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PubMed2006

Triptans in orgasmic headache.

Orgasmic headache (headache associated with sexual activity type 2 according to the International Headache Society classification) is a sudden severe headache which occurs at orgasm. Experiences with triptan therapy are described. Two out of four patients with severe headache continuing for >2 h had a positive response to acute triptan therapy. Two out of three patients using triptans as short-term prophylaxis reported a reliable response on several occasions. Triptans might be a treatment option to shorten orgasmic headache attacks after the diagnosis is clear and, particularly, subarachnoid haemorrhage has been excluded. In patients who chose to predict their sexual activity, short-term prophylaxis with oral triptans 30 min before sexual activity might be a therapeutic option in those not responsive to or not tolerating indomethacin.

Adult↗

PubMed2006

Orgasm-induced seizures: a study of six patients.

PURPOSE: Reflex seizures are known as the epileptic seizures triggered by some specific stimuli in sensitive patients. They are often classified according to the stimuli that trigger them rather than by the type of the seizure. Epileptic seizures induced by sexual orgasm are very rare in the literature. METHODS: We report six patients with different epileptic syndromes who experienced seizures after sexual intercourse and orgasm. RESULTS: All patients are women whose epileptogenic focus was in the right temporal in four and left frontal in one patient. One patient had pure generalized reflex epilepsy. CONCLUSIONS: Seizures induced by orgasm are very rare, with female and right hemisphere dominance requiring complex mechanisms to occur.

Adult↗

PubMed2002

Sexual activity, orgasm and tampon use are associated with a decreased risk for endometriosis.

OBJECTIVE: The purpose of the study was to determine if sexual behaviors, orgasm, tampon use, and douching during menstruation modify the risk of endometriosis. METHODS: A case-control study was conducted. Subjects (n = 2,012) consisted of members of the Endometriosis Association and friends not affiliated with the organization who completed mailed surveys. Data were analyzed using chi(2), Fisher's exact test, t test, and regression analyses. RESULTS: There was no difference between study groups concerning douching practices. However, cases were less likely than controls to report sometimes or often engaging in sexual behaviors during menstruation (p = 0.002, OR = 1.5), and sexual behaviors during menstruation that included orgasm (p = 0.001, OR = 1.5). Cases were also less likely than controls to report using only tampons (p < 0.0001, OR = 2.6). CONCLUSION: Sexual activity, orgasm, and tampon use during menstruation may confer protection against endometriosis.

Adult↗

PubMed2006

Response to Puts and Dawood's 'the evolution of female orgasm: adaptation or byproduct?'--Been there.

David Puts and Khytam Dawood's recent critique of my book, The Case of the Female Orgasm: Bias in the Science of Evolution, attempts to make plausible an adaptive account of female orgasm based on a hypothesized mechanism of uterine upsuck and sperm competition. Yet the authors fail to respond to the criticisms of such accounts that I detailed previously in my book. They raise a further concern about my definition of adaptation--a red herring--and manufacture a conceptual error regarding heritability that they then attribute to me. Most seriously, they fail to address the glaring failure of sperm competition accounts to accord with evidence from sexology. Specifically, the distribution curve of orgasm-with-intercourse--according to Dawood et al.'s own data, as well as others'--is relatively flat across the various classes. This curve needs to be tested against a well-formed multistrategy adaptive hypothesis; it cannot be explained by the adaptive account defended by Puts and Dawood in their critique.

Adaptation, Physiological↗

PubMed1983

Supravaginal uterine amputation vs. hysterectomy. Effects on libido and orgasm.

