Sexual arousal: similarities and differences between men and women

Sexual arousal encompasses activation of physiological systems that coordinate sexual function in both sexes and can be divided into central arousal, peripheral non-genital arousal, and genital arousal. Genital arousal leads to erection in men and to vaginal lubrication and clitoral/vulvar (vestibular bulb) congestion in women. Persisting biases in the understanding of the pathophysiology of sexual arousal are exemplified by the current differences in definitions. In men, sexual arousal disorders are identified with erectile disorders. In women, a more sophisticated set of definitions is described. It includes the subjective arousal disorder, the genital arousal disorder, the mixed arousal disorder, and the persistent sexual arousal disorder. Painful arousal, although not officially included in current nosology, should be considered. A preliminary critical consideration of similarities and differences in the definitions of arousal disorders, in the physiology of sexual arousal, in the causes of arousal disorders, and the influence of arousal disorders on satisfaction with the partner and happiness will be presented. In contrast to popular opinion, women's arousal disorders influence their physical (OR = 7.04 (4.71–10.53)) more than their emotional satisfaction (OR = 4.28 (2.96–6.20)). Furthermore such disorders are reported to have a greater effect on women's physical satisfaction (OR = 7.04 (4.71–10.53)) than erectile dysfunction has on men's physical satisfaction (OR = 4.38 (2.46–7.82)). More research and clinical investigation in needed to increase clinicians’ understanding of the similarities and differences between male and female sexual physiology and pathophysiology, promote parallel thinking in sexual medicine, and facilitate clinical diagnoses of arousal disorders.