Exposing orgasm in the brain: a critical eye

Validation of a Visual Analogue Scale to measure the subjective perception of orgasmic intensity in females: The Orgasmometer-F

The female orgasm represents one of the most complex functions in the field of human sexuality.

The conjunction of the anatomical, physiological, psycho-relational and socio-cultural components contributes to make the female orgasm still partly unclear. The female orgasmic experience, its correlates and the relation with sexual desire, arousal and lubrication as predictors are highly debated in scientific community. In this context, little is known about the impact of female sexual dysfunction (SD) on sexual pleasure expressed by subjective orgasmic intensity, and there are no suitable psychometric tools suited to investigate this dimension. Thus, we validate, in female subjects, a Visual Analogue Scale (VAS) that we named Orgasmometer-F, to verify if SD is accompanied by a lower perceived orgasmic intensity. A total of 526 women, recruited through a web-based platform and from sexological outpatient clinic, were enrolled in the study. They were divided into, on the basis of the Female Sexual Function Index (FSFI) score in two groups: 1) 112women suffering from SD, (SD Group); and 2) 414 sexually healthy women (Control Group). The participants were requested to fill out the Orgasmometer-F, recording orgasmic intensity on a Likert scale from 0 (absence of orgasmic intensity) to 10 (maximum orgasmic intensity experienced). Women with SD experienced significantly lower orgasmic intensity than controls, as measured by the Orgasmometer-F (p < 0.0001). Interestingly, masturbatory frequency was positively correlated with orgasmic intensity, as were the lubrication, orgasm and sexual satisfaction domains of the FSFI. The Orgasmometer-F was well understood, had a good test-retest reliability (ICC = 0.93) and a high AUC in differentiating between women with and without sexual dysfunction (AUC = 0.9; p < 0.0001). The ROC curve analysis showed that a cut-off <5 had 86.5% sensitivity (95% CI 82,8–89,6), 80.4% specificity (95% CI 71.8–87.3), 75.4% positive predictive value (PPV) and 89.5% negative predictive value (NPV). In conclusion, the Orgasmometer-F, a new psychometrically sound tool for measuring orgasmic intensity in female population, demonstrated that SD impair orgasmic intensity.

The Physiology of Female Sexual Function and the Pathophysiology of Female Sexual Dysfunction (Committee 13A)

INTRODUCTION

The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects.

AIM

To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant.

CONCLUSION

Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.

The pharmacology of the human female orgasm - its biological and physiological backgrounds

The female orgasm has been examined over the years by numerous scientific disciplines yet it still has many secrets to be disclosed. Because its physiology, especially its neurophysiology, is sparingly understood its pharmacology is necessarily limited based mainly on the side effects of drugs. Few published studies have used a placebo group as controls. The paucity of focussed studies is well illustrated by the fact that there still is no approved medication to treat female orgasmic dysfunction. The present brief overview examines the most important aspects of its biology and especially its physiology highlighting the many questions that need answering if we are to have a comprehensive pharmacology of the female orgasm.

Sex for fun: a synthesis of human and animal neurobiology

Sex is a fundamental pleasure, and crucial to the survival of our species. Though not many people would disagree with the proposition that sexual behaviour depends on the brain, the neuroscientific study of human sex is still relatively taboo and much remains to be discovered. On the contrary, excellent experimental animal models (mostly rat) are available that have uncovered major behavioural, neurochemical, and neuroanatomical characteristics of sexual behaviour. Restructuring sexual behaviour into broader terms reflecting behavioural states (wanting, liking, and inhibition) facilitates species comparison, revealing many similarities between animal and human sexual pleasure cycles, some of which can serve as potential avenues of new human sex research. In particular, behavioural and brain evidence clearly shows that motivational and consummatory phases are fundamentally distinct, and that genitally-induced sexual reward is a major factor in sexual learning mechanisms.