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Neuroendocrine and cardiovascular response to sexual arousal and orgasm in men.

Data regarding the neuroendocrine response pattern to sexual arousal and orgasm in man are inconsistent. In this study, ten healthy male volunteers were continuously monitored for their cardiovascular and neuroendocrine response to sexual arousal and orgasm. Blood was continuously drawn before, during and after masturbation-induced orgasm and analyzed for plasma concentrations of adrenaline, noradrenaline, cortisol, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, growth hormone (GH), beta-endorphin and testosterone. Orgasm induced transient increases in heart rate, blood pressure and noradrenaline plasma levels. Prolactin plasma levels increased during orgasm and remained elevated 30 min after orgasm. In contrast, none of the other endocrine variables were significantly affected by sexual arousal and orgasm.

Adult↗

The role of the Grafenberg Spot and female ejaculation in the female orgasmic response: an empirical analysis.

Despite earlier contrary claims, researchers have found evidence that a sensitive area (Grafenberg Spot) exists in the vaginal barrel. This area is a potential source of orgasm independent of clitoral stimulation. Other researchers have reported that some women experience a sudden spurt of fluid at the moment of orgasm. In the interest of contributing to further understanding of physiological and psychological sexual satisfaction, and alleviation of concerns about perceived urination during orgasm, the investigators explored a series of variables thought to be associated with perceptions of the Grafenberg Spot and its relationship, if any, to the female orgasmic response and female ejaculation. An anonymous questionnaire was distributed to 2,350 women in the United States and Canada, with a subsequent 55% return rate. A number of factors were found to be associated with perceived existence of a sensitive area in the vaginal barrel which, when properly stimulated, activates orgasm. Women who reported sensitive area orgasms were also more likely to report a spurt of fluid at moment of orgasm.

Body Fluids↗

Cardiovascular and endocrine alterations after masturbation-induced orgasm in women.

OBJECTIVE: The present study investigated the cardiovascular, genital, and endocrine changes in women after masturbation-induced orgasm because the neuroendocrine response to sexual arousal in humans is equivocal. METHODS: Healthy women (N = 10) completed an experimental session, in which a documentary film was observed for 20 minutes, followed by a pornographic film for 20 minutes, and another documentary for an additional 20 minutes. Subjects also participated in a control session, in which participants watched a documentary film for 60 minutes. After subjects had watched the pornographic film for 10 minutes in the experimental session, they were asked to masturbate until orgasm. Cardiovascular (heart rate and blood pressure) and genital (vaginal pulse amplitude) parameters were monitored continuously throughout testing. Furthermore, blood was drawn continuously for analysis of plasma concentrations of adrenaline, noradrenaline, cortisol, prolactin, luteinizing hormone (LH), beta-endorphin, follicle-stimulating hormone (FSH), testosterone, progesterone, and estradiol. RESULTS: Orgasm induced elevations in cardiovascular parameters and levels of plasma adrenaline and noradrenaline. Plasma prolactin substantially increased after orgasm, remained elevated over the remainder of the session, and was still raised 60 minutes after sexual arousal. In addition, sexual arousal also produced small increases in plasma LH and testosterone concentrations. In contrast, plasma concentrations of cortisol, FSH, beta-endorphin, progesterone, and estradiol were unaffected by orgasm. CONCLUSIONS: Sexual arousal and orgasm produce a distinct pattern of neuroendocrine alterations in women, primarily inducing a long-lasting elevation in plasma prolactin concentrations. These results concur with those observed in men, suggesting that prolactin is an endocrine marker of sexual arousal and orgasm.

Adult↗

Genetic influences on variation in female orgasmic function: a twin study.

Orgasmic dysfunction in females is commonly reported in the general population with little consensus on its aetiology. We performed a classical twin study to explore whether there were observable genetic influences on female orgasmic dysfunction. Adult females from the TwinsUK register were sent a confidential survey including questions on sexual problems. Complete responses to the questions on orgasmic dysfunction were obtained from 4037 women consisting of 683 monozygotic and 714 dizygotic pairs of female twins aged between 19 and 83 years. One in three women (32%) reported never or infrequently achieving orgasm during intercourse, with a corresponding figure of 21% during masturbation. A significant genetic influence was seen with an estimated heritability for difficulty reaching orgasm during intercourse of 34% (95% confidence interval 27-40%) and 45% (95% confidence interval 38-52%) for orgasm during masturbation. These results show that the wide variation in orgasmic dysfunction in females has a genetic basis and cannot be attributed solely to cultural influences. These results should stimulate further research into the biological and perhaps evolutionary processes governing female sexual function.

