Woman’s sexual pleasure response is a neurobiological sensation that results from an end-organ trigger during physical intimacy. It is characterized by inputs from the cerebral cortex and limbic system to the structures in the external genitalia (clitoris, labia, vagina), with coordinated responses from the neurovascular and endocrine systems.
The autonomic trigger results in contractions of the pelvic floor muscles around the clitoris, urethra and vaginal introitus. Additional involuntary contractions / sensations may spread to other regions leading to a generalized sensation of intense pleasure and euphoria.
Brain mapping studies in women have demonstrated increased activity in the right cerebral cortex and the limbic system during this process. As one of the common forms of female sexual disorders (FSD), the relative incidence of sexual pleasure or orgasmic disorder is 16–48% and is generally more prevalent in younger women (primary anorgasmia) compared to other age groups. Secondary anorgasmia can result from common medical conditions including diabetes mellitus, other neurological, vascular and hormonal problems, pelvic or genital surgeries or as a side effect of prescription medication, particularly SSRIs. The management will focus on the specific precipitating factor for this condition. Once identified, the available options are optimizing hormones, treating co-morbid clinical issues and addressing psychological, inter-personal, partner-related, socio-cultural and environmental factors through sex therapy and counseling.
The off-label treatment options include use of dopamine agonists (bupropion), oxytocin, phosphodiesterase type 5 inhibitors (sildenafil) and alpha-2 adrenoceptor blockers (yohimbine). Until recently, the Gräfenberg (G-) spot has been under evaluation for sexual pleasures in women. This sensitive area is considered to be located in the anterior wall of the vagina, midway between the symphysis pubis and uterine cervix along the course of the urethra. As a vestigial homologue of the male prostate, it is a complex structure of blood vessels, nerves, paraurethral glands and ducts surrounding the bladder neck. The Skene’s glands expel a clear fluid when G-spot is stimulated in most women; this is often equated to a form of female ejaculation. Some investigators have questioned the existence of G-spot since it was difficult to demonstrate a distinctive structure of high nerve density in the designated area of the vaginal wall. Anatomically, distal vagina, clitoris and urethra share the same blood supply and innervations and therefore, it is likely that during sexual activity, these regions may respond as a unit. If the G-spot is proven to be a false entity, it may relieve many women of concerns and feelings of sexual inadequacy.
As a psychology and medicine student in the sixties and early seventies I realized that sexology was missing in the education and training curriculum for most health professionals. This concern encouraged me to ask my own department and the University of Gothenburg to modify the current curricula making sexology a compulsory subject in the academic training for physicians and psychologists in the first place.
The psychotherapy section of the WPATH Standards of Care for the Health of Transsexual, Transgender and Gender nonconforming People (SOC) is the most obvious component of the SOC that has to do with “heart”, the theme of this conference. Psychotherapy, to be good, requires empathy and imagination, connection and relatedness, and listening to story.
The LET'S TALK ABOUT SEX foundation coordinated an educational project ahead of the Euro 2012 Football Championship in Poland. This preventative and educational program
The medical sexology can be a significant domain for clinical Psychiatry. It is crucial to stress the importance of evaluating sexual life in the clinical global assessment of psychiatric patients/clients: Diagnoses, treatment and quality of their sexual life’s. It is stressed the sexological approach done by the psychiatrists or psychologists in the medical or surgical team in Liaison Psychiatry inside the general hospital.
This presentation, "Responding to the needs of consumers with complex trauma histories a consumer perspective" focuses on the needs of adult survivors of child abuse, highlighting the frequent