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Neurochemical Aspects of the Sexual Response Cycle

Published online by Cambridge University Press:  07 November 2014

Angelos Halaris
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Abstract

What drives the human sexual response cycle? The human sexual response cycle is a highly complex phenomenon that encompasses many transmitters and transmitter systems centrally and peripherally. The endocrine system is also intricately involved in the brain and in the periphery organs. Integration of these systems is a function of the nervous system that ultimately produces a vast array of cognitive, emotional, physiological, and behavioral responses. Therefore, it is not surprising that a disturbance in even a single system will lead to dysfunction in one or more phases of the sexual response cycle. This article highlights the complex roles the aminergic system plays along with key hormones that are equally involved. The article also points out how rudimentary and fragmented our knowledge is in this field and how few controlled studies are available. The potential for development of specific agents that target selective sexual dysfunctions is exemplified in sildenafil, the first such agent ever to be brought to market.

Type
Review
Information
CNS Spectrums , Volume 8 , Issue 3: Sexual Dysfunction and Function , March 2003 , pp. 211 - 216
Copyright
Copyright © Cambridge University Press 2003

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References

REFERENCES

1.Halaris, A. Sex and the brain. In: Halaris, A, ed. Bailliere's Clinical Psychiatry: Sexual Dysfunction. London, England: Bailliere Tindall; 1997:25–42.Google Scholar
2.Meston, CM, Frohlich, PF. The neurobiology of sexual function. Arch Gen Psychiatry. 2000;57:1012–1030.CrossRefGoogle ScholarPubMed
3.Segraves, RT. Bethanechol reversal of imipramine-induced ejaculatory dysfunction. Am J Psychiatry. 1987;144:1243.Google ScholarPubMed
4.Blanco, R, Saenz de Tejada, I, Goldstein, I, et al.Cholinergic neurotransmission in human corpus cavernosum, II: acetylcholine synthesis. Am J Physiol. 1988;254:H468–H472.Google ScholarPubMed
5.Godec, CJ, Bates, H. Cholinergic receptors in corpus cavernosum. Urology. 1984;24:31–33.CrossRefGoogle Scholar
6.Kruger, T, Exton, MS, Pawlak, C, et al.Neuroendocrine and cardiovascular response to sexual arousal and orgasm in men. Psychoneuroendocrinology. 1998:23:401–411.CrossRefGoogle ScholarPubMed
7.Meston, CM, Heiman, JR. Ephedrine-activated physiological sexual arousal in women. Arch Gen Psychiatry. 1998;55:652–656.CrossRefGoogle ScholarPubMed
8.Morales, A, Condra, M, Owen, JA, et al.Is yohimbine effective in the treatment of organic impotence? Results of a controlled trial. J Urol. 1987;137:1168–1172.CrossRefGoogle ScholarPubMed
9.Susset, JG, Tessier, CD, Wincze, J, et al.Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. J Urol. 1989;141:1360–1363.CrossRefGoogle ScholarPubMed
10.Sonda, LP, Mazo, R, Chancellor, MB. The role of yohimbine for the treatment of erectile impotence. J Sex Marital Ther. 1990;16:15–22.CrossRefGoogle ScholarPubMed
11.Piletz, JE, Segraves, KB, Feng, Y, et al.Plasma MHPG response to yohimbine: treatment in women with hypoactive sexual desire. J Sex Marital Ther. 1998;24:43–54.CrossRefGoogle ScholarPubMed
12.Everitt, BJ. Sexual motivation: a neural and behavioral analysis of the mechanisms underlying appetitive and copulatory responses of male rats. Neuroscience Biobehavior Rev. 1990;14:217–232.CrossRefGoogle ScholarPubMed
