title: Cigarette smoking decreases the genital vascularization in young healthy, eumenorrheic women.
abstract: BACKGROUND
  Cigarette smoking is a major health hazard and may impair the normal sexual response.
  
  
  OBJECTIVE
  To evaluate (in the early follicular phase, and independently from sexual stimulation) in young, eumenorrheic, healthy, lean women the general and genital vascular effects of the smoking habit.
  
  
  METHODS
  One hundred thirty-seven patients undertook, in the early follicular phase of the menstrual cycle (day 3-5): the administration of the two-factor Italian McCoy Female Sexuality Questionnaire (MFSQ); two-dimensional (2-D) color Doppler evaluation of the ophthalmic, carotid, uterine, clitoral, and labia minora arteries; three-dimensional (3-D) analysis of clitoral and labia minora vascularization; and blood pressure evaluation. Fasting blood samples were drawn to test plasma estradiol, androstenedione, and testosterone circulating levels.
  
  
  METHODS
  The two-factor Italian MFSQ; the pulsatility index (PI) of internal carotid, ophthalmic, uterine, clitoral, and labia minora arteries; the vascularization index (VI), the flow index (FI), and the vascularization flow index (VFI) of clitoral body and labia minora, blood pressure measurement, and hormonal assay.
  
  
  RESULTS
  The subjects were divided in: nonsmokers (Group I; N=72); current (>2 years) light smokers-1 to 10 cigarettes/day-(Group II; N=35); and current heavy smokers->10 cigarettes/day-(Group III; N=30). The 2-D Doppler analysis of the ophthalmic and internal carotid arteries showed significant increased resistance in Group III compared with Group II and Group I. The genital vessels (uterine, clitoral, and labium minus arteries) showed the lowest PIs in the nonsmokers. The 3-D power Doppler histogram analysis of clitoral and labium minus blood flow showed the worst vascular indices (VI, FI, VFI) in the heavy smokers.
  
  
  CONCLUSIONS
  Cigarette smoking may favor a reduced central and peripheral tissue perfusion with consequent increased risk of cerebrovascular and cardiovascular diseases and with genital vessels stiffness and impaired sexual performances.
authors.affiliation: Department of Gynecology and Pathophysiology of Human Reproduction, University of Bologna, Bologna, Italy. cesare.battaglia@unibo.it
authors.forename: Cesare
authors.initials: C
authors.lastname: Battaglia
authors.forename: Bruno
authors.initials: B
authors.lastname: Battaglia
authors.forename: Fulvia
authors.initials: F
authors.lastname: Mancini
authors.forename: Nicola
authors.initials: N
authors.lastname: Persico
authors.forename: Rossella E
authors.initials: RE
authors.lastname: Nappi
authors.forename: Roberto
authors.initials: R
authors.lastname: Paradisi
authors.forename: Stefano
authors.initials: S
authors.lastname: Venturoli
mesh_terms: D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging; D001783:Blood Flow Velocity / Q000502:physiology; D002987:Clitoris / Q000098:blood supply*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D009948:Orgasm / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology; D012907:Smoking / Q000009:adverse effects*; D018615:Ultrasonography, Doppler, Color; D014844:Vulva / Q000098:blood supply*