Adult↗

Sexual psychophysiology and effects of sildenafil citrate in oestrogenised women with acquired genital arousal disorder and impaired orgasm: a randomised controlled trial.

OBJECTIVE: Some postmenopausal women lose genital sexual responsivity despite preserved subjective sexual arousal from non-genital stimuli. When oestrogen replacement is without benefit, both the underlying pathophysiology and management of this acquired genital female sexual arousal disorder are unclear. We aimed to study the effect of sildenafil on sexual arousal and orgasmic functioning of such women. Secondly, we aimed to explore the concordance between a detailed historical assessment of genital response in real life, with laboratory vaginal photoplethysmographic assessment of genital vasocongestion. DESIGN: Session one consisted of a semi-structured clinical interview to assess real life sexual arousal. Session two employed vaginal pulse amplitude and self-report questionnaire assessment of erotica-induced sexual arousal. Sessions three and four were a randomised, double-blind, placebo-controlled crossover administration of sildenafil on orgasm latency, intensity, perception of genital congestion and subjective arousal to erotica plus clitoral vibrostimulation. SETTING: University associated Sexual Medicine Clinic and Psychophysiology Laboratory. SAMPLE: Volunteer sample of 34 oestrogenised postmenopausal women with acquired genital female sexual arousal disorder and impaired orgasm. METHODS: Sildenafil (50 mg) or placebo administered over two laboratory sessions. MAIN OUTCOME MEASURES: Orgasm latency and intensity during drug sessions; subjective and psychophysiological sexual arousal during photoplethysmography session. RESULTS: The erotic video significantly increased subjective sexual arousal in all women. Vaginal pulse amplitude responses varied from robust to absent. Although across all women, sildenafil improved neither arousal nor orgasm, subsequent analyses comparing high versus low vaginal pulse amplitude responders revealed significantly reduced latency to orgasm, and increased subjective sexual arousal and perception of genital arousal in the latter group of women. CONCLUSION: The data suggest that oestrogenised postmenopausal women with genital female sexual arousal disorder and orgasmic impairment based only on clinical assessment do not benefit from sildenafil. However, the photoplethysmograph had predictive value-those women showing low vaginal pulse amplitude response benefited from sildenafil compared with women with a higher response. Thus, oestrogenised women diagnosed with acquired genital female sexual arousal disorder may be a heterogeneous group and the photoplethysmograph might be useful in their further characterisation.

Adult↗

[Vaginal contractions in female orgasm].

Masters and Johnson (1966) described 3-15 rhythmic contractions of the orgasmic platform in the outer third of the vagina as the physiological basic of female orgasm. Bohlen et al. (1982) in a more recent research registered in some subjects during "long orgasms" up to 34 additional irregular pelvic contractions. In some subjects no contractions occurred during their orgastic experience. Our own findings are based on Czech sexological questionnaires SGZ and SFZ/K, which include questions asking about subjective experience of vaginal contractions or pulsation during orgasm. In a sample of 200 women treated for neurotic disorders, about 60% reported such contractions or pulsations. In a sample of 100 female health professionals and counselors, contractions were reported in 80%. Contractions seem to frequently accompany subjective experience of female orgasm, but are not its necessary condition. Some women experience their orgasm regularly without contractions and some report having contractions during orgasm only occasionally.

Adult↗

Female orgasm rate increases with male dominance in Japanese macaques.

