Background

Female sexual dysfunction (FSD) is characterized by Prolonged or ongoing issues with the sexual response cycle, causing personal distress. FSD affects roughly 30-50% of women globally, often impacting their quality of life. This may include conditions such as vaginismus, dyspareunia, vulvodynia, hypoactive sexual desire disorder, sexual interest and arousal disorder, anorgasmia, vaginal dryness, or others.

The clitoris is a critical organ for female sexual function due to it being made up of erectile tissue. Previously, the clitoris has been studied to determine if there is an influence between clitoral blood flow and sexual arousal. This research has revealed that blood flow to the clitoris can change due to menstrual cycles and other types of FSD. Meaning, there may be a chance to diagnose some types of FSD by assessing clitoral blood flow (vascularization).

Pelvic floor muscle (PFM) tone is most commonly described as the resting tension or stiffness of PFM, otherwise known as how “tight” the muscle group is. PFM may have influence over clitoral vascularization, and women’s sexual arousal and response due to many clitoral blood vessels passing through the PFM.

Study Objectives

• Expand understanding of FSD causes by assessing the relationship between PFM tone and clitoral blood flow in women without FSD.
• Determine if there is a correlation between vaginal introitus pressure and blood flow velocity in dorsal clitoral artery.
  • Vaginal introitus pressure is the pressure exerted by PFM at the opening of the vagina.
  • Blood flow velocity is best described as how fast blood is flowing through the blood vessels.

Methods

• 21 women without FSD (according to the Female Sexual Function Index), and who were not pregnant or menstruating, as menstruation can affect clitoral blood flow, were included.
• Each was assessed using a color doppler ultrasound probe to measure systolic velocity of the dorsal clitoral artery.
• Vaginal pressure gauge (iEase) coupled with a mercury manometer were used.
• Three separate readings capture from a relaxed state and a muscle contraction state.
• This would ensure that each woman acted as a control variable for herself and allow researchers to assess the difference in clitoral vascularization depending on PFM pressure.

Key Results/Analysis

• Clinically meaningful differences in systolic velocities between relaxed and contracted states.
  • Inverse association: as pressure increased, systolic velocity decreased.
  • Around 25.6% of variability in systolic velocity is due to pressure values.
• These results differ from previous research, which had found no significant changes in velocity after contraction and in a relaxed state.
• Results also confirm previous research of menstrual cycle phases, showing a difference in clitoral blood flow is dependent on physiological changes.
• With further research, clitoral blood flow may be useful for assessing FSD, namely, FSD of physiological origin, such as vulvodynia.

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Resources:

• Franco, L. C., & Dussan, L. E. (2025). Association between clitoral Doppler flow and pelvic floor muscle tone in women without sexual dysfunction. The Journal of Sexual Medicine, 22(6), 991–992. https://doi.org/10.1093/jsxmed/qdaf098