Objective To verify whether sildena®l is effective in young premenopausal women affected by arousal disorder.Design A double-blind cross-over study. Setting Centre for Sexological Research, Department of Microbiological and Gynaecological Science, University of Catania, Italy.Sample Fifty-three volunteer women aged 22±28 years affected by arousal disorders.Methods The study consisted of three 4-week periods: sildena®l, washout, placebo, by six possible sequences. sildena®l was used at 25 mg or 50 mg.Main outcome measures Ef®cacy was assessed at baseline and once monthly by the Personal Experiences Questionnaire based on the 5-point Likert scale. The questionnaire quanti®ed subjective arousal (primary endpoint), and orgasm, enjoyment, sexual frequency, and the number of sexual fantasies.Results Fifty-one women completed the study. Mean (SD) usage of sildena®l 25mg and 50mg was, respectively, 2.8 (0.8) and 2.7 (1.3) times weekly, while mean usage of placebo was 2.8 (1.6) times weekly. During both sildena®l dosages, arousal and orgasm improved with respect to placebo (P , 0.001). Therapeutically significant differences were not noted during the treatment with both 50 mg and 25 mg of sildena®l for arousal and orgasm. The frequency of sexual fantasies and of sexual intercourse, and enjoyment, improved in the women treated with sildena®l (P , 0.05).Conclusions Our study suggests that sildena®l may improve sexual performance of women affected by sexual dif®culties such as arousal disorder, and may indirectly improve other aspects of sexual life. Moreover, further studies need to de®ne the use of PDE type 5 inhibitors in this sexual pathophysiology.

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Introduction In mammals, the effects of ovarian steroids influence sexual behavior. In humans, there are a few studies that take into account if ovulation occurs. Aim The study aims to investigate if a woman's sexuality changes during the week and over the menstrual cycle, and if so, in what way. Methods This is a prospective cohort study; 1,957 heterosexual women were involved over the period January 2004–December 2011. Two subgroups were taken into consideration, women having a partner and singles. Main Outcome Measure Sexual interview and the Female Sexual Function Index and Female Sexual Distress Scale questionnaires were used to exclude women with sexual dysfunction. Women with ovulation confirmed by sonography were enrolled. Women were given diary cards on which to report their daily sexual activity. Serum concentrations of estradiol, progesterone, total testosterone, sex hormone binding globulin, and free androgen index were measured during the follicular, periovular, and luteal phase of the menstrual cycle. Results One thousand one hundred eighty women (age range 18–40 years) were included in the analyses. Of them, 925 had a heterosexual relationship and 255 were single. Women with a partner had more sexual activity during the weekend, while the singles had a constant sexual activity over the week. The sexual activity of singles was higher during the ovulatory phase and lower during menses than that of the women with a partner. A linear correlation between sexual activity and androgenic hormonal profile during the menstrual cycle in women with and without a partner was observed. Conclusions Ovarian steroids modulate a woman's sexual activity. This aspect was more evident in singles than in women having a partner, in which a variety of nonhormonal factors can have a role.

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Introduction Hyperandrogenism produces change in quality of life of women. Aim To prespectively determine the changes of the sexual behaviour of hyperandrogenic women using an oral contraceptive containing 30 µg ethinylestradiol and 2 mg chlormadinone acetate (EE/CMA). Methods Seventy-two volunteer women (age range, 18–32 years), with moderate to severe hirsutim and acne were treated with EE/CMA for 9 cycles. Main Outcomes Measure(s) To assess hirsutism, the Ferriman-Gallwey (F-G) scoring system was used. Serum FSH, LH, estradiol, total and free testosterone, DHEAS, androstenedione, and SHBG levels were measured at baseline and at the 9th cycle of pill intake. The Short Personal Experience Questionnaire (SPEQ), the Short Form-36 (SF-36), and a visual analog scales questionnaires were used to assess the QoL, at baseline and after 3, 6 and 9 cycles of pill use. Result(s) A reduction of 65% and 81% in the total mean F-G score was observed after the 6th cycle and the 9th cycle, respectively. The serum Androstenedione, and total and free testosterone levels decreased, and SHBG levels increased after the 9th cycle (p < 0.05). The SF-36 score was higher after 6 (p < 0.05) 9 cycles (p < 0.001) with respect to baseline. Frequency of sexual intercourse and of orgasm by intercourse increased, and the frequency of masturbation decreased during the 6th (p < 0.05) and the 9th cycle (p < 0.001). Conclusion(s) The EE/CMA pill has anti-androgenic properties reducing the anti-aesthetic effect of hyperandrogenism and improving female sexual and social self-esteem.

Unlike the rhinomanometric airflow and trans-nasal pressure, the olfactory threshold to odours seems to depend on the variations of the ovarian steroids during the menstrual cycle and on the iatrogenic effects of oral contraceptives.

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