Showing posts with label Komisaruk. Show all posts
Showing posts with label Komisaruk. Show all posts

12.27.2016

Freudian BS in a Legit, Peer-Reviewed Journal: A Journal Article I Read




Welcome back to 'A Journal Article I Read,' a series where I summarize a lady-gasm related journal article in a way that is hopefully both comprehensive and also not too long. You can find a list of all the journal articles in this series HERE.

Here is what I'll be summarizing today.

A woman's history of vaginal orgasm is discernible from her walk.
Nicholas A1, Brody S, de Sutter P, de Carufel F.
J Sex Med. 2008 Sep;5(9):2119-24.

The BS intent of this article - a background from me
This is a unique summary for me because I have a lot to say about not only this article, but also about the author of this article and the background of why this article exists. Spoiler alert: I'm pretty darn disappointed with the amount of bias, the direct link to Freudian BS, the incorrect assumptions about scientific understanding of vaginal orgasm, and the experimental design. 

Let me begin with the quickest summary of my discontent that I can conjure up.
 Freud thought the vaginal orgasm was the only mature way for a woman to orgasm and that ability to orgasm from clitoral stimulation only was a sign of immaturity. He just made that shit up. Like if I just decided to say that for men, orgasm from penile stimulation was infantile, and to gain full maturity a man must be able to orgasm from anal intercourse...and people believed me and acted like it made sense.

Anyway, it was not backed up by reality or scientific investigation and it still isn't. In fact, there actually is still not any physical evidence at all in scientific literature that women can orgasm through vaginal stimulation alone. This is after decades of research into female orgasm - which does btw clearly back up the knowledge that women can and do orgasm from outer clitoral/vulva stimulation just as men do from penile stimulation. Clitorally stimulated orgasms have been observed and physically verified numerous times. Just like penile orgasms, it is fairly clear in scientific literature how they can happen, what happens in the body when they do, and to some extent who can have them...i.e. any intact healthy body is capable of a penile or clitorally (really anything around that tissue even if it's somewhere in between a clit and a penis) stimulated orgasm. Female orgasm is not mysterious or confusing, but vaginal orgasm is because as much as it's discussed, researched, and advised about, scientists have not yet found physical evidence that orgasms can happen though stimulation inside the vagina without additional external genital stimulation.

So, to be real clear, when a person (and believe you me a shit ton of these people are scientists in peer reviewed journals*) speaks about the vaginal orgasm, about what women and/or their bodies are like who have them, about their health benefits, about what they look like in the brain, these people are, if you will, talking out of their ass. If they make no mention that orgasms caused by stimulation inside the vagina, with no additional outer vulva/clitoral stimulation, have never been physically verified, then they are not speaking, and may not even understand, the whole story. We don't actually know if these orgasms can happen. We don't know what is actually happening in the body when the women who say they have vaginal orgasms are experiencing what they call vaginal orgasms. So please tell me how we can make distinctions between women who do and do not have them?

NO RESEARCH ARTICLE YOU'VE EVER READ OR HEARD OF THAT TELLS YOU ABOUT A DIFFERENCE IN WOMEN WHO ORGASM VAGINALLY VS. THOSE WHO CAN'T IS ACTUALLY ABLE TO BACK UP THE CLAIM BECAUSE THEY DO NOT KNOW FOR SURE THAT THE WOMEN WHO CLAIM TO ORGASM VAGINALLY ACTUALLY ARE PHYSICALLY DOING THAT. #RealTalk ya'll. Feel free to go through the existing research yourself. If you find something that proves that wrong. I would LOVE to see it.

So...what exactly pisses me off so much
Incorrectly going about a study as if vaginal orgasms (orgasms caused by stimulation inside the vag only w/ no additional outer stimulation) are a scientifically understood and verified phenomenon is sadly pretty normal for female orgasm studies in peer reviewed journals. Me critiquing that uninformed assumption in these journal summaries is par for the course, so that's not what I'm most worried about in this one. I'm worried about the Freud-was-right-vaginal-orgasms-are-the-only-mature-sexual-climax-a-woman-can-have-and-clitoral-orgasms-make-women-less-mentally-and-physically-healthy agenda this article and this author seem to have. Because I do feel like there is evidence for this kind of agenda.

A little history of clit hate
Freud made that shit up about vaginal orgasm in his whole psychoanalysis deal. Wilhelm Reich was a student of Freud. Alexander Lowen was a student of Reich. All of them had similar feelings about the supremacy of the vaginal orgasm. Reich combined elements of the body into psychoanalysis and Lowen updated Reich's philosophy. It's called bioenergetic analysis. A main tenet of which is "blocks to emotional expression and wellness are revealed and expressed in the body as chronic muscle tensions which are often subconscious. The blocks are treated by combining bioenergetically designed physical exercises, affective expressions and palpation of the muscular tensions." - from Wikipedia.

Stuart motha-fuckin' Brody
Let me also point out that this is an article by a man named Stuart Brody, who is an absolutely prolific writer of scholarly, peer reviewed research articles jocking hard on vaginal orgasms, penile-vaginal intercourse, and even barebacking. He's not the lead author in this particular one, but I see him as a constant player in Freudian BS studies, so I'm picking on him. Please see a list of some of his articles at the bottom of this post - and it's just a few. This dude really cranks these out. But seriously, just take a minute to check out the names of these articles. I think it will help orient you.

The premise of the article
Anyway, Brody was an author on a previous article that claims to show that women who orgasm vaginally use less immature defense mechanisms. Since one must find some type of measurable aspect of maturity in order to prove someone (non-vaginally orgasming women, perhaps?) immature, that study uses a series of self-report questionnaires about personality and psychological defense mechanisms against a questionnaire about their sex lives...and voila, proof that non-vaginally orgasming women are less mature. And do be sure, Brody cites that study several times to back up a variety of statements he makes in his article I will be summarizing below.

This, I would argue, is the first backbone intent in the article I will be summarizing below: Freud/Reich/Lowen were actually right about vaginal orgasms reflecting female maturity! The second backbone intent takes it all a bit further to prove, as Lowen's bioenergetic analysis would tell us, a mental problem (immaturity) manifests itself in us as a physical problem...often tension or 'muscle blocks.'

So, put those together, and we get why the fuck someone (Brody) would even care to study whether a woman's history of vaginal orgasm is discernible from her walk...because immature clitorally orgasming women probably have tension and muscle blocks, and they won't have that swaaang in their walk like the mature vaginal orgasmers...and this article will prove this and Freud and bioenergetics were right all along!!!!!!


What annoys me? Let me count the things.
  1. So, the premise here in itself is annoying to me. Freud just made shit up. Just. made. shit. up. There's been decades since then that have shown us he was pretty off base - particularly about female orgasm. Why are people still acting like what he says is worth further scientific investigation?
  2. The fact that in this study, and in every other study, Brody and his cohorts assume vaginal orgasms are a verified and scientifically understood entity and that the women in their studies who say they orgasm vaginally are actually orgasming vaginally shows ignorance of the existing scientific data and bad experimental design - and is annoying to me. 
  3. That this study bases its data on how some 'experts' visually rate women's body movement instead of using technology to actually take measurements of things like women's hip rotation is lazy and possibly extremely biased - and is also annoying to me. 
  4. Maybe the most annoying thing is that this shit is somehow legitimate lady-gasm science. This article's in a respected peer reviewed journal - a lot of his studies are. Brody is legit. He doesn't seem to be an outcast from the mainstream lady-gasm researchers (although he does have critics- thank you Prause and others, he's still getting his work into mainstream journals). He teams up occasionally with some of the most well known scientists in female orgasm research (Komisaruk for example) and gets included in major journal expert reviews on the topic of vaginal orgasm. This article has also been referenced a fair amount in pop culture. It was even used in a quite popular book Vagina by Naomi Wolfe to emphasize the importance of and help prove the existence of vaginal orgasms.  

More proof of Lowen/Bioenergetic asshole-ery
Before we begin the summary, I'd first like to show you I'm not completely making assumptions about how deep into the vaginal-orgasms-are-real-things-and-also-the-best-things agenda this article, this author, and Lowen/bioenergetics has. Below is a quote from a book written by Lowen (the father of Bioenergetic Analysis). This book is cited in this here article I am about to summarize. I repeat. This is not from this Brody article, but from a book that is referenced in this Brody article.
Most men feel that the need to bring a woman to climax through clitoral stimulation is a burden. If it is done before intercourse but after the man is excited and ready to penetrate, it imposes a restraint upon his natural desire for closeness and intimacy. Not only does he lose some of his excitation through this delay, but the subsequent act of coitus is deprived of its mutual quality. Clitoral stimulation during the act of intercourse may help the woman to reach a climax but it distracts the man from the perception of his genital sensation and greatly interferes with the pelvic movements upon which his own feeling of satisfaction depends. The need to bring a woman to climax through clitoral stimulation after the act of intercourse has been completed and the man has reached his climax is burdensome since it prevents him from enjoying the relaxation and peace which are the rewards of sexuality. Most men to whom I have spoken who engage in this practice resented it.    
I do not mean to condemn the practice of clitoral stimulation if a woman finds that this is the way she can obtain a sexual release. Above all she should not feel guilty about using this procedure. However, I advice my patients against this practice since it focuses feelings on the clitoris and prevents the vaginal response. It is not a fully satisfactory experience and cannot be considered the equivalent of a vaginal orgasm.  
-Lowen, A. Love and Orgasm: A Revolutionary Guide to Sexual Fulfillment. New York, Collier Books, 1975. pp.216-217.

