Normal and Persistent Genital Arousal in Women: New Perspectives

Abstract

Interest in women's sexual functioning has increased in recent years although the primary emphasis has been on deficits in both genital and subjective sexual response. Female sexual psychophysiology research suggests that women are capable of greater sexual responsiveness than previously thought and can experience genital response in the absence of a subjective experience of sexual arousal. Women who report relatively persistent genital arousal, both with and without accompanying distress, provide case examples of the potential for dissociation between genital and psychological sexual response. In this article, we provide case illustrations of women reporting unprovoked genital arousal both with and without distress and suggest that what appears to be spontaneous genital arousal in some women may be the result of either subconscious processing of sexual stimuli in the environment—stimuli that are either consciously unacceptable or not noticed. Finally, we suggest that there may exist three types of genital arousal in women: 1) spontaneous sensations of genital arousal that are appraised as mildly pleasurable; 2) persistent feelings of genital arousal that are experienced as mildly distracting but not especially unwelcome or bothersome; and 3) continuous, intense, and persistent genital arousal that is extremely distracting, distressing, and worrisome. A variety of psychological, pharmacological, vascular, and neurological factors may account for these differences in women's genital arousal responsiveness. However, a full understanding of the range and variation in women's sexual experience remains to be elucidated.

Notes

¹Using the principles of light reflectance, vaginal photoplethysmography measures the changes in bloodflow to the vaginal epithelium that occur during female sexual response. The most commonly reported measure of genital bloodflow—change in vaginal pulse amplitude (VPA)—has been shown to be a valid measure of vaginal vasocongestion specific to sexual response in women (Laan et al., 1995).

²The terms genital response and sexual arousal are not interchangeable: the former is a physiological response, whereas the latter is an emotional response resulting from the appraisal of physiological, psychological, and contextual factors as sexually appetitive (see Chivers, 2005).