Abstract
Female sexual arousal results from a complex series of psychological, neurologic, and cardiovascular events. Various sexual stimulations lead to central nervous system activation, resulting in engorgement of genital structure and vaginal lubrication. Functional MRI (fMRI) technique can clarify brain function associated with sexual arousal and response. fMRI studies have revealed the functional neuroanatomy of the brain associated with sexual arousal by visual sexual stimulation, and fMRI looks very promising for investigating the effects of hormonal therapy or other medication on central nervous system arousal. Further intensive studies are needed to verify fMRI findings and to obtain additional information on the neural mechanism of sexual function in women. This article reviews the basic principle of fMRI and its clinical applications, for the study of female sexual function.
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References and Recommended Reading
Laumann EO, Paik A, Rosen RC:Sexual dysfunction in the United States: prevalence and predictors.JAMA 1999,281:537–44. [Published erratum appears inJAMA 1999,281:1174.]
Lewis RW, Fugl-Meyer KS, Bosch R, et al.:Epidemiology/risk factors of sexual dysfunction.J Sex Med 2004,1:35–39.
Beharry RK, Hale TM, Wilson EA, et al.:Evidence for centrally initiated genital vasocongestive engorgement in the female rat: findings from a new model of female sexual arousal response.Int J Impot Res 2003,15: 122–128.
Park K, Goldstein I, Andry C, et al.:Vasculogenic female sexual dysfunction: the hemodynamic basis for vaginal engorgement insufficiency and clitoral erectile insufficiency.Int J Impot, Res 1997,9:27–37.
Traish AM, Kim NN, Munarriz R, et al.:Biochemical and physiological mechanisms of female genital sexual arousal.Arch Sex Behav 2002,31:393–400.
Goldstein I, Alexander JL:Practical aspects in the management of vaginal atrophy and sexual dysfunction in perimenopausal and postmenopausal women.J Sex Med 2005,2(Suppl3):154–165.
Min K, Munarriz R, Berman J, et al.:Hemodynamic evaluation of the female sexual arousal response in an animal model.J Sex Marital Ther 2001,27:557–565.
Park K, Ahn K, Lee S, et al.:Decreased circulating levels of estrogen alter vaginal and clitoral blood flow and structure in the rabbit.Int J Impot Res 2001,13:116–124.
Sipski ML:Central nervous system based neurogenic female sexual dysfunction: current status and future trends.Arch Sex Behav 2002,31:421–424.
Stoleru S, Gregoire MC, Gerard D, et al.:Neuroanatomical correlates of visually evoked sexual arousal in human males.Arch Sex Behav 1999,28:1–21.
Ring HA, George M, Costa DC, Ell PJ:The use of cerebral activation procedures with single photon emission tomography.Eur J Nucl Med 1991,18:133–141.
Longworth C, Honey G, Sharma T:Science, medicine, and the future: functional magnetic resonance imaging in neuropsychiatry.BMJ 1999,319:1551–1554.
Amaro E Jr, Barker GJ:Study design in fMRI: basic principles.Brain Cogn 2006,60:220–232.
Ogawa S, Lee TM, Kay AR, Tank DW:Brain magnetic resonance imaging with contrast dependent on blood-oxygenation.Proc Natl Acad Sci USA 1990,87:9868–9872.
Lue TF:Experimental models for the study of male sexual function. InSexual Medicine: Sexual Dysfunctions in Men and Women. Edited by Lue TF. Paris: Health Publications; 2004:243–286.
Goldstein I:Blood flow: magnetic resonance imaging and brain imaging for evaluating suxual arousal in women. InWomen’s Sexual Function and Dysfunction: Study, Diagnosis and Treatment. Edited by Goldstein I, Meston C, Davis S, Traish A. London: Taylor and Francis; 2006:368–382.
Park K, Kang HK, Seo JJ, et al.:Blood-oxygenationlevel-dependent functional magnetic resonance imaging for evaluating cerebral regions of female sexual arousal response.Urology 2001,57:1189–1194.
Kim HJ, Jeong GW, Eun SJ, et al.:Qualitative and quantitative measurement of brain activity associated with visual sexual arousal in males and females: 3.0 Tesla functional MR imaging.J Korean Radiol Soc 2004,51:179–190.
Papez JW:A proposed mechanism of emotion.Arch Neurol Psychiatry 1937,38:725–743.
Karama S, Lecours AR, Leroux JM, et al.:Areas of brain activation in males and females during viewing of erotic film excerpts.Hum Brain Mapp 2002,16:1–13.
