Female Hormones and Persistent Sexual Arousal Disorder

While having genital sensations from time to time is normal, when these sensations occur multiple times per day and are non-sexual in nature, it may be a sign of hormonally based female sexual dysfunction. This is known as persistent sexual arousal disorder (PGAD).

A person with PGAD feels constant genital sensitivity and engorgement without any sexual stimulation. Even if they do have an orgasm, the feeling of arousal returns.

1. Estrogen

Estrogen, a female sex hormone and member of the steroid family, is responsible for powering the menstrual cycle and triggering secondary sexual characteristics (breast development and pubic hair growth) in puberty. The ovaries make the bulk of estrogen, but adrenal glands and fat cells also produce small amounts. Estrogens are highest during the egg-releasing follicular phase of the menstrual cycle and during pregnancy. They build and maintain the uterus, thickening the endometrium to support a fetus and prevent sloughing during menstruation.

As the ovaries age, the levels of estrogen drop and eventually stop producing completely during menopause. Low estrogen levels can cause a number of symptoms, including vaginal dryness and instability in mood and sleep patterns.

High-dose oral estrogens are sometimes prescribed for women to treat a number of menopausal symptoms, including hot flushes and vaginal atrophy. However, there is a risk of endometrial cancer with this type of therapy. It is important to balance hormones with progesterone rather than estrogen after menopause, as unopposed estrogen can increase the risk of endometrial cancer and cause a recurrence of symptoms associated with low sex drive.

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2. Progesterone

Known as progesterone, this hormone is an important part of the sex hormone cycle. As a balancing hormone of estrogen, it has some opposing actions on your body and is known to decrease sexual desire in some women (Roney, 2013). High levels can cause premenstrual syndrome and low levels lead to estrogen dominance, which is associated with lowered libido.

One of progesterone’s main roles is thickening the uterine lining, called the endometrium, for implantation (a fertilized egg attaching to the uterus). As the uterus prepares for pregnancy, progesterone and estrogen levels are balanced. Progesterone levels rise just before your period and during pregnancy. If implantation does not occur, and your body’s progesterone levels drop, the endometrium breaks down and menstruation begins. Progesterone also encourages the growth of milk-producing glands in pregnant women.

Supplemental progesterone is available for prescription as a cream, tablet or injection, and as a combination of estrogen and progestin in hormonal contraceptives. Depending on the type and formulation of supplemental progesterone you take, it can be helpful for controlling symptoms of PMS, reducing symptoms of menopause or for birth control. Your provider can explain how progesterone works in your body and its role in the menstrual cycle, pregnancy and menopause. Normal value ranges may vary from laboratory to laboratory, so talk to your provider about the meaning of your test results.

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3. Testosterone

The sex hormone testosterone is produced by the Leydig cells in the testicles of men and the ovaries of women. Testosterone is a member of the androgen group of hormones, and is a primary male sex hormone that promotes development of male sex organs, masculine characteristics such as body and facial hair, a deeper voice, and muscle strength. Testosterone also helps to produce sperm in men and plays an important role in sexual desire, sex drive, aggression, and the ability to achieve orgasm.

Testosterone levels decrease with age in both men and women. Low testosterone levels can impact sexual desire and performance, contribute to erectile dysfunction in men, and limit arousal in women. Low testosterone levels can cause symptoms such as fatigue, weight gain, and low bone density.

A number of factors can affect a woman’s testosterone levels, including menopause and medications. The condition characterized by too much estrogen and low testosterone is known as hormonal imbalance or andropause, and is associated with symptoms such as fatigue, weight gain, and lower energy levels.

Researchers have found that a combination of estrogen therapy and testosterone can increase female sexual desire, though the exact mechanism remains unclear. The testosterone may work by binding to SHBG and increasing free estradiol or by working centrally to boost testosterone and estradiol production.

4. Serotonin

Serotonin is a naturally occurring monoamine neurotransmitter (which also acts as a hormone) that sends messages between nerve cells throughout your body. It is known to impact mood, cognition, reward, learning and memory. Additionally, it is involved in many physiological processes such as vomiting and vasoconstriction.

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Most of the serotonin your body produces is found in your intestines, and it helps control your bowel movements, digestion and blood platelets. It is also believed to act as a natural mood stabilizer. In fact, some medications that treat depression and anxiety are thought to work by increasing serotonin activity in your brain.

Your brain uses serotonin to send messages to your muscles, and it is also needed for proper functioning of your lungs and heart. It is also the precursor for melatonin, which is necessary for your sleep-wake cycle and the regulation of your internal clock.

Serotonin also plays a significant role in environmental response pathways. It shapes the auditory information received by the IC structure of your midbrain, which is connected to social interactions and vocalizations.

Another major function of serotonin is triggering your body’s genital arousal and sexual behavior. The arousal is often triggered by a non-sexual stimuli, and the feelings of genital arousal may persist for days, weeks or even months. This can be a very distressing experience and can cause serious problems if it interferes with daily activities.

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