Postoperative symptoms of hysterectomy have received relatively little attention. In the present study, the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation preoperatively and 6 weeks, 6 months and 12 months postoperatively. Participation in the follow-up study was 99.5% (211/212) at one year. This paper deals with the effects of the two operations on libido and the frequency of orgasms. In the statistical analysis, McNemar's test of symmetry and the Fisher exact test were used. Weak or absent libido was reported preoperatively by 28.0% of hysterectomy patients and by 26.4% of amputation patients. One year postoperatively the corresponding figures were 35.4% and 31.4%. No statistical changes were observed between the two groups or within either group. In the frequency of orgasms a highly significant (p less than 0.001) reduction from the situation before operation to one year postoperatively was detected after hysterectomy. In the supravaginal amputation group no statistically significant decrease was detected. Preoperatively the two groups were alike; one year postoperatively the difference was almost significant (p less than 0.05). The reductions in orgasms after hysterectomy as compared with supravaginal amputation appears to result from the greater radicality of the former; at hysterectomy, the autonomous innervation of the proximal vagina and cervix is damaged more than in supravaginal amputation, the anatomy of the vagina is altered and scar tissue forms in the vagina. It is probable that these changes and subconscious psychological reactions due to total removal of the uterus explain why supravaginal uterine amputation gives better results than hysterectomy.

Adult↗

PubMed2004

Increasing orgasm and decreasing dyspareunia by a manual physical therapy technique.

CONTEXT: Female sexual pain and dysfunction. OBJECTIVE: To evaluate the effectiveness of a new site-specific, manual soft-tissue therapy in increasing orgasm and reducing dyspareunia (painful intercourse) in women with histories indicating abdominopelvic adhesion formation. DESIGN AND INTERVENTION: A total of 29 new patients presenting with infertility or abdominopelvic pain-related problems, and also indicating sexual pain or dysfunction, received a series of treatments (mean, 19.5 hours) designed to address biomechanical dysfunction and restricted mobility due to adhesions affecting the reproductive organs and adjacent structures. OUTCOME MEASURES: Primary outcome measures were post-test vs pretest scores on: (1) the Female Sexual Function Index (FSFI) full scale, orgasm domain, and pain domain; and (2) 3 supplemental 10-point rating scales of sexual pain levels. Secondary outcome measures were post-test vs pretest scores in the other 4 FSFI domains (desire, arousal, lubrication, and satisfaction). The Wilcoxon signed-rank test was used for all statistical analyses. RESULTS: For the 23 patients available for follow-up, the paired FSFI post-test vs pretest scores were significant (P < or = .003) on all measures. Of the 17 patients who completed the 3 sexual pain scales, the paired post-test vs pretest scores were significant (P < or = .002). CONCLUSIONS: Many cases of inhibited orgasm, dyspareunia, and other aspects of sexual dysfunction seem to be treatable by a distinctive, noninvasive manual therapy with no risks and few, if any, adverse effects. The therapy should be considered a new adjunct to existing gynecologic and medical treatments.

Adult↗

PubMed1979

Female orgasm: role of pubococcygeus muscle.

An examination is made of the role of the pubococcygeus muscle in relation to female orgasm in 281 women. A statistically significant difference is reported between orgasmic and anorgasmic women and the physiological state of the pubococcygeus muscle as measured using a pressure sensitive device inserted in the vagina. These data suggest the pubococcygeus muscle plays an important part in the pathophysiology of female orgasm.

Adult↗

PubMed2003

Duplex Doppler ultrasound assessment of clitoral hemodynamics after topical administration of alprostadil in women with arousal and orgasmic disorders.

There are limited hemodynamic data in women with arousal or orgasmic disorders and even fewer normative control hemodynamic data in women without sexual dysfunction. In addition, there is limited experience with topical vasoactive agents (used to maximize genital smooth muscle relaxation) applied to the external genitalia during hemodynamic evaluations. The aim of this study was to report duplex Doppler ultrasound clitoral cavernosal arterial changes before and after topical PGE-1 (Alprostadil) administration in control women and in patients with arousal and orgasmic sexual disorders. We found that women with sexual arousal and orgasmic disorders had significantly (p < 0.05) diminished clitoral peak systolic and end diastolic velocity responses compared to controls. Further research is needed to establish the diagnostic role of topical vasoactive agents in the hemodynamic evaluation of women with sexual dysfunction.

Administration, Topical↗

PubMed2005

Bethanecol chloride for treatment of clomipramine-induced orgasmic dysfunction in males.

