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Excitation transfer, the transfer of arousal from one emotion to another, might be a mechanism in the development of unusual sexual interests. In this pilot study, we investigated whether we could induce excitation transfer between various emotions and sexual arousal in a laboratory setting with 30 male volunteers. We induced low-level sexual arousal in four different emotional states (aggression/dominance, endearment, fear, disgust) and a neutral state. Sexual arousal was measured using penile plethysmography and self-report. Although there was no mean group effect, possibly due to large interindividual variations, 60% of the subjects showed more sexual arousal in response to sexual stimulation in at least one of the emotional states than in the neutral state. Excitation transfer was most prominent with aggression/dominance and least prominent with disgust. Genital excitation transfer was strongly related to lower penile reactivity and to higher self-reported erotophilia. This pilot study paves the way for further research into excitation transfer as a mechanism to increase the salience of stimuli that otherwise would not have been sexual in nature.

Little is known about the role of subjective sexual arousal within romantic relationships. The current paper addresses this limitation using a prospective study design that investigates the direct associations between subjective sexual arousal induced by a romantic partner (partner arousal) and arousal induced by pornography (porn arousal) on changes in relational outcomes. A total of 309 participants who were in a current romantic relationship completed measures of partner and porn arousal as well as relational outcomes (i.e., sexual satisfaction and relationship quality and stability) at baseline (T1) and completed a second assessment of relational outcomes 2 months later (T2). Partner arousal was found to have no significant associations with changes in relational outcomes; however, porn arousal was associated with significant declines in sexual satisfaction and relationship quality and stability over a 2-month period. This paper is the first to examine how feeling sexually aroused by porn may impact relational outcomes for those in romantic relationships.

Problematic sexual arousal (PSA) is an umbrella term to describe a range of clinical presentations related to excessive sexual thinking (e.g., sexual preoccupation) and sexual behavior (e.g., hypersexuality). Although such concepts are known to affect sexual recidivism among individuals convicted of sexual offences, PSA is not routinely or directly targeted in offending behavior programs in England and Wales. However, in recent years, there have been moves to incorporate pharmacological interventions for addressing this among people with sexual offence histories. Although some work to understand the experiences of those taking SSRI medication for this purpose has emerged, little is known about the experiences of service users taking anti-androgen medication. In this study, we interviewed all individuals in prison taking anti-androgens for the treatment of problematic sexual arousal following convictions for sexual offences in England at the time of data collection ( N  = 10). Using a phenomenologically oriented thematic analysis, we established themes pertaining to “Differing needs: Motivations for treatment,” “Medication as a risk management strategy,” and how the medication helped the men in their pursuit of “Discovering a ‘new me’.” This work contributes important knowledge to inform the development of ethical and effective prescribing of anti-androgen medication with this population and offer recommendations for both future research and the development of clinical practice.

Although women and men rate their subjective arousal similarly in response to “female-centric” erotic videos, women rate their subjective arousal lower than men in response to “male-centric” videos, which often end with the male’s ejaculation. This study asked whether ratings of subjective sexual arousal and desire using the Sexual Arousal and Desire Inventory (SADI) would be altered if this ending was present or absent, and whether including or excluding the accompanying soundtrack would influence the magnitude and direction of the responses. A total of 119 cis-gendered heterosexual undergraduates (59 women and 60 men) viewed an 11-min sexually explicit heterosexual video that ended with a 15-s ejaculation scene. Two versions of the video were created, one with the ejaculatory ending (E+) and one without (E−). Participants were assigned randomly to view one of the two versions with (S+) or without (S−) the accompanying soundtrack, after which they completed the state version of the SADI. Women and men found both sequences without sound less arousing on the Evaluative, Motivational, and Physiological subscales of the SADI relative to the S+ sequences. However, on the Negative/Aversive subscale, women found the E + S- sequence more negative than did men, whereas this difference was not found with sound. Thus, women and men were sensitive to the auditory content of sexually explicit videos, and scenes of sexual intercourse ending with explicit ejaculation increased the Evaluative and Motivational properties of subjective sexual arousal and desire. However, this occurred in women only when the auditory cues signaled a clear and gratifying sexual interaction.

This article reviews and critiques the DSM-IV-TR diagnostic criteria for Female Sexual Arousal Disorder (FSAD). An overview of how the diagnostic criteria for FSAD have evolved over previous editions of the DSM is presented and research on prevalence and etiology of FSAD is briefly reviewed. Problems with the essential feature of the DSM-IV-TR diagnosis—“an inability to attain, or to maintain…an adequate lubrication-swelling response of sexual excitement”—are identified. The significant overlap between “arousal” and “desire” disorders is highlighted. Finally, specific recommendations for revision of the criteria for DSM-V are made, including use of a polythetic approach to the diagnosis and the addition of duration and severity criteria.