13.Everitt, BJ, Bancroft, J. Of rats and men: the comparative approach to male sexuality. Annu Rev Sexual Res. 1991;2:77–118.Google Scholar
14.Bowers, MB, Van Woert, M, Davis, L. Sexual behavior during L-dopa treatment for Parkinsonism. Am J Psychiatry. 1970;127:1691–1693.CrossRefGoogle Scholar
15.Angrist, B, Gershon, B. Clinical effects of amphetamine and L-dopa on seuality and aggression. Comp Psychiatry. 1976;17:715–722.CrossRefGoogle ScholarPubMed
16.Frajese, G, Rocco, A, Falashi, P, et al.Reproductive parameters in prolactinaemic men. Arch Androl. 1983;10:179–183.Google Scholar
17.Lal, S, Ackman, D, Tharundayil, JX, et al.Effects of apomorphine, a dopamine receptor agonist, on penile tumescence in normal subjects. Progress Neurol Psychopharmacol Biol Psychiatry. 1984;8:695–699.CrossRefGoogle ScholarPubMed
18.Lal, S, Laryea, E, Tharundayil, JX, et al.Apomorphine-induced penile tumescence in impotent patients-preliminary findings. Progress Neurol Psychopharmacol Biol Psychiatry. 1987;11:235–242.CrossRefGoogle ScholarPubMed
19.Lal, S, Tesfaye, Y, Tharundayil, JX, et al.Apomorphine: clinical studies on erectile functioning and yawning. Progress Neurol Psychopharmacol Biol Psychiatry. 1989;13:329–339.CrossRefGoogle Scholar
20.Danjou, P, Alexander, L, Warot, D, et al.Assessment of erotogenic properties of apomorphine and yohimbine in man. Br J Clin Pharmacol. 1988;26:733–739.CrossRefGoogle Scholar
21.Segraves, RT, Bari, M, Segraves, K, Spirnak, P. Effect of apomorphine on penile tumescence in men with psychogenic impotence. J Urol. 1991;145:1174–1175.CrossRefGoogle ScholarPubMed
22.Miller, NS, Gold, MS. The human sexual response and alcohol and drugs. J Subst Abuse Treat. 1988;5:171–177.CrossRefGoogle ScholarPubMed
23.Cohen, S. Cocaine. JAMA. 1975;231:74–75.CrossRefGoogle ScholarPubMed
24.Smith, DE, Wesson, DR, Apter-Marsh, M. Cocaine and alcohol-induced sexual dysfunction in patients with addictive disease. J Psychoactive Drugs. 1984;16:359–361.CrossRefGoogle ScholarPubMed
25.Meston, CM, Gorzalka, BB. Psychoactive drugs and human sexual behavior: the role of serotonergic activity. J Psychoactive Drugs. 1992;24:1–40.CrossRefGoogle ScholarPubMed
26.Feiger, A, Kiev, A, Shrivastava, RK, et al.Nefazodone versus sertraline in outpatients with major depression: focus on efficacy, tolerability, and effects on sexual function and satisfaction. J Clin Psychiatry. 1996;57:(suppl 20):53–62.Google ScholarPubMed
27.Preskorn, SH. Comparison of the tolerability of bupropion, fluoxetine, imipramine, nefazodone, paroxetine, sertraline, and venlafaxine. J Clin Psychiatry. 1995;56(suppl 6):12–21.Google ScholarPubMed
28.Montejo-Gonzalez, AL, Llorca, G, Izquierdo, JA, et al.SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther. 1997;23:176–193.CrossRefGoogle Scholar
29.Tagliamonte, A, Tagliamonte, P, Gessa, GL, Brodie, BB. Compulsive sexual activity induced by p-chlorophenylalanine in normal and pinealectomized rats. Science. 1969;166:1433–1435.CrossRefGoogle Scholar
30.Stevenson, RWD, Solyom, D. The aphrodisiac effect of fenfluramine: two case reports of a possible side effect to the use. J Clin Psychiatry. 1990;10:69–71.Google ScholarPubMed
31.Gartrell, N. Increased libido in women receiving trazodone. Am J Psychiatry. 1986;143:781–782.Google ScholarPubMed
32.Sullivan, G. Increased libido in three men treated with trazodone. J Clin Psychiatry. 1988;49:202–203.Google ScholarPubMed
33.Woodrum, ST, Brown, CS. Management of SSRI-induced sexual dysfunction. Ann Pharmacother. 1998;32:1209–1215.CrossRefGoogle ScholarPubMed
34.Chiueh, C, Hong, J-S, Leong, S, eds. Nitric Oxide. New York, NY: Annals of the New York Academy of Sciences; 2002.Google Scholar