PURPOSE: To investigate whether bethanecol chloride may be an alternative for the clinical management of clomipramine-induced orgasmic dysfunction, reported to occur in up to 96% of male users. METHODS: In this study, 12 fully remitted panic disorder patients, complaining of severe clomipramine-induced ejaculatory delay, were randomly assigned to either bethanecol chloride tablets (20 mg, as needed) or placebo in a randomized, double-blind, placebo-controlled, two-period crossover study. A visual analog scale was used to assess severity of the orgasmic dysfunction. RESULTS: A clear improvement was observed in the active treatment period. No placebo or carry-over effects were observed. CONCLUSION: These findings suggest that bethanecol chloride given 45 minutes before sexual intercourse may be useful for clomipramine-induced orgasmic dysfunction in males.

Adolescent↗

PubMed1975

Secondary orgasmic dysfunction. II. Case study.

The treatment of a case of secondary orgasmic dysfunction is described. In this case, a direct behavioral retraining program was employed to increase the couple's repertoire of effective sexual behaviors. An extinction and successive approximation procedure was used to transfer ortasmic responsiveness from solitary masturbation to heterosexual coitus. Since other data have indicated that nonsexual marriage problems contribute to the maintenance of secondary orgasmic dysfunction, a direct, confrontive intervention into the marital relationship was made concurrent with the sexual retraining program. Outcome data are presented to illustrate the effectiveness of the reatment procedures.

Adult↗

PubMed1984

Relationships among intravaginal pressure, orgasmic function, parity factors, and urinary leakage.

Women's ability to contract pelvic musculature voluntarily was related to reports of ability to have orgasm, parity, and urinary leakage problems. Data collected from 92 women presenting for routine pelvic examinations provided no evidence of a general relationship between strength of voluntary pelvic muscle contractions and orgasmic function. There were negative relationships between strength of voluntary pelvic muscle contractions and parity, weight of the largest baby, and a woman's age.

Adolescent↗

PubMed1978

Effects of group systematic desensitization on female orgasmic dysfunction.

This study investigated the impact of group systematic desensitization (SD) on varied aspects of sexual functioning in primary and secondary nonorgasmic women. After serving as their own controls, 22 women (eight primary, 14 secondary) received 15 sessions of group SD using four common hierarchies of sexual scenes. The measures were administered to each subject and her regular sex partner at each of the testing periods. Significant positive treatment effects were found on measures of general and specific sexual adjustment and in extracoital orgasmic frequency. Treatment also enhanced sexual communication among subjects and their partners, increased the females' acceptance of their mates as being satisfactory sexual partners, and increased the females' self-acceptance as sexual beings. All but one of the treatment effects (degree of pleasure experienced during extracoital stimulation) were maintained at the 6-week follow-up. Secondary subjects reported significantly greater pleasure from coital and extracoital stimulation and significantly increased frequency of orgasm in response to extracoital stimulation than primary subjects. Primary and secondary subjects did not differ in their evaluation of the experiment. The need for controlled comparative treatment investigations is stressed.

Adult↗

PubMed2004

Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves.

Women diagnosed with complete spinal cord injury (SCI) at T10 or above report vaginal-cervical perceptual awareness. To test whether the Vagus nerves, which bypass the spinal cord, provide the afferent pathway for this response, we hypothesized that the Nucleus Tractus Solitarii (NTS) region of the medulla oblongata, to which the Vagus nerves project, is activated by vaginal-cervical self-stimulation (CSS) in such women, as visualized by functional magnetic resonance imaging (fMRI). Regional blood oxygen level-dependent (BOLD) signal intensity was imaged during CSS and other motor and sensory procedures, using statistical parametric mapping (SPM) analysis with head motion artifact correction. Physiatric examination and MRI established the location and extent of spinal cord injury. In order to demarcate the NTS, a gustatory stimulus and hand movement were used to activate the superior region of the NTS and the Nucleus Cuneatus adjacent to the inferior region of the NTS, respectively. Each of four women with interruption, or "complete" injury, of the spinal cord (ASIA criteria), and one woman with significant, but "incomplete" SCI, all at or above T10, showed activation of the inferior region of the NTS during CSS. Each woman showed analgesia, measured at the fingers, during CSS, confirming previous findings. Three women experienced orgasm during the CSS. The brain regions that showed activation during the orgasms included hypothalamic paraventricular nucleus, medial amygdala, anterior cingulate, frontal, parietal, and insular cortices, and cerebellum. We conclude that the Vagus nerves provide a spinal cord-bypass pathway for vaginal-cervical sensibility in women with complete spinal cord injury above the level of entry into spinal cord of the known genitospinal nerves.

