To understand FOD, it is first necessary to understand the physiological changes that normally take place in a woman's body during sexual arousal and orgasm. There is a significant increase in clitoral cavernosal pressure as well [ 19 ]. However, whereas there are emotional and relational elements to sexual function, it has become increasingly evident that female sexual dysfunction can occur secondary to medical problems and have organic roots. The prevalence of female sexual dysfunction is a topic that has generated extensive discussions in the medical and lay communities alike. At the same time, it has been reported that administration of VIP, either intravenously or by injection in the vaginal wall, increases vaginal blood flow and induces vaginal fluid production [ 10 , 30 ].
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Overall, the state of our knowledge is less advanced regarding female sexual physiology in comparison with male sexual function. This involves educating the patient regarding facts of physiology, endocrinology, contraception, or normal sexual response. Female sexual dysfunction is clearly an important women's health issue that affects the quality of life of many female patients. Additional moistening during intercourse comes from secretions of the paired greater vestibular or Bartholin's glands, although some believe that these glands also have a more primal function of emitting an odiferous fluid to attract the male. This means ruling out major depression, chronic fatigue symptoms, and the range of other emotional and relationship conflicts that may impact on a patient's desire and happiness. This ultimately results in symptoms of vaginal dryness and dyspareunia.
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Female orgasmic disorder - causes, DSM, effects, therapy, drug, used, medication, effect

There are a number of situations in which an educational pelvic examination proves to be a useful clinical tool Table 2. As of , clinical trials are under way to investigate the effect of sildenafil Viagra on women's sexual response. In an older population of patients, physicians may subscribe to larger social norms that devalue sexuality among the aged, viewing them as asexual or not capable of sustaining a sexual relationship. Connected to the glans clitoris is the body of the clitoris. The distal two-thirds of the vagina is suggested to be a derivative of the urogenital sinus whereas the proximal part is thought to originate from the uterovaginal primordium [ 39 ].
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A recent study by Min and colleagues showed that pelvic nerve stimulation PNS caused a frequency-dependent increase in genital blood flow in New Zealand white rabbits 19 and confirmed that genital tissue engorgement is regulated by PNS. Histologically, it causes diffuse clitoral fibrosis, thinned vaginal epithelial layers, and decreased vaginal submucosal vasculature. The educational pelvic examination allows the physician to assess problems, inform the patient, and recommend specific medical, surgical, or therapeutic treatments indicated by the examination. The medial amygdala appears to be an important center that utilizes vasopressin as a central neurotransmitter [ 34 ]. The dose should be adjusted according to symptoms, free testosterone levels, cholesterol levels, triglyceride levels, HDL levels, and LFT. J Sex Marital Ther In generalized FOD, the failure to have an orgasm occurs with different partners and in many different settings.
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Clitoris berman diagram

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