Detecting genital arousal much harder in women with arousal-specific sexual dysfunction

Women with arousal-specific sexual dysfunction are significantly less likely to perceive when their genitals are sexually aroused compared to women who have decreased sexual function or are sexually functional, according to an analysis of data from 5 studies totaling 214 women that appears in The Journal of Sexual Medicine.

All participants viewed an erotic movie while their physiologic genital arousal was measured with a vaginal photoplethysmograph, which detects changes in blood volume in genital tissue. Simultaneously, the women used a handheld device that recorded their perceived perception of the amount of blood in their genitals on a scale of 0 to 7.

 “Many women complain of difficulty becoming sexually aroused and clinicians often assume that means they have less blood flow to their genitals during sexual arousal,” said co-author Cindy Meston, PhD, a professor of clinical psychology at the University of Texas at Austin. “But it could also mean that some women are simply not able to accurately perceive their level of genital arousal.”  

The goal of the current analysis was to determine whether there are differences between women with and without an arousal disorder in their actual and perceived levels of genital arousal during a sexually arousing movie.

“What we found was that for actual genital arousal, there were no substantial differences among the 3 groups of women,” Dr. Meston told Contemporary OB/GYN. “However, for perceived genital responses, there were significant differences in women with arousal-specific sexual dysfunction compared to the women in the other 2 groups. Women who have specific arousal disorders reported experiencing significantly less genital arousal.”  

Dr. Meston is not surprised by any of the findings. “However, it would be surprising to most clinicians that there were not significant differences in the actual genital measures between the 3 groups,” she said. “This lack of differences is important because if a woman comes in and says she is not aroused, one should not jump to the conclusion that blood is not flowing into her genitals during a sexual scenario. Blood may be flowing into her genitals; she just may not be perceiving it.” 

Specifically, women who exhibit an arousal disorder “may be showing a genital response and may be experiencing blood flow into their genitals when they are in a sexual situation,” Dr. Meston said. “But they may not be attending to it or perceiving it as a sexual response.”

For clinicians who are helping women who have problems becoming sexually aroused, “you first want to check if the woman is having a genital response,” Dr. Meston noted. “However, you also want to ensure that even if the woman is having a genital arousal response, that she is perceiving that response – that she is paying attention to it, that she is aware of it and that she is interpreting it as a sexual response – because realizing your body is responding sexually can be a meaningful aspect of a woman’s overall experience of feeling psychologically sexually ‘turned on’ or aroused.”