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Student Editorials

Female sexual dysfunction

BMJ 2005; 331 doi: https://doi.org/10.1136/sbmj.0507267 (Published 01 July 2005) Cite this as: BMJ 2005;331:0507267
  1. Ozge Tuncalp, postdoctoral fellow1,
  2. Susan Richman, director, reproductive health2
  1. 1affiliation
  2. 2Department of obstetrics and Gynecology, Yale University School of Medicine

Ozge Tuncalp and Susan Richman discuss the medicalisation of sexual arousal in women

Sexuality became the focus of academic investigation relatively recently, in the second half of the 20th century. It still remains an exciting, yet sensitive and controversial subject. Although the evaluation and treatment of sexual problems in men have focused almost exclusively on erection, female sexual responses have proved much more difficult to quantify. How do you describe what is “normal”? And what do we diagnose as a “dysfunction,” when female sexuality has more than just the mechanical aspect to be taken into consideration. Psychological, sociocultural, and relationship factors are just as important.

Untangling arousal

For the past 40 years, the clinical ideal for normal sexual functioning has been the model of sexual response first described in 1966 by William Masters and Virginia Johnson.1 Their now classic human sexual response model includes four phases-excitement, plateau, orgasm, and resolution. The phases are characterised on the basis of changes in respiration, heart rate, muscle tension, and genitalia.1 This model has been criticised, however, for its inability to assess and manage women's sexual problems.

Research confirms …

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