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Description:The pathophysiology of female sexual dysfunction appears more complex than that of males, involving multidimensional hormonal, neurological, vascular, psychological, and interpersonal aspects. Dysfunction of the sensory fibers may interfere with the afferent signaling and sensory modalities that are quite important in female sexual response. Diabetes mellitus, which is known to cause erectile dysfunction in men, may interfere with sexual function in women [ 55 - 58 ]. Interneurons mediating these reflexes are known to be in a column in the central portion of the spinal gray matter. In general, it is believed that any central lesion would alter the efferent and afferent pathways of female sexual response leading to dysfunction. Studies with a rabbit model have shown that electrical stimulation of the vaginal branch of the pelvic nerve increases clitoral intracavernosal pressure and blood flow, vaginal wall pressure and blood flow, and vaginal length [ 19 ]. Immunohistochemical description of nitric oxide synthase isoforms in human clitoris.
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