Clitoral Stimulation Research Articles

“Did You Come?” A Qualitative Exploration of Gender Differences in Beliefs, Experiences, and Concerns Regarding Female Orgasm Occurrence During Heterosexual Sexual Interactions

This study explored gender differences in young adult heterosexual men's and women's experiences, beliefs, and concerns regarding the occurrence or nonoccurrence of orgasm during sexual interactions, with emphasis on the absence of female orgasm during intercourse. Qualitative reports were obtained from five female focus groups (N = 24, M age = 19.08) and five male focus groups (N = 21, M age = 19.29), involving three to five participants per group. Transcripts of the discussions were analyzed for emerging themes across focus group discussions. Results indicated that, for both male and female participants, the most common concern regarding lack of female orgasm in a partnered context focused on the negative impact this might have on the male partner's ego. Male and female participants also agreed that men have the physical responsibility to stimulate their female partner to orgasm, while women have the psychological responsibility of being mentally prepared to experience the orgasm. Men and women tended to maintain different beliefs, however, regarding clitoral stimulation during intercourse, as well as the importance of female orgasm for a woman's sexual satisfaction in a partnered context. Findings suggest foci for sexual education.

Pilot Echographic Study of the Differences in Clitoral Involvement following Clitoral or Vaginal Sexual Stimulation

Women describe at least two types of orgasms: clitoral and vaginal. However, the differences, if any, are a matter of controversy. In order to clarify the functional anatomy of this sexual pleasure, most frequently achieved through clitoral stimulation, we used sonography with the aim of visualizing the movements of the clitorourethrovaginal (CUV) complex both during external, direct stimulation of the clitoris and during vaginal stimulation. The ultrasounds were performed in three healthy volunteers with the General Electric® Voluson® sonography system (General Electric Healthcare, Vélizy, France), using a 12-MHz flat probe and a vaginal probe. We used functional sonography of the stimulated clitoris either during manual self-stimulation of the external clitoris or during vaginal penetration with a wet tampon. Functional and anatomic description, based on bidimensional ultrasounds, of the clitoris and CUV complex, as well as color Doppler signal indicating speed of venous blood flow, during arousal obtained by external or internal stimulation. The sagittal scans obtained during external stimulation and vaginal penetration demonstrated that the root of the clitoris is not involved with external clitoral stimulation. In contrast, during vaginal stimulation, because of the movements and displacements, the whole CUV complex and the clitoral roots in particular are involved, showing functional differences depending on the type of stimulation. The color signal indicating flow speed in the veins mirrored the anatomical changes. Despite a common assumption that there is only one type of female orgasm, we may infer, on the basis of our findings, that the different reported perceptions from these two types of stimulation can be explained by the different parts of the clitoris (external and internal) and CUV complex that are involved.

Clitoral anesthesia disrupts paced copulation in the female rat

Clitoral stimulation produced by sexual contact with a partner or during manual stimulation is associated with pleasure in humans, and produces conditioned place preference in rats. The present experiment investigated the effect of blocking genitosensory stimulation of the clitoris with lidocaine during copulation in female rats on a measure of female sexual motivation: pacing behavior. Sexually naïve, ovariectomized female rats were treated with 10μg estradiol benzoate 48h and 500μg progesterone 4h prior to a 30-min copulatory trial with a sexually vigorous stimulus male scheduled every 4days. A total of 10 copulatory sessions were divided into two phases of 5 trails each. In the first phase, females received an injection (0.05ml) of either 2% lidocaine, saline, or no injection to the clitoral sheath under isoflurane anesthesia immediately prior to the start of a copulatory session, and were then placed on one side of a paced mating chamber and allowed to copulate for 30min. In the second phase, females previously injected with lidocaine were switched to saline and vice versa, and the no injection group remained the same. Variables measured included overall time spent with the males, number of solicitations, contact–return latencies following male mounts, intromissions, and ejaculations; the frequency of entrances and exits from the male chamber, and frequency of mounts, intromissions, ejaculations. Sexual behavior was examined at session 1, session 5, and session 10. At test 5, females that received LID had a greater number of entrances/exits but spent significantly less time in the presence of the male during the copulatory bout than CNTL animals. These females also displayed a trend for longer contact return latencies s after ejaculations than VEH and CNTL groups. On session 10, females that received LID and subsequently switched to VEH treatment no longer differed from controls in entrance/exit numbers, time spent with males or ejaculation contact return latency. They did however, receive a greater number of intromissions and displayed shorter inter intromission intervals compared to CNTLs. We suggest that clitoral stimulation in the rat serves as both a reward signal and may contribute to the detection of differences in copulatory stimuli that are critical to pacing and potentially, the initiation of pregnancy.

