, Meston C, Schover L, van Lankveld J, Schultz WW. Revised definitions of women's sexual dysfunction. J Sex Med 2004;1:40–8.
    Direct Link:
  • 111
    Bell C, Richardson D, Goldmeier D, Crowley T, Kocsis A, Hill S. Persistent sexual arousal in a woman with associated cardiac defects and raised atrial natriuretic peptide. Int J STD AIDS 2007;18:130–1.
  • 112
    Goldmeier D, Leiblum SR. Persistent genital arousal in women—A new syndrome entity. Int J STD AIDS 2006;17:215–6.
  • 113
    Goldmeier D, Leiblum S. Interaction of organic and psychological factors in persistent genital arousal disorder in women: A report of six cases. Int J STD AIDS 2008;19:488–90.
  • 114
    Goldstein I, De EJB, Johnson JA. Persistent sexual arousal syndrome and clitoral priapism. In: Goldstein I, Meston C, Davis SR, Traish A, eds. Women's sexual function and dysfunction. Study, diagnosis and treatment. London: Taylor & Francis; 2006:674–88.
  • 115
    Graham CA. The DSM diagnostic criteria for female sexual arousal disorder. Arch Sex Behav 2010;39:240–55.
  • 116
    Hatzimouratidis K, Hatzichristou D. Sexual dysfunctions: Classifications and definitions. J Sex Med 2007;4:241–50.
    Direct Link:
  • 117
    Korda JB, Pfaus JG, Goldstein I. Persistent genital arousal disorder: A case report in a woman with lifelong PGAD where serendipitous administration of varenicline tartrate resulted in symptomatic improvement. J Sex Med 2009;6:1479–86.
    Direct Link:
  • 118
    Korda JB, Pfaus JG, Kellner CH, Goldstein I. Persistent genital arousal disorder (PGAD): Case report of long-term symptomatic management with electroconvulsive therapy. J Sex Med 2009;6:2901–9.
    Direct Link:
  • 119
    Leiblum S, Nathan SG. Persistent sexual arousal syndrome: A newly discovered pattern of female sexuality. J Sex Marital Ther 2001;27:365–80.
  • 120
    Leiblum S, Brown C, Wan J, Rawlinson L. Persistent sexual arousal syndrome: A descriptive study. J Sex Med 2005;2:331–7.
    Direct Link:
  • 121
    Leiblum S, Seehuus M, Brown C. Persistent genital arousal: Disordered or normative aspect of female sexual response? J Sex Med 2007;4:680–7.
    Direct Link:
  • 122
    Leiblum S, Seehuus M, Goldmeier D, Brown C. Psychological, medical, and pharmacological correlates of persistent genital arousal disorder. J Sex Med 2007;4:1358–66.
    Direct Link:
  • 123
    Leiblum SR, Chivers ML. Normal and persistent genital arousal in women: New perspectives. J Sex Marital Ther 2007;33:357–73.
  • 124
    Leiblum SR, Goldmeier D. Persistent genital arousal disorder in women: Case reports of association with anti-depressant usage and withdrawal. J Sex Marital Ther 2008;34:150–9.
  • 125
    Mahoney S, Zarate C. Persistent sexual arousal syndrome: A case report and review of the literature. J Sex Marital Ther 2007;33:65–71.
  • 126
    Medina CA. Clitoral priapism: A rare condition presenting as a cause of vulvar pain. Obstet Gynecol 2002;100(5 Pt 2):1089–91.
  • 127
    Thorne C, Stuckey B. Pelvic congestion syndrome presenting as persistent genital arousal: A case report. J Sex Med 2008;5:504–8.
  • 128
    Waldinger MD, van Gils AP, Ottervanger HP, Vandenbroucke WV, Tavy DL. Persistent genital arousal disorder in 18 Dutch women: Part I. MRI, EEG, and transvaginal ultrasonography investigations. J Sex Med 2009;6:474–81.
    Direct Link:
  • 129
    Waldinger MD, Schweitzer DH. Persistent genital arousal disorder in 18 Dutch women: Part II. A syndrome clustered with restless legs and overactive bladder. J Sex Med 2009;6:482–97.
    Direct Link:
  • 130
    Wylie K, Levin R, Hallam-Jones R, Goddard A. Sleep exacerbation of persistent sexual arousal syndrome in a postmenopausal woman. J Sex Med 2006;3:296–302.
    Direct Link:
  • 131
    Yero SA, McKinney T, Petrides G, Goldstein I, Kellner CH. Successful use of electroconvulsive therapy in 2 cases of persistent sexual arousal syndrome and bipolar disorder. J ECT 2006;22:274–5.
  • 132
    Brotto L, Chik H, Ryder A, Gorzalka BB, Seal BN. Acculturation and sexual function in Asian women. Arch Sex Behav 2005;34:613–26.
  • 133
    Jensen PT, Groenvold M, Klee MC, Thranov I, Petersen MA, Machin D. Int J Radiat Oncol Biol Phys 2003;56:937–49.
  • 134
    Xiao D, Huang X, Pearce W, Longo L, Zhang L. Effect of cortisol on norepinephrine mediated contraction in ovine uterine arteries. Am J Physiol Heart Circ Physiol 2003;284:1142–51.
  • 135
    Exton N, Exton MS. Neuroendocrine response to film-induced sexual arousal in men and women. Psychoneuroendocrinology 2000;25:199.
  • 136
    Brotto LA, Erskine Y, Carey M, Ehlen T, Finlayson S, Heywood M, Kwon J, McAlpine J, Stuart G, Thomson S, Miller D. Gynecol Oncol 2012;125:320–5.
  • 137
    Bitzer J, Giraldi A, Pfaus J. A standardized diagnostic interview for Hypoactive Sexual Desire Disorder in women: Standard operating procedure (SOP part 2). J Sex Med 2012. doi: 10.1111/j.1743-6109.2012.02817.x.
    Direct Link:
View Full Article (HTML) Get PDF (173K)