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PubMed2001

Sexual arousal and orgasm in women: effects of spinal cord injury.

Sexual disorders are common in women; however, the neurological basis of female sexual response has not been adequately investigated. This information is necessary to characterize the impact of various neurological disorders on sexual arousal in women and to develop appropriate management strategies for sexual dysfunction. To assess the spinal mediation of sexually stimulated genital vasocongestion in women, we conducted two laboratory-based, controlled analyses: (1) of women's genital, subjective, and autonomic responses to audiovisual erotic and audiovisual erotic combined with manual genital stimulation; and (2) of women's ability to achieve orgasm. Subjects included 68 premenopausal women with spinal cord injuries (SCIs) and 21 able-bodied, age-matched controls. Results indicated that preservation of sensory function in the T11-L2 dermatomes is associated with psychogenically mediated genital vasocongestion. Less than 50% of women with SCIs were able to achieve orgasm, compared with 100% of able-bodied women (p = 0.001). Only 17% of women with complete lower motor neuron dysfunction affecting the S2-S5 spinal segments were able to achieve orgasm, compared with 59% of women with other levels and degrees of SCIs (p = 0.048). Time to orgasm was significantly increased in women with SCIs compared with able-bodied controls (p = 0.049). Independent raters were unable to differentiate between subjective descriptions of orgasm from SCI women compared with controls. This information should be used when counseling women with spinal dysfunction about their sexual potential.

Adult↗

PubMed1994

The effect of orgasm on prostate-specific antigen.

To identify the effect of orgasm on serum prostate-specific antigen (PSA) levels, a prospective trial before and after orgasm was performed in 14 healthy colleagues aged 32-62 years (mean, 44.4 years) with no evidence of prostatic disease. PSA determinations were performed on serum samples obtained before and after orgasm. Significant changes in PSA levels after orgasm were found (P = 0.002, analysis of variance). We conclude that the impact of orgasm on PSA levels should be taken into account when the latter are used for the detection of prostatic disease.

Adult↗

PubMed1979

Models of female orgasm.

Self-report instruments concerning personality and subjective responses to sexual orgasm were filled out by 281 female university undergraduates. Exploratory and confirmatory factor analyses were used to evaluate the dimensionality of women's subjective responsiveness to orgasm. The results did not support the concept of a unidimensional orgasm process; separate coital and masturbatory factors of orgasmic experience were obtained. Highly internally consistent scales were developed to assess the two factors, and both scales were found to be significantly correlated with indices of extraversion, attitudes toward masturbation, and sexual experience. A path-analytic model was developed which is consistent with the hypothesis that heterosexual and monosexual behaviors act as mediators between extraversion, neuroticism, and attitudes toward masturbation, on the one hand, and subjective coital or masturbatory orgasmic responsiveness, on the other. It appears that attitudes toward masturbation may also have a direct influence on masturbatory responsiveness. Various therapeutic implications of the path model are described. Replications and extensions of the study with older, more experienced populations are necessary.

Adult↗

PubMed1980

The male orgasm: pelvic contractions measured by anal probe.

Pelvic muscle contractions during sexual response can be monitored conveniently by the anal probe method described. Eleven young adult male subjects were each recorded for three sessions of masturbation to orgasm. Electrical signals from an anal pressure probe were automatically digitized by computer. Orgasmic contractions were easily distinguished from voluntary contractions by the steadily increasing intervals and complete muscle relaxation between orgasmic contractions. At orgasm each subject produced a characteristic series of contractions starting abruptly at an intercontraction interval of about 0.6 seconds, and continued for 10 to 15 contractions at an increasing increment of about 0.1 second per contraction. Pressure amplitude, representing the force of contractions, increased from the beginning of the regular series to a maximum at the seventh or eighth contraction. Area under the pressure curve, reflecting muscular exertion during contraction, generally increased throughout the regular series. Each man's pattern of contractions was very similar from one session to the next and distinguished his records from others'. Individuals' patterns could be grouped into three types, based chiefly on the location of the regular contraction series within the subjective span of orgasm. The most common type was a simple series of regular contractions. It had the shortest duration and fewest contractions. The next most common pattern began with the regular series, followed by a number of irregular contractions. This type was longest in duration. One man with a third type of intermediate duration, had a number of preliminary contractions before the series of regular contractions began in midorgasm.

Adult↗

PubMed1976

Written descriptions of orgasm: a study of sex differences.

