The Role of 3-D Ultrasonography in the Evaluation of Menstrual Cycle-Related Vascular Modifications of the Clitoris. A Prospective Pilot Study

Abstract

Introduction Clitoral functional modifications occur during the menstrual cycle. Aim To prospectively evaluate, by the three-dimensional (3-D) Doppler flow analysis, the hemodynamic clitoral blood flow variations during the menstrual cycle. Methods Fourteen young (18–35 years), eumenorrheic (menstrual cycle of >25 and <35 days) women in a stable heterosexual relationship (>1 year) and without any sexual dysfunction (as resulted from the two-factor Italian McCoy female sexuality questionnaire ≥35) were submitted, in the early follicular (day 3–5) and in the periovulatory (day 12–14) phases of the menstrual cycle, to bi- and tridimensional ultrasonographic and color Doppler analyses of the clitoral structures. On the same days, the circulating estradiol values were assayed. Main Outcomes Measures Two-dimensional ultrasonographic evaluation of follicular diameter and color Doppler evaluation of the dorsal clitoral arteries; 3-D power Doppler analysis of the clitoral body volume and of the indices of clitoral vascularization and blood flow; estradiol assay. Results The mean virtual organ computer-aided analysis (VOCAL) volume of the clitoral body was lower in the follicular (0.79 ± 0.19 mL) phase with respect to the periovulatory phase (0.98 ± 0.22 mL; P <0.001); the clitoral arteries demonstrated a significant decrease of the pulsatility index (PI) from the follicular (1.75 ± 0.18) to the periovulatory phase (1.26 ± 0.21; P = 0.002); the 3-D power Doppler histogram analysis showed significant changes of the indices of vascularization and blood flow (vascularization index [VI] = 2.239 ± 1.201 vs. 3.302 ± 1.305, P = 0.001; flow index = 27.290 ± 2.454 vs. 33.620 ± 1.712, P < 0.001; vascularization flow index = 0.578 ± 0.573 vs. 1.091 ± 0.461; P = 0.001) between the follicular and the periovulatory phase of the menstrual cycle. The relationship between the different parameters evidenced that estradiol is positively correlated with the VOCAL clitoral body volume (r = 0.512; P = 0.033) and inversely correlated with the dorsal clitoral artery PI (r = −497; P = 0.048) and with VI (r = 0.622; P = 0.011). Conclusions During the normal menstrual cycle, the estrogens may, probably, influence the clitoral anatomic and vascular structures and the 3-D ultrasonography may easily and precisely demonstrate these modifications.

Moderate Alcohol Intake, Genital Vascularization, and Sexuality in Young, Healthy, Eumenorrheic Women. A Pilot Study

“…One of the earliest signs of changes in the female sexual excitation is an increase in the vulval, clitoral, and vaginal blood flow. The modifications in vulvoclitoral blood flow may be objectively measured by photopletismography, oxygenation temperature method, laser Doppler perfusion imaging, or color Doppler ultrasonography [26,[36][37][38]. In the present study, performed in the early hypoestrogenic follicular phase of the menstrual cycle and independently from sexual stimulation, the genital vascularization did not show any significant difference between drinking and nondrinking women.…”

Sexual Behavior and Oral Contraception: A Pilot Study

“…The mean cycle length was 28.7 Ϯ 1.6 days. The BMI was within the normal range (19)(20)(21)(22)(23)(24)(25) and did not change during therapy (21.7 Ϯ 3.2 vs. 21.5 Ϯ 1.1; P = 0.280). Before the treatment the SHBG, E 2 , T, and A plasma levels resulted within the normal range (Table 1).…”

“…Furthermore, the well-known EE capacity to enhance the hepatic production of SHBG was further associated with significantly lower FEI values (an indicator of the free plasma E 2 concentrations). The role of estrogens in the regulation of female sexual function has been previously reported [17,18,21]. Estrogens are known to be vasoprotective and to regulate the vascular smooth muscle tone [22].…”

“…The role of estrogens in the regulation of female sexual function has been previously reported [17,18,21]. Estrogens are known to be vasoprotective and to regulate the vascular smooth muscle tone [22].…”

Sexualmedizin in der Gynäkologie

“…Über vaginale Trockenheit berichteten nach 3 Zyklen 28 Frauen (30,4%) der VL-Gruppe, 12,7% der Frauen in der L-Gruppe und nur 2,1% der Frauen mit dem005). Jedoch wurden in dieser Studie subjektive Messverfahren angewandt.Die vorliegende Studie zeigt, dass der durch hormonale Kontrazeptiva induzierte Hypoöstro genismus zu einem signifikanten Anstieg des Puls atilitäts-Index der dorsalen Klitorisarterie und zu einer signifikanten Abnahme des Klitorisvolumens führt(Battaglia et al 2009). Ebenso stiegen die sexuellen Phantasien der Frauen, und die Häufigkeit Frequenz von Geschlechtsverkehr nahm zu.…”