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PubMed1983

Methodological issues in the study of sex therapy: effective components in the treatment of secondary orgasmic dysfunction.

Three components commonly utilized in sex therapy for secondary orgasmic dysfunction (Sensate Focus I, Sensate Focus II, and ban on intercourse) were studied, with the aim of not only exploring their effects on therapy outcome but also, in part, of sensitizing investigators to the benefits of incorporating component analyses within larger investigations of therapy outcome. The subjects were 23 married couples with the problem of secondary orgasmic dysfunction in the wife. Subjects were administered a multicomponent therapy program over a 14-week period. Daily self-monitoring data were analyzed to assess the impact of Sensate Focus exercises and banning intercourse on both broad (e.g., enjoyment) and narrow (e.g., orgasmic response) criteria of therapeutic effectiveness. Results indicated that for females, sensate focus exercises, in combination with a ban on intercourse, led to a significant increase in level of enjoyment for subsequent noncoital sexual caressing as well as intercourse. Orgasmic responsiveness, however, was not affected. The methodological issues of broad versus narrow therapeutic effects, compliance with treatment, and cost-effective techniques for the study of sex therapy components are discussed.

Adult↗

PubMed1987

The treatment of secondary orgasmic dysfunction II.

This study investigated the impact of group treatment on women with secondary orgasmic dysfunction and their partners. Eleven couples received 4 hours of basic sex education, after which seven of the couples received a Combination treatment format consisting of communication skills followed by sexual skills, while four of the couples received the opposite sequence. No significant differences were found between the two sequences. When compared with similarly recruited control couples in a previous study, a significantly greater number of treated women reached or exceeded the 50% criterion for coital orgasmic functioning after treatment. Couples who reported a better relationship adjustment prior to treatment reported a significantly greater gain in total sexual harmony than did less adjusted couples. Across the treatment conditions, women who had reached coital orgasm prior to treatment reported a significantly greater increase in relationship adjustment between the post-sex education and 6-month follow-up testing periods than women who had never reached coital orgasm. Some discrepancies in outcome were found in comparison with our earlier study, suggesting that subject heterogeneity may influence differential outcomes.

Adult↗

PubMed1992

Infrequent orgasms in women.

Out of a sample of 2,425 gynecological patients aged 21-40 and married for at least one year, three groups were selected according to the frequency of coital orgasm. The first, orgastic, group contained 1,266 (52.2%) orgastic women, the second group included 466 (19.2%) patients with infrequent orgasms, and the third group consisted of 151 (6.2%) patients whose infrequent orgasms were felt by the examinees as distressing. Significant differences were found between the three groups concerning family environment and childhood, level of education and professional standing, sexual development and life, and in the incidence of psychopathological symptoms. It appears that the insufficient capacity of many women to attain regular orgasms in sexual intercourse is caused by several factors of both biological and psychosocial nature.

Adult↗

PubMed1978

Sexual behavior correlates of female orgasm and marital happiness.

The present study was designed to investigate sexual behavior correlates of marital happiness and female orgasm. Forty-eight female students of Baylor University who were 20 to 35 years old and had been married at least 2 years participated in the survey. A specially compiled 131-item marital relations questionnaire provided data for an intercorrelational analysis. Marital happiness, fidelity, and experience of orgasm correlated with certain specific sexual behaviors. These variables were related also to dissatisfaction with marital sex, which is consistent with previous research. However, when dissatisfaction resulting from performing less desired sexual acts was separated from dissatisfaction resulting from not performing desired sexual acts, the correlations differed, often markedly. Thus, the data suggest that unitary measures of dissatisfaction with marital sex may obscure meaningful differences. Also, information was obtained concerning the orgasmic and multiple orgasmic experience of the women, their extramartial experience, and their relative use of and preference for various intercourse positions and noncoital sexual activities.

Adult↗

PubMed2004

Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasms.

BACKGROUND: The pathophysiology of the explosive type of headache associated with sexual activity is not completely understood. Five reported cases of patients with thunderclap headache, precipitated by sexual activity, in association with concomitant cerebral arterial narrowing, were found in the literature. METHODS: A 44-year-old woman with both coital and masturbatory headaches during orgasm associated with segmental reversible cerebral artery vasospasm was investigated. Cerebral anatomy and eventual spasm was documented by magnetic resonance imaging or digital angiography before, during, and after resolution of the orgasmic headache-vasospasm clinical manifestation. CONCLUSION: Findings of cerebral arterial narrowing, presented by some patients shortly after orgasmic headache attacks, support the hypothesis that segmental vasospasm may exert a role in the pathogenesis of this uncommon type of headache. The literature is reviewed, and possible mechanisms underlying the development of orgasmic headache are discussed.