It has generally been assumed that a male's experience of orgasm is different from a female's experience of orgasm. In this study, a questionnaire consisting of 48 description of orgasm (24 male and 24 female) was submitted to 70 judges. These professionals (obstetrician-gynecologists, psychologists and medical students) were to sex-identify the description to discover whether sex differences could be detected. The judges could not correctly identify the sex of the person describing an orgasm. Furthermore, none of the three professional groups represented in the sample of judges did better than any of the other groups. Male judges did no better than female judges and vice versa. These findings suggest that the experience of orgasm for males and females is essentially the same.

Female↗

PubMed2001

Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence.

This current study examined the effect of a 3-week period of sexual abstinence on the neuroendocrine response to masturbation-induced orgasm. Hormonal and cardiovascular parameters were examined in ten healthy adult men during sexual arousal and masturbation-induced orgasm. Blood was drawn continuously and cardiovascular parameters were constantly monitored. This procedure was conducted for each participant twice, both before and after a 3-week period of sexual abstinence. Plasma was subsequently analysed for concentrations of adrenaline, noradrenaline, cortisol, prolactin, luteinizing hormone and testosterone concentrations. Orgasm increased blood pressure, heart rate, plasma catecholamines and prolactin. These effects were observed both before and after sexual abstinence. In contrast, although plasma testosterone was unaltered by orgasm, higher testosterone concentrations were observed following the period of abstinence. These data demonstrate that acute abstinence does not change the neuroendocrine response to orgasm but does produce elevated levels of testosterone in males.

Adult↗

PubMed1988

Urinary incontinence during orgasm.

Urinary incontinence occurring during orgasm in women is an infrequently volunteered symptom. We studied 3 such patients to understand the mechanism behind such leakage. Urodynamic studies were performed prior to and during orgasm. It was found that during orgasm, there was involuntary bladder contraction with simultaneous urethral relaxation, resulting in leakage. Similar studies performed prior to orgasm did not reveal any involuntary bladder contraction. We believe that incontinence during orgasm is multifactorial: the most important causes are sphincter incompetence, neuropathic hyperreflexic bladder, and non-neuropathic idiopathic bladder instability.

Adult↗

PubMed1995

The coital alignment technique and directed masturbation: a comparative study on female orgasm.

To evaluate the effectiveness of two sexual therapy techniques, a non-clinical population of 36 married women were randomly assigned with their spouses to either a sexual enrichment workshop with instruction on the coital alignment technique (19 women) or directed masturbation (17 women). Both workshops yielded clinically significant improvements in orgasm consistency during sexual intercourse, orgasm strength, and the overall number of orgasms experienced in partner-related activities. In instances where differences in the workshop were discovered (increases in orgasm consistency during sexual intercourse), the coital alignment technique yielded a somewhat more positive outcome than did directed masturbation. Treatment approaches that combine the two techniques, such as orgasm consistency training, may prove more beneficial than a treatment model that depends on either one or the other.

Adult↗

PubMed1989

[Changes in the psychophysical experience of orgasm in pregnancy].

A semistructured questionnaire was used as the basis for an examination of qualitative and quantitative changes in orgasm among 200 pregnant women brought to term. The frequency of orgasm gradually diminished over the 9 months in most women, only occasionally increasing. A total of 149 women (79.5%) said they had felt no pain during orgasm, 20.5% reported increased pleasure or incomplete post-orgasmic resolution. It should be pointed out that none of the women had experienced painful orgasm prior to their pregnancy.

Female↗

PubMed1987

[Psychologic study of the female orgasm].

In contrast to the physiology of female orgasm the orgasm experience (the psychology of orgasm) has hardly been examined and not precisely been determined. In most cases descriptions of the experience are cited. A standardized procedure to estimate the frequency and intensity of symptoms recognized at orgasm is introduced here. The sample included 422 females aged from 18 to 50 years, among them 25 patients in psychotherapeutic settings and 23 twin pairs. Results show inter alia: large differences in the frequency of recognizing the different symptoms of orgasm (14 have been selected here). Three groups of symptoms are distinguished. A surprisingly low reflection of the muscle contractions in the mind. This problem is being discussed more in detail. What is the actual rating of the contractions of the orgastic ring? Multiorgastically reacting women observe all symptoms more often and intensively.

Adolescent↗

PubMed1986

Treatment of secondary orgasmic dysfunction: an outcome study.

