Regulation of Female Sexual Function

Abstract

The mechanisms governing female sexual function are among the most complex in the human body. It is not surprising, therefore, that they are extremely susceptible to dysfunction. The central regulatory organ is the hypothalamus, which not only contains receptors for all the peripheral hormones, but also serves as a relay point between the endocrine system and environmental influences. It is from here that the “master” endocrine gland, the anterior pituitary, is controlled by the secretion of low-molecular polypeptides called releasing factors. These stimulate the pituitary to secrete adrenocorticotropic, somatotropic, and thyrotropic hormones (ACTH, STH, TSH, respectively), prolactin, as well as the gonadotropic hormones that control ovarian function: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Follicle maturation, ovulation, corpus luteum formation and, thus, the cyclic production of the principal female sex hormones, estrogens and progesterone, occur under their influence. Estrogens and progesterone are ultimately responsible for the development of the typical female secondary sex characteristics: the growth of the breasts and uterus, the cyclic changes in the endometrium, and menstruation. In addition to their peripheral function, they also exert positive or negative feedback effects on the hypothalamic centers, thus giving rise to a number of closed-loop regulatory mechanisms.