Sexual arousal and orgasm in women: Effects of spinal cord injury

Sexual disorders are common in women! however, the neurological basis of fe male sexual response has not been adequately investigated. This information is necessary to characterize the impact of various neurological disorders on sexual arousal in women and to develop appropriate management strategies for sexual dysfunction. To assess the spinal mediation of sexually stimula ted genital vasocongestion in women, we conducted two laboratory-based, con trolled analyses: (1) of women's genital, subjective, and autonomic respons es to audiovisual erotic and audiovisual erotic combined with manual genita l stimulation; and (2) of women's ability to achieve orgasm. Subjects inclu ded 68 premenopausal women with spinal cord injuries (SCIs) and 21 able-bod ied, age-matched controls. Results indicated that preservation of sensory f unction in the T11-L2 dermatomes is associated with psychogenically mediate d genital vasocongestion. Less than 50% of women with SCIs were able to ach ieve orgasm, compared with 100% of able-bodied women (p = 0.001). Only 17% of women with complete lower motor neuron dysfunction affecting the S2-S5 s pinal segments were able to achieve orgasm, compared with 59% of women with other levels and degrees of SCIs (p = 0.048). Time to orgasm was significa ntly increased in women with SCIs compared with able-bodied controls (p = 0 .043). Independent raters were unable to differentiate between subjective d escriptions of orgasm from SCI women compared with controls. This informati on should be used when counseling women with spinal dysfunction about their sexual potential.