00:01
Let's talk about desire, arousal and orgasm.
00:04
There are different factors that affect each of these.
00:07
Do you know what ignites and drives desire in a woman?
Not sure, let's go on and see.
00:22
Desire is actually driven by several factors
good health, a good partner, erotic stimuli, the use of drugs
actually inhibits desire and testosterone which happens during the LH surge
and the menstrual cycle also drives desire.
00:41
What about female sexual dysfunction and impairment of desire?
Of course, we talked about psychosocial factors so depression,
a dysfunctional relationship with your partner, antidepressants and various drugs,
medical diseases such as hypothyroidism and a lack of testosterone
can actually impair your desire.
01:05
Let's now find out what restores your desire if you've lost it.
01:09
A new life maybe changing your environment or changing your job.
01:15
A new partner, perhaps you and your partner are not compatible,
antidepressants and other unnecessary drugs
if you stop them desire may return.
01:26
Remember, that SSRI's have a common side effect of causing sexual problems.
01:31
Medical diseases and testosterone has been known to restore desire.
01:37
Let's now talk about aging and review the features
that can be associated with female sexual dysfunction,
ovarian failure or insufficiency and menopause can be associated.
01:51
You also have as we age adrenal atrophy, this decreases your androgens
and therefore your desire may wane.
02:00
Medical or surgical events such as removing the ovaries
can also take away the source of androgens.
02:06
This is the case with bilateral oophorectomy, premature ovarian failure or insufficiency
has also been associated with female sexual dysfuntion.
02:17
Older women tend to be on corticosteroid therapy have hypopituitarism,
have adrenal insufficiency and even with oral contraceptive pills
in women of all ages including older women in their perimenopause
can actually decrease LH therefore decreasing testosterone and libido.
02:36
Let's now talk about the LH surge and testosterone.
02:42
You can see here in this graph, you have a normal menstrual cycle
and at the mid cycle, there is a peak in LH.
02:50
This no longer happens in menopausal women,
although they may be making some LH, they don't have the peak mid cycle.
02:57
The mid cycle testosterone is what is responsible for inspiring sexuality.
03:05
During this time, scent communication, speech and voice and even dress
can change in response to the LH surge.
03:14
When women undergo a bilateral oophorectomy,
their testosterone decreases dramatically.
03:22
You can see here in this graph before surgery, their testosterone levels are high.
03:27
However, post-surgery they are low.
03:30
That happens both in the pre and post-menopausal woman.
03:35
Thank you for listening. Good luck on your exam.