Endocrine Disorders and Sexuality II: Ovary

The knowledge of the physiology of sexual function in women is not completely defined; therefore, in recent years, there has been renewed interest in the role of sexual steroids in women’s normal sexual function and dysfunction. Endocrine changes due to the aging process as well as different ovary disorders may either directly or indirectly modulate sexual function by altering sex hormones or by impacting vascular, neurogenic, and/or psychologic factors. Population studies on sexual function identify female sexual interest arousal disorder as being the most common sexual complaint among premenopausal women. Some studies assessing sexual function across menstrual cycle identify the periovulatory days as those with more sexual desire or activity. Studies of the influence of hormone therapy including the oral contraceptive pill on sexual function are contradictory with most prospective controlled studies showing no deleterious or even a positive effect. Studies of the influence of endogenous androgens on sexuality are also contradictory showing no correlation in one large cross-sectional study, whereas some other studies suggest that low androgens are common in women with sexual dysfunction. Studies on the effect on sexual function of estrogen and testosterone therapy in pre- and postmenopausal women are difficult to generalize, with no clear dose-response effect. Finally, it should be noted that sex hormones can have a modifying effect on sexual function, but social influences and learned responses are just as important.