Conceptualizing women's sexual function: linear vs. circular models of sexual response.

INTRODUCTION: The lack of an adequate empirical base for models of female sexual response is a critical issue within the female sexual dysfunction (FSD) literature. AIM. The current research compared the extent to which a linear model of sexual response and Basson's circular model of female sexual response represent the sexual function of women with and without FSD.

MAIN OUTCOME MEASURES: Women's levels of sexual function/dysfunction were assessed with the Female Sexual Function Index and additional items measured women's endorsement of models of female sexual function as representing their own sexual experience.

METHODS: An anonymous online survey assessing female sexual response and associated aetiological factors was completed by a random sample of 404 women.

RESULTS: Although the linear model of sexual response was a good fit for women with and without sexual dysfunction, the relationship between sexual arousal and orgasm was mediated by sexual desire for women with FSD. The fit of the initial circular model of women's sexual response was poor for both groups. Following pathway modification, the modified circular model adequately represented the responses of both groups and revealed that a number of the relationships between sexual response variables were stronger for women with FSD.

CONCLUSIONS: The linear model was a more accurate representation of sexual response for women with normal sexual function than women with FSD and sexual arousal and orgasm was mediated by sexual desire for women with FSD. The modified circular model was a more accurate representation of the sexual response of women with FSD than women with normal sexual function.