THE ARTICLE SUMMARY
So, that's the point from which I'm starting this summary, but I'd like to let you see for yourself. I will summarize below as straightforward as I can - just as I always try to do, and I will only add in my thoughts or opinions in the me brackets "[Me:]" So, please enjoy,

Summary quick-style
This article is actually quite simple. 16 women take a survey with a question about how often they reach vaginal orgasm. 8 said they vaginally orgasm always or usually and another 8 say they vaginally orgasm rarely or never. The ladies then meet the researchers outside and walk for 100 meters while thinking of something nice, and another 100 meters while thinking of a man they are interested in romantically. They are taped from a distance doing this, and then 4 people, "two appropriately trained (in Functional-Sexological therapy) professors of sexology...and two female research assistants" watch the tapes and come to a consensus on whether or not each woman has had vaginal orgasms or not. "The basis for judgment was a global impression of the woman's free, fluid, energetic, sensual manner of walking (with an emphasis on energy flow through the rotation of the pelvis and the spine)."

The raters made a correct assessment for 6 of the 7 women who claimed vaginal orgasm and 7 of the 9 women who claimed not to have vaginal orgasms.

Introduction
I'm going to go over some main points the authors put forth in the introduction with a quick discussion of the studies they cited to support their statements;

This article begins with, "A growing corpus of empirical research has clarified that orgasm triggered by stimulation of the vagina and cervix differs physiologically from climax induced by clitoral stimulation." This is backed up by citations for 2 Komisaruk studies about women with spinal cord injuries having 'cervical orgasms' that are facilitated by the vagus and not the pudendal nerve and also by Brody's own studies about vaginal orgasms being associated with less use of immature psychological defense mechanisms and about there being more prolactin hormone releases after p-in-v intercourse vs. after masturbation.
[Me: Not one of these studies actually verifies that the women who claim vaginal orgasm are having an orgasm, so they're, let's say, not all that convincing. Also, the 'cervical orgasms' in the Komisaruk studies are not only never physically verified as orgasms, but furthermore they are strangely 'achieved' by a method of cervical stimulation that is not something one could do at home or even with a penis during intercourse. These Komisaruk studies referenced here are cited in pretty much any study talking about vaginal orgasms, but are rarely cited, in my opinion, in a way that could actually back up what the authors presume to back up. I detail the main Komisaruk study HERE].

"At a more speculative, theoretical level, the idea that chronic muscle blocks (or excessive muscle flaccidity) impair sexual function by impairing feeling, sexual motility (and perhaps being a tangible representation of corresponding  psychological blocks), and the discharge of sexual tension has it's roots in a theory developed by Reich [11]. His student Lowen [12,13] developed that theory (and safely distanced it from one of Reich's less well reasoned theories later in his life) and the corresponding psychotherapeutic approach of  bioenergetics, which sought to integrate psychoanalytic psychotherapy approaches with direct liberation of chronic muscle blocks. Other body therapies focus more exclusively on the muscle blocks alone. These body therapies and the underlying theory have rarely been subject to empirical evaluation."
[Me: The citations [11-13] are Reich and Lowen's philosophical work including the book by Lowen that I quoted above.].

"However, one study of men found that the Rolfing method of tissue manipulation led to both a decrease in standing pelvic tilt angle and an increase in cardiac vagus nerve tone associated with improved parasympathetic function [14]." [Me: Maybe check out the Wikipedia on Rolfing HERE] There is then a quick discussion of a few more studies, including one that these authors admit does not have clear controls, that relate physical therapy to improved sexuality. The articles cited in this section are pictured below.



"Observation of the characteristics of a person's walk can convey diagnostic information beyond the obvious musculoskeletal an neurological disorders" It goes on to point towards a few studies (pictures below) that illustrate the point.





The Introduction ends with: "The primary hypothesis in the present study is that clinical sexologists appropriately trained in the relationship between personality, sexology, and body movement will be able to differentiate between women with and without a history of vaginal orgasm purely on the basis of observing the women walking. As an exploratory measure, there is also an examination of the association of vaginal orgasm history with specified components of the walk (described below)."

[Me: The introduction of a scientific article, in my opinion, is meant for a few things. It orients the reader to the history of research on the subject thus far. It also sorta justifies why this the experiment being undertaken is a worthwhile experiment and what the outcome of this experiment might mean to the science of this subject. So in many ways, the introduction is an incredibly important thing to read because it gives you a look into the authors' mind. It exposes biases that aren't usually discussed as biases.]

[Me cont: So, to put this in perspective, let me piece together what the authors of this article are trying to do here. They are linking together 1. the Freudian/Reich/Lowen assumption that vaginal orgasm are better for women in the mind, body, and soul. 2. The idea in bioenergetics that psychological/emotional problems manifest themselves in the body, i.e. 'chronic muscle blocks' and 'excessive muscle flaccidity'  and 3. that if a woman were to have these psychological/emotional problems manifest in their body, one might be able to see it in her movement. So, in essence, the authors are going from the hypothesis that vaginally orgasming women are mentally/emotionally/physically  healthier people who will express that health in their energetic movement. Women who do not orgasm vaginally are less mentally/emotionally/physically who will express that unhealthiness in their bad, unenergetic movement.]


Materials and Methods
  • Female psychology students in Belgium were asked (by a female researcher) to answer a preliminary questionnaire on sexual behavior.
  • Of the women who did the questionnaire and who indicated their willingness to be contacted further, 10 were chosen who responded that they 'always"'or 'often' had vaginal orgasms (vaginally orgasmic) and 10 were chosen who responded that they 'rarely' or 'never' had vaginal orgasms (vaginally anorgasmic). Vaginal orgasms being defined as "triggered solely by penile-vaginal penetration." [Me: Are women who 'rarely' have vaginal orgasms the same as women who 'never' have them? I mean, I'm obviously skeptical of all these answers, given that their ability to have vaginal orgasms is not physically verified (and vaginal orgasms themselves have never been physically verified), but even if one believed these women's answers to be completely true, wouldn't one wonder if they were grouped incorrectly? Maybe women who 'rarely' have them are physically capable of vaginal orgasm and the 'nevers' are not. So grouping them together would confuse the results. The authors don't discuss this as a possible problem. Experimental design, people.]
  • The women also reported their ability to have clitorally stimulated orgasms on the questionnaire
  • After anonymity and confidentiality were assured, the women were given a complete description of the study although participants "were blind to the experimental hypothesis." Written informed consent was obtained, and they were scheduled individually to meet the researchers in a public place
  • 4 participants (3 vaginally orgasmic and 1 vaginally anorgasmic) did not show up, making 16 total participants.
  • Participants were asked to walk 100 meters while "thinking pleasant thoughts of being on a vacation beach" and then another 100 meters while "being in the same local but with in the company of a man for whom they had thoughts of love."
  • These walks were filmed at a distance and the videotapes were then rated by "two appropriately trained (in Functional-Sexological therapy) professors of sexology...and two female research assistants." 
  • "The raters conferred and agreed on a vaginal orgasm status for each woman."  [Me: Why did they confer? Why not let them all rate separately and see if they match each other and match the women's self reports? Did they try it that way first but found it made the results messy as hell, so they had them confer and luckily got better, more positive results? It makes me wonder.]
  • "The basis for judgment was a global impression of the woman's free, fluid, energetic, sensual manner of walking (with an emphasis on energy flow through the rotation of the pelvis and the spine)."
  • The researchers all also rated each woman's walk (from 0-10) for the extent of their: hip adduction, hip rotation, stride length, arm movement, and fluidity of movement. [Me: this was made in 2008. It was very possible at that time to use video of women walking to not just visually rate these things, but to do actual objective measurements of things like stride length and arm movement. Since the authors are trying to create evidence that the psychological problems from not orgasming vaginally can literally manifest physically as muscle tension and 'blocks' that make the women walk less 'fluidly,' you would think it useful to show that there are real objectively measured limitations in these non-vaginally orgasming women's movement. Yet, all the ratings on the movements are just, like, the rater's opinions, man. I mean, I'd at least like to see the authors acknowledge their choice and give a quick explanation for why they chose to have only subjective ratings of these women's movements. And, in case you are wondering if 2008 was too early for people to be thinking about the technology to do objective measuring from video and the pros and cons of rating movement that way, you're wrong. Here's a 2007 textbook dedicated to analyzing human movement patterns in relation to sports biomechanics.]
  • "An additional derived variable reflecting the movement of the leg through the back (sum of ratings of stride length and vertebral rotation) was calculated."
  • The correlation between women's reported experience of vaginal orgasm and the researchers' guesses of vaginal orgasm was examined using "chi-square and Fisher's exact tests (a similar analysis was performed for clitoral orgasm history)" 
  • The associations between the researchers ratings of the individual components of a woman's walk and her history of vaginal orgasm were examined.

