Genital stimulation as a trigger for neuroendocrine and behavioral control of reproduction

The whole versus the sum of some of the parts: toward resolving the apparent controversy of clitoral versus vaginal orgasms

BACKGROUND

The nature of a woman's orgasm has been a source of scientific, political, and cultural debate for over a century. Since the Victorian era, the pendulum has swung from the vagina to the clitoris, and to some extent back again, with the current debate stuck over whether internal sensory structures exist in the vagina that could account for orgasms based largely on their stimulation, or whether stimulation of the external glans clitoris is always necessary for orgasm.

METHOD

We review the history of the clitoral versus vaginal orgasm debate as it has evolved with conflicting ideas and data from psychiatry and psychoanalysis, epidemiology, evolutionary theory, feminist political theory, physiology, and finally neuroscience.

RESULTS

A new synthesis is presented that acknowledges the enormous potential women have to experience orgasms from one or more sources of sensory input, including the external clitoral glans, internal region around the "G-spot" that corresponds to the internal clitoral bulbs, the cervix, as well as sensory stimulation of non-genital areas such as the nipples.

CONCLUSIONS

With experience, stimulation of one or all of these triggering zones are integrated into a "whole" set of sensory inputs, movements, body positions, autonomic arousal, and partner- and contextual-related cues, that reliably induces pleasure and orgasm during masturbation and copulation. The process of integration is iterative and can change across the lifespan with new experiences of orgasm.

Neural and hormonal mechanisms of reproductive-related arousal in fishes

The major classes of chemicals and brain pathways involved in sexual arousal in mammals are well studied and are thought to be of an ancient, evolutionarily conserved origin. Here we discuss what is known of these neurochemicals and brain circuits in fishes, the oldest and most species-rich group of vertebrates from which tetrapods arose over 350 million years ago. Highlighted are case studies in vocal species where well-delineated sensory and motor pathways underlying reproductive-related behaviors illustrate the diversity and evolution of brain mechanisms driving sexual motivation between (and within) sexes. Also discussed are evolutionary insights from the neurobiology and reproductive behavior of elasmobranch fishes, the most ancient lineage of jawed vertebrates, which are remarkably similar in their reproductive biology to terrestrial mammals.

Differential effects of progesterone and genital stimulation on sequential inhibition of estrous behavior and progesterone receptor expression in the rat brain

The effect of genital stimulation, either by vaginocervical stimulation (VCS) using a calibrated vaginal probe combined with manual flank stimulation (FS), or by mounts performed by the male, on the hypothalamus and preoptic area concentration of the progesterone receptors A (PR-A) and B (PR-B) was assessed in ovariectomized (ovx) estrogen-primed rats. VCS/FS or stimulation provided by male mounts, even without intromission, significantly decreased PR-B concentration in the hypoythalamus. Down regulation of PR produced by genital stimulation was quantitatively similar to that elicited by progesterone (P) administration. Bilateral or unilateral transection of the pelvic or the pudendal nerves prevented down regulation elicited by VCS/FS. Repeated VCS/FS elicited lordosis behavior in most ovx estrogen primed rats, but the lordosis intensity was lower than that observed in response to P. P administered to ovx estrogen primed rats, induced sequential inhibition, i.e., failure to display estrous behavior in response to a second P injection (24h after the initial P injection). VCS/FS failed to elicit sequential inhibition, since rats responded with normal estrous behavior to the second injection of P. This suggests that down regulation by VCS, by contrast with P, failed to inhibit the subpopulation of PR involved in the facilitation of estrous behavior by P.

The onset of puberty in female mice as reflected in urinary steroids and uterine/ovarian mass: interactions of exposure to males, phyto-oestrogen content of diet, and ano-genital distance

Development of puberty in female mice was examined in relationship with the ano-genital distance index (AGDI), phyto-oestrogen content of diet and exposure to males post weaning. Throughout gestation and post-natal development, females were exposed to a regular diet or a nutritionally similar diet deficient in phyto-oestrogens. After segregation at weaning on the basis of short or long AGDI, an indirect measure ofin uteroandrogen exposure, females were housed alone or underneath two outbred adult males for 2 weeks. Female urinary samples were collected non-invasively throughout this exposure, then assayed for oestradiol, progesterone and creatinine. Females were then killed and uterine and ovarian mass was determined. Urinary oestradiol was substantially reduced in females raised on the phyto-oestrogen-free diet. Oestradiol levels were more dynamic over days in urine of male-exposed females, especially among those on the regular diet. Urinary progesterone was not strongly influenced by diet. Progesterone was more dynamic in urine of male-exposed females, and was generally elevated compared with levels in isolated females, the size of this effect dependent on AGDI, diet and whether the measure was adjusted for creatinine. Urinary creatinine was elevated by the phyto-oestrogen-free diet and reduced by male exposure, tending to decline over days in females exposed to males. Male exposure increased uterine and ovarian mass and was influenced by AGDI in interaction with diet and male exposure.