Sexual experience blocks the ability of clitoral stimulation to induce a conditioned place preference in the rat

We have previously established the rewarding value of clitoral stimulation (CLS) through the demonstration that manual, distributed, CLS induces a significant conditioned place preference (CPP) and conditioned partner preference in naïve, hormonally primed and non-hormonally primed rats. The present experiment asks whether previous sexual experience might inhibit the ability of clitoral stimulation to induce a conditioned place preference.Female Long–Evans rats were ovariectomized and treated with 10μg of estradiol benzoate (EB) 48h and 500μg of progesterone (P) 4h prior to receiving either 0, 1, or 5 consecutive copulatory sessions with a sexually vigorous male. Each copulatory session ended when females received at least 1 ejaculation. Females then experienced 10 alternating trials of distributed CLS or no CLS paired with one side of a non-biased CPP box under the same hormone-priming regimen. Females that experienced 5 consecutive copulatory sessions did not develop a significant place preference indicated by both a preference score (the proportion of time spent in the reinforced chamber) and a difference score (time in the non-reinforced chamber minus the time in the reinforced chamber) compared prior to and following the 10 conditioning trials. This suggests that repeated copulatory experience might induce a desensitization of the genitosensory circuit since copulation includes both clitoral, and vaginocervical stimulation from mounts plus intromissions. Alternatively, repeated sexual experience prior to conditioning may generate a UCS pre-exposure effect that cannot be altered when manual clitoral stimulation is paired with a new environment.

Notes from the Back Room: Gender, Power, and (In)Visibility in Women's Experiences of Masturbation

While popular culture has more frequently depicted women's masturbation in recent years, scholarly attention to women's own meaning making about masturbation remains largely absent. Existing research that emphasizes women's masturbation frequency, health correlates, masturbation as a factor in couples therapy, and masturbation as a substitute for partnered sexual behaviors have dominated the research, largely neglecting social identity correlates and women's subjectivities about masturbation. This study drew upon qualitative interviews with 20 women (mean age = 34, SD = 13.35) from diverse backgrounds to illuminate five themes in women's experiences with masturbation: a) assumptions that most women self-penetrate during masturbation even when primarily using clitoral stimulation; b) masturbation as sexual labor; c) masturbation as a threat to male dominance; d) masturbation as routine tension release; and e) masturbation as a source of joy, fun, and pleasure. Because women revealed such a diverse set of experiences, we explored the advantages and disadvantages of the invisibility of women's masturbation. As a result of the internalization of stereotypically masculine scripts about sexuality—including an imagined penetrative focus, goal-oriented drive toward orgasm, sex as labor, and masturbation as nonemotional—women's masturbation experiences, regardless of sexual orientation, revealed the power imbalances often present in partnered (hetero)sexual dynamics.

Female orgasm but not male ejaculation activates the pituitary. A PET-neuro-imaging study

The pituitary gland plays an important role in basic survival mechanisms by releasing fluctuating amounts of hormones into the bloodstream, depending on the circumstances the individual finds itself. However, despite these changes in pituitary hormonal production, neuroimaging studies have never been able to demonstrate changes in the activation level of the pituitary. The most apparent reason is the much higher blood flow rate in the pituitary than in the brain. However, the present PET-scanning study demonstrates for the first time that neuroimaging techniques can identify increased pituitary activity. In a study with 11 healthy women sexual orgasm compared to rest caused an increased blood supply to the pituitary. We assume that this increase signifies elevated pituitary activation in order to produce higher plasma concentrations of oxytocin and prolactin. These hormones induce vaginal and uterus movements, ovulation and enhancement of sperm and egg transport. No increased blood supply was observed comparing clitoral stimulation, orgasm attempt, and faked orgasm with rest. In a study with 11 healthy men comparing ejaculation with rest did not reveal increased pituitary activation, probably because ejaculation causes a much lower increase of oxytocin and prolactin plasma concentration than female orgasm.