Results
  • "The hypothesis was supported, because the trained sexologists were able to infer vaginal orgasm history on the basis of watching the women's walk."
  • "Reported clitoral orgasm ability was unrelated to both rated vaginal orgasm ability and to reported vaginal ability."
  • The only statistically significant correlation found between history of vaginal orgasm and any of the ratings of individual components of the women's walks were from the data points made from the sum of stride length and vertebral rotation. [Me: it seems a little fishy to me that this combination was the only element of the researchers' individual movement ratings to show correlation with the women's reported vag-gasm history. What actual meaning does that combo number have in the end? Clearly none of the straight-forward movement ratings such as stride length or hip rotation correlated, and it makes me wonder if that lack of correlation led them to start combining the ratings in every possible way until they found one that happened to have a statistical correlation with the vaginal orgasm self-reports. They call it exploratory, so I imagine this is close to the case. that kind of thing is probably not an uncommon practice and not really unethical or wrong, but it sure seems like it's sort of a disingenuous way to make a study show more positive results. To their credit I will say that when they spoke of this correlation in the Discussion section. They said "However, the exploratory nature of the secondary finding implies that less emphasis be placed upon it pending appropriate replication."  So, I think even the researchers don't place much meaning on this combo rating of stride length and vertebral rotation.]
  • "Age was unrelated to the sexual variables."

Discussion
  • "Appropriately trained sexologists were able to infer vaginal orgasm history on the basis of watching women walk. The sexologists made global inferences about the women's vaginal orgasm history based on the extent to which the women had a fluid, sensual, energetic, free gait. The ratings were unrelated to the women's reports of clitoral orgasm with a partner, and clitoral orgasm was unrelated to vaginal orgasm."
  • 6 women who claimed to be vaginal orgasmers were rated correctly, and 1 was rated incorrectly.
  • 7 women who claimed not to be vaginal orgasmers were rated correctly and 2 were rated incorrectly.



  • "Although the couple of incorrect diagnoses could simply be that, it is also possible that in the case of the two false positives, it might be that the women have the capacity for vaginal orgasm, but have not yet had sufficient experience or met a man of sufficient quality to induce vaginal orgasm." [Me: I'm assuming the 2 women who were rated incorrectly as vaginally orgasming are not ones who marked themselves as 'rarely' vaginally orgasming (since clearly they DO have a capacity for it), because if that were the case, I feel REAL confident the authors would have been real quick to tell us that and make their results look even better.]
  • The study goes on to say that these women who were pinned by the researchers as vaginal orgasmers but were not, may not have a man with a '"penis of sufficient length to produce cervical buffeting" or that isn't able to keep his erection (either because of erectile dysfunction of premature ejaculation) long enough. They also note the there are studies saying women are most likely to have vaginal orgasms with men who have signs of greater fitness - like attractiveness. [Me: Can I just quickly mention that 'buffeting' can be defined as 'to strike against forcefully and especially repeatedly; batter.' So cervical buffeting with a big ol' dick sounds to me not like a good way to bring about lady-gasms as these researchers seem to say it is, but like a terribly painful sexual encounter akin to a really long and brutal gynecological exam. This banging the cervix for orgasm thing seems kinda out of touch with reality to me, and it's also not backed up in scientific literature, and contrary to what this article would have one believe, it's certainly not backed by the Komisaruk article they cite here. They cite the same Komisaruk article they cite and I discuss in the Introduction that finds women with spinal cord injuries can orgasm from cervical stimulation, but the conclusion is a stretch of the evidence at best (I detail it here). And seriously, this study does not include buffeting the cervix. It actually uses a make-shift thing that does not actually touch the cervix but creates a suctiony stimulation at the cervix, so even if this study did find that orgasms were created from this stimulation (which it doesn't in any verified physical way), it would not be something that could be replicated by ramming a big dick into a woman's cervix. This is the only study I know of (and there are no others referenced) that can support the idea of women needing cervical stimulation or  'buffeting' to orgasm... and it's not a great one.]
  • They point out that "as in any correlational study, a universe of possible unmeasured forces could play a role in the observed findings." They mention that maybe some anatomical features could predispose women to less readiness for vaginal orgasm, and specifically use a recent study correlating more distance between the vagina and urethra to women who claim vaginal orgasm [Me: you can see more on that study HERE. Surprise surprise, there are no actual vaginal orgasms verified in this research, so one should be skeptical of its conclusions] "such characteristics might conceivably influence both vaginal orgasm and pelvic movement directly, whether they are a true precursor of vagina orgasm, or develop as a consequence of developing vaginal orgasm." 
  • They also mention that it might be that women who orgasm vaginally might feel more confident or comfortable or have a better relationship and it shows in their walk. [Me: Ooooorrrrrr...maybe being vaginally orgasmic is a thing women covet because of how much women in movies and porn and books are able to do so, and how much it seems that men like it (remember: stimulating the clit is pretty inconvenient and men resent doing it according to Lowen up there), so after saying they can do that on a survey, those women feel all good about themselves, but the women who just had to admit that they are lame and can't orgasm vaginally on a survey feel, well, lame. Ooooooorrrrr...there were only 16 women in the study, and the raters only got about 82% right, so it might be the luck of the draw and their walks are not really different between groups at all.]
  • They point out this was a small convenience sample of volunteers so that may "limit the generalizability of these results to older women and to the wider community"
  • "The present finding of vaginal orgasm being associated with a more fluid, sensual, energetic, free, unblocked gait adds to the empirical research findings of penis-vaginal orgasm history being specifically associated with the indices of women's better psychological and interpersonal function." 
  • They mention that a recent study [their own previous study] associated women who could orgasm vaginally with having less use of immature psychological defense mechanisms - and say that "Two of the specific immature defense mechanisms (somatization and dissociation) that differentiated vaginally orgasmic and vaginally anorgasmic women might be related to aspects of the present finding. Dissociation involves disconnection of the usually integrated psychological (including sensory-motor) functions of the self, and somatizations involves converting psychological problems into physical complaints and impairments." 

Conclusion
The authors say that even with the small sample, the results are consistent with both theory [Me: made-up Freudian and neo-freudian theory?] and previous empirical findings about vaginally orgasming women having better psychological function. [Me: Let it be known the 'previous empirical findings' they cited were all Brody's own previous studies - 4 of them were cited]
They also say the present findings provide some potential support for "theoretical assumptions of a link between muscle blocks and impairment of sexual and character function" [Me: this is cited with 3 works by the neo-Freudians Lowen and Reich - including the book by Lowen that I quote above.]
The authors also say the findings are "consistent with the possible utility of incorporating training in movement, breathing and muscle patterns into the treatment of sexual dysfunctions"

Appendix
*I want to give Dr. Nicole Prause a shout out for being a scientist in the lady-gasm field who speaks out in direct ways against those non-sense assumptions about vaginal orgasm. I talk more about here HERE.]

More Articles By Stuart Brody!
Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis. Brody S1, Weiss P.
J Sex Med. 2010 Aug;7(8):2774-81.

Slimmer women's waist is associated with better erectile function in men independent of age. Brody S1, Weiss P. Arch Sex Behav. 2013 Oct;42(7):1191-8.

Women's partnered orgasm consistency is associated with greater duration of penile-vaginal intercourse but not of foreplay. Weiss P1, Brody S. J Sex Med. 2009 Jan;6(1):135-41.

Simultaneous penile-vaginal intercourse orgasm is associated with satisfaction (sexual, life, partnership, and mental health). Brody S1, Weiss P. J Sex Med. 2011 Mar;8(3):734-41.

Condom use for penile-vaginal intercourse is associated with immature psychological defense mechanisms. Costa RM1, Brody S. J Sex Med. 2008 Nov;5(11):2522-32.

Immature defense mechanisms are associated with lesser vaginal orgasm consistency and greater alcohol consumption before sex. J Sex Med. 2010 Feb;7(2 Pt 1):775-86.

Vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip. Brody S1, Costa RM. J Sex Med. 2011 Oct;8(10):2793-9.

Greater tactile sensitivity and less use of immature psychological defense mechanisms predict women's penile-vaginal intercourse orgasm. Brody S1, Houde S, Hess U. J Sex Med. 2010 Sep;7(9):3057-65.

Vaginal orgasm is associated with less use of immature psychological defense mechanisms.Brody S1, Costa RM. J Sex Med. 2008 May;5(5):1167-76.

8.05.2015

Hey BBC - The Female Orgasm Is Actually Not A Mystery!



Those of you that have been reading this blog or have seen our movie, Science, Sex and the Ladiescould probably guess where my gripes with the BBC article, "The Mystery of the Female Orgasm." begin - THE FEMALE ORGASM IS NOT A MYSTERY.

Reading that article would lead one to believe that the lady-gasm is incredibly complicated to figure out in the ol' bedroom, that it revolves around the vagina, that science doesn't have a clue what it even is, and that only quite recently have scientists really begun to find any answers. All of that is utterly incorrect. The female orgasm is no more complicated than the male orgasm. It revolves around the external clitoral glans. Science has had this shit pretty solidly figured out since about 1966 - about as long as it's had the male orgasm figured out, and all of the exciting new studies in this article that are supposedly cracking this female-orgasm thing wide open: Well, actually they're better categorized as studies that focus on fringe ideas about female orgasm - speculating about ways of coming that have never been verified in scientific literature.

