Clinical significance of sensory nerve tests on external genitalia for diagnosis of female sexual dysfunction

Abstract

Purpose: It is thought that neurological disorders are one of the main causes of organic female sexual dysfunction. However, it is difficult to diagnose due to the lack of measuring tools for assessing genital neural function. Sensory nerve tests on external genitalia is a new challenge for diagnosing female sexual dysfunction. In this study, we aimed to evaluate the clinical significance of the quantitative measurement of the genital sensory threshold in female sexual dysfunction. Materials and methods: Forty women with complaints of sexual dysfunction were evaluated with physical and vagina examination, serum hormonal tests, routine urinalysis and a questionnaire (the brief index of sexual function for women). A genitosensory analyzer (GAS, Medoc, Israel) was used to quantitative measure the vaginal and clitoral warm, cold and vibratory sensory thresholds. Results: Of the 40 women, an arousal disorder was reported in 40%, orgasmic disorder in 82.5%, sexual pain disorder in 17.5% and a decreased libido in 17.5%. Of the 40 women, 86.4 and 91.2% showed impairment of vaginal cold (A-δ fiber) and warm (unmyelinated C fiber) sensations, respectively. However, the touch and vibratory sensations (A-β fiber) showed relatively lower impairments; vagina and clitoris in 20.0 and 89.2% of the patients, respectively. Conclusions: In this study, most of the patients with sexual problems had significant vaginal and clitoral sensory nerve fiber impairments. The results support the significance of organic origins in female sexual dysfunction and the usefulness of quantitative analysis of genital sensation in diagnosing the etiology.