Acute Disease↗

PubMed1978

A controlled study to evaluate directed masturbation in the management of primary orgasmic failure in women.

This paper presents the results of a prospective controlled study evaluating a programme of directed masturbation against a combined sensate focus and supportive psychotherapeutic approach in the management of female primary orgasmic failure. Of the 20 patients who followed the masturbation programme 90 per cent gained orgasmic capacity compared with 53 per cent of 15 patients who were treated conventionally. Eighty-five per cent of the patients treated by the masturbation programme and 47 per cent of the control group of patients became coitally orgasmic on at least 75 per cent of coital occasions. The difference is statistically significant at the 5 per cent level. The results suggest that directed masturbation is an effective adjunct in the management of primary female orgasmic failure.

Adult↗

PubMed1990

Naloxone inhibits oxytocin release at orgasm in man.

We examined the effect of naloxone on plasma oxytocin levels during sexual activity in men. Eight normal men took part in a double-blind, two-period, cross-over design. Mean plasma oxytocin rose to 362% of baseline values at orgasm with placebo (saline) but showed no increase with naloxone (P less than 0.01). While naloxone had no effect on heart rate or blood pressure at orgasm, a decrease in the level of subjective arousal and pleasure at orgasm was noted. We conclude that opioid receptor blockade with naloxone has an inhibitory effect on the neural pathways mediating the oxytocin response at orgasm.

Adult↗

PubMed2005

Genetic and environmental influences on the frequency of orgasm in women.

This study reports on genetic and environmental influences on the frequency of orgasm in women during sexual intercourse, during other sexual contact with a partner, and during masturbation. Participants were drawn from the Australian Twin Registry, and recruited from a large, partly longitudinal twin-family study. Three thousand and eighty women responded to the anonymous self-report questionnaire, including 667 complete monozygotic (MZ) pairs and 377 complete dizygotic (DZ) same-sex pairs, 366 women from complete DZ opposite-sex pairs, and 626 women whose co-twins did not participate. Significant twin correlations were found for both MZ and DZ twin pairs for all three items of interest. Age effects were statistically significant for some items. Models incorporating additive genetic, shared and nonshared environmental influences provided the best fit for Items 1 and 3, while a model with additive and nonadditive genetic influences along with nonshared environment fitted the data from Item 2. While an independent pathway model fits the data most par-simoniously, a common pathway model incorporating additive genetic (A), shared environment (C), and unique environment (E) effects cannot be ruled out. Overall, genetic influences account for approximately 31% of the variance of frequency of orgasm during sexual intercourse, 37% of the variance of frequency of orgasm during sexual contact other than during intercourse, and 51% of the variance of frequency of orgasm during masturbation. Following Baker (1996), we speculate that this additive genetic variance might arise from frequency-dependent selection for a variety of female sexual strategies.

Environment↗

PubMed2005

[Assessment of orgasmic capacity of postmenopausal women].

OBJECTIVE: To correlate the capacity of healthy postmenopausal women to have orgasms (during intercourse or by solitary masturbation) with psychosocial, behavioral, climacteric, hormonal and interpersonal factors. METHODS: Nine hundred and ninety-nine women (aged from 41 to 60 years) underwent physical and supplementary tests and answered questionnaires regarding sexual behaviour. Sixty healthy women, sexually active, with one or more years of amenorrhea, without hormone therapy and with a partner capable of intercourse were chosen from this group. A Logistic Regression Model with one dependent variable -- orgasmic capacity -- and seventeen independent variables -- psychosocial, behavioral, interpersonal, climacteric and hormonal factors -- was developed. RESULTS: The orgasmic capacity correlated significantly with the practice of masturbation (p=0.000), with pleasure in embracing and caressing the partner's body (p=0.036) and with the presence of vaginal dryness (p=0.021). CONCLUSIONS: This study shows that the most important factors were interpersonal and behavioral and that the other parameters considered were not statistically significant. Women with vaginal dryness, who however engage in masturbation and maintain an affective relationship with their partner, obtain an equal or a greater number of orgasms when compared to the frequency of sexual intercourse.

Adult↗

PubMed2002

Sexual enjoyment and orgasm postpartum: sex differences and perceptual accuracy concerning partners' sexual experience.