Under specific circumstances, nonhuman primate females may experience orgasm. The occurrence of female copulatory orgasm appears to be highly variable, however, and its proximate causation is poorly understood. We investigated the proximate mechanisms that control orgasmic response in female macaques. During 238 h of observation of sexual behaviour in a large captive group of Japanese macaques, Macaca fuscata, 240 copulations were recorded involving 68 different heterosexual pairs formed by 16 males and 26 females. Female orgasmic responses were observed in 80 of 240 copulations (33%). The frequency of orgasms was not correlated with female age or dominance rank, but it was higher for copulations lasting longer and involving a higher number of mounts and pelvic thrusts. When the level of physical stimulation experienced by females during copulation was statistically controlled, the highest frequency of female orgasms was found among pairs formed by high-ranking males and low-ranking females and the lowest frequency among pairs formed by low-ranking males and high-ranking females. These findings suggest that the proximate mechanisms that control orgasmic threshold in female macaques are more responsive to social stimuli and less constrained by physiological limitations than previously thought. Copyright 1998 The Association for the Study of Animal Behaviour.

Journal Article↗

Spontaneous remission of SSRI-induced orgasm delay.

BACKGROUND: Orgasm delay is a common side effect of SSRIs,causing negative influence on patients' compliance and quality of life. A possible strategy for the management of SSRI-induced orgasm delay is waiting for tolerance to develop. The authors studied the natural course of SSRI-induced orgasm delay over a period of 6 months. METHODS: One hundred eight patients having been started on SSRIs were included in an open, naturalistic study. Sexual dysfunction was assessed at monthly intervals using a structured interview. RESULTS: Twenty-six patients developed clinically relevant SSRI-induced orgasm delay. Eight patients (30.8%) reported complete remission of sexual dysfunction, while four patients (15.4%) noted a marked improvement. Four patients (15.4%) continued to describe severe orgasm delay at the end of the observation period. High severity of orgasm delay significantly correlated with lack of remission. CONCLUSIONS: A significant proportion of patients, especially those with mild to moderate orgasm delay, develop tolerance within 6 months.

Adult↗

Effect of bupropion-SR on orgasmic dysfunction in nondepressed subjects: a pilot study.

UNLABELLED: The objective of this study was to determine whether the aminoketone antidepressant bupropion has beneficial effects in orgasmic dysfunction. DESIGN: Single-blind, sequential treatment order of three weeks each: placebo, bupropion-SR 150 mg/day, bupropion-SR 300 mg/day. SUBJECTS: Nondepressed women (n = 20) and men (n = 10) having nonphysiologic orgasmic delay or inhibition. MAIN OUTCOME MEASURES: Reported difficulty or delay in achieving orgasm, satisfaction with orgasm and erectile function, and subjective impressions of drug effect. RESULTS: In the women, there were significant improvements relative to baseline (p < .01) on both doses of bupropion-SR in all measured aspects of sexual function, and significant improvements relative to placebo (p < .05) in overall sexual satisfaction on both doses and satisfaction with intensity of orgasm on 150 mg/day (300 mg/day, p = .10). In the men, significant improvements over baseline (p < .01) were observed with both doses in overall sexual satisfaction, ability to achieve an erection, and delay in reaching orgasm/ejaculation; significant improvements relative to placebo (p < .05) were observed in overall sexual satisfaction on both doses, ability to achieve erection on 150 mg/day, and delay in orgasm/ejaculation on 150 mg/day. Seventy percent of subjects reported improvement in libido, arousal, or orgasmic function during bupropion administration. CONCLUSIONS: Bupropion-SR may be a useful agent for treating orgasmic delay and inhibition, and possibly disorders of sexual arousal. The results argue against bupropion's apparent prosexual effect in depressed patients being simply a result of its antidepressant activity.

Adult↗

The pubococcygens and female orgasm: a correlational study with normal subjects.

The relationship of pubococcygeal condition to orgasmic responsiveness in 102 women from a university community was examined in a controlled, prospective investigation. Pubococcygeal strength was measured with a perineometer while responsiveness was assessed by a standardized interview yielding reliable measures of self-reported orgasmic response. Subjects whose responsiveness might have been impaired by such factors as alcohol consumption, inadequate stimulation, and high sexual anxiety were excluded from analyses. Excellent within-session but poor across-session test-retest reliability of the perineometer measures was noted. Initial Strength Contracting proved to be the most reliable measure. Though the majority of the parous women had performed Kegel exercises after delivery, parity was negatively related to pubococcygeal strength on most measures. Contrary to experimental hypotheses, pubococcygeal strength was not found to be positively related to frequency or self-reported intensity of orgasm. Furthermore, women with higher pubococcygeal strength did not report that vaginal stimulation contributed more to attainment of orgasm, nor did they rate vaginal sensations during coitus as more pleasurable. Only in the case of pleasurability of orgasm through clitoral stimulation was a significant, though low, relationship obtained. Possible factors contributing to the discrepancy between these findings and previous uncontrolled investigations are discussed, as are the implications of these findings for the use of Kegel exercises in the treatment of orgasmic dysfunction.