Neural pathways mediating vaginal function: the vagus nerves and spinal cord oxytocin

The initial observations, made in our laboratory with Knut Larsson, of the ability of vaginocervical stimulation (VCS) to block withdrawal responses to foot pinch in rats has led to findings of multiple behavioral, autonomic, and neuroendocrine effects of this potent stimulus in rats and also in women. It has led to an understanding of: (1) the neuroanatomical and neurochemical basis of a novel and potent pain-blocking mechanism; (2) likely neuroanatomical pathways mediating both the Ferguson reflex and a specific autonomic response - the pupil-dilating effect of VCS; (3) a role for oxytocin as a putative central nervous system neurotransmitter that stimulates autonomic sympathetic preganglionic neurons within the spinal cord; and (4) a novel pathway that can convey sensory activity from the cervix, adequate to induce orgasm, via the vagus nerves. This latter pathway bypasses the spinal cord and projects directly to the medulla oblongata, and thus can convey genital afferent activity despite complete spinal cord injury at any level.

Estrogen receptor-alpha and neural circuits to the spinal cord during pregnancy

Estrogen receptor immunoreactivity and mRNAs are present in spinal cord neurons in locations that are associated with sensory and autonomic innervation of female reproductive organs. The present study was undertaken to examine the expression of estrogen receptor-alpha in the spinal cord during different stages of pregnancy and to determine whether estrogen receptor-alpha-expressing neurons are related to uterine afferent nerves bringing information to the spinal cord at parturition. Immunohistochemistry showed estrogen receptor-alpha-immunoreactive neurons in the dorsal one-half of the spinal cord, i.e., dorsal horn, dorsal intermediate gray areas (dorsal commissural nucleus), and around the central canal and sacral parasympathetic autonomic nucleus of the lumbosacral spinal cord. Neurons in these areas corresponded topographically to the distribution of central processes of visceral primary afferent neurons (e.g., containing calcitonin gene-related peptide and substance P) that innervate and activate second-order spinal cord neurons (evidenced by their expression of Fos) at parturition. Western blots showed that estrogen receptor-alpha increases in the spinal cord, with a peak at day 20 of gestation, followed by a slight decrease by 2 days postpartum. These studies show that estrogen receptor-alpha is expressed by neurons in autonomic and sensory areas of the lumbosacral spinal cord that have connections with the female reproductive system and that the level of estrogen receptor-alpha changes over the course of pregnancy, which may follow profiles of steroid hormones. Many of these neurons may be involved in processing information related to reproductive organ function, changes during pregnancy, and relays to other CNS centers.

Appetitive and consummatory sexual behaviors of female rats in bilevel chambers. II. Patterns of estrus termination following vaginocervical stimulation

Copulation with intromission or manual vaginocervical stimulation (VCS) shortens the duration that intact female rats maintain lordosis responding during estrus. The present study examined whether VCS could shorten the duration of both appetitive and consummatory measures of female sexual behavior, and whether these effects occur differentially in time and across different hormone priming intervals. Ovariectomized, sexually experienced female rats were administered subcutaneous injections of estradiol benzoate 48 h and progesterone 4 h, before receiving 50 manual VCSs with a lubricated glass rod distributed over 1 h. Control females received sham VCSs distributed over the same time. The females were then tested for sexual behavior in bilevel chambers with two sexually vigorous males (to one ejaculatory series or 10 min with each male, separated by 5 min) 12, 16, and 20 h after VCS. Prior to the final hormone treatment, different groups of females had been given the same hormone treatment either 28, 14, 7, or 4 days before. In females tested at 28- and 14-day hormone intervals, VCS induced both active and passive rejection responses at 12, 16, and 20 h. In contrast, females that received sham VCS displayed relatively normal sexual behavior at 12 h, although by 16 and 20 h these females displayed active and passive rejection. Females tested at 7- or 4-day intervals displayed normal levels of lordosis at all testing times, regardless of VCS treatment. These data indicate that VCS facilitates rejection responses that precede the decrease in lordosis responsiveness. However, the effects of VCS are dependent on the frequency of hormone priming, suggesting that hormone treatment may block some of the long-term inhibitory effects of VCS on female sexual behavior.