35.Rajfer, J, Aronson, WJ, Bush, PA, et al.Nitric oxide as a mediator of relaxation of the corpus cavernosum in response to nonadrenergic, noncholinergic neurotransmission. N Eng J Med. 1992;326:90–94.CrossRefGoogle ScholarPubMed
36.Burnett, AL, Calvin, DC, Silver, RI, et al.Immunohistochemical description of nitric oxide synthase isoforms in human clitoris. J Urol. 1997;158:75–78.CrossRefGoogle ScholarPubMed
37.Montorsi, F, McDermott, TE, Morgan, R, et al.Efficacy and safety of fixed-dose oral Sildenafil in the treatment of erectile dysfunction of various etiologies. Urology. 1999;53:1011–1018.CrossRefGoogle ScholarPubMed
38.Dinsmore, WW, Hodges, M, Hargreaves, C, et al.Sildenafil citrate (Viagra) in erectile dysfunction: near normalization in men with broad-spectrum erectile dysfunction compared with age-matched healthy control subjects. Urology. 1999;53;800–805.CrossRefGoogle ScholarPubMed
39.Goldstein, I, Lue, TF, Padma-Nathan, H, et al.Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med. 1998;338:1397–1404.CrossRefGoogle ScholarPubMed
40.Kaplan, SA, Reis, RB, Kohn, IJ, et al.Safety and efficacy of sildenafil in postmenopausal women with sexual dysfunction. Urology. 1999;53:481–486.CrossRefGoogle ScholarPubMed
41.Ashton, AK. Sildenafil treatment of paroxetine-induced anorgasmia in women. Am J Psychiatry. 1999;156:800.CrossRefGoogle Scholar
42.Ashton, AK, Bennett, RG. Sildenafil treatment of serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry. 1999;60:194–195.CrossRefGoogle ScholarPubMed
43.Nurnberg, HG, Hensley, PL, Lauriello, J, et al.Sildenafil for women patients with antidepressant-induced sexual dysfunction. Psychiatr Serv. 1999;50:1076–1078.CrossRefGoogle ScholarPubMed
44.Kwan, M, Greenleaf, WJ, Mann, J, et al.The nature of androgen action on male sexuality: combined laboratory-self-report study on hypogonadal men. J Clin Endocrinol Metabolism. 1983;57:557–562.CrossRefGoogle Scholar
45.Udry, JR, Billy, JO, Morris, NM, et al.Serum androgenic hormones motivate sexual behavior in adolescent boys. Fertile Steril. 1985;43:90–94.CrossRefGoogle ScholarPubMed
46.Halpern, CR, Udry, JR, Suchindran, C. Monthly measures of salivary testosterone predict sexual activity in adolescent males. Arch Sex Behav. 1998;27;445–465.CrossRefGoogle ScholarPubMed
47.Schiavi, RC, White, D. Androgen and male sexual function: A review of human studies. J Sex Marital Ther. 1976;2:214–228.CrossRefGoogle ScholarPubMed
48.O'Carroll, R, Shapiro, C, Bancroft, J. Androgens, behavior and nocturnal erection in hypogonadal men: the effects of varying the replacement dose. Clin Endocrinol. 1985;23:527–538.CrossRefGoogle ScholarPubMed
49.Alexander, GM, Swerdloff, RS, Wang, CW, Davidson, T. Androgen-behavior correlations in hypogonadal men and eugonadal men I: mood and response to auditory sexual stimuli. Horm Behav. 1997;31:110–119.CrossRefGoogle ScholarPubMed
50.Ehrenreich, H, Halaris, A, Ruether, E, et al.Psychoendocrine sequelae of chronic testosterone deficiency. J Psychiatr Resear. 1999;33:379–387.CrossRefGoogle ScholarPubMed
51.Sands, R, Stud, J. Exogenous androgens in postmenopausal women. Am J Med. 1995;98(suppl 1A):76s–79s.CrossRefGoogle ScholarPubMed
52.Rako, S. The Hormone of Desire: The Truth about Sexuality, Menopause and Testosterone. New York, NY: Harmony Books; 1996.Google Scholar
53.Warnock, JK, Bundren, JC, Morris, DW. Female hypoactive sexual desire disorder due to androgen deficiency: clinical and psychometric issues. Psychopharmacol Bull. 1997;33:761–766.Google ScholarPubMed
