Female Sexual Function and the Pelvic Floor

Sarit O. Aschkenazi;   Roger P. Goldberg


Expert Rev of Obstet Gynecol. 2009;4(2):165-178. 

In This Article

Expert Commentary

Following the ongoing basic and clinical research on adult male sexual dysfunction, tremendous developments have been made in recent years in understanding the complexity of the female sexual cycle. At the same time, progress has been made in understanding the normal anatomy and physiology of the female pelvic floor and what the pertinent processes that ultimately lead to the development of PFDs are. There is growing investment in gaining knowledge regarding mediators and cellular mechanisms determining female sexual cycle and sexual responses. The classification of healthy and dysfunctional female sexuality is under dynamic evolution as more insight is gained on the mechanisms that impact normal and abnormal response. Consequently, as research in this field accumules, there is an increased understanding of the complexity of the normal female sexual cycle, which has led to a change in the definitions to reflect women's individual self-reporting and lifetime experiences.

Several risk factors have been linked to the development of FSDs. These involve a multitude of areas, which underscores the complexity of the female sexual cycle. It is becoming accepted that FSDs are very prevalent, which is not surprising in view of the host of factors that can upset normal sexual function in women. There is a fine balance between physiological, anatomical, hormonal and social components, which all interact to maintain healthy sexual function. Research efforts have recently yielded results that are shedding light on the link between specific risk factors and subtypes of female sexual dysfunctions. At present, little is known regarding which factors are most influential and have the greatest impact on sexual functioning, and how treatment can improve or restore normal function.

There is increasing acknowledgement of the strong link between normal pelvic floor function and healthy female sexual function. With this comes the recognition that PFDs may adversely affect sexual function. This realization has led to a rise in clinical research to further elucidate the complex relationship between female sexual function and various treatment modalities for PFDs. However, more is unknown than is understood. Elucidating processes that lead to specific pelvic floor and sexual dysfunctions will potentially provide a path for timely diagnosis and new, more effective treatment modalities, which will ultimately lead to better quality of life and functionality.


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