Sexual motivation--an inquiry into events determining the occurrence of sexual behavior

For the individual engaged in it, sexual behavior has no finality or purpose other than its own execution. Data are presented showing that the execution of sexual reflexes can promote learning, i.e. it functions as reinforcement. Furthermore, positive affect is generated. Based on these principles, a model of sexual motivation has been elaborated. The conceptual framework is the incentive motivation theory previously proposed by Bindra D, A motivational view of learning, performance, and behavior modification, Psychol Rev 1974: 81:199-213; A Theory of Intelligent Behavior, New York: Wiley, 1976; How adaptive behavior is produced: a perceptual-motivational alternative to response reinforcement, Behav Brain Sci 1978; 1:41-52. Although the model is intended for application to most mammals, the rat is used as example. Essentially, sexual approach behaviors are activated by appropriate incentives (conditioned in the male, unconditioned in the female). Approach is, in the inexperienced male, followed by the execution of copulatory reflexes as a consequence of accidentally obtained tactile stimulation of the perineal region. In the female, copulatory acts are activated by tactile stimulation of the flanks and hinds provided by the mounting male. The role of conditioning for the execution of copulatory reflexes and for the acquisition of incentive value of neutral stimuli is analyzed. It is also shown that the incentive properties of sexual acts are not substantially different from those of other incentives. Sexual exhaustion is suggested to be either a case of negative alliesthesia or of stimulus habituation and the Coolidge effect is, in consequence, an example of dishabituation. Studies in women and men support this proposal. It is emphasized that sexual behavior is best understood as being entirely mechanistic albeit not deterministic.

Appetitive and consummatory sexual behaviors of female rats in bilevel chambers. I. A correlational and factor analysis and the effects of ovarian hormones

This study investigated measures of sexual behavior displayed by female rats in bilevel chambers, the statistical relationships among the measures, and their dependency on hormone priming. Normative data from a standard 35-min test of sexual behavior were gathered from 82 fully primed sexually experienced Long-Evans females and subjected to multiple correlational and factor analyses. Several consummatory measures of copulation were related significantly, whereas appetitive level changing was statistically independent of consummatory measures. Factor analyses were conducted using orthogonal rotations of correlational matrices derived either from (a) measures of female behavior alone or (b) measures of female and male behavior together. The first analysis revealed five factors that accounted for 84% of the intersubject variance: Receptivity, Pacing, Appetitive Level Changing, Lordosis Reflex, and Solicitation. The second factor analysis with male data included revealed seven factors that accounted for 95% of the intersubject variance: Pacing, Copulatory Rate, Mount Count, Receptivity, Appetitive Level Changing, Solicitation, and Lordosis Reflex. Subsequently, subsets of these females were maintained on different steroid priming regimens (oil, low estrogen, high estrogen, high estrogen and progesterone) prior to a standard test of sexual behavior. Although the expression of all sexual behaviors required estrogen priming, appetitive level changing, solicitation, and pacing required progesterone for their full expression. Finally, appetitive level changing developed following hormone treatment alone, regardless of whether the females received access to sexually active males, inactive castrated males, or other females. Use of bilevel chambers allows complex patterns of sexual behavior to be observed in female rats and may thus facilitate the identification of neurochemical or endocrine mechanisms associated with different aspects of female sexual motivation and performance.

Pheromones and novel male-induced pregnancy disruptions in mice: exposure to conspecifics is necessary for urine alone to induce an effect

Previous research indicates a role of pheromones in novel male-induced early pregnancy disruptions. Although some reports suggest that urine alone is sufficient to produce this effect, others raise procedural concerns and fail to replicate such effects. On Days 1 to 5 after insemination, female CF-1 mice had their nasal regions repeatedly painted with water, urine from males housed in isolation, or urine from males housed in proximity to females. Almost all (87.5%) of the control females delivered litters. There was a small nonsignificant reduction in proportion parturient (78.5%) among females exposed to urine of males housed without social contact. The proportion of females parturient (57.1%) after treatment with urine from males housed in proximity to females was significantly different from controls. The magnitude of the effect of socially stimulated male urine is substantially less than that recorded when males are housed directly above inseminated females separated by a wire-mesh grid. These data suggest that production of pregnancy-disrupting male pheromones is stimulated by contact with conspecifics.