Adult↗

Libido and orgasm in middle-aged woman.

OBJECTIVES: Determine which social, demographic and sexual function variables that most influence libido or desire and orgasm domains in the premenopausal and postmenopausal women. METHODS: A cross-sectional analysis of 231 Colombian-born women, aged 40-62 years. The sexual function was measured by self-questionnaire. The analysis was performed by using the chi2-test and multivariate regression analysis. The sexual function was divided in five domains: desire, arousal, lubrication, orgasm, pain; additionally satisfaction was included. RESULTS: The women with a higher level of education and with a good perception of their satisfaction with their partners, reported better performance in the desire. Age and the non existence of sexual partner influenced in a negative way on the desire. In sexual active women the orgasm was negatively influenced by low satisfaction scores, lack of emotional closeness with their partners and low educational level. High scores in lubrication and desire were associated with a good performance in the orgasm. The hormone therapy (HT) was associated with better scores in orgasm. CONCLUSIONS: Age, level of education, the presence or lack of sexual partner, degree of satisfaction with emotional closeness with the partner and adequate lubrication, influence the desire and orgasm domains in a significant way. By identifying these associations we can then perform some inexpensive interventions. Improving lubrication for menopausal women. Including men in educational activities to sensitize them toward women's feelings. Organizing educational campaigns for middle-aged women to demystify that sexuality is only for young people.

Adult↗

[Orgasm and its impact on quality of life after radical prostatectomy].

INTRODUCTION: Orgasm is a neurophysiological event, which produces bulbous cavernous muscle contraction that usually coincided with ejaculation. The aim of this study was to assess the orgasm's presence and quality in patients treated with radical prostatectomy, as well as its impact on quality of life of these patients. METHOD: The medical records of 152 patients with radical prostatectomy were reviewed retrospectively. Patients were operated between january 1999 and december 01, with an average age of 64.4 (44-75) years and the follow-up period was 33 (21-45) months. 42 (31.6%) patients showed erectile dysfunction (ED) previous to surgery. The research was performed by a personal interview through a questionnaire. RESULTS: 134 patients (96.4%) treated showed post operative ED, 91.6% of patients had stable relationship and 44.4% have sexual intercourse, 23.3% masturbation only and 32.3% no sexual activity. 84 patients (55.2%) were not interested in receiving treatment and 25 (16.4%) referred a reduced libido. Concerning to orgasm sensation, 140 patients (92.1%) preserved a subjectively normal orgasm, 4 (2.6%) referred lack of it and 8 (5.2%) a weakened or anomalous sensation. Furthermore 24 patients (15.7) had urine loss during orgasm. CONCLUSIONS: After radical prostatectomy, both the orgasmic function and libido were kept by the majority of patients despite the neuro vascular bundle damaged caused. Only a minority of patients having urine loss, as a consequence of surgical procedure.

Adult↗

Effects of penile implant surgery on ejaculation and orgasm.

Thirty-five patients who had received a penile implant were interviewed to assess their pre- and postsurgical ejaculatory and orgasmic experience. Prior to surgery, most men were able to experience ejaculation (71%) and orgasm (80%) even though erectile capability was impaired or lost completely. The implantation of a prosthetic device did not interfere with ejaculation or orgasmic functioning. Two patients who lost their ejaculatory functioning following surgery did so because of advances in their illnesses. Five men who had been non-orgasmic earlier reported having orgasm after surgery. In these cases of psychogenic orgasmic dysfunction, the penile prosthesis helped overcome the psychological barriers to this function.

Ejaculation↗

Vaginal eroticism and female orgasm: a current appraisal.

