This article provides a review of the past and current literature on the neurobiology of sexual function. The influence of endocrine, neurotransmitter, and central nervous system influences on male and female sexual function are discussed for sexual desire, arousal, and orgasm or ejaculation stages of sexual responding. Endocrine factors reviewed include the following: androgens, estrogens, progesterone, prolactin, oxytocin, cortisol, and pheromones. Neurotransmitters and neuropeptides discussed include nitric oxide, serotonin, dopamine, epinephrine, norepinephrine, opioids, acetylcholine, histamine, and γ-aminobutyric acid. Central nervous system influences on sexual function are discussed briefly with reference to brainstem regions, the hypothalamus, and the forebrain.
Sexual stimulation leads to the production of nitric oxide which in turn stimulates a cascade of events that, providing normal functioning, leads to penile and clitoral tumescence. Erectile dysfunction, and possibly female sexual arousal dysfunction, can be treated with a medication such as sildenafil (Viagra) that facilitates and/or prolongs penile or clitoral tumescence by inhibiting the metabolism of cyclic guanosine monophosphate (cGMP). GTP indicates guanosine triphosphate; PDE, phosphodiesterase; and PDE5, phosphodiesterase type 5.
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