Steroid modulation of neurotransmitter function to alter female reproductive behavior

The hormonal induction of reproductive behavior in rodents is well established, but many of the mechanisms mediating this induction remain unknown. The ability of the gonadal steroids, estrogen and progesterone, to act simultaneously upon several neurotransmitter systems and at multiple loci in a coherent manner helps to coordinate the timing of behavioral receptivity with ovulation and assures maximal reproductive success. Investigations revealing the multitude of steroid actions on neurotransmitters illustrate the neuronal plasticity present in the adult brain. Furthering our understanding of the mechanisms by which steroids alter brain functioning to change behavior profoundly, but transiently, serves to provide information not only in the field of reproductive biology but that of basic neuroscience as well.

Behavioral responses to uterine or vaginal distension in the rat

Afferent fibers in the rat hypogastric and pelvic nerves supply the uterus and vagina, respectively, the former being responsive mainly to intense uterine stimuli, the latter to gentle and intense vaginal stimuli (Berkley et al. 1993c). If such responses result in sensory experiences, those produced by uterine and vaginal stimulation should differ, uterine stimuli being experienced mainly as pain and vaginal stimuli experienced in various ways, including pain. To test this hypothesis, 48 young virgin rats were first trained to make an operant response to escape a noxious tail-pinch stimulus. Latex balloons inserted into the rat's uterine horn or vagina were then distended to various volumes and the metestrous rat's detection behaviors and operant escape response probabilities measured. Approximately 26% of the 23 rats tested failed to respond to uterine stimulation, even when it produced ischemia. For the rest, detection and escape responses occurred only to ischemic stimuli and never to all of them, even at the highest volumes. In contrast, all 25 rats tested responded readily to vaginal distension, often to all of them at high volumes. Detection behaviors occurred at distension magnitudes lower than those that evoked escape responses. These results support the hypothesis that sensory consequences of uterine and vaginal stimulation differ. Because effective uterine stimuli were larger than any that would occur in a normal physiological state in non-pregnant/parturient rats, normally occurring uterine states in such rats are probably insensible. In addition, while the behavioral responses did indeed reflect differences in hypogastric and pelvic nerve response properties, the results also indicated that activity produced in those fibers, even by abnormal stimuli, does not inevitably result in behavior.

Pelvic neurectomy blocks oxytocin-facilitated sexual receptivity in rats

The effect of bilateral pelvic, hypogastric, or pudendal neurectomy on oxytocin-induced facilitation of lordosis behavior was examined in ovariectomized, estrogen, and progesterone primed female rats. Oxytocin-induced facilitation of lordosis behavior was significantly decreased following bilateral pelvic, or combined bilateral pelvic and hypogastric neurectomy. Hypogastric only or pudendal only neurectomy had no effect on the facilitation of lordosis behavior after systemic administration of oxytocin. These results suggest that the integrity of the pelvic nerve is necessary and sufficient to mediate the stimulatory effects of systemically administered oxytocin on receptivity.

Sexual stimulation activates c-fos within estrogen-concentrating regions of the female rat forebrain

Regions of the brain that concentrate estrogen and progesterone are thought to regulate female sexual behavior by altering gene expression and neural sensitivity to afferent stimulation. We used immunocytochemistry and in situ hybridization to examine c-fos gene expression within estrogen-concentrating regions of the forebrain following various types of sexual stimulation with or without hormone treatment. Ovariectomized rats received injections of estradiol benzoate 48 h and progesterone 4 h before testing. Control rats that had been ovariectomized at least 5 months before testing did not receive hormone treatment. Rats were then either placed into bilevel testing chambers with sexually vigorous males, received manual stimulation of the flanks, received vaginocervical stimulation with a glass rod, or were left in their home cages. Copulation with intromission and ejaculation in hormone-treated rats, or stimulation of the vaginal cervix in both hormone-treated and control rats, produced a dramatic induction of c-fos mRNA and Fos-like immunoreactivity in estrogen-concentrating regions, such as the lateral septum, medial preoptic area, bed nucleus of the stria terminalis, paraventricular nucleus of the hypothalamus, ventromedial hypothalamus, lateral habenula, and medial amygdala, in addition to regions that do not readily concentrate estrogen, such as the neocortex, thalamus, and striatum. Mechanical stimulation of the flanks produced a smaller induction of Fos in these rats, whereas hormone treatment alone had no effect. These data demonstrate that afferent sensory stimulation, but not estrogen or progesterone, regulates c-fos gene expression within different estrogen-concentrating and non-concentrating regions of the female rat forebrain.