This study investigated the differential effectiveness of various treatment formats for 55 couples in which the woman reported secondary orgasmic dysfunction (defined as the inability of the woman to reach orgasm during intercourse, with or without clitoral stimulation, more than 50% of the time for the last 5 months). Couples received two 2-hr sessions of sexual reeducation and were then assigned into one of four treatment conditions (a communication skills format, a sexual skills format, one of two combination formats) or into one of two control conditions (an attention-comparison control condition which consisted of didactic presentations, or a waiting-list control condition). Treatment was conducted by one of two female clinical psychologists in groups of between four to six couples. No significant differences were found between the different treatment conditions at the posttest or at the 6-month follow-up. Statistical comparisons conducted between the combined treatment and combined control conditions showed that the couples who received treatment reported significantly less overall sexual dissatisfaction and significantly greater sexual harmony at the posttest; however, these differences became nonsignificant at the follow-up. In comparison with the women in the control conditions, a significantly greater number of women who received treatment reached or exceeded the project's 50% criterion for coital orgasmic functioning at the posttest; however, these differences became nonsignificant at the follow-up. Couples who reported less relationship adjustment prior to treatment showed greater overall gains in coital orgasmic frequency than couples who reported better relationship adjustment.

Adult↗

PubMed1985

Hemodynamics of sequential orgasm.

Seventeen women masturbated to orgasm several times in succession while being measured intravaginally by a device that allows continuous oxygen and blood flow readings. Analysis of covariance showed significant differences between fantasy and orgasm and between orgasm and interorgasm relaxation periods. The data do not provide physiological evidence that successive orgasms are either physiologically or subjectively stronger but do provide physiological evidence of a plateau phase of sexual response in women.

Adult↗

PubMed2005

Prolactinergic and dopaminergic mechanisms underlying sexual arousal and orgasm in humans.

Dopaminergic mechanisms play a major role in modulating sexual behavior in humans and animals. Animal data demonstrate important interactions between the dopaminergic and prolactinergic system. As recently demonstrated, dopamine agonists have facilitatory properties for penile erection but may also enhance sexual drive and orgasmic quality. In contrast, chronic elevations of prolactin inhibit appetitive as well as consummatory parameters of sexual behavior. Recent human studies show a marked increase in prolactin after orgasm in males and females. Concerning the biological relevance of acute prolactin alterations after orgasm, prolactin might serve as a neuroendocrine reproductive reflex for peripheral reproductive organs. Alternatively, prolactin may feedback to dopaminergic neurons in the central nervous system and thereby modulate sexual drive and satiation. Here, we provide a brief overview of the physiology of dopamine and prolactin in regulating sexual behavior. In addition, recent experimental and clinical evidence for a postulated feedback mechanism for prolactin and its implications for orgasmic disorders are discussed.

Dopamine↗

PubMed2005

Focal paraneoplastic limbic encephalitis presenting as orgasmic epilepsy.

PURPOSE: To report orgasmic epilepsy as a manifestation of paraneoplastic limbic encephalitis in a patient with small cell lung cancer. CASE REPORT: A 57 years-old woman presented with 2 month history of daily spells that consisted of a sudden pleasure provoking feeling described 'like an orgasm' lasting for 30 s to 1 min. She was a heavy smoker and had noted recent weight loss. Bronchial biopsy, following the finding of a right lung mass, confirmed the diagnosis of small cell lung cancer (SCLC). Spells subsided after starting carbamazepine. The lung cancer was treated with chemotherapy and chest radiation therapy resulting in a complete radiologic response. RESULTS: Brain magnetic resonance imaging (MRI) revealed left temporal lobe area of increased signal on T2 and FLAIR sequence. T1-weighted images after contrast administration demonstrated a circumscribed area of enhancement in the left anterior medial temporal lobe. Electroencephalogram (EEG) showed focal left mid-temporal sharp waves and intermittent slowing. Anti-Hu antibodies were detected in her serum supporting a diagnosis of paraneoplastic limbic encephalitis as the cause of her orgasmic epilepsy. The patient has been followed for 2 years after treatment without tumor recurrence or neurological deterioration. CONCLUSION: Orgasmic epilepsy is another mode of presentation of paraneoplastic limbic encephalitis leading to the diagnosis of an occult SCLC. EEG and MRI findings suggest that in this case the seizures originated from the left hemisphere. It is possible that early recognition and treatment of the SCLC will improve the prognosis of this neurologic entity.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2005

Ecstasy (MDMA) mimics the post-orgasmic state: impairment of sexual drive and function during acute MDMA-effects may be due to increased prolactin secretion.