In the light of very recent studies, this paper reviews two controversial issues in the area of female sexuality: vaginal eroticism and female orgasm. From the available evidence, it is concluded that most (and probably all) women possess vaginal zones, mainly located on the anterior wall, whose tactile stimulation can lead to orgasm. The apparent contradiction between this finding and the ample evidence indicating that coitus is an inefficient method of eliciting female orgasm might be explained, at least in part, by topographical and mechanical reasons, as well as by differences between male and female orgasm latencies. As to the confusion regarding the types of female orgasm, it may be clarified by applying this concept not to the real phenomenon of orgasm, but only to its manner of elicitation.

Clitoris↗

The semantics of success: do masturbation exercises lead to partner orgasm?

Do masturbation exercises assigned in preorgasmic women's groups enable previously nonorgasmic women to achieve orgasms during partner sex? Studies by Wallace and Barbach and Ersner-Hershfield and Kopel report encouraging partner orgasmic success rates of 87% and 82%, respectively, and these figures are commonly cited in reviews of the literature. I argue that these rates are misleading because they reflect overly liberal research definitions of "nonorgasmic," "orgasmic success," and "partner orgasm." A reanalysis of Ersner-Hershfield and Kopel's data using more stringent and intuitive criteria yields a partner success rate at 10 weeks after termination of 20% (or 47%, if women who require the use of a vibrator to have orgasm during partner sex are included as successes), as opposed to their original figure of 82%. These results suggest that masturbation training in preorgasmic women's groups is not the treatment of choice for most previously nonorgasmic women seeking partner orgasm. They also illustrate how different ideological conceptions of the meaning of sex can lead to different definitions of outcome categories and different evaluations of the same data.

Coitus↗

Concordance between women's physiological and subjective sexual arousal is associated with consistency of orgasm during intercourse but not other sexual behavior.

Many studies have found a discordance between women's genital (vaginal pulse amplitude) and subjective sexual arousal responses to erotica. We hypothesized that the association between the physiological and subjective domains would be greater for women with greater orgasmic consistency during penile-vaginal intercourse but not for orgasm consistency during other sexual behaviors. We confirmed this specific hypothesis in a sample (N = 38) of postmenopausal women. In addition, we discovered that the correlation between the domains was unrelated to social desirability responding, that orgasm consistency was not less for intercourse than for other sexual activity, and that orgasm consistency during intercourse was uncorrelated with orgasm consistency during masturbation. We discuss the results in terms of the unique nature of penile-vaginal intercourse, our study's implications for sex therapy, and orgasm consistency during intercourse being an operational measure of functional vaginal sensitivity and sexual pleasure integration and organization.

Arousal↗

The evolution of female orgasm: adaptation or byproduct?

Do women experience orgasm because this trait was shaped by natural selection to augment female fitness? Or are women merely the lucky recipients of developmental patterns favored by selection to produce orgasm in males? A recent and widely publicized book by Elisabeth Lloyd (2005a) contends that there is insufficient evidence to validate any of the adaptive explanations yet proposed for female orgasm. We agree. But our reading of the data differs from Lloyd's. In this essay, we outline why, unlike Caton (2006), whose review of Lloyd's book appeared previously in this journal, we are not persuaded by Lloyd's argument that female orgasm is a nonadaptive byproduct of orgasm in men. We hold this view because we disagree with the criteria Lloyd uses to evaluate evolutionary hypotheses, and because we believe Lloyd defines female orgasm too narrowly, ignoring critical information about its affective aspects.

Adaptation, Physiological↗

Coitus-induced orgasm stimulates prolactin secretion in healthy subjects.

Previous data have indicated that orgasm produces marked alterations in plasma prolactin concentrations in men and women. Thus, the current study aimed to extend these data by examining prolactin response to coitus in healthy males and females. Ten pairs of healthy heterosexual couples participated in the study. Blood was drawn continuously for 20 min before, during, and until 60 min following sexual intercourse and orgasm. Plasma was subsequently analysed for prolactin concentrations. Coitus-induced orgasm produced a marked elevation of plasma prolactin in both males and females. Plasma prolactin concentrations remained elevated 1 h following orgasm. These data, together with previous evidence that masturbation-induced orgasm produces pronounced, long-lasting increases in plasma prolactin concentrations in both males and females, suggest a role for acute prolactin alterations in modifying human sexual desire following orgasm.

Adult↗