The impact of brief exposure to sexually explicit video clips on partnered female clitoral self-stimulation, orgasm and sexual satisfaction

Inconsistent coital orgasm is a common complaint among women presenting with sexual function concerns. While sex therapy interventions incorporating explicit instructions and specific models of direct clitoral stimulation have been used to improve coital orgasm consistency among women, it is unclear whether simple exposure to sexually explicit models without specific instructional focus can stimulate such change. The purpose of this study was to determine if exposure to models of clitoral stimulation can induce imitative behaviour and enhance sexual functioning in a nonclinical sample of women. Female undergraduate students (N=64) were randomly assigned to view humourous media, or erotic media, or erotic media featuring explicit models of clitoral self-stimulation during partnered sexual behaviour. One week later, participants reported on their sexual behaviours, including frequency of clitoral self-stimulation (over the previous seven days), consistency of orgasm, and sexual satisfaction. The results indicated partial support for the hypothesized effect of exposure to clitoral stimulation models. Women who viewed explicit models of clitoral self-stimulation subsequently engaged in clitoral self-stimulation 3.51 times more often during subsequent partnered sexual behaviour than women exposed to humorous media, and engaged in clitoral self-stimulation in a greater proportion of their partnered sexual behaviours (Mdn=29%) than did women who viewed erotic media (Mdn=0%), or humorous media (Mdn=0%). However, no differences were found in reported consistency of orgasm or sexual satisfaction among the groups. These preliminary results provide evidence for a specific imitative effect following exposure to sexual media.

Calendar

Pubic hair removal is prevalent among women in the United States. However, most studies related to pubic hair removal are based on cross‐sectional surveys and retrospective recall.The purpose of this research was to, in a prospective event‐level daily diary study, assess demographic, affective, relational, situational, and behavioral factors related to women's pubic hair removal.Data collection occurred as part of a 5‐week prospective, Internet‐based daily diary study.Age; Affective predictors (positive mood, negative mood, feeling interested in sex, feeling in love); Relational predictors (partner support, partner negativity, partner type, partner gender); Situational predictors (any vaginal symptoms, use of any vaginal hygiene products; having applied any creams to the genitals); Behavioral variables (penile–vaginal sex, penile–anal sex, had finger inserted into vagina, had clitoris stimulated with fingers, inserted toy into vagina, used vibrator on clitoris, inserted finger into anus, inserted toy into anus, duration of penetration, intensity of penetration).A total of 2,453 women ages 18 to 68 (mean age 32.69) completed the study, contributing 49,287 total diaries (mean per person 24.5; standard deviation 10.3, median 30); 15.2% of all days (N = 7,362) involved pubic hair waxing or shaving, with the vast majority of hair removal days involving shaving (N = 7,302; 99%). Pubic hair removal was significantly associated with younger age, a greater interest in sex, vaginal fingering, finger–clitoral stimulation, having a casual sex partner, using vaginal hygiene products, and applying cream to the genitals. Hair removal was marginally associated with longer duration of vaginal penetration.These findings provide greater insight into the factors associated with women's pubic hair removal and their sexual experiences on a day‐to‐day level. Clinical and educational implications are discussed. Herbenick D, Hensel D, Smith NK, Schick V, Reece M, Sanders SA, and Fortenberry JD. Pubic hair removal and sexual behavior: Findings from a prospective daily diary study of sexually active women in the United States. J Sex Med 2013;10:678–685.

