Physiological and Subjective Sexual Arousal in Pre- and Postmenopausal Women and Postmenopausal Women Taking Replacement Therapy

Twenty premenopausal, 14 postmenopausal, and 14 postmenopausal women receiving replacement estrogen therapy were studied to determine whether differences in hormone status were associated with differences in physiological and subjective sexual responses. All subjects viewed a neutral, an erotic, and a second neutral videotape while photoplethysmographic vaginal pulse amplitude was continuously recorded. Self-report ratings of sexual arousal and affective response were collected. Serum levels of testosterone, estradiol, estrone, and luteinizing hormone were obtained. The three groups did not differ in either average or maximum vaginal pulse amplitude to the videotapes nor in latency of sexual response. The postmenopausal women not taking replacement estrogen reported significantly less vaginal lubrication in response to the erotic videotape than the higher estrogen premenopausal and replacement hormone groups. Estradiol level was significantly correlated with ratings of vaginal lubrication in response to the erotic videotape but not with vaginal pulse amplitude. Results thus suggest that estrogen is important in maintaining vaginal lubrication and the perception of sexual arousal but not in determining vaginal vasocongestion.