Gender Difference in Brain Activation to Audio-Visual Sexual Stimulation

Do Women and Men Experience the Same Level of Arousal in Response to the Same Video Clip?

WS Chung; SM Lim; JH Yoo; H Yoon


Int J Impot Res. 2013;25(4):138-142. 

In This Article

Abstract and Introduction


Factors related to sexual arousal are different in men and women. The conditions for women to become aroused are more complex. However, the conventional audio-visual stimulation (AVS) materials used to evaluate sexual arousal are universal. In the present study, we investigated sexual differences in the response to different types of AVS by studying activated areas of the brain using functional magnetic resonance imaging (fMRI). fMRI was performed during two types of AVS in 20 healthy heterosexual volunteers (aged 20–28 years, 10 men and 10 women). The two AVS types were: (1) mood type, erotic video clips with a concrete story and (2) physical type, directly exposing sexual intercourse and genitalia. fMRI images were analyzed and compared for each stimulation with a Mann–Whitney U test, with statistical significance set at P<0.05. Men preferred the physical type of AVS to the mood type (mean arousal score 2.14 vs 1.86 in females) and women preferred the mood type (mean arousal score 2.14 vs 1.86 in males) (P<0.05). Degrees of activation in brain areas differed between genders and types of AVS for each gender. This should be considered when applying the AVS method to evaluate and diagnose female sexual dysfunction.


Arousal and desire are interwoven and expressed in different ways in men and women. Understanding human sexual responses and their basic mechanisms and abnormalities is essential for diagnosing and managing female sexual dysfunction.

The human sexual response cycle, sexual desire, activities, satisfaction, and physical and mental responses in men and women are different. Men usually feel sexual satisfaction during sexual activity and are more prone to physical attraction, whereas women are more affected by the environment and emotions related to the sexual partner or sexual fantasy in terms of sexual satisfaction.[1,2] Men generally respond to visual sexual stimuli, such as attractive nude or erotic pictures, or erotic films. Women respond differently to the same sexual stimuli. Some women feel repulsed by muscular, erotic male photos, and some are sexually attracted by emotional or lingual stimulation.[3] In other words, men are more sexually aroused by visual stimuli, but women are more sexually aroused by concrete, auditory, olfactory, touch and emotionally relevant sexual stimulation.[4–6] For example, adolescent boys frequently feel strong genital responses to visual sexual stimuli, which are usually accompanied by a craving for sexual expression or masturbation. In contrast, adolescent girls' sexual feelings often arise from emotional reactions to their partner, or romantic themes in films, novels and magazines. Some experimental studies have shown that men respond more to sexual stimuli than women do.[1,2]

These may be referred to as 'the gender differences of sexual response and sexual function.' There appears to be a clear gender difference in sexual response and function. For optimal outcome, we should therefore consider the different preferences of the two genders when studying sexual function and dysfunction.

Functional magnetic resonance imaging (fMRI) is a widely used method to detect individual sexual arousal by measuring and mapping activated areas of the brain. Improvements in MRI methodology and mechanics provide more discrete functional information in addition to anatomical information of the human brain.

Historically, there have been a few studies of MRI-based brain region activation in response to visual sexual stimuli in different genders or sexual preferences.[6–10] However, only a few previous studies reported gender differences in brain activation response to certain sexual stimuli.[11,12] Although audio-visual stimulation (AVS) is widely used in the clinical setting to induce sexual arousal to examine male or female sexual dysfunction, personal or gender preference to such stimuli-inducing sexual arousal has not been considered, despite discrete sexual preferences between men and women in general AVS examination settings.

There is a lack of data using different AVS to measure sexual response and preference in both men and women to each stimulation.

Therefore, in this study, we aimed to investigate the differences in sexual arousal between men and women in response to different types of AVS in view of gender specificity.