The Impersonal is Poclitical

Sarah-JeanKrahn Author's Note: This poem is comprised of what a search for "clitoris" on the internet reveals, using whatever words that pop up in association with it, without examining the words' orig inal contexts. It acts as a comment on the social understanding of the clitoris at its surface. Most of the words or brief phrases are patched together from unrelated fragments that have been taken out of context; any similarity in the meaning of uncited lines to other writing is purely coincidental. Even those longer phrases that must be attributed to their authors may have been taken out of context or manipulated slightly in order to emphasize the starkness of the phrases as they appear in the search engine's descriptions. The Impersonal is Poclitical Let's get the name calling out of the way first. Her epithet was "The Virgin Queen": Independent. Feminist. Cliterati. A female orgasm. Imagine trying to explain to someone what it feels like to sneeze or yawn1 or to hear the screams of someone having her head hacked off. With the help of a razor or knife many girls die throughout their whole lives. (It is not the book that cuts the clitoris, but its interpretations aid and abet the mutilation.2) FeministStudies39, no. 1. © 2013 by Sarah-Jean Krahn 277 278 Sarah-Jean Krahn Clitoris Not A Must3 Thank God! Apparently the long tyranny of the clitoris is coming to an end, dearest.4 For a while there we were moving toward a period of ubiquitous, cyborg technology5... Now if you ask me, If you want sex as a mechanical act, you want to put on a clitoris.6 Oh darling, I feel your frustration. I couldn't find my clitoris if [...] led there by Sir Ranulph Fiennesf!]7 Below is a manual for both these poor souls. Simple steps are given to develop their intuitions and allow them to make their first maps of the clitoris. The Manual [A] dense 200-plus pages of instruction with some clear line drawings to illustrate[!]8 Origins and erogenous zones! Your eyes, their pleasure! Doctor's orders! You will find yourself thinking, "Hmm, so that's where they come from." This book is now available for the first time on DVD and Blu-Ray: Bigger. Longer. And uncut9 Not winning when it comes to detached lower lips? Runaway Beaver Cut Offat Pass: Man FracturesArms Dual-use items (such as the labia minora/majora) can be used to manufacture arms for military catch-&-release tactics: Sarah-Jean Krahn 279 cotton swabs, rubber gloves, and scopes of various sizes. (Please note: Clitoridectomy requires the removal of the entire regi me " on ME.) Levels of enjoyment may vary. However, if you are a stranger to sexual experience and you enjoy it, YOU are going to he[ck!]10 So, excite. (Warning: Clitoral stimulation [may proliferate] genetic birth defects.)11 Then excise. Ohí of [the Bush] and Back to theAmerican Cities'2 My clitoris is positively swollen! The next patient will require general anesthesia and a fish hook. Imagine the women's quiet desperation13 as Officials perforate the fibrous capsule [.. .and] project into the spaces" Noise. Then, on the floor of a dusty closet, they stitch both sides of the organ back together, just as God intended. Specimens may remain stationary for up to a decade. Clitoris Widely Known beforeMan's Discovery (Such as by female neonates with nothing better to do.) Still, is often omitted on anatomical diagrams given young students. 28o Sarah-Jean Krahn Visible! Biopunk. Concealed. Cultish. Kittenesque! A species of meat art[?]15 Sex. Weirdshit. Choice between1,000s ofNervous Endings Means Old Wives' Tails about to Be Published "[I] should be kissed, and kissed often."16 "Ring the doorbell and wait for me to open the door." "She taught me to use this vibrator in car jackings." "The conflict has left many internally displaced." "I ... am an exorcism." "Cultural relativism fails to justify my pleasure." "Passionate Love Affairswiththe Clitoris Dull the Blades of Razors or Knives." Notes This phrase appears all over the internet. It seems impossible to deter mine where it originated. Following is the citation of the site to which I...

Activation of hypothalamic gono-like neurons in female rats during estrus.

In mammals, gonadal function is controlled by the activity of hypothalamic gonadotropin-releasing hormone neurons, which control the secretion of adenohypophyseal and gonadal hormones. However, there are a number of unanswered questions in relation to gonadal function. It is currently unknown how erotogenic stimulation of the genitals influences the subpopulation of hypothalamic medial preoptic area neurons, antidromically identified as projecting to the median eminence at different periods of the estrous cycle. Additionally, the distinctiveness of hypothalamic medial preoptic area neurons, with respect to methods of feedback control by exogenous hormones, is also unknown. In this study, spontaneous discharges from individual neurons encountered within the medial preoptic area, gono-like neurons, were recorded extracellularly using glass microelectrodes. To confirm the cellular and histochemical properties of the recording units, antidromic stimulation was performed using a side-by-side bipolar stimulating electrode placed into the median eminence, alongside microiontophoretic injections of the conventional tracer, horseradish peroxidase. In addition, further immunohistochemical analyses were performed. Results showed that elevated gono-neuron activity was accompanied by increased background activity and greater responses to erotogenic stimuli during estrus. Application of clitoral traction stimulation resulted in increased activation of the gono-like neurons. This neuronal activity was noticeably inhibited by β-estradiol administration. Immunohistochemical analyses revealed the presence of gonadotropin-releasing hormone-reactive protein in hypothalamic cells in which electrophysiological recordings were taken. Thus, medial preoptic area neurons represent the subset of hypothalamic gonadotropin-releasing hormone neurons described from brain slices in vitro, and might serve as a useful physiological model to form the basis of future in vivo studies.

