Chronic stress and sexual function in women

J Sex Med. 2013 Oct;10(10):2443-54. doi: 10.1111/jsm.12249. Epub 2013 Jul 10.


Introduction: Chronic stress is known to have negative effects on reproduction, but little is known about how it affects the sexual response cycle. The present study examined the relationship between chronic stress and sexual arousal and the mechanisms that mediate this relationship.

Aim: The aim of this study is to test the relationship between chronic stress and sexual arousal and identify mechanisms that may explain this relationship. We predicted that women experiencing high levels of chronic stress would show lower levels of genital arousal and dehydroepiandrosterone (DHEAS) and higher levels of cortisol and cognitive distraction compared with women with average levels of stress.

Methods: Women who were categorized as high in chronic stress (high stress group; n=15) or average in chronic stress (average stress group; n=15) provided saliva samples and watched an erotic film while having their genital and psychological arousal measured.

Main outcome measures: Main outcome measures were vaginal pulse amplitude, psychological arousal, salivary cortisol, salivary DHEAS, and heart rate and compared them between women with high and average levels of chronic stress.

Results: Women in the high stress group had lower levels of genital, but not psychological arousal, had higher levels of cortisol, and reported more distraction during the erotic film than women in the average stress group. The main predictor of decreased genital sexual arousal was participants' distraction scores.

Conclusions: High levels of chronic stress were related to lower levels of genital sexual arousal. Both psychological (distraction) and hormonal (increased cortisol) factors were related to the lower levels of sexual arousal seen in women high in chronic stress, but distraction was the only significant predictor when controlling for other variables.

Keywords: Attention; Cortisol; DHEAS; Sexual Arousal; Stress.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arousal*
  • Attention
  • Chronic Disease
  • Cognition
  • Dehydroepiandrosterone / metabolism
  • Erotica
  • Female
  • Genitalia, Female / innervation*
  • Heart Rate
  • Humans
  • Hydrocortisone / metabolism
  • Photic Stimulation
  • Saliva / metabolism
  • Sexual Behavior*
  • Sexual Dysfunctions, Psychological / blood
  • Sexual Dysfunctions, Psychological / diagnosis
  • Sexual Dysfunctions, Psychological / etiology*
  • Sexual Dysfunctions, Psychological / metabolism
  • Sexual Dysfunctions, Psychological / physiopathology
  • Sexual Dysfunctions, Psychological / psychology
  • Stress, Psychological / complications*
  • Stress, Psychological / metabolism
  • Stress, Psychological / physiopathology
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • Young Adult


  • Dehydroepiandrosterone
  • Hydrocortisone