The 'orgasms' this article focuses on are G-spot orgasms, vaginal orgasm, and orgasm from inner clitoral leg or cervical stimulation. These are just things people talk about. There is no scientific proof that they exist. Seriously, an orgasm caused this way has never been observed or recorded in science, not even in the scientific research this BBC article references. In the same way, for men, spiritual orgasms, orgasms from anal sex, prostate stimulated orgasms, and mental orgasms are just things that people talk about. They are not actual orgasms well documented in scientific literature. The big difference here is that an article about male orgasm would treat these things as the  fringe hearsay that they are, and an article about the female orgasm treats these as what female orgasm is.

I honestly don't want to blame the author of this article or the BBC for this. It's bigger than them. This article flies because it is the status quo. It is what people understand about female orgasm. I will put a touch of blame on the scientists interviewed for this article. I know they have to at least be aware that vaginally induced orgasms have never been physically verified in science, and I know they know that their research does not prove this orgasm exists, but only speculates about how this orgasm might happen if it exists. And if they are not aware of this, may I be so bold as to say that they should probably become a bit more thoughtful about what exactly they are researching?

So, let me re-write this article for you:

Hi Everyone! BBC Future presents: The Female Orgasm - It Ain't Such a Mystery (my re-write)

Lady-gasms?!? What Are Them Things?
Orgasm is the rhythmic release of the pelvic muscle tension created during arousal, and it is caused by sufficient stimulation of the penis or the clitoral glans/vulva area. It's the same for all sexes, all genders, trans people, gay people, straight people, intersex people - you name em' if they got something that is like a penis or a clitoral glans, then it can be stimulated to orgasm. Males generally trigger ejaculation at orgasm, but orgasms and ejaculation are 2 different things and can be experienced separately. It is possible for men to have multiple orgasms if they are able to hold off ejaculation until they orgasm a couple times, although it doesn't seem to be common. They are also able to ejaculate w/o orgasm, sometimes due to prostate (G-spot) stimulation through the anus. It seems some women can ejaculate through direct stimulation of their G-spot, which is the sorta female version of the male prostate that surrounds the urethra that can be felt through the vaginal wall. Although this doesn't seem to be super common either - and it has never been shown to cause an orgasm. Add in some clitoral stimulation, though, with the G-spot stimulation and a woman might be able to orgasm and ejaculate at the same time. Although it is possible for both men and women to ejaculate, it is the orgasm that is that release of muscle tension pent up through arousal.

Now, let's go back a bit. A person first needs to be aroused before he or she can orgasm. Any ol' stimulus can arouse; smell, touch, sound, sight. It's incredibly individual and has everything to do with a person's culture, past experiences, and state of mind (I'd argue our culture creates a lot more barriers to female arousal than to male), but once the arousal happens, our bodies all react quite similarly. An increase of blood flow begins to makes the penis hard and lubrication seep through the walls of the vagina and for the inner clitoral legs swell. Ladies and gentlemen both have a similar amount of blood pooling in the groin. We just see men's more easily. Then if arousal is continued and if there is appropriate stimulation to either the penis or the clitoral glans, an orgasm will occur. The pelvic muscle of men and women alike will rhythmically release that tension. It is recordable, predictable, and no knowledgeable researcher out there would deny that this can be described as an orgasm.

What About Vaginal Orgasms?!?
There is a minority of women who claim to orgasm from vaginal stimulation alone. Although women's claims should never be disregarded, it is important to realize that this type of orgasm has never actually been observed and recorded in scientific literature, and it's possible that at least some of these claims involve the use of the word 'orgasm' to mean something other than the physical orgasm that can be identified through rhythmic pelvic muscular activity. It's actually possible that an orgasm caused only by stimulation inside the vagina is merely a myth made up by Freud. As some Italian researchers pointed out just this year as part of their criticism of the re-naming of female genitals and female sexual response happening in a lot of recent research on female sexual response, "(Komisaruk) ignores the fact that 'vaginal orgasm' has no scientific basis; the term was invented by Freud in 1905, and medical authorities writing in French, German, and English during Freud's time were unanimous in holding that female pleasure originated in the structures of the vulva generally and in the clitoris specifically. No alternative sites were proposed."  (Puppo 291)

In fact, in 1966 researchers Masters and Johnson released Human Sexual Response, a large, groundbreaking study that described arousal and orgasm in both men and women. Their findings are still important and relevant, and they unequivocally said that all female orgasms resulted from stimulation of the clitoral glans, laying to rest Freud's vaginal orgasm. Since the time Masters and Johnson released their work, there have been over 40 year of studies investigating what might cause a vaginal orgasm, but not a one of those studies has actually documented a vaginal orgasm. That's a lot of years that have gone by with absolutely no proof, and it's not particularly hard to get the proof. Recording the rhythmic pelvic muscle activity during orgasm is completely possible to do. It's probably even easier to do now than it was in M&J's time. Studies have done it plenty of times, further corroborating Master and Johnson's findings. Strange that this has not happened for vaginally stimulated orgasm. If these orgasms do exist, they are yet undocumented, and likely even less common than we now believe them to be - certainly a fringe situation.

My Critique From The Beginning of the BBC Article to End

The article begins with anecdotes and metaphors creating a sentiment that can basically be summed up by the picture below.


Then, the article tells us "It's a stark contrast to a man's experience; so long as they can get an erection, a few minutes of vigorous stimulation generally results in ejaculation."

Okay,
1. An erection means a man is aroused, and similarly, as long a woman can get aroused, she too needs only a few minutes of vigorous stimulation in order to come. (Seriously, women can masturbate to orgasm about as fast as men do.)
 2. Ejaculation and orgasm are different things, remember. Since this is an article about orgasm, I think the author probably should have used the word orgasm instead of ejaculation.

So, clearly the article is coming from the premise that lady-gasms are confusing, but it tells us, "recent years have seen a flurry of studies by these real-life Masters of Sex, and they are finally getting some answers."

This is particularly funny to me because these 'real-life Masters of Sex' the article refers to are the scientists interviewed for this article, and they are all working on fringe ideas of female orgasm. The article completely ignores the work of the actual real-life Masters of Sex, Masters and Johnson. These are the people who did the work to actually understand female (and male) orgasm. These are the researchers who lifted the mystery from lady-gasms, but clearly, even with a Showtime series about them, their contribution has gotten overshadowed, skewed, and ignored over the years. It absolutely boggles my mind that an article about the female orgasm from a revered news site like the BBC doesn't even mention Masters and Johnson or their discoveries. It is an appalling oversight, but it is also completely unsurprising and indicative of how far from reality the cultural discussion of female orgasm is, and how few people seem to notice.

After informing us that scientists are just now doing studies that begin to answer these long held secrets of the female orgasm and that fMRI studies basically show that male and female brains are similar during orgasm. (Here's a good 2011 overview of the fMRI research on arousal and orgasm to date btw. It's the full text article - not just the abstract!)
Then things get a little dicey again. We are told that pinning down the anatomy of an orgasm is hard because, "the penis has just one route for carrying sensations to the brain, the female genital tract has three or four."

A point about female orgasmic pathways being more complicated than male orgasmic pathways is being made here, but it's comparing apples to oranges. The penis is the male organ of sexual pleasure and the 'female genital tract' is the clitoris (the female organ of sexual pleasure), plus the vagina, the cervix and uterus, hell they're probably throwing the urethra in too. So, yeah, obviously the female genital tract will have more routes for carrying sensation to the brain than just the penis. However, if we compare the two organs that are able to be stimulated to orgasm, the clitoris/vuvla area and the penis, they both have one route, the pudendal nerve. The pelvic nerve, for instance, does involve itself with inside the vagina and cervix, but for men it is involved with erection and the rectum, so the male genital tracts has more than one route too, but that doesn't mean there are more ways for males to orgasm.

Here's the 1 external clitoral glans portion of the article. Although it is introduced as the "seat of female pleasure," it is only really discussed as one of many instead of the organ of sexual pleasure (the way an article might discuss the penis and male orgasm). There is no discussion about the scientific research that cemented its place, alongside the penis, as where orgasms arise. There is just a brief discussion of when the clit was acknowledged through history, ending with Freud's assessment that orgasm from clitoral stimulation is inferior to vaginal orgasm. The article then tells us, "Between thirty and forty percent of women claim never to have experienced an orgasm through vaginal penetration alone - though many more can have orgasms through clitoral stimulation. The suggestion that the vaginal orgasm is somehow superior has irked feminists. It sounds as if women who don't experience vaginal orgasm just aren't trying hard enough. So should vaginal orgasms be a rite of passage for all women, or just a privileged few? Is it even possible to have an orgasm in the absence of the clitoris?"After that, the article moves directly into discussing orgasm in relation to vaginal penetration. 

There's a few things about this section that bother me. I understand that there was an attempt here to give a nod to the clit and to question the idea that vaginal orgasms are more mature, but I think as a whole, it fails to do that, and possibly gives even more credibility to Freud's backward ideas about vaginal orgasm.

1. The stat here put the amount of women who have vaginally orgasmed at around 60-70%. I don't know where in particular that stat's from, but it's high. I understand how stats can range on this topic because depending on how specific the survey question is about whether additional clitoral stimulation is used during intercourse, the numbers vary (The Case of the Female Orgasm: Bias in the Science of Evolution has a fantastic overview of lots of surveys on this), but the numbers I normally see are only about 30% of women claim to orgasm with only vaginal stimulation.