P.1.d.012 Conditioned place aversion induced by different neuroleptics in mice: an animal model to predict adherence to treatment

Clitoral stimulation produced by sexual contact with a partner or during manual stimulation is associated with pleasure in humans, and produces conditioned place preference in rats. The present experiment investigated the effect of blocking genitosensory stimulation of the clitoris with lidocaine during copulation in female rats on a measure of female sexual motivation: pacing behavior. Sexually naïve, ovariectomized female rats were treated with 10 μg estradiol benzoate 48 h and 500 μg progesterone 4 h prior to a 30-min copulatory trial with a sexually vigorous stimulus male scheduled every 4 days. A total of 10 copulatory sessions were divided into two phases of 5 trails each. In the first phase, females received an injection (0.05 ml) of either 2% lidocaine, saline, or no injection to the clitoral sheath under isoflurane anesthesia immediately prior to the start of a copulatory session, and were then placed on one side of a paced mating chamber and allowed to copulate for 30 min. In the second phase, females previously injected with lidocaine were switched to saline and vice versa, and the no injection group remained the same. Variables measured included overall time spent with the males, number of solicitations, contact–return latencies following male mounts, intromissions, and ejaculations; the frequency of entrances and exits from the male chamber, and frequency of mounts, intromissions, ejaculations. Sexual behavior was examined at session 1, session 5, and session 10. At test 5, females that received LID had a greater number of entrances/exits but spent significantly less time in the presence of the male during the copulatory bout than CNTL animals. These females also displayed a trend for longer contact return latencies s after ejaculations than VEH and CNTL groups. On session 10, females that received LID and subsequently switched to VEH treatment no longer differed from controls in entrance/exit numbers, time spent with males or ejaculation contact return latency. They did however, receive a greater number of intromissions and displayed shorter inter intromission intervals compared to CNTLs. We suggest that clitoral stimulation in the rat serves as both a reward signal and may contribute to the detection of differences in copulatory stimuli that are critical to pacing and potentially, the initiation of pregnancy.

The role of ovarian hormones in sexual reward states of the female rat

To what extent does the reward value of sexual stimulation in females depend on ovarian hormones? The effects of estradiol benzoate (EB) and progesterone (P) were examined on the acquisition and expression of sexual reward induced by paced copulation and clitoral stimulation (CLS) in ovariectomized (OVX) rats. In experiment 1 we examined the expression of a pacing‐induced conditioned place preference (CPP). Ovariectomized, hormone-primed rats were given experience with paced copulation associated with one side of a CPP apparatus. Changing hormonal status prior to the final CPP test did not alter pacing-induced CPP. However, subsequent partial extinction of CPP was observed only in rats primed with EB+P, a treatment previously shown to induce sexual desire and receptivity. In Experiment 2, significant CLS-induced CPP developed in ovariectomized rats regardless of hormone priming. Our results show that the expression of the sexual reward state induced by paced copulation, and CLS in particular, is independent of hormone priming. We propose that ovarian hormones sensitize sensory and motor pathways necessary for sexual behavior and stimulation to induce reward.

Greater Resting Heart Rate Variability Is Associated with Orgasms Through Penile–Vaginal Intercourse, But Not with Orgasms from Other Sources

