Sustratos hormonales de la respuesta sexual femenina

The sex steroids estrogens and androgens are both currently ascribed important roles in women's sexual function. Estrogens are critical for preserving the structure and function of female urogenital tract, crucial for a satisfactory sexual response, where estrogen receptors are richly expressed. The effects of estrogens on sexual desire are more controversial. Thus whereas estrogen replacement therapy seems to improve sexual interest of many menopausal women, in a substantial number of them shows little benefit on this specific aspect of sexual function even though their urogenital atrophy becomes effectively corrected. In fact it seems that the blood estrogen levels necessary for preserving sexual interest are rather high, viz similar to those found just during the ovulatory phase of the menstrual cycle. As women's sexual interest/activity shows more stable patterns the above finding suggests that any significant endocrine influence on sexual desire should be mediated by a different kind of hormone. Androgens, which show less marked cyclical changes, are the most likely candidates. Androgens are now ascribed an important role in fostering sexual desire/interest in men and women, possibly in cooperation with estrogens. All the brain areas thought to be involved in sexual motivation express in various amounts both androgen and estrogen receptors. It seems, therefore, that the effects of estrogens and androgens on the woman's sexual response system are both complementary and additive. That supports the combined treatment with both estrogens and androgens for a full restoration of sexual function in women deprived of their ovaries' hormonal output.