Physiology of Women's Sexual Function: Basic Knowledge and New Findings

Introduction.  Data concerning the physiology of female sexual functioning are still obtained from animal studies, but an increasing amount of novel evidence comes from human studies. Aim.  To gain knowledge of psychological and biologic physiology of women's sexual functioning, mainly addressing sexual arousal and orgasm. Methods.  A broad-based literature review of current knowledge of the psychological and biologic physiology aspects of women's sexual functioning. Results.  A comprehensive understanding of the anatomical, neurobiological, and psychological mechanisms behind sexual function and responses is of paramount importance. A biopsychological paradigm was considered when reviewing currently available data, thus considering aspects of: (i) sexual differentiation of the brain, which is critical for sex differentiation in behavior; (ii) central neurobiology of sexual function, highlighting specific and innovative findings from neuroimaging methods that enable visualization of active brain areas during arousal and orgasm; and (iii) peripheral functional anatomy, mainly addressing genital arousal and orgasm. Translational science was also covered, providing data about the actual role of sexual arousal in women in both procreation/reproduction and recreation/pleasure. The interaction between physiological and psychological states of women's sexual response, nonspecific sexual response, interoceptive awareness, and flexibility of sexual interests have also been addressed. Conclusion.  Further research on normal physiology of women's sexual function is needed in order to expand and "translate" current knowledge into the pathophysiological clinical setting. This manuscript encompasses data presented at the 3rd International Consultation on Sexual Medicine in Paris, France, July 10-13, 2009. Salonia A, Giraldi A, Chivers ML, Georgiadis JR, Levin R, Maravilla KR, and McCarthy MM. Physiology of women's sexual function: Basic knowledge and new findings. J Sex Med 2010;7:2637-2660.