Resting heart rate variability (HRV), a marker of parasympathetic activity, is a predictor of health and longevity. Better erectile function is associated with greater resting HRV (assessed by high frequency power [HF]), and in both sexes, penile-vaginal intercourse (PVI) is the only sexual behavior consistently associated with indices of better physical and mental health, including greater resting HRV (assessed by standard deviation [SD] of heart rate [HR]). To examine the hypotheses that greater frequency of orgasms attained through PVI (for women, without additional simultaneous clitoral stimulation; vaginal orgasm) are associated with greater resting HRV. A differential hypothesis is that HRV measures will be unrelated to orgasmic frequency from noncoital sexual activities. Coitally experienced men and women (N = 143) had their heart rate measured for 5 minutes and reported the frequency of various sexual behaviors and corresponding orgasms in a recent representative month. Partial correlations and analyses of covariance controlling for social desirability responding were used to examine the associations of sexual activities with time and frequency domains of HRV. For men, greater resting SD of HR was associated with greater PVI orgasm frequency. For women, greater resting SD of HR was associated with any vaginal orgasm. These findings remained after controlling for cohabitation. Sexual activities were unrelated to HF. Lifetime number of PVI partners was unrelated to SD of HR and HF. Findings are discussed in the context of orgasms through PVI enhancing HRV, and greater parasympathetic tone favoring the capacity to engage in PVI, and in the case of women, to reach vaginal orgasm. The possibility of healthier people having greater resting HRV and more frequent orgasms through specifically PVI is also considered.

The human female orgasm: a critical evaluation of its proposed reproductive functions

The review critically examines two functional claims involving the human female orgasm. The first is that it is involved in the transport of spermatozoa by its release of oxytocin to create uterine contractions that suck up more semen at a faster rate. There is no physiological evidence for this scenario and the published experimental studies with oxytocin do not mimic the conditions of natural coitus. There is no evidence that orgasm has a role to play in reproductive fitness. The second claim is that as penile-vaginal intercourse (PVI) and its induced orgasm is the only sexual arousal that involves possible reproduction, evolution has rewarded it, and not clitorally-induced arousal (which it punishes), with highly specific health rewards. Apparently these cannot be generated by clitoral stimulation, moreover, its employment previous to and even at the same time as PVI negates these health advantages. The studies rely not only on women's retrospective self-reports of the genital structures creating their orgasms, which are known to have an “ambiguity problems”, but also on correlations from which causality is claimed or inferred. They have not been confirmed by independent researchers. Despite all women having the same genital structures from which sexual arousal is generated and that orgasm is not involved in reproduction via sperm transport, it is more than surprising that evolution has apparently created a situation where the majority of women do not or cannot generate orgasms from PVI alone and are thus imbued with poorer physical and mental health. This is even more unexpected when it is known that PVI actually stimulates the clitoris through thrusting traction on its attached ligaments via the anterior vaginal wall.

The Gräfenberg spot (G-spot) does not exist—a rebuttal of Dwyer PL: Skene’s gland revisited: function, dysfunction and the G spot

Dear Editor, Dr. Peter Dwyer wrote: “The distal urethra and vagina have an intimate relationship with the clitoris, both anatomically and functionally” [1]. In fact, the vagina and the urethra have no intimate relationship either anatomically or functionally with the clitoris; besides, the female urethra is only 3–4 cm long and the author does not clarify the meaning of “distal urethra” [2]. Dr. Dwyer wrote: “The clitoris consists of an exterior glans, a midline densely neural nonerectile structure that is continuous with the erectile tissue of the paired bulbs and crura, which surround the distal urethra and vagina” [1]. The clitoris is a female external genital organ: it is the homologue of the glans and of the two corpora cavernosa of the male penis. The clitoris is in part free formed by the body and glans. The body of the clitoris is formed by two thin cylindrical organs, i.e. corpora cavernosa, with cavernous tissue that becomes turgid with sexual arousal. The corpora cavernosa begin with the roots or crura (i.e. the hidden part of the clitoris), which are situated alongside the ischiopubic ramus; the crura does not surround the distal urethra and vagina [2]. Dr. Dwyer wrote: “The distal urethra, vagina, and clitoris have a shared vasculature and nerve supply (the dorsal nerve to the clitoris) and form a tissue cluster described by O’Connell et al. [4] as the “locus of female sexual function and orgasm”” [1]. The vasculature and the dorsal nerve of the clitoris are not shared with the distal urethra and vagina; the definition for the “tissue cluster” by O’Connell et al. has no embryological, anatomical, or physiological support. The locus of female sexual function and orgasm is not the distal urethra and vagina, but rather the clitoris and the other female erectile organs [2]. Dr Dwyer wrote: “In 1950, Ernest Grafenberg described an area a few centimeters up on the anterior vaginal wall that produces an orgasm different from one produced by clitoral stimulation” [1]. “G-spot” is not a term used in human anatomy. In 1950 Grafenberg did describe some cases of female and male urethral masturbation and the corpus spongiosum of the female urethra. He did write that the intraurethral glands could release a fluid that is not urine during orgasm; however, he did not report an orgasm of the intraurethral glands [2]. The Grafenberg spot does not exist. Clitoral/vaginal/ uterine orgasm and G, A, C, U, or K-spot orgasm are terms that should not be used by urologists, gynecologists, sexologists, the mass media, or women in general [2].