Background A strong, satisfying sexual relationship—for which sexual desire and arousal can be key components—is often important for maintaining well-being in long-term romantic relationships. However, sexual interest/arousal disorder, defined by persistently low and distressing levels of sexual desire and/or arousal, is the most common sexual problem among women and gender-diverse people and is associated with psychological (e.g., depressive symptoms) and relational (e.g., lower relationship satisfaction) consequences. Partners of individuals with sexual interest/arousal disorder have also reported lower sexual and relationship satisfaction, higher sexual distress, and poorer sexual function compared to partners of people without this disorder. Prominent clinical and theoretical models emphasize that sexual interest and arousal are strongly influenced by interpersonal factors, and emerging dyadic studies support these conceptualizations. Although couple-based sex therapy is recommended, no studies have examined the efficacy of an evidence-based couple therapy for sexual interest/arousal disorder, nor its mechanisms of change. The current randomized clinical trial (RCT) aims to address these gaps by evaluating the efficacy of a novel cognitive-behavioral couple therapy for sexual interest/arousal disorder. Methods We aim to recruit women and gender-diverse people with sexual interest/arousal disorder and their partners ( N  = 170 couples), who will be randomly assigned to either an intervention or waitlist control condition. The intervention is a cognitive-behavioral couple therapy consisting of 16, 60-min (first session 90 min) manualized therapy sessions delivered over 18 weeks by a supervised therapist trained in clinical psychology. Participants will complete validated measures at baseline, during the treatment period, post-treatment, and at a 6-month follow-up. Conditions will be compared on primary outcomes of sexual desire and distress and secondary sexual and psychological outcomes using an intention-to-treat approach and multilevel modeling. Emotion regulation will be analyzed as a potential mediator of treatment benefits. Discussion This study is the first to evaluate the efficacy of cognitive-behavioral couple therapy for sexual interest/arousal disorder, which has yet to be tested in a large RCT. Findings aim to provide clinicians with an evidence-based treatment to better support couples coping with sexual interest/arousal disorder and to identify a key mechanism for treatment benefits. Trial registration This study was registered 15 January, 2025 on ClinicalTrials.gov (identifier: NCT06777277).

Treatment of early-stage cervical and endometrial cancer has been associated with significant sexual difficulties in at least half of women following hysterectomy. Despite the fact that women report such sexual side effects to be the most distressing aspect of their cancer treatment, evidence-based treatments for Female Sexual Arousal Disorder (FSAD), the most common sexual symptom in this group, do not exist. We developed and pilot tested a brief, three session psychoeducational intervention (PED) targeting FSAD in 22 women with early-stage gynecologic cancer. The PED consisted of three, 1-h sessions that combined elements of cognitive and behavioral therapy with education and mindfulness training. Women completed questionnaires and had a physiological measurement of genital arousal at pre- and post-PED (sessions 1 and 4) and participated in a semi-structured interview (session 4) during which their feedback on the PED was elicited. There was a significant positive effect of the PED on sexual desire, arousal, orgasm, satisfaction, sexual distress, depression, and overall well-being, and a trend towards significantly improved physiological genital arousal and perceived genital arousal. Qualitative feedback indicated that the PED materials were very user-friendly, clear, and helpful. In particular, women reported the mindfulness component to be most helpful. These findings suggest that a brief 3-session PED can significantly improve aspects of sexual response, mood, and quality of life in gynecologic cancer patients, and has implications for establishing the components of a psychological treatment program for FSAD.

Vaginal vasocongestion and lubrication serve to prepare the vaginal lumen for sexual activity. Lubrication is important for sexual functioning and difficulties with lubrication are one of the most commonly reported symptoms of sexual dysfunction. Few studies have empirically examined how vasocongestion and lubrication relate to one another and there are currently no well-established measures of lubrication. In this study, we designed and tested a simple method to assess lubrication at the vaginal introitus in 19 healthy women, using litmus test strips. We examined the relationship between lubrication and vaginal vasocongestion (measured with a photoplethysmograph) when elicited by audiovisual sexual stimuli (male–female sexual interactions). Lubrication was elicited by the sexual stimuli and was strongly correlated with reports of sexual arousal. Unexpectedly, lubrication was not correlated with vasocongestion, even though the latter was also elicited by the sexual stimuli. We discuss the implications of these findings for informing our understanding of the female sexual response and the potential clinical and scientific utility of this new measure.

A high proportion of self-identified gay men exhibit aspects of bisexuality during their lives. Some identify as bisexual before later identifying as gay; this has been called transitional bisexuality . Although many gay men report no attraction to women—or even sexual disgust toward them—others report some slight attraction to women. The latter have been studied as mostly homosexual men. We studied men with and without a history of transitional bisexuality, as well as mostly homosexual (i.e., those with Kinsey scores of 5) and completely homosexual (i.e., those with Kinsey scores of 6) men with respect to their sexual history with women, their current self-reported sexual arousal and disgust toward women and men, and their patterns of genital sexual arousal to female and male stimuli. Gay men with a history of transitional bisexuality generally lacked current sexual attraction and sexual arousal to women, compared with other gay men. Thus, transitional bisexuality among future gay men is mostly a matter of transitional bisexual identification. In contrast, mostly homosexual men showed statistically significant increases in genital arousal to female stimuli, compared with completely homosexual men.

Self-identified bisexual men report high sexual arousal to both male and female stimuli, but no study to date has compellingly demonstrated that such men have a bisexual pattern of genital arousal. We examined sexual arousal patterns among bisexual men recruited using stringent criteria designed to exclude those who were less likely to have sexual interest in both sexes. Furthermore, we included a bisexual stimulus depicting a man engaged in sex simultaneously with another man and a woman. On average, the bisexual men showed a bisexual arousal pattern, with respect to both self-reported and genital arousal. Additionally, the bisexual men were more aroused by the bisexual stimulus compared with the homosexual and heterosexual men. Some bisexual-identified men have bisexual genital arousal patterns, although it remains unclear how common they are.