54.Sherwin, BB, Gelfand, MM, Brender, W. Androgen enhances sexual motivation in females: a prospective, crossover study in sex steroid administration in the surgical menopause. Psychosom Med. 1985;47:339–351.CrossRefGoogle ScholarPubMed
55.Gelfand, MM. Treating menopausal symptoms with estrogen and androgen preparations. Contemp Obstet/Gynecol. 1994;31–36.Google Scholar
56.Redmond, GP. Hormones and sexual function. Int J Fertil. 1999;44:193–197.Google ScholarPubMed
57.Halpern, CT, Udry, J, Suchindran, C. Testosterone predicts initiation of coitus in adolescent females. Psychosom Med. 1997;59:161–171.CrossRefGoogle ScholarPubMed
58.Persky, H, Charney, N, Lief, HIet al.The relationship of plasma estradiol level to sexual behavior in young women. Psychosom Med. 1978;40:523–535.CrossRefGoogle Scholar
59.Abplanalp, JM, Rose, RM, Donnelly, AF, Livingston-Vaughn, L. Psychoendocrinology of the menstrual cycle: II. The relationship between enjoyment of activities, moods and reproductive hormones. Psychosom Med. 1979;41:605–615.CrossRefGoogle ScholarPubMed
60.Sherwin, B. Changes in sexual behavior as a function of plasma sex steroid levels in postmenopausal women. Maturitas. 1985;7:225–233.CrossRefGoogle Scholar
61.Berman, JR, Goldstein, I. Female sexual dysfunction. Urol Clin North America. 2001;28:405–416.CrossRefGoogle ScholarPubMed
62.Berman, JR, Berman, I, Goldstein, I. Female sexual dysfunction: Incidence, pathophysiology, evaluation, and treatment options. Urology. 1999;54:385–391.CrossRefGoogle ScholarPubMed
63.Warner, P, Bancroft, J. Mood, sexuality, oral contraceptives and the menstrual cycle. J Psychosom Res. 1988;32:417–427.CrossRefGoogle ScholarPubMed
64.Bouloux, PM, Grossman, A. Hyperprolactinemia and sexual function in the male. Brit J Hosp Med. 1987;37:503.Google ScholarPubMed
65.Schwartz, MF, Bauman, JE, Masters, WH. Hyperprolactinemia and sexual disorders in men. Biol Psych. 1982;17:861–876.Google ScholarPubMed
66.Foster, RS, Mulcahy, JJ, Callaghan, JT, et al.Role of serum prolactin determination in evaluation of impotent patient. Urol. 1990;36:499–501.CrossRefGoogle ScholarPubMed
67.Hulter, B, Lundberg, PO. Sexual function in women with hypothalamo-pituitary disorders. Arch Sex Behav. 1994;23:171–183.CrossRefGoogle ScholarPubMed
68.Kayner, CE, Zager, JA. Breast-feeding and sexual response. J Fam Pract. 1983;17:69–73.Google ScholarPubMed
69.Koppelman, MCS, Parry, BL, Hamilton, JA, et al.Effect of bromocriptine on mood, affect and libido in hyperprolactinemia. Am J Psychiatry. 1987;144:1037–1041.Google ScholarPubMed
70.Shukovski, l, Findlay, JK, Smith, AI. Identification of a non-covalent oxytocin/neurophysin-1 complex in the bovine ovary. J Endocrinol. 1991;128:305–314.CrossRefGoogle Scholar
71.Murphy, MR, Seckl, JR, Burton, S, et al.Changes in oxytocin and vasopressin secretion during sexual activity in men. J Clin Endocrinol. 1987;65:738–741.CrossRefGoogle ScholarPubMed
72.Carmichael, MS, Humbert, R, Dixen, J, et al.Plasma oxytocin increases in the human sexual response. J Endocrinol Metab. 1987;64:27–31.CrossRefGoogle ScholarPubMed
73.Carmichael, MS, Warburton, VL, Dixen, J, et al.Relationships among cardiovascular, muscular, and oxytocin responses during human sexual activity. Arch Sex Behav. 1994;23:59–77.CrossRefGoogle ScholarPubMed
74.Anderson-Hunt, M, Dennerstein, L. Increased female sexual response after oxytocin. Br Med J. 1994;309:929.CrossRefGoogle ScholarPubMed
75.Anderson-Hunt, M, Dennerstein, L. Oxytocin and female sexuality. Gynecol Obstet Invest. 1995;40:217–221.CrossRefGoogle ScholarPubMed
76.Insel, TR. A neurobiological basis of social attachment. Am J Psychiatry. 1997;154:727–735.Google ScholarPubMed