The effects of acute and chronic stress on sexual arousal in women

In most adult animals, stress is generally thought to be detrimental to reproductive (sexual) function. However, in humans, there is a limited body of literature that indicates some stress can potentially be beneficial for sexual function. One theory is that there is an inverted U relationship between stress and sexual function with low and high levels of stress (or anxiety) causing an impairment of sexual response, while a moderate level of stress facilitates sexual arousal. This aim of this dissertation is to identify the mechanisms through which both acute and chronic stress may facilitate or impair sexual arousal in women. In particular, I examined the role of adrenal hormones, the autonomic nervous system (ANS), and psychological factors. To test these mechanisms, I measured cortisol, dehydroepiandrosterone sulfate (DHEAS), heart rate, distraction, and misattribution of arousal during stressful and sexual laboratory situations. Two of the studies examined the effects of acute stress, and the final study focused on chronic stress. Results indicated that acute stress is beneficial for genital arousal in women, and that the sympathetic branch of the ANS is the key mechanism involved in that relationship. High levels of chronic stress were found to significantly impair genital arousal compared to average levels of chronic stress. Increased levels of cortisol and distractions contributed to this effect. DHEAS did not appear to play a role in the relationship between stress and sexual arousal, and there was no evidence for misattribution of arousal. Neither acute nor chronic stress affected women’s subjective (psychological) arousal. Acute and chronic stressors affect sexual arousal in different ways and through separate mechanisms. The findings from these studies can inform treatment approaches for women with sexual arousal difficulties.