The sexual relations of parents at the postpartum stage have been researched relatively often, but still there exist serious research deficits (for example, neglect of male partners, of the later postpartum stages beyond the third month, and neglect of sexual feelings, enjoyment and orgasm). The aim of this study was to gain more knowledge about German couples' sexual enjoyment and orgasm with regard to non-genital tenderness, French kissing, breast stimulation, manual-genital stimulation, cunnilingus, fellatio, vaginal intercourse, anal intercourse and masturbation at seven months postpartum. As part of a larger longitudinal study 60 women and men (30 couples) answered a newly developed Sexual Preferences Questionnaire (SPQ), which assesses sexual activity and enjoyment. Descriptive data about sexual enjoyment, sex/gender differences and perceptual differences between self-report and reports of partners' enjoyment are analyzed and SPQ data are validated with interview and other questionnaire data (PFB-tenderness). Both genders find the same activities most pleasant (tenderness, vaginal intercourse, receiving manual-genital stimulation) and most exciting (intercourse, receiving manual-genital and oral-genital stimulation) and reach orgasm most easily through intercourse, masturbation and receiving manual-genital stimulation. But men generally describe a higher sexual enjoyment and overestimate their partners' enjoyment, especially with regard to female orgasm through intercourse. The results are critically discussed with regard to limitations and strengths of the sample and the method.

Adult↗

PubMed1979

Some linguistic considerations related to the issue of female orgasm.

The purpose of this paper has been to identify a linguistic issue that continues to cloud our thinking about the subject of female orgasm. A specific technical revision has been recommended, i.e., that female orgasms be described as either coital or noncoital. It has been suggested that we help our female patients to become aware of this vocabulary and that we let them know that the clitoral/vaginal dichotomy is incorrect. Systematic adherence to the correct vocabulary is therapeutic. The linguistic implications concerning the issue of female orgasm have been examined as they relate to both theory and practice. It has been argued that linguistic usage pertaining to female sexuality generally is the product of a patriarchal value structure and, as such, reflects patriarchal prejudices about female sexuality. It has been suggested that the apparent inability of many women to achieve coital orgasms is related to centuries-old cultural attitudes and that linguistic usages, particularly dichotomies, tend to perpetuate the prejudices that underlie many cultural attitudes. Freud's view of the role of language in clinical practice has been indicated. Finally, it has been suggested that the linguistic recommendation made in this paper can be viewed as implementing the process by which recent biological findings are used to strengthen psychoanalytic theory and practice.

Female↗

PubMed2006

[The neurophysiology of the female orgasm].

The way women experience orgasm during passionate sexual activity has been of interest throughout the ages. The astonishing advances of functional imaging techniques recently allowed unravelling the neuroanatomy of female orgasm within a distributed corticosubcortical neural network. In the present article, we review the clinical and experimental evidence that attributes orgasm not only a peripheral but also a central origin. We thus outline the importance of integrating orgasm as a complex process involving the entire woman, mind and body. In light of this, future studies in female sexuality would need to take account of the consequences of both standard approaches in sexology and functional imaging results in the understanding of the human sexual function and in the treatment of sexual dysfunctions.

Female↗

PubMed2005

Functional MRI of the brain during orgasm in women.

Women diagnosed with complete spinal cord injury (SCI) at T10 or higher report sensations generated by vaginal-cervical mechanical self-stimulation (CSS). In this paper we review brain responses to sexual arousal and orgasm in such women, and further hypothesize that the afferent pathway for this unexpected perception is provided by the Vagus nerves, which bypass the spinal cord. Using functional magnetic resonance imaging (fMRI), we ascertained that the region of the medulla oblongata to which the Vagus nerves project (the Nucleus of the Solitary Tract or NTS) is activated by CSS. We also used an objective measure, CSS-induced analgesia response to experimentally induced finger pain, to ascertain the functionality of this pathway. During CSS, several women experienced orgasms. Brain regions activated during orgasm included the hypothalamic paraventricular nucleus, amygdala, accumbens-bed nucleus of the stria terminalis-preoptic area, hippocampus, basal ganglia (especially putamen), cerebellum, and anterior cingulate, insular, parietal and frontal cortices, and lower brainstem (central gray, mesencephalic reticular formation, and NTS). We conclude that the Vagus nerves provide a spinal cord-bypass pathway for vaginal-cervical sensibility and that activation of this pathway can produce analgesia and orgasm.

Brain↗

PubMed1994

[Orgasmic expulsions in women].