2. This might be just me being obsessive, but contrasting the stats for vaginal orgasm versus the "many more" that can have orgasms through clitoral stimulation makes it seem like an either/or situation, as if there are some women who are 'wired differently' and have the ability to orgasm through vaginal stimulation but not clitoral and vice versa (and some who can do both). The truth is that there is every indication that all healthy women can orgasm from clitoral glans stimulation, and there is no indication that there are other women who are 'wired' to orgasm vaginally.

3. Why are we still even approaching Freud and his ideas on lady-gasms as worthwhile? He literally just made up that shit. Asking if vaginal orgasms should be a rite of passage or for only a privileged few validates not only that vaginal orgasms are a thing, but that they are something special that should be envied.

4. Saying feminists were 'irked' by the idea of vaginal orgasms being superior sounds trivial, minimizing the egregious nature of Freud's assertions and how ridiculous and harmful they were. The inability to have vaginal orgasms classified women as psychologically damaged by the established medical community up into the 1970's. Feminists in the 70's and 80's were outspoken about this, not just because it 'irked' their feminist sensibilities, but because they were on the side of science. The first actual large scale studies about female orgasm had come out and shown quite clearly that vaginal orgasm was not even a thing, much less some kind of superior thing. They were looking at female orgasm from the perspective of scientific knowledge and what they saw was women being punished for the inability to do something that their bodies actually couldn't do.

The article goes right into research by Barry Komisaruk. He and Beverly Whipple did a study in which women with spinal cord injuries that severed the ability for clit stimulation to get to the brain, were still able to orgasm through vaginal stimulation - likely due to the Vagus nerves that carry sensation from the cervix to the brain without using the spinal cord. Komisaruk thinks maybe this is why women describe clitoral orgasms as more localized and external and vaginal orgasms as more whole-body and internal. He also says of this study, "Women with spinal cord injury who could not feel their clitoris, nevertheless had orgasms from vaginal stimulation. That's probably the best evidence that vaginal orgasms exist."

If this is the best evidence for vaginal orgasm, then things don't look good for the vaginal orgasm. First off, as with all vag-gasm studies, the women merely said they had an orgasm. It was not physically verified. It's just that 3 of the 5 women in this study claimed to orgasm and were taken at their word. Maybe they did, maybe they didn't, but since this is a scientific investigations, and as of yet no orgasm like the one they are claiming to have has ever been observed, it really does need to be verified.
Secondly, nonchalantly calling the stimulation these 5 women were receiving 'vaginal stimulation' is rather misleading. That makes it sound like it was just some in-out of the vagina with a dildo or something, but in fact it was a very specific type of cervical stimulation that involves a pessary, which is kinda like a hard cervical ring that had to be professionally fitted to each woman individually. The pessary has Velcro on it, and a device that ends with a modified tampon with Velcro on the end is inserted in and attached to the Velcro on the pessary. It is controlled by the patient and sort of puts suction-y pressure on the cervix (without really touching the cervix - cause that can hurt like a bitch, right?). It’s not your average vaginal stimulation, so even if this contraption did cause a verifiable physical orgasm in these 3 women with spinal cord injuries, it's not exactly the kind of stimulation that's easily replicated at home.
I go into more detail about this study HERE.

Never the less, that study, which certainly does not prove women can orgasm from vaginal stimulation is deemed sufficient enough for the article to state the following. "So if different nerves can carry sensation from different regions of the female genitalia - and both can trigger orgasm - are some regions of the vagina more sensitive than others? Where should couples go hunting for the elusive vaginal orgasm?"

And the article is still stuck on the false premise that vaginal orgasms are a proven reality.

I described above that stimulation of the G-spot, or more clearly stated - the female prostate, has been shown to cause ejaculation, but not orgasm, in women. However, that distinction is often lost, and the 'G-spot' becomes a way to describe something that doesn't exist - a button in the vagina that causes orgasm. That is where this article ends up in the section on the G-spot. It first describes that studies have shown the G-spot is a bundles of nerves, blood vessels, and remnants of the prostate gland, and then it goes on to say that a minority of women could stimulate it to trigger, "powerful orgasms and the release of a small amount of fluid from the urethra that was not urine," but admits that actual evidence to support or refute the G-spot is patchy.

Of course the evidence for the G-spot is spotty because the word 'G-spot' is sometimes used to mean the female prostate area and sometimes used to mean a mystical orgasm button in your vag. Although there is plenty more research that should go into ejaculation and the female prostate, it's largely evident that there is a prostate-like area around the urethra in women that can be felt through the vaginal wall and that some women can ejaculate when it's stimulated. There is no evidence, however, that stimulation to anything in the vagina, much less the prostate-like area, can cause orgasm. One way of speaking about the G-spot is backed by evidence and the other is not, but in both research and common language it's confused, and so yeah, it makes the research look spotty.

The article next moves to a study with 20 women by a researcher named Jannini that showed there does,"seem to be physical differences between women who claim to experience vaginal orgasm and those who don't." A thicker area of tissue between the vagina and the urethra correlates with women who orgasm vaginally.

It's true. That is what the study finds, but it must be noted that per usual there is no proof that the women who say they can orgasm vaginally can actually do that. I know I harp on this, but the word orgasm, when it comes to women, is used so loosely, and the cultural assumptions about it are so confusing that it is not unreasonable to think that there may be a woman or two out there who says, and maybe even believes, that she orgasms from vaginal stimulation only, but she actually does not. Maybe she just has a psychological or spiritual 'climax.' Maybe she ejaculated. These things might feel pleasurable or satisfying but if she does not exhibit the release of pelvic muscle tension known to indicate orgasm, then scientifically, it should not be categorized as an orgasm. If even 1 of the women in this study were using the word orgasm incorrectly, then that would make a huge difference to the results of a 20 person study like this. Also, even if it were verified that the claims of vaginal orgasm were true, there is no proof that the thickness differences have anything to do with the ability to orgasm this way. It's merely a correlation. In the end this study says nothing about if or how women orgasm vaginally. It is at best merely a starting point for further investigation. I go into more detail about this study HERE.

Jannini conducted another study on 3 women where ultrasound was used to find that moving a lubricated tampon in and out of the vagina shifted both the internal parts of the clit and the tissue around the urethra. When the women just rubbed their external clit, just the external parts of the clit shifted. The article uses this to back up the idea that the inner clitoral legs, stimulated through the vaginal wall, might be the way vaginally stimulated orgasms happen.

Maybe. Or maybe not. No orgasms were observed in this study. This, like the last study, can only really be viewed as a starting point. If vaginal orgasms happen, then this article might be a starting point for investigating the mechanism for how they happen. That's about as much as can be taken from it. I go into more detail about this study HERE.

Pauls, another researcher, did a case study about a woman with incredibly unique genital structure that included a clit positioned closer to the vaginal opening than normal. She claimed to vaginally orgasm every time she had sex (although it was never physically verified that she was able to do this). (I go into detail about that study HERE). The article wondered if this indicated that vaginal penetration may be "stimulating both the external and internal parts of the clitoris." Pauls and her colleagues wondered about this too, and created a study to see if the size and location of the clit made a difference in ability to orgasm. With MRI measurements, the researchers found that for the 30 subjects, "the smaller the pea-shaped glans, and the further from the vagina, the harder they found it to achieve orgasm."

That was the conclusion that came from the study, but I don't think that conclusion is reasonably supported by this study. Out of the ~ 23 measurements of the clit size and distance, only 5 actually show significant differences between the groups. In fact, the clitoral glans area that the authors put forth as a significant difference between the two groups of women is only significant when they measured it from the coronal, but not the sagittal view. Unfortunately, this study also failed at asking the participants the proper questions so that they could be grouped in a way that would create meaning when compared to the clitoral measurements. Statistics are only as good as the understanding that exists of the population it is describing, and I don't think the understanding was good at all. I go into more detail on this study HERE.

"Taken together, these studies imply that there are multiple routes by which women can experience an orgasm, be it through vaginal stimulation, clitoral stimulation, or both at once. "

Or not. These studies taken together show that the vaginally stimulated orgasm has still not been observed, and although there are lots of theories, just as there has been for the past 40 years, as to how this type of orgasm might occur, none are conclusive...particularly because it's awful hard to prove the mechanism that causes vaginally stimulated orgasms, when a vaginally stimulated orgasm has never been observed. Maybe, just maybe, these types of 'orgasms' are so mysterious because they don't really exist, and so investigating them would naturally be tricky.

Komisaruk chimes in a final time in reference to a study he did revealing that, "projections from different regions of the female genitals - and indeed the nipples - all converge on the same general region of the brain, albeit in slightly different areas." (I go into more detail about that study HERE). He says, "There's a good neuroanatomical basis for different types of orgasms and different types of sensations." He goes on to say, "This could account for why combining clitoral, vaginal, and cervical stimulation seems to produce these more intense, complex and pleasurable orgasms that women describe." 

I'll just leave it at this. No, there is actually not good evidence for different types of orgasms. Different types of sensations? Sure. Moving a penis in and out of the vagina feels different than lightly touching the vulva, feels different that sucking on the nipple, and feels different than kissing the back of the neck. I personally like them all, but that doesn't mean they all can cause orgasm. Also, I'd like to know more about these more intense, complex and pleasurable orgasms that women describe. When do they describe them? How are they more complex, intense and pleasurable? And how exactly did he find that these amazing orgasms were specifically related to a combination of cervical, vaginal, and clitoral stimulation?