Context alters the ability of clitoral stimulation to induce a sexually-conditioned partner preference in the rat

We have shown previously that clitoral stimulation (CLS) of female rats induces significant conditioned place preference (CPP), indicating that it is rewarding. The present study asked whether CLS could induce a conditioned partner preference. In the first experiment, sexually naïve females received 10 alternating trials of CLS and No-CLS in the presence of a male rat behind a wire-mesh screen. For one group, CLS was made in the presence of the male scented with almond extract. On alternating trials, those females received sham CLS in the presence of an unscented male behind the screen. The order was reversed for the other group. After 5 trials in each condition, females were placed into an open field with two sexually vigorous males, one scented and the other unscented. Contrary to expectation, females displayed a preference for the male associated with sham CLS. The second experiment examined whether a partner preference could be conditioned by associating CLS with the almond odor alone. A new group of sexually naive females received the same CLS-odor, No-CLS-No Odor pairings as above, but with the odor presented on cotton gauze in the chamber. During the final open field test, those females selectively solicited the scented male. We conclude that CLS that induces CPP also induces conditioned partner preference. However, we propose that CLS in the presence of an inaccessible male created a sexual inhibitory state for female rats.

Clitoral stimulation modulates appetitive sexual behavior and facilitates reproduction in rats

In rats, sexual reward, appetitive sexual behaviors and reproduction are modulated by the amount and rate of vaginocervical stimulation. Here the effect of clitoral stimulation (CLS) on proceptivity was assessed. In Exp 1, ovariectomized, hormone-primed Wistar females formed three groups: G1 (1 CLS every second), G2 (1 CLS every 5 s) and G3 (no CLS). Precopulatory CLS consisted of 5 cycles of 1 min of stimulation with the tip of a cotton swab connected to a vibrator device, followed by 1–2 min of rest. CLS increased proceptive behavior in G1 compared to G2, but not compared to G3. In Exp 2, gonadally-intact rats in late proestrous received CLS prior to copulation. No differences in sexual behavior were detected between the groups, but CLS enhanced reproduction in females that received > 9 intromissions. 28, 66 and 10% of females became pregnant in G1, G2, and G3, respectively. These data indicate that precopulatory CLS affects proceptive behaviors depending on the pattern and rhythm of stimulation in hormone-primed females. In virgin rats that have received sufficient vagino cervical stimulation CLS also increases fertility.

The somatosensory representation of the human clitoris: An fMRI study

We studied the central representation of pudendal afferents arising from the clitoral nerves in 15 healthy adult female subjects using electrical dorsal clitoral nerve stimulation and fMRI. As a control body region, we electrically stimulated the right hallux in eight subjects. In a block design experiment, we applied bilateral clitoral stimulation and unilateral (right) hallux stimulation. Activation maps were calculated for the contrasts ‘electrical dorsal clitoral nerve stimulation versus rest’ and ‘electrical hallux stimulation versus rest’.A random-effect group analysis for the clitoral stimulation showed significant activations bilateral in the superior and inferior frontal gyri, insulae and putamen and in the postcentral, precentral and inferior parietal gyri (including the primary and secondary somatosensory cortices). No activation was found on the mesial surface of the postcentral gyrus. For the hallux, activations occurred in a similar neuronal network but the activation in the primary somatosensory cortex was localized in the inter-hemispheric fissure.The results of this study demonstrate that the central representation of pudendal afferents arising from the clitoral nerves and sensory inputs from the hallux can be studied and distinguished from each other by fMRI. From the somatotopic order described in the somatosensory homunculus one would expect for electrical clitoral nerve stimulation activation of the mesial wall of the postcentral gyrus. In contrast, we found activations on the lateral surface of the postcentral gyrus.

