title: Arousing properties of the vulvar epithelium.
abstract: OBJECTIVE
  The initiation of genital tactile stimulation is regarded as a precursor to sexual arousal and perhaps in women it is the most easily recognized initiator of central nervous system arousal. Unfortunately little published material details the specific mechanisms preceding arousal, beginning at the epithelial level, which are the sensory precursors to arousal. Little is known about its cutaneous receptors, nerves and the other histochemical properties of this epithelial tissue that contribute to sexual arousal. Sexual sensitivity evaluations target female genital somatosensory pathways for cutaneous sensation by testing evoked potentials of nerves, hot/cold and vibratory sensory discrimination. The anatomical bases of these several sensibilities form a subject for future investigation. We reviewed the known influences and mechanisms responsible for the arousing properties of the epithelium in the female external genitalia as well neural pathways associated with sexual arousal originating from the vulvar epithelium.
  
  
  METHODS
  A comprehensive review was done of published, relevant clinical and histological material in human and nonhuman vertebrate studies.
  
  
  RESULTS
  Tactile stimulation of the vulvar epithelium initiates changes suggesting complex integrative mechanisms. Influences of skin temperature, hormonal environment, mechanical tissue compliance and inflammation as well as the large number of transmitters and neuropeptides involved in peripheral pathways serving female sexual arousal speak of a direct sensory role.
  
  
  CONCLUSIONS
  Genital epithelial cells may actively participate in sensory function to initiate sexual arousal by expressing receptors and releasing neurotransmitters in response to stimuli, resulting in epithelial-neuronal interactions.
authors.affiliation: Department of Neurobiology and Behavior, Rockefeller University, New York, New York, USA.
authors.forename: Nieves
authors.initials: N
authors.lastname: Martin-Alguacil
authors.forename: Justine
authors.initials: J
authors.lastname: Schober
authors.forename: Lee-Ming
authors.initials: LM
authors.lastname: Kow
authors.forename: Donald
authors.initials: D
authors.lastname: Pfaff
mesh_terms: D000818:Animals; D004848:Epithelium / Q000294:innervation / Q000502:physiology; D005260:Female; D006801:Humans; D014844:Vulva / Q000294:innervation* / Q000502:physiology*