Genital responsiveness in healthy women with and without sexual arousal disorder

Introduction. Most pharmacological treatments that are currently being developed for women with sexual arousal disorder are aimed at remedying a vasculogenic deficit. Aim. This study investigated whether pre- and postmenopausal women with sexual arousal disorder are less genitally responsive to visual sexual stimuli than pre- and postmenopausal women without sexual problems. Method. Twenty-nine medically healthy women with sexual arousal disorder (15 premenopausal and 14 postmenopausal), diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria, and 30 age-matched women without sexual problems (16 premenopausal and 14 postmenopausal) were shown sexual stimuli depicting cunnilingus and intercourse. Main Outcome Measure. Genital arousal was assessed as vaginal pulse amplitude (VPA) using vaginal photoplethysmography. Results. Results showed no significant differences between the two groups in mean and maximum VPA, nor in latency of VPA response. Conclusion. Women with sexual arousal disorder diagnosed according to DSM-IV criteria were not less genitally responsive to visual sexual stimuli than women without such problems. These findings are in line with previous studies. The sexual problems these women report are clearly not related to their potential to become genitally aroused. We argue that the DSM-IV criteria for sexual arousal disorder are in need of revision. In medically healthy women, impaired genital responsiveness is not a valid diagnostic criterion.