Koukounas E, McCabe M:Sexual and emotional variables influencing sexual response to erotica.Behav Res Ther 1997,35:221–230.
Hamann S, Herman RA, Nolan CL, et al.:Men and women differ in amygdala response to visual sexual stimuli.Nat Neurosci 2004,7:411–416.
Of importance Gizewski ER, Krause E, Karama S, et al.:There are differences in cerebral activation between females in distinct menstrual phases during viewing of erotic stimuli: a fMRI study.Exp Brain Res 2006,174:101–108. This paper demonstrated that the menstrual cycle influences female sexual arousal, using fMRI and reported differences between females.
Berman JR, Berman LA, Werbin TJ, et al.:Clinical evaluation of female sexual function: effects of age and estrogen status on subjective and physiologic sexual responses.Int J Impot Res 1999,11(Suppl 1):S31-S38.
Genazzani AR, Spinetti A, Gallo R, Bernardi F:Menopause and the central nervous system: intervention option.Maturitas 1999,31:103–110.
Jeong GW, Park K, Youn G, et al.:Assessment of cerebrocortical regions associated with sexual arousal in premenopausal and menopausal women by using BOLD-based functional MRI.J Sex Med 2005,2:645–651.
Murphy DG, DeCarli C, McIntosh AR, et al.:Sex differences in human brain morphometry and metabolism: an in vivo quantitative magnetic resonance imaging and positron emission tomography study on the effect of aging.Arch Gen Psychiatry 1996,53:585–594.
Berman KF, Schmidt PJ, Rubinow DR, et al.:Modulation of cognition-specific cortical activity by gonadal steroids: a positron-emission tomography study in women.Proc Natl Acad Sci U S A 1997,94:8836–8841.
Of major importance Archer JS, Love-Geffen TE, Herbst-Damm KL, et al.:Effect of estradiol versus estradiol and testosterone on brain-activation patterns in postmenopausal women.Menopause 2006,13:528–537. This paper showed the effects of hormonal replacement therapy on the brain activation patterns, using fMRI.
Henderson VW, Guthrie JR, Dudley EC, et al.:Estrogen exposures and memory at midlife: a population-based study of women.Neurology 2003,30:1369–1371.
Grady D, Yaffe K, Kristof M, et al.:Effect of postmenopausal hormone therapy on cognitive function: the Heart and Estrogen/progestin Replacement Study.Am J Med 2002,113:543–548.
Binder EF, Schechtman KB, Birge SJ, et al.:Effects of hormone replacement therapy on cognitive performance in elderly women.Maturitas 2001,38:137–146.
Markowska AL, Savonenko AV:Effectiveness of estrogen replacement in restoration of cognitive function after long-term estrogen withdrawal in aging rats.J Neurosci 2002,22:10985–10995.
Joffe H, Hall JE, Gruber S, et al.:Estrogen therapy selectively enhances prefrontal cognitive processes: a randomized, double-blind, placebo-controlled study with functional magnetic resonance imaging in perimenopausal and recently postmenopausal women Menopause 2006,13:411–422.
Lue TF:Women’s orgasm. InSexual medicine: Sexual Dysfunctions in Men and Women. Edited by Lue TF. Paris: Health Publications; 2004:785–850.
Goldstein I:The physiology and pathophysiology of the female orgasm. InWomen’s Sexual Function and Dysfunction: Study, Diagnosis and Treatment. Edited by Goldstein I, Meston C, Davis S, Traish A. London: Taylor and Francis; 2006:228–235.
Komisaruk BR, Whipple B:Functional MRI of the brain during orgasm in women.Annu Rev Sex Res 2005,16:62–86.
Whipple B, Komisaruka BR:Brain (PET) responses to vaginal-cervical self-stimulation in women with complete spinal cord injury: preliminary findings.J Sex Marital Ther 2002,28:79–86.
Zarahn E, Aguirre GK, D’Esposito M:A trial-based experimental design for fMRI.Neuroimage 1997,6:122–138.
Conturo TE, Mckinstry RC, Akbudak E, Robinson BH:Encoding of anisotropic diffusion with tetrahedral gradients: a general mathematical diffusion formalism and experimental results.Magn Reson Med 1996,35:399–412.
Conturo TE, Lori NF, Cull TS, et al.:Tracking neuronal fiber pathways in the living human brain.Proc Natl Acad Sci U S A 1999,96:10422–10427.
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Park, K., Jeong, GW. The role of functional MRI in neural assessment of female sexual dysfunction. Curr Sex Health Rep 4, 33–40 (2007). https://doi.org/10.1007/BF02938329
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DOI: https://doi.org/10.1007/BF02938329