The article ends with some advice from Pauls and Jannini. I particularly appreciate that Pauls tells us if we don't have orgasms through straight out vaginal penetration, then that's normal. She's absolutely right, but her one statement within an article that focuses almost entirely on vaginally stimulated orgasms is a beautifully perfect microcosm of our sexual culture. Sure we hear now and then that lots of women need clitoral stimulation to orgasm, but as a whole our culture obsesses on the completely un-verified vaginally stimulated orgasm to a point, I would argue, of absurdity.

I honestly don't want to hate on the author of this article. It was certainly not that she was ignorant or terrible at her job. The sources she used and the people she spoke to are top studies and top researchers in female orgasm. What she said in her article is not off-base from things other reporters and sexperts say. I critique this article, but it is more a critique of the sexual culture that stimulates this type of discussion around female orgasm and that allows this type of article to be published by the BBC and that makes audiences accept the misinformation so easily.

What I do want is to open eyes and start tough conversations, and I hope this critique helps to do that.

Extra Info
If you are unsure about my assertions that orgasm can be defined with the rhythmic pelvic muscle activity, or that the clitoris needs to be stimulated to cause orgasm, or that Masters and Johnson really did create important, fundamental and still relevant work in regards to human sexual response, then please check out a debate I had with Edward Clint at Skeptic Ink HERE. I address all those things in detail.

If you want to understand more clearly what I mean when I say vaginal stimulation has never been shown to cause orgasms. I detail that out HERE.

If you want to see more about the affects and reasons for this cultural misunderstanding of female orgasm - Watch Science, Sex and the Ladies HERE.

If you want to see an artist doing bold, important work on the ignorance about and cultural erasing of the clitoris (which goes hand in hand with the ignorance about and cultural erasing of a realistic female orgasm), check out 101 Laws of Cliteracy by Sophia Wallace.

Cited
"Relationships Among Cardiovascular, Muscular, and Oxytocin Responses During Human Sexual Activity" Carmichael, et al. Archives of Sexual Behavior Vol. 23, No. 1 1994

Response to the letter to the editor by Barry K. Komisaruk "re: Puppo V, Puppo G. 2014. Anatomy of sex: Revision of the new anatomical terms used for the clitoris and the female orgasm by sexologists". Puppo V1, Puppo G. Clin Anat. 2015 Apr;28(3):291-2. doi: 10.1002/ca.22500. Epub 2014 Dec 22.

"Relationships Among Cardiovascular, Muscular, and Oxytocin Responses During Human Sexual Activity" Carmichael, et al. Archives of Sexual Behavior Vol. 23, No. 1 1994

The Case of the Female Orgasm: Bias in the Science of Evolution. LLoyd, Elisabeth A.  Cambridge: Harvard University Press. 2005.

Women's clitoris, vagina, and cervix mapped on the sensory cortex: fMRI evidence. Komisaruk BR1, Wise N, Frangos E, Liu WC, Allen K, Brody S. J Sex Med. 2011 Oct;8(10):2822-30. doi: 10.1111/j.1743-6109.2011.02388.x. Epub 2011 Jul 28.

Clitoral size and location in relation to sexual function using pelvic MRI. Oakley SH1, Vaccaro CM, Crisp CC, Estanol MV, Fellner AN, Kleeman SD, Pauls RN. J Sex Med. 2014 Apr;11(4):1013-22. doi: 10.1111/jsm.12450. Epub 2014 Feb 13.

Sexual function in a woman with congenital bladder exstrophy and multiple pelvic reconstructive surgeries: a case report. Vaccaro CM1, Herfel C, Karram MM, Pauls RN. J Sex Med. 2011 Feb;8(2):617-21.

Pilot echographic study of the differences in clitoral involvement following clitoral or vaginal sexual stimulation. Buisson O1, Jannini EA. J Sex Med. 2013 Nov;10(11):2734-40.

"Measurement of the thickness of the urethrovaginal space in women with or without vaginal orgasm." Gravina GL, Brandetti F, Martini P, Carosa E, Di Stasi SM, Morano S, Lenzi A, Jannini EA. J Sex Med. 2008 Mar;5(3):610-8.

Female ejaculation orgasm vs. coital incontinence: a systematic review. Pastor Z. J Sex Med.2013 Jul;10(7):1682-91. 2013 May 1.

Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves. Komisaruk BR1, Whipple B, Crawford A, Liu WC, Kalnin A, Mosier K. Brain Res. 2004 Oct 22;1024(1-2):77-88.

Human Sexual Response. Masters, W. and V. Johnson. Little, Brown & Co. 1966.

7.31.2015

MRIs of Stimulation to the clitoris, Cervix, and Vagina - A Journal Article I Read



Yes, another Journal Article I Read. This one is pretty simple, really.

Women's clitoris, vagina, and cervix mapped on the sensory cortex: fMRI evidence. Komisaruk BR1, Wise N, Frangos E, Liu WC, Allen K, Brody S. J Sex Med. 2011 Oct;8(10):2822-30. doi: 10.1111/j.1743-6109.2011.02388.x. Epub 2011 Jul 28.

"The aim of this study was to map the sensory cortical fields of the clitoris, vagina, cervix, and nipple toward an elucidation of the neural systems underlying sexual response." Basically, they used fMRI to investigate what parts of the brain received increased blood flow (which assumes neurons in that part of the brain are getting activated) when the cervix, vagina, clitoris, and nipples were being stimulated. All this in an effort to better understand sexual response.

The verdict? "As seen in the present findings, using fMRI, in which the women applied clitoral, vagina, or uterine cervical self-stimulation, there is clear evidence of activation in the medial region of the paracentral lobule, in the sensory genital region of the homuncular map of Penfield and Rasmussen. In addition, there is an occasional secondary activation in the dorsolateral paracentral loule, indicative of groin stimulation."


Background

  • "The original map of the representation of the genitals in the sensory cortex in humans was generated by applying roving electrical stimulation to the brain in awake men, and asking the men from which part of the body the stimulation seemed to emanate" It was mapped to the medial cortex.
  • The medial cortex was associated to the penis in a couple more studies, and it was assumed, given some indirect evidence, that this is the same area that would be associated to the clitoris
  • However, more recent PET and fMRI studies associated the penis to "a more dorsolateral portion of the paracentral lobule rather than its medial region." The studies include one in which the researcher stimulated the penis with a toothbrush while recording fMRI, one in which the subjects partner manually stimulated the penis while recording PET, and one in response to electrical stimulation of the penis.
  • This discrepancy about where penis stimulation is associated in the brain (more dorsolateral or more medial) is not fully understood or rectified.
  • Recently PET and MRI studies associated the clitoris to the dorsolateral rather than the medial region of the paracentral lobule - matching the more modern penis studies. The studies include one in which the subjects partner manually stimulated the clitoris while recording PET, and one using fMRI recordings are taken in response to electrical stimulation of the clitoris.
  • To the researcher's knowledge, an investigation of where stimulation of the vagina and cervix projects onto the human brain has not been done until now.

The Experiment
  • 11 women were recruited by word-of mouth. They were healthy, right-handed, 23-56 years old, and not pregnant. They were also pre-screened with the Symptoms Checklist-90-R questionnaire to "rule out any psychological contraindications."
  • Their heads were stabilize with individually fitted frames to limit head motion while fMRI was being recorded.
  • The trials for each body part were 5 minutes long with 5 repeated sequences of 30 seconds of rest followed by 30 seconds of stimulation. The subjects wore headphones through which the researchers would give them instructions.
The Stimulation
  • "Control trials consisted of an experimenter rhythmically tapping a participant's thumb or toe in separate trials to establish reference points on the sensory cortex."
  • "Experimental mapping trials consisted of participants self-stimulating, by hand or personal device, using 'comfortable' intensity, the clitoris, anterior wall of the vagina, the cervix, or the nipple in separate, randomized-sequence trials."
  • "Clitoral self-stimulation was applied using rhythmic tapping with the right hand."
  • "Vaginal self-stimulation (of the anterior wall) was applied using the participants own stimulator (typically a 15 mm-diameter S-shaped acrylic rounded-top cylinder)."
  • "Cervical self-stimulation was applied using a similar diameter, glass or acrylic straight, rounded-tip cylinder brought to the study by each participant."
  • "Nipple self-stimulation was applied using the right hand to tap the left nipple rhythmically."
The fMRI
  • During each 5-minute sensory session, 150 image sets of 32 slices per Repetition Time were obtained. (If you want more details about the fMRI situation, put it in the comments, and I'll update).
  • "Group maps" were created for each anatomical trial. It doesn't say specifically what that means, but I am assuming from context that this is a combination of all 11 women's MRI recordings per each trial...so, all the clitoral stimulation tests for all 11 women were combined, and so on. (If you know this to be incorrect, let me know).
  • A software program called MRIcro was used "for visualization of group maps on a standardized anatomical template."

Results
  • In Figure 2 below, the arrows "indicate sensory cortical brain regions activated by the specific stimuli."
  • Not all the "lighting up" going on in the pictures below is related to the part of the body being specifically investigated. Since the vagina, clit, and cervix are all self-stimulated, you are also seeing areas of the brain involved in hand-movement.