Methylenedioxymethamphetamine (MDMA or "Ecstasy") is a major stimulant drug of abuse worldwide. MDMA produces euphoria, enhances interpersonal communication and feelings of closeness with others. In contrast to the induced emotions of affection and sensual enhancement, clinical studies show that it impairs sexual drive and functioning. In drug-free humans, sexual stimulation with orgasm induces a pronounced secretion of prolactin, which may mediate the post-orgasmic state. The phenomenological features of the psychological state induced by MDMA show some similarities with features of the post-orgasmic state. In addition, MDMA also induces a prominent increase of prolactin plasma levels with a similar time kinetic compared to the post-orgasmic prolactin increase. Here, we present the hypothesis that the impairment of sexual parameters after MDMA may be mediated by increased prolactin.

N-Methyl-3,4-methylenedioxyamphetamine↗

PubMed2002

Orgasm-induced prolactin secretion: feedback control of sexual drive?

Recent studies from our laboratory have investigated the hormonal response to various forms of sexual stimulation, including film, masturbation, and coitus in both men and women. This series of studies clearly demonstrated that plasma prolactin (PRL) concentrations are substantially increased for over 1h following orgasm (masturbation and coitus conditions) in both men and women, but unchanged following sexual arousal without orgasm. Here we discuss evidence suggesting that the PRL response to orgasm may play an important role in the control of acute sexual arousal following orgasm. Supporting this position, chronic elevations of PRL (hyperprolactinemia) produce pronounced reductions in animal sexual activity, and significant reduction of libido and gonadal function in both men and women. These data suggest that PRL may represent a peripheral regulatory factor for reproductive function, and/or a feedback mechanism that signals CNS centres controlling sexual arousal and behaviour. Thus, we propose a theoretical model of the role of PRL as a neuroendocrine reproductive reflex.

Animals↗

PubMed1986

[Some factors which modify the ability of the female to achieve orgasm].

Between 1952 and 1984 a sexological study was conducted among 2,159 gynecologic patients who had been referred to Franzensbad for treatment. All the women had been married for at least one year. Their ages ranged from 21 to 40. The number of women those born between 1911 and 1960 who frequently achieved orgasm has increased. Women with late menarch (from age 16 onward) generally were less able to achieve orgasm than those with menarche at age 11. The average age at menarch among women born between 1911 and 1920 was 13.92 years. Among women born after 1950 it was 13.06 years. Within the same period of time the age at which the first coitus took place dropped from 20.75 to 17.92 years. The average age at which the first coitus occurred increases commensurately with age at menarche. Statistically, women who experienced orgasm began their full sex-life significantly earlier than those with low orgasm ability or anorgasmy. On average, women with only elementary school education first had sexual intercourse earlier than those who had attended a higher school and sat a school-leaving examination. Only 7% of the women born after 1950 had grown up in families with 6 or more children, while this was the case for a quarter of the women surveyed who were born between 1911 and 1920. The findings described support the view that the positive changes in women's sex-lives are influenced by the simultaneous effect of biological and psychosocial factors.

Adult↗

PubMed2006

A general look at female orgasm and anorgasmia.

Male and female genital anatomy evolves from the same embryonic tissue. Is it therefore possible that males and females have the same potential for orgasmic response? Have forces external to a woman's biology influenced her potential enjoyment of this bodily function, or is female orgasm a by-product of that early sameness and variable because it has no or very little functional or evolutionary benefit? In modern times, we continue to study the anatomy and physiology of female sexual responses. The journey now is to understand the similarities and differences between the male and female sexual responses and be respectful of both. Female sexual response models and the classification of female sexual dysfunctions direct the thoughts and treatments of sexual and relationship therapists. The ultimate aim is to allow each woman to have the best possible sex life and orgasm, namely the one she wants. The psychophysiological treatments for female orgasmic dysfunction are on the whole successful. However, in anorgasmia proven to be biological in aetiology, following menopause for example, physiological changes occur that cannot be resolved by these strategies alone. We need to be supportive of the pharmaceutical industry finding medication that we can appropriately and responsibly use for the good of women with sexual difficulties, because good sexuality is a very important quality of life issue for very many women.

Coitus↗