Adult↗

PubMed2001

The nature of human orgasm: a critical review of major trends.

This critical review presents a synthesis of the available theoretical and empirical literatures on human orgasm. Findings from both normal and clinical human populations are included. Two major trends in the literature, the dichotomization of biological and psychological perspectives and the assumption of gender differences, are highlighted. A new multidimensional model of the psychological experience of orgasm is described with a view to futhering a biopsychological approach applicable to both sexes. Clinical applications of this new model are discussed.

Female↗

PubMed1998

Masturbatory-orgasmic extracephalic pain.

Two single men, one with compressive spondylitic cervical myelopathy and another with tethered cord and intraspinal lipoma, experienced severe paroxysmal ice pick-like pains, solely referred to the neck in the first and to the groin and genitalia in the second, that were precipitated by masturbation and masturbatory orgasms. Continuous, but less intense, background pain was reported by both patients over the same anatomic areas. Neither had intracranial lesions, epilepsy, or suffered from migraine. Recently, extratrigeminal ice pick status was reported in this journal. These two unusual cases represent examples of extracephalic ice pick-like pain triggered by sexual activity, in the absence of orgasmic cephalgia.

Headache↗

PubMedDate not supplied

Behavioral assessment of couples' communication in female orgasmic disorder.

Communication problems are believed to play a central role in many sexual dysfunctions. The present study behaviorally assessed communication patterns within heterosexual couples in which the woman was experiencing female orgasmic disorder and within two groups of control couples. The sexually dysfunctional couples evidenced significantly poorer communication than controls, primarily but not exclusively when discussing sexual topics. Specifically, women with orgasmic disorder or their male partners demonstrated more blame and less receptivity. We discuss the etiologic and treatment implications of these findings.

Adult↗

PubMedDate not supplied

Intercourse orgasm consistency, concordance of women's genital and subjective sexual arousal, and erotic stimulus presentation sequence.

Many studies report discordance between women's genital (vaginal pulse amplitude) and subjective sexual arousal responses to erotica. Consistent with our previous research, I hypothesized that the association between physiological and subjective domains would be greater for women with greater orgasmic consistency (OC) during penile-vaginal intercourse but not for OC during masturbation or noncoital partnered sexual activities. I confirmed this specific hypothesis in a sample of young Dutch women (N = 27, mean age 20, all with current partners), replicating our earlier psychophysiological findings with postmenopausal women. Also replicated were the findings that intercourse OC (40% of the women had an orgasm from 90-100% of intercourse events, 44% from 9-89% of intercourse events) was not less than for other sexual activity and that OC during intercourse was uncorrelated with OC during masturbation. We observed the association of intercourse consistency with genital-subjective concordance when visual erotica was presented in a sequence of increasing intensity (analogous to typical real sexual encounters) but not when presented in decreasing, random, or fixed-intensity sequence. I discuss the results in terms of the unique nature of penile-vaginal intercourse and the study's implications for sex therapy and sex research.

Adult↗

PubMed1978

Response of women with primary orgasmic dysfunction to audiovisual education.

Of 17 women ages 19 to 38 with primary orgasmic dysfunction, 7 achieved orgasm within a week after viewing an audiovisual sex education program, a statistically significant change (p less than .02). No other intervention (educational, behavioral, psychotherapeutic) occurred between the audiovisual session and later inquiry about subsequent sexual response. These results suggest that explicit sex education can help remedy sexual dysfunction in a significant number of women and that further investigation is needed.

Adult↗