Clitoral stimulation induces conditioned place preference and Fos activation in the rat

The present study examined the ability of clitoral stimulation (CLS) to induce conditioned place preference (CPP) and Fos protein in the brain. Ovariectomized, hormone-primed Long–Evans rats were randomly assigned to receive either distributed CLS (1 stimulation every 5 s for 1 min prior to being placed in one distinctive side of a nonbiased CPP box for 2 min, after which the cycle of stimulation and CPP exposure were repeated for 4 more cycles, totaling 60 stimulations) or continuous CLS (1 stimulation per second for 1 min with 2 min in one side of the CPP box, repeated for 4 more cycles, totaling 300 stimulations). Two days later, females were placed into the other side of the CPP box without prior stimulation. CPP was tested after 5 sequential exposures each of CLS and no stimulation. Females given distributed stimulation developed a significant CPP whereas females given continuous stimulation did not. CLS induced Fos in hypothalamic and limbic structures, including the nucleus accumbens, piriform cortex, arcuate nucleus, and dorsomedial portion of the ventromedial hypothalamus, compared to no stimulation. However, distributed CLS induced more Fos in the medial preoptic area than continuous CLS or no stimulation. In contrast, continuous CLS induced more Fos in the posteroventral medial amygdala compared to no stimulation. These data indicate that CLS induces a reward state in the rat and a pattern of Fos activation in regions of the brain that process genitosensory input, incentive salience, and reward.

Long-Term Anatomical and Functional Outcomes in Patients with Disorders of Sexual Development

Purpose To assess the long-term anatomical, and functional outcomes of adult patients who were surgically treated for DSD as infants or children. Material and Methods An attempt was made to contact patients 18 years or older, who were treated surgically for DSD as infants or children at our institution. Of 27 patients, we were able to reach only 13, and of these, 4 refused to participate in the extensive questionnaires. Patients were compensated $150.00 for completing the questionaires. Nine patients answered a detailed psychosocial questionnaire. Seven of the nine completed the female version of the Self Assessment of Genital Anatomy and Sexual Function Questionnaire. Five had CAH and 2 had MGD. Results The clitoris was judged too large in 4, small in 1, and not located in 2. In the 5 where location was possible, it was on the pubic bone in 1, just below the pubic bone in 1, at the top of the labia in 2, and below the top of the labia, just inside the vagina in 1. Six of the 7 patients noted the vaginal opening was adequate for sexual penetration, but three of the 6 indicated that penile penetration still caused tearing or bleeding. Five patients said their vaginal opening was in the anatomically correct position and 2 said it was far back near the anus. Three patients had strong, 3 had moderate, and 1 had no sexual pleasure with clitoral stimulation. Three had strong, 2 had mild, and 2 had no orgasms. Conclusions Long-term follow-up of adult DSD patients who had surgery as infants or children was disappointingly difficult to obtain. Of the small number of responders, most participated in sexual activities but functional results were mixed. It is important to develop better tracking systems for long-term follow up of adult DSD patients so that those who have residual functional problems can benefit from re-evaluation and further management. To assess the long-term anatomical, and functional outcomes of adult patients who were surgically treated for DSD as infants or children. An attempt was made to contact patients 18 years or older, who were treated surgically for DSD as infants or children at our institution. Of 27 patients, we were able to reach only 13, and of these, 4 refused to participate in the extensive questionnaires. Patients were compensated $150.00 for completing the questionaires. Nine patients answered a detailed psychosocial questionnaire. Seven of the nine completed the female version of the Self Assessment of Genital Anatomy and Sexual Function Questionnaire. Five had CAH and 2 had MGD. The clitoris was judged too large in 4, small in 1, and not located in 2. In the 5 where location was possible, it was on the pubic bone in 1, just below the pubic bone in 1, at the top of the labia in 2, and below the top of the labia, just inside the vagina in 1. Six of the 7 patients noted the vaginal opening was adequate for sexual penetration, but three of the 6 indicated that penile penetration still caused tearing or bleeding. Five patients said their vaginal opening was in the anatomically correct position and 2 said it was far back near the anus. Three patients had strong, 3 had moderate, and 1 had no sexual pleasure with clitoral stimulation. Three had strong, 2 had mild, and 2 had no orgasms. Long-term follow-up of adult DSD patients who had surgery as infants or children was disappointingly difficult to obtain. Of the small number of responders, most participated in sexual activities but functional results were mixed. It is important to develop better tracking systems for long-term follow up of adult DSD patients so that those who have residual functional problems can benefit from re-evaluation and further management.