The segmental distribution of afferent fibers from the vaginal cervix and hypogastric nerve in rats

Injections of horseradish peroxidase-wheat germ agglutinin (HRP-WGA) into the walls of the vagina and cervix (vaginocervical injections) of rats resulted in labeling of dorsal root ganglia (DRG) cells located at T11-L4 and L6-S2. In a second group of animals, exposure of the hypogastric nerve to HRP-WGA resulted in a similar bimodal distribution of labeled cells as compared to vaginocervical injections. In a third group, unilateral hypogastric nerve transection prior to injection of HRP-WGA into the vaginocervical walls resulted in a significant reduction in DRG cells labeled at T13, L1, L2, L6 and S1. Bilateral transection of the hypogastric nerves prior to vaginocervical injections eliminated labeled DRG cells at thoracolumbar levels but not at L6 and S1. Bilateral pelvic neurectomy reduced, but did not eliminate labeled DRG cells at L6 and S1 following vaginocervical injections. These results indicate that the hypogastric nerve constitutes a major sensory pathway from the vaginocervical walls to thoracic, lumbar and sacral levels of the spinal cord. The hypogastric nerve may subserve the transmission of noxious input from the vaginocervical walls as well as the activation of ascending spinal pathways involved in neuroendocrine reflexes during parturition.

Psychogenic pregnancy disruptions in mammals

Evidence scattered over the literatures of zoology, psychology, agricultural science, and medicine indicates that diverse stressors will interfere with pregnancy in its early stages. It is probable that the most sensitive period is around the point of intrauterine implantation of fertilized ova. Although there is some indication that conventional "stress" hormones of the pituitary-adrenal axis can inhibit implantation, this evidence is too weak and inconsistent to suggest that these hormones are primary mediators of early pregnancy disruptions. Increasingly, evidence indicates that the balance of ovarian steroids is most important for pregnancy maintenance. It is well known that minute amounts of exogenous estrogens can completely disrupt pregnancy, and some new evidence suggests that endogenous estrogens may be released from the adrenals and/or ovaries during psychological stress.

Duration of mating relates to fertility in mice

In normal mating, house mice vary dramatically in the number and duration of intromissions that precede ejaculation. Also, some proportion of inseminations typically fails to yield litters. The present studies involved systematic observations of matings of females in natural estrus with males of proven fertility. After standardized observation of mating behavior culminating in ejaculation and a sperm plug, females were allowed to produce litters in undisturbed conditions. In two replications, greater numbers of intromissions and a longer latency from first intromission to ejaculation both correlated positively with litter size.

Amniotic fluid ingestion before vaginal/cervical stimulation produces a dose-dependent enhancement of analgesia and blocks pseudopregnancy

A substance in amniotic fluid (AF) and placenta has been shown to enhance analgesia produced by morphine, late pregnancy, footshock, and vaginal/cervical stimulation (VS). When morphine-induced analgesia was assessed previously, the degree of enhancement by ingestion of AF or placenta was found to be a function of the amount of analgesia being generated. We have extended these results to include the analgesia produced by VS. Analgesia induced by 75, 125, 175, or 225 g of vaginal/cervical pressure was measured in rats pretreated with 0.25 ml (by orogastric infusion) of either AF or saline. AF infusion enhanced the analgesia produced by 125 g VS, but did not affect the analgesia produced by 75, 175, or 225 g VS. Unexpectedly, we also found that infusion of AF shortly before the application of VS prevents VS-induced pseudopregnancy (PsP). Whereas the incidence of PsP following 75, 125, or 175 g VS was less than 19% and not statistically different for AF and saline pretreatments, the incidence of PsP after 225 g VS was 44% in saline-pretreated rats, but only 10% in AF-pretreated rats. Protection from the induction of pseudopregnancy, which could be caused by mechanical stimulation of the cervical area during delivery, may be an additional benefit of parturitional ingestion of placenta and amniotic fluid (placentophagia).