Endothelial Function Testing

Content Written By: Irwin Goldstein, MD

Cardiovascular disease in women and sexual arousal disorders in women may be linked to endothelial dysfunction, as they have been well-documented in men. As with small vessels of the limb, increased ?ow and resultant increased shear stress-induced vasodilatation in the clitoral cavernosal and vaginal arteries appear to be mediated via nitric oxide.

Menopausal women with vascular risk history or women with metabolic syndrome (increased waist circumference, diabetes, high blood pressure, hypercholesterolemia, etc) with sexual arousal disorders may have endothelial dysfunction in other vascular beds as well in the clitoral cavernosal or vaginal arteries. However, endothelial damage may occur differentially in various vascular beds and in a time-dependent manner such that dysfunction within the clitoral artery or vaginal artery endothelium could theoretically occur prior to its occurrence in other parts of the circulation. More research is needed.

Chronic low-grade in?ammation contributes to all stages of the arterial disease called atherosclerosis. Chronic low-grade in?ammation is noted from the initial phase of increased permeability of the arterial lining cells, the endothelium. Chronic low-grade in?ammation is noted during formation of the mature atherosclerotic plaque that blocks and reduces arterial inflow.

Increased blood levels of in?ammatory markers have been documented in coronary artery disease. Endothelial cell function and in?ammation are highly associated. Normal arterial vascular endothelium has anti-in?ammatory properties. On the other hand, endothelial function is impaired in the presence of in?ammatory conditions.

It is not yet well known, as it is in men, that sexual arousal disorder in menopausal women with vascular risk factor exposure or with metabolic syndrome, are associated with markers and mediators of subclinical in?ammation and endothelial activation.

If however a pre- or post menopausal woman has sexual arousal disorder, has a family history of vascular disease, has metabolic syndrome or has exposure to vascular risk factors, a logical work up would include some inflammatory biomarkers such as: hs C-reactive protein, ?brinogen, von Willebrand factor, interleukins (IL)-1b and 6 and adhesions molecules (intracellular adhesion molecule-1 [ICAM] and vascular cell adhesion molecule-1 [VCAM]).

Find a Doctor

Enter your city, state or zipcode and find the nearest doctor in your area who specializes in treating: Anhedonia/Pleasure Dissociative Orgasmic Disorder (PDOD)

diagnostic tool teaser

Share your Story

shareDo you have a personal health story that you would like to share with others? Many people, especially when newly diagnosed, find comfort in knowing that others are having a similar experience. Our story areas are a place to share experiences about living with and treating sexual health issues.

Join the Forums

joinDo you have a question, want to share medical advice, or just need to discuss your situation with someone else having a similar experience?

The forums are a resource for everyone to share and discuss their health and medical needs with others, and get answers to medical questions from the leading experts in the field of sexual medicine

Stay updated with our monthly newsletter

Sign up to receive our monthly newsletter—Get updates about advances in the field, new products and medical trials in your area. Your information will never be shared without your consent.

Leave this field empty