Department of Obstetrics and Gynecology, University of Bologna, Via Massarenti 13, Bologna 40138, Italy.
J Sex Med. 2009 Oct;6(10):2715-21. doi: 10.1111/j.1743-6109.2009.01430.x. Epub 2009 Aug 4.
Clitoral functional modifications occur during the menstrual cycle.
To prospectively evaluate, by the three-dimensional (3-D) Doppler flow analysis, the hemodynamic clitoral blood flow variations during the menstrual cycle. METHODS. Fourteen young (18-35 years), eumenorrheic (menstrual cycle of >25 and <35 days) women in a stable heterosexual relationship (>1 year) and without any sexual dysfunction (as resulted from the two-factor Italian McCoy female sexuality questionnaire > or =35) were submitted, in the early follicular (day 3-5) and in the periovulatory (day 12-14) phases of the menstrual cycle, to bi- and tridimensional ultrasonographic and color Doppler analyses of the clitoral structures. On the same days, the circulating estradiol values were assayed. MAIN OUTCOMES MEASURES. Two-dimensional ultrasonographic evaluation of follicular diameter and color Doppler evaluation of the dorsal clitoral arteries; 3-D power Doppler analysis of the clitoral body volume and of the indices of clitoral vascularization and blood flow; estradiol assay.
The mean virtual organ computer-aided analysis (VOCAL) volume of the clitoral body was lower in the follicular (0.79 +/- 0.19 mL) phase with respect to the periovulatory phase (0.98 +/- 0.22 mL; P < 0.001); the clitoral arteries demonstrated a significant decrease of the pulsatility index (PI) from the follicular (1.75 +/- 0.18) to the periovulatory phase (1.26 +/- 0.21; P = 0.002); the 3-D power Doppler histogram analysis showed significant changes of the indices of vascularization and blood flow (vascularization index [VI] = 2.239 +/- 1.201 vs. 3.302 +/- 1.305, P = 0.001; flow index = 27.290 +/- 2.454 vs. 33.620 +/- 1.712, P < 0.001; vascularization flow index = 0.578 +/- 0.573 vs. 1.091 +/- 0.461; P = 0.001) between the follicular and the periovulatory phase of the menstrual cycle. The relationship between the different parameters evidenced that estradiol is positively correlated with the VOCAL clitoral body volume (r = 0.512; P = 0.033) and inversely correlated with the dorsal clitoral artery PI (r = -497; P = 0.048) and with VI (r = 0.622; P = 0.011).
During the normal menstrual cycle, the estrogens may, probably, influence the clitoral anatomic and vascular structures and the 3-D ultrasonography may easily and precisely demonstrate these modifications.
在月经周期中，阴蒂的功能会发生改变。
通过三维（3-D）多普勒血流分析，前瞻性评估月经周期中阴蒂血流的变化。
14 名年轻（18-35 岁）、月经规律（周期 25-35 天）、处于稳定异性恋关系（>1 年）且无性功能障碍的女性（通过意大利 McCoy 女性性功能问卷的两因素得分>或=35），在月经周期的早期卵泡期（第 3-5 天）和排卵前期（第 12-14 天），进行阴蒂结构的二维和三维超声及彩色多普勒分析。在同一时期，检测循环中的雌二醇水平。
二维超声评估卵泡直径，彩色多普勒评估阴蒂背侧动脉；3-D 能量多普勒分析阴蒂体体积及阴蒂血管化和血流指数；雌二醇检测。
阴蒂体的虚拟器官计算机辅助分析（VOCAL）体积在卵泡期（0.79±0.19mL）显著小于排卵前期（0.98±0.22mL；P<0.001）；阴蒂动脉的搏动指数（PI）从卵泡期（1.75±0.18）显著下降至排卵前期（1.26±0.21；P=0.002）；3-D 能量多普勒直方图分析显示血管化和血流指数显著变化（血管化指数[VI]=2.239±1.201 比 3.302±1.305，P=0.001；血流指数=27.290±2.454 比 33.620±1.712，P<0.001；血管化血流指数=0.578±0.573 比 1.091±0.461；P=0.001）。月经周期中卵泡期和排卵前期之间不同参数的关系表明，雌二醇与 VOCAL 阴蒂体体积呈正相关（r=0.512；P=0.033），与阴蒂背侧动脉 PI（r=-497；P=0.048）和 VI（r=0.622；P=0.011）呈负相关。
在正常月经周期中，雌激素可能会影响阴蒂的解剖和血管结构，3-D 超声可以方便、准确地显示这些变化。
