madman
Super Moderator
Clitoral Doppler ultrasound (CDU) is a noninvasive and easily applicable test used to assess the vascular patency and perfusion of clitoral arteries by measuring the rate of change in blood flow. Among hemodynamic parameters assessed during CDU, the pulsatility index (PI) is proposed to reflect genital vascular resistance and predict cardiovascular risk factors. The PI is an intrinsic Doppler ultrasound value, which is automatically calculated from different hemodynamic parameters during a defined cardiac cycle and is obtained by the following formula: (peak systolic velocity – minimal diastolic velocity) / mean velocity. Importantly, since PI is derived from multiple flow parameters derived on the same Doppler spectrum, it is considered to mitigate potential instrument-dependent errors or an inappropriate angle of insonation by the sonographer. Moreover, PI was recognized for its safety, repeatability, and sensitivity in monitoring early and minimal changes in hemodynamic parameters. Based on these favorable characteristics, PI has been adopted in clinical practice for measuring vascular resistance in pulsatile systems across various pathologic conditions.1
*Clitoral arteries have an even smaller diameter (range, 0.7-1.1 mm)than penile arteries (averaging 1-2 mm). This size difference suggests that assessing narrowing and resistance in clitoral arteries might be even more accurate in predicting cardiovascular risk than in the male counterpart. Therefore, the purpose of this Expert Opinion article is to briefly summarize evidence on the use of CDU, while recognizing the areas of uncertainty in the field and fostering future research and specifically designed studies to assess the predictive value of this technique.
With the growing body of evidence supporting the role of vascular evaluation of the clitoris with ultrasound as a potential marker of forthcoming cardiovascular risk in females, the European Society for Sexual Medicine has developed the ESSM Female Ultrasound School (EFUS).6 The EFUS aims to offer high-level “female ultrasound courses” to train and educate experts in the field of female ultrasound for the evaluation of female SD. The primary goal is to promote standardization of methodology in the assessment of female SD while ensuring the highest level of quality and expertise in this specialized area.
EFUS will also foster the wider adoption and dissemination of the CDU methodology to definitely disentangle the role of clitoral vascular impairment as a harbinger of cardiovascular health, which may stimulate exploring the role of CDU in the diagnostic armory of female SD.
*Clitoral arteries have an even smaller diameter (range, 0.7-1.1 mm)than penile arteries (averaging 1-2 mm). This size difference suggests that assessing narrowing and resistance in clitoral arteries might be even more accurate in predicting cardiovascular risk than in the male counterpart. Therefore, the purpose of this Expert Opinion article is to briefly summarize evidence on the use of CDU, while recognizing the areas of uncertainty in the field and fostering future research and specifically designed studies to assess the predictive value of this technique.
With the growing body of evidence supporting the role of vascular evaluation of the clitoris with ultrasound as a potential marker of forthcoming cardiovascular risk in females, the European Society for Sexual Medicine has developed the ESSM Female Ultrasound School (EFUS).6 The EFUS aims to offer high-level “female ultrasound courses” to train and educate experts in the field of female ultrasound for the evaluation of female SD. The primary goal is to promote standardization of methodology in the assessment of female SD while ensuring the highest level of quality and expertise in this specialized area.
EFUS will also foster the wider adoption and dissemination of the CDU methodology to definitely disentangle the role of clitoral vascular impairment as a harbinger of cardiovascular health, which may stimulate exploring the role of CDU in the diagnostic armory of female SD.
