Penile erection is the most obvious feature of the male body's response to sexual excitement. It is a complex neurovascular response, influenced by cognitive inputs and facilitated by testosterone. Other features of that response include increases in skin temperature, blood pressure, heart and breathing rates, facial and bodily flushing, dilation of the pupils, and nipple erection. There are also changes in skin's sensitivity to touch. These changes are similar in both men and women.Erection response to sexual interest is the result of interplay between tactile, visual, auditory, and olfactory signals, combined with cognitive inputs, such as fantasy and memory (Figure 1). These stimuli may be erectogenic or erectolytic, pleasant or unpleasant, and are integrated in specific nuclei within the mid-brain. This balance between stimuli may result in pro-erectile signaling transmitted via the spinal cord, pelvic nerves and cavernous nerves running either side of the prostate gland, before finally terminating around the vascular smooth muscle of the corpora cavernosa.
Many professionals within our healthcare system maintain a position that lesbian health is synonymous with women’s health, secure in their belief that it is unnecessary to identify women as lesbian or bisexual within a consultation. Indeed, some well-meaning providers regard enquiry about lesbianism as overly intrusive and to be actively avoided. However, being part of a minority sexuality group influences patterns of health and illness and requires specific enquiry within most consultations. International population-based studies indicate a prevalence of lesbian and bisexual identity of around 1.5%, with up to 8% of women reporting homosexual desire or behaviour.