Cigarette Smoking Decreases the Genital Vascularization in Young Healthy, Eumenorrheic Women

Cesare Battaglia, Bruno Battaglia, Fulvia Mancini, Nicola Persico, Rossella E. Nappi, Roberto Paradisi, Stefano Venturoli

Research output: Contribution to journalArticlepeer-review


Introduction. Cigarette smoking is a major health hazard and may impair the normal sexual response. Aim. 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. Main Outcome Measures. 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.

Original languageEnglish
Pages (from-to)1717-1725
Number of pages9
JournalJournal of Sexual Medicine
Issue number6
Publication statusPublished - Jun 2011


  • Clitoris
  • Doppler
  • Genital Blood Flow
  • Labia Minora
  • Smoking
  • Ultrasound

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynaecology
  • Reproductive Medicine


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