The Site of Female Sex Issues

Neuroanatomic Correlates of Female Sexual Dysfunction in Multiple Sclerosis.
Winder K, Linker RA, Seifert F, Deutsch M, Engelhorn T, Dörfler A, Lee DH, Hoesl KM, Hilz MJ. Ann Neurol. 2016 Jul 27. doi: 10.1002/ana.24746. [Epub ahead of print]


OBJECTIVE: This study intended to determine associations between alterations of female sexual arousal as well as vaginal lubrication and the site of cerebral multiple sclerosis (MS) lesions.
METHODS:
In 44 women with MS (mean age 36.5±9.9 years), we assessed their medical history and evaluated sexual function using the Female Sexual Function Index scores for arousal and vaginal lubrication. We determined potential confounding factors of sexual dysfunction: age, disease duration, physical disability, depression, bladder or urinary dysfunction, and total volume of cerebral lesions. Arousal and lubrication scores were correlated with each other and with potential confounding factors. Cerebral MS lesions were recorded on imaging scans. 


RESULTS: Decreased arousal scores correlated with decreased lubrication scores; decreased lubrication scores were associated with bladder or urinary symptoms. Arousal and lubrication scores were not associated with any other variables. Multivariate analysis including arousal and lubrication scores showed right occipital lesions associated with impaired arousal and left insular lesions associated with decreased lubrication. Impaired lubrication remained associated with left insular lesions after adjustment for bladder or urinary dysfunction.
INTERPRETATION: Our data indicate that impaired female sexual arousal is associated with MS lesions in the occipital region integrating visual information and modulating attention towards visual input. Impaired lubrication correlated with lesions in the left insular region contributing to mapping and generating visceral arousal states


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