Orgasm is in some women accompanied by the release of fluid from the external genitalia. This fluid can sometimes eject under pressure and thus resemble male ejaculation. It may presumably originate in the vagina, in the bladder (orgastic urination) or in the paraurethral (Skene's) glands, labeled by some authors as the female prostate. Analysis of the fluid samples showed it to be urine, secretion of Skene's glands or a mixture of both. The relationship of these expulsions to the stimulation of the vaginal G spot has been reported. Zaviacic et al. (1988) established in female volunteers undergoing digital stimulation of the G spot that in some women there is no expulsion, in some there is expulsion accompanied by orgasm and in some expulsions occur easily without orgasm or even without sexual arousal. Our own findings are based on the use of the sexological questionnaire SGZ, which contains items concerning the occurrence of "release of fluid" during orgasm or of "expulsion of fluid, similarly as in male ejaculation". We obtained data from 200 women treated for the neurosis and from 100 female health professionals and counselors. Organistic expulsions resembling male ejaculation were reported in 6% of both samples. Additional 13% had at least some experience with such expulsions. Release of fluid without ejaculation was reported by approximately 60% of females in both samples. We consider "female ejaculation" to be a rare phenomenon, which nevertheless deserves attention in sexological consultations. It should not cause feelings of shame, but should be accepted as a normal part of female sexual reaction.

Exocrine Glands↗

PubMed1998

[Neurobiology of ejaculation and orgasm disorders].

OBJECTIVE: To determine the neurologic alterations of patients with ejaculatory and orgasmic disorders. METHODS: A study of the neuroandrologic profile was performed in eight patients; 6 presented an ejaculation, one premature ejaculation and one presented an orgasm. The neuroandrologic profile consisted in performing selective electromyography of the bulbocavernosus muscle, recording of the S2-S4 evoked potentials, evoked somatosensory potentials of the pudendal nerve, electromyography of the smooth cavernous muscle (SPACE), sympathetic skin response and cystometry. RESULTS: The sympathetic lesion was more frequent in the cases with an ejaculation (four cases; 66%); a pudendal efferent lesion was demonstrated in one case (17%) and a suprasacral lesion in one case (16%). A pudendal afferent lesion was observed in the two cases with premature ejaculation (100%). Both cases with an orgasm had a pudendal afferent lesion (100%) and one of them also presented a sympathetic lesion (50%). CONCLUSIONS: An ejaculation appears to be caused by sympathetic, motor pudendal or suprasacral lesion. An altered perception of genital sensations due to lesion of the afferent pudendal pathway appears to be present in premature ejaculation. An orgasm could be ascribed to an alteration of the pudendal sensibility or to the absence of ejaculation.

Adult↗

PubMed2006

Orgasmic headache and middle cerebral artery dissection.

A patient with a 20 year history of primary orgasmic headache is described who, after suffering an unusually severe episode of orgasmic headache was found to have a middle cerebral artery dissection. This unusual association of primary and secondary orgasmic headache emphasises the need for a thorough diagnostic examination when the orgasmic headache differs from that of previous episodes or is associated with neurological symptoms.

Adult↗

PubMed1983

The relationship between mode of female masturbation and achievement of orgasm in coitus.

To determine the relationship between masturbatory and coital behavior, 117 middle-class female volunteers were classified into three styles of masturbatory behavior--direct, indirect, and nonmasturbators. Direct masturbation was defined as the direct digital manipulation of the clitoris or use of a vibrator. Indirect masturbation included all other methods of masturbation not defined as direct. The classification was done on the basis of responses to a questionnaire. Of the masturbators 70% reported no change in their masturbatory style from initial masturbatory experiences. No relationship was found between either ability to masturbate or masturbatory style and coital orgasmic capacity. It was also found that (a) nonmasturbators achieved orgasm in coitus via additional clitoral stimulation significantly less frequently than either direct or indirect masturbators and (b) direct masturbators have a significantly greater preference for clitoral, as opposed to vaginal, stimulation as a means of achieving orgasm. The results are interpreted within the context of possible deficiencies in the questionnaire and confounding between the ongoing psychological and biological processes occurring in sexual activity. Within these constraints, the findings support current methods of treatment for primary and secondary anorgasmia.

Adult↗

PubMed1981

Time factors and orgasmic response.

A retrospective review of data from a 619-member female sample presenting for treatment of sexual dysfunction was conducted to determine if foreplay and intromission duration variables were related to sexual dysfunction. Patients were assigned to coitally anorgasmic and noncoitally anorgasmic, coitally anorgasmic and noncoitally orgasmic, or coitally and noncoitally orgasmic categories on the basis of interview data collected by a nurse-physician team. Duration measure differences are not found between diagnostic categories. However, significant differences are reported for the duration measures between status of relationship groupings: married, single, divorced, or cohabitating (p less than 0.05). Data from the sexually dysfunctional sample are compared with data from the surveys of Kinsey, Fisher, and Hunt. The importance of extended foreplay and intromission in enhancing female coital orgasmic response is not supported.

Female↗