  • "Note the absence of hand movement in the case of experimenter-applied thumb stimulation."
  • Although the participants only used their right hands to apply self-stimulation, the areas in the brain for both hands were activated - which surprised the researchers. Although they later point out that there is substantial evidence in the literature for "bilateral sensory cortical response to unilateral hand stimulation."
  • In the case of the investigator-applied toe stimulation, hand areas in the participants brains were also activated - which also surprised the researchers. They later guess that this maybe has something to do with a "stumble" response in which the hands subtly twitch in response to foot stimulation so that the hands are ready to catch a person when the feet falter, but it's only a speculation.
  • Cervical, Vaginal, and Clitoral activation sites, "are all in the medial paracentral lobule, but are regionally differentiated." The researchers hypothesize that the different brain areas affected by clitoris, vagina, cervix could be due to the different nerves that serve each of those anatomical structures.
  • There is some overlap between the parts of the brain activated during vaginal and cervical stimulation. The researchers think this must be due at least in part to the stretching of the vagina that happens when the dildo is inserted for both cervical and vaginal stimulation.
  • "Nipple self-stimulation not only, as expected, activated the thoracic (rib) region...but also, unexpectedly, the genital sensory cortex, i.e., the genital (medial) region of the paracentral lobule."
  • Nipple self-stimulation and vaginal self-stimulation each activated both the genital area and  activated the rib area. The authors wonder if this has to do with fact that both types of stimulation release oxytocin and the connection between nipple stimulation and uterine contractions that nursing mothers would certainly recognize.

  • So in relation to the discrepancy between earlier studies (and this study) indicating penis/clit projecting to the medial and later studies showing the projection in the dorsolateral paracentral lobule, the authors posit the following. "...based on the present findings, the discrepancy in the literature may be due to the responses to indirect stimulation of the perinial (groin) region rather than to adequate stimulation of the genital per se."
  • "Under the conditions of the present study, it is not possible to discern whether the overlap among regions of the sensory cortex activated in response to self-stimulation of each of these three genital regions is due to true overlap of the brain regions that would be activated by 'pure' stimulation of each of these three genital regions separately, or whether the overlap is due to incidental stimulation of one genital region (e.g., vagina) during self-stimulation of a different genital region (e.g., cervix). What is clear, however, is that the sensory cortical regions activated by each of these three genital regions are to some extent separable and distinct."
  • "The cerebellum activation observed in the present study during vaginal and cervical self-stimulation is a common observation during genital stimulation, especially during orgasm. It is likely this is involved in controlling muscle tension during genital stimulation."
Concluding Statements
  • "The present findings provide evidence that, rather than vaginal stimulation being just an indirect means of stimulating the clitoris [18,25], vaginal and cervical stimulation per se activate specific sensory cortical regions that are distinct from the clitoral sensory projection." *
  • "While the present study mapped the primary sensory field of genital input to the sensory cortex, it would be of interest in future studies to extend this analysis to brain fields beyond the sensory cortex that are activated when genital stimulation is perceived as "erotic" vs. when it is perceived as "just pressure."


My Thoughts
There's not too much to say about this one. It is certainly a worthwhile study that added to the scientific discussion on where genital sensation is projected in the sensory cortex, and could be useful to reference in further investigation.

I do wonder why self-stimulation was chosen in this particular study. It adds the extra variable of intentional body movement into the brain activity. Also, the self-stimulation for the vagina and cervix (moving a dildo inside the vagina) seems to me to be much more complicated than the self-stimulation involved with the clitoral and nipple self-stimulation (simply tapping). So, I wonder if the more complicated holding and moving actions involved with the dildos affected the ability to compare cervix and vagina results with the nipple and clit stimulation results. I also wonder if there was any discrepancy among the 11 women about where the different stimulations were projected. I honestly don't know anything about how the fMRIs are combined, but I know the authors didn't discuss any discrepancies that might affect the study's outcome, so I assume all 11 women were quite similar. Just a thought, but overall I don't have complaints about the experimental design.

Extra things that I just want to talk about....
I think that the authors of this study (with the statement starred * above) are specifically weighing in on an argument that relates to female orgasm. Although female orgasm was not specifically mentioned in the statement, I believe, based on the works they cite in that statement, they are pointing out that their work here is contrary to 2 different hypotheses about how orgasm can happen during intercourse with no extra manual clitoral stimulation.

The 1st way was proposed (and observed) by Masters and Johnson. The say that the clitoral glans can be indirectly stimulated through vulva movement during intercourse that pulls the clitoral hood and gently stimulates the clitoral glans so that a weak orgasm may occur.

The second is what I would say is one of the most pop hypotheses for understanding how a vaginally activated orgasm might work. This hypothesis goes something like this: 'All orgasms are clitoral, actually. What we call vaginal orgasms are really just clitoral orgasms caused by stimulation of the inner clitoral legs through the vagina.'

Another opposing (and I'd say a bit less currently popular among sexperts) view on how a vaginal orgasm might occur is that there is some aspect of the vagina or cervix themselves that cause an orgasm to happen when stimulated. This less pop one is the one these authors seem to throw their weight towards. Their reasoning is that if cervical or vaginal stimulation is projected to a different part of the brain than the clit stimulation, then vaginal orgasms are likely caused by something specific about stimulation of the vagina, not just indirect stimulation of the clitoris. I must point out, though, that no orgasm from stimulation inside the vagina has ever been observed anyway - be it through the inner clitoral legs or through something specific about the vagina itself, so speculating about what might cause this thing that might not exist is maybe not so useful.

Okay - one final thing about a possible Freud obsession
At the end of the discussion - directly after the starred statement we just discussed, the authors write this:

"The differential routes of entry into the brain are undoubtedly of significance in activating the diverse and differential consequences of clitoral, vaginal or cervical stimulation; they include differential physiological effects (e.g., on prolactin secretion [26], analgesia [27], and blood pressure reactivity to stress [28]) and differential behavioral effects (e.g., on orgasm [29], sexual satisfaction [30], and intimate relationship quality [31.32]).

I bring this passage up because, if I may be blunt, it seems like it has an agenda.The authors concluded that stimulation of the clitoris, vagina and cervix activate different areas of the sensory cortex and are trying to point out that this finding is in line with the idea that stimulation of the vagina, the cervix, and the clitoris each have different effects on women. It's not the craziest speculation to make, I guess. However what bothers me is that most of these citations are from the study's 6th author, Stuart Brody, who if I may be blunt again, seems to definitely have an agenda. He's a little obsessed with proving that Freud was not just making shit up about lady-gasms, and that penis-in-vagina sex and vaginally stimulated orgasms (which, let's review, haven't actually been observed in scientific literature) are basically the bestest, most healthy things a woman could ever have.

I've linked all the citations and you can see the titles, authors and sometimes a smart ass description from me below. Feel free to judge for yourself, but I thought this passage seemed at best to be a tagged on way to get more of their own previous work into the citations (which I heard recently is pretty important for researchers - and that sometimes citations get added into papers a little shadily) or at worst an indication that the rest of these authors also have a bit of an obsession or at least a professional stake in preserving a Freudian idea of vaginal orgasm.

You might also be interested in some of Brody's other studies not listed below: A Woman's History of Vaginal Orgasm is Discernible from Her Walk (2008) because, obviously, right? and Vaginal Orgasm Is Associated with Less Use of Immature Psychological Defense Mechanisms (2008) - He wanted to test Freud's theory that women who couldn't orgasm vaginally were immature....and guess what? He found that they were. That ol' dog Freud was right!

 [26] The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety. Brody S1, Krüger TH. 

[27] Analgesia produced in women by genital self-stimulation. Whipple B1, Komisaruk BR.

[28] Blood pressure reactivity to stress is better for people who recently had penile-vaginal intercourse than for people who had other or no sexual activity. Brody S1.

[29] Sexual response in women Winnifred B. Cutler, PhDa, Millicent Zackera (DO), Norma McCoy, PhDa, Elizabeth Genovese-Stone, MDa, Erika Friedman, PhDa - the only article here not written by one of these authors.

[30] Sexual behavior predictors of satisfaction in a Chinese sample. Tao P1, Brody S.  - Guess what? Satisfaction was associated with P-in-V sex and vaginal orgasm for the ladies!

[31Women's relationship quality is associated with specifically penile-vaginal intercourse orgasm and frequency. Costa RM1, Brody S. - I think you get the gist.

[32The Relative Health Benefits of Different Sexual Activities Stuart Brody PhD - A little surprise ending.... P-in-V sex? Associated with better mental AND physical health! All them other ways to do it? Don't have nothin' to do with health...OR associated with worse mental and physical health (I'd stay away from anal sex and masturbation, ya'll).

7.13.2015

Cervical Stimulation and Orgasm in Women with Spinal Cord injuries - A journal Article I read



Here is another installment of A Journal Article I read. This one is about an article I've been meaning to do for a long time. It's one that's used A LOT in articles (everything from crappy web articles to the background parts of other journal articles), TV segments, and in even debates with me as proof that there is stuff up in the vagina that can actually make women orgasm. Also, this is an article with Beverly Whipple and Barry Komisaruk as authors. Both are very active in the media and often pop up as the the expert in articles about female orgasm.  Whipple was one of the 3 authors of the G-Spot and Other Recent Discoveries About Female Sexuality - the book that introduced the G-spot and female ejaculation to pop culture. Komisaruk is a scientist in the psychology department at Rudgers and has been researching about females and orgasm for a long while - working closely with Whipple actually since at least the early 90's. This seems to me to be their most famous work.

Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the vagus nerves.
Komisaruk BR1, Whipple B, Crawford A, Liu WC, Kalnin A, Mosier K. Brain Res.
2004 Oct 22;1024(1-2):77-88.

The Quick Version
I'm going to give a quick overview for those of you who don't like the details. I actually think this research into women with Spinal Cord Injury (SCI) is pretty cool stuff - and probably promising for many women with SCI (There's also another good study about women with SCI and orgasm HERE. I'll review it eventually, but check it out if you're interested)

 In this study, 5 women with Spinal Cord Injury (SCI)  were given cervical stimulation. And...it’s a particular kind of cervical stimulation that involves a pessary, which is kinda like a hard cervical ring that had to be professionally fitted to each woman individually. The pessary has Velcro on it, and a device that ends with a modified tampon with Velcro on the end is inserted in and attached to the Velcro on the pessary. It is controlled by the patient and sort of puts suction-y pressure on the cervix (without really touching the cervix - cause that hurts like a bitch, right?). It’s not your average vaginal stimulation, ya know? Three of the five women verbally reported orgasm which was accompanied by an increase in brain activity in places the researchers felt, given some past studies, were consistent with what would be expected during orgasm. Heart rate, respiration, and blood pressure were not measured and neither was pelvic muscular activity. They suggest the Vagus nerve bypasses the spine and makes this possible even with the spinal injuries.

So, the study supports a very particular type of cervical stimulation having some amount of direct pathway to the brain. However, 3 of the 5 women claimed that this cervical stimulation caused an orgasm also. Increased brain activity was found at the time these 3 women claimed to orgasm, and that was seen as proof that the orgasm happened. However, as of yet there is no clear understanding of whether that brain activity is a reliable marker to indicate any particular kind of climactic sexual experience, much less the muscle contractions identified by M&J’s work (which were not tested for directly either). There is also no understanding of what that brain activity correlates to physically, or if it correlates to anything physical at all. Although a kind of cool study, it does not show proof for vaginal or cervical stimulated orgasms as is often suggested.

The Details

Background
The background discussion mostly focuses of whether or not there is direct connection between the brain and female genitals. It points out evidence in rat studies that basically say there seems to be a direct connection through the Vagus nerve between the cervix / uterus and the brain - meaning that it doesn't first go through the spine. They say this because there were some stimuli that could still be detected in these rat's brains even when the spine was severed in a place that should not allow stimulus detection that far down their bodies. It goes on to say that until this article there was no evidence that this was true in humans also.

The Experiment
The 5 women ranged in age from 23 to 54 and there time with SCI ranged from 1 to 21 years. They were all found to be healthy both physically and mentally. They were also examined to ascertain the level and completeness of the SCI using standard methods.
"Individuals were imaged in the coronal and sagittal planes using standard functional MR imaging BOLD techniques....Individuals' heads were immobilized with foam and taped to the head holder to limit motion."
Each woman first went through a series of tests in the MRI as a sort of control to demarcate the Nucleus Tractus Solitarii (NTS) region of the medulla oblongata. This was done because that is where the Vagus nerve is known to project, and the hypothesis is that the cervical stimulation will project there too since it is believed that the Vagus nerve is carrying the stimuli directly to the brain. This was done by having the women perform activities that are known to project on or near the NTS. These included things like tapping a finger and tasting sweet, sour, salty and bitter.

The women later self stimulated their cervix, using the contraption described above (I also added a quote with the specifics of this device at the end of this article), and MRI images were taken during the process. There is no information given about how long the women were allowed to stimulate their cervix or if there were particular instructions for the process.

Results
Basically, theses authors found that there was, as expected, activation in the projection zone of the Vagus nerves during the time the women were applying Cervical Self Stimulation (CSS). It was found to be in the lower part of the NTS which means it was lateral to the area activated by taste sensations (which is expected to be in the anterior part of the NTS) and it was adjacent to the part activated during finger tapping (which was expected to be in the nucleus cuneatus which is next to the NTS).

Komisaruk et al. Brain Res. 2004 Oct 22;1024(1-2):77-88.

For the 3 women who claimed to orgasm, there was gradual increase in brain activity, from onset of CSS to orgasm. It doesn't really give data about if there was or was not an increase in brain activity during CSS for the 2 women who did not orgasm, and it did not compare the brain activity of the women who did and did not orgasm. There was also no discussion of how long each of these women engaged in CSS - except that EL went from CSS onset to orgasm in about 8 minutes.

Komisaruk et al. Brain Res. 2004 Oct 22;1024(1-2):77-88.

All of the women reported a sensation when the stimulator was placed against the pessary on the cervix, although they each described it a little differently. AN described a feeling of changing pressure, VA described a "chill inside," AP and EL described a "touch inside," with EL also feeling vaginal muscle contraction at that time.

The women were also checked for pain threshold during the cervical stimulation compared with resting pain threshold. I know from reading their prior studies focused exclusively on this test that this was ascertained using a device to put increasing pressure on the fingertip, but strangely I couldn't find anything about the experimental method for this in the study even though the results were reported here. The authors tell us each woman had increased pain threshold during the cervical self stimulation. It seems weird to me that it's not in there, but I'm not too worried about it since I've seen one of their studies on it before - which I will review soon.

Discussion
The discussion first focuses on the spinal injuries each women has and whether it seems clear that the brain activation that occurred during cervical self-stimulation could be confidently said to have occurred through direct brain-cervix access by the Vagus nerve. The later part of the discussion mostly focused on what other studies showed about brain activation during orgasm and arousal.
"There appeared to be an overall increase in brain activation at orgasm in the present study in which activation of specific and multiple brain regions could be discerned...Differences between regional activation during, versus before or after, orgasm suggest that areas more directly related to orgasm include paraventricular area of the hypothalamus, medial amygdala, anterior cingulate region of the limbic cortex, and region of the nucleus accumbens. At present, we cannot distinguish whether these regions are activated uniquely at orgasm, or whether their activity increases gradually, only exceeding an arbitrary detection threshold at orgasm."

Komisaruk et al. Brain Res. 2004 Oct 22;1024(1-2):77-88.

The authors go on to tell us there is no known evidence of orgasm in rats, but compares the brain scans in this study to those of cervix stimulation in rats.

 Below is the only discussion about how previous studies about brain imaging during orgasm match up to this study.
"To our knowledge, this is the first evidence of activation of hypothalamus during orgasm in men or women. Earlier reports of orgasm in men found activation in prefrontal cortex, but not subcortical structures [74]. Recently, Holstege et al. using positron emission tomography reported that during orgasm, elicited in men by penile stimulation by a partner [21,24] and elicited in women by clitoral stimulation by a partner [25], the mesodiencephalic region, cerebellum, and several cortical areas, but not the hypothalamus, became activated."
The authors then discuss a prior study by Wallet et al. of men during sexual arousal - not orgasm- caused by visual stimulation. The fMRI in this study, "reported that activity was increased in the amygdala, hippocampus, hypothalamus in men relative to women, wheras the striatal regions (candate and nucleus accumbens) were activated in women."

I am no brain fMRI expert or neuroscience expert here, but from the past data they are comparing this to, it seems like the activation they are seeing might be as close to the studies capturing visually stimulated arousal as it is to the studies capturing orgasm.  I might be wrong here, but it just didn't seem like the activation observed in this study were clearly types of activation that indicates orgasm .

The the authors go on to discuss brain areas activated in this study that may indicate oxytocin release. However, as they themselves mention, oxytocin release, although part of orgasm, is also part of all kinds of other things, including vaginal or cervical stimulation (known as the Ferguson Reflex). They then make connections with the oxytocin release and the women's increased pain tolerance, and talk more about what might be involved in that increased pain tolerance observed in this study. The only other part of the discussion that involves itself with orgasm specifically is the following assertion.
"A salient and reliable feature of brain regions activated during orgasm was activation of the cerebellum. The cerebellum modulates muscle tension via the gamma efferent system, and it receives proprioceptive information [45]. Since muscle tension can reach peak levels during orgasm [44] and contribute to the sensory pleasure during orgasm [31,32], it is not unlikely that the cerebellum thereby plays a significant motoric and hedonic role in orgasm." 

So, it seems the authors are pointing to the activation in the cerebellum as the most important and reliable indication that an orgasm really did happen. They point to this because the cerebellum deals with muscles. It's funny to me because when they say this, they cite Masters and Johnson's Human Sexual Response (that's the [44]), which means to me that they are acknowledging that the rhythmic muscle activity that Masters and Johnson identified as a reliable marker of orgasm, is in fact quite important and reliable.  It's funny to me because these authors have a long track record of advocating for widening the scope of what the word 'orgasm' (particularly female orgasm) means beyond the very clear, observable, and widely accepted definition Masters and Johnson set out in the book cited above. They also have a long history of not checking for or even really discussing that reliably observable marker for orgasm in their studies about female orgasm.

So, maybe the brain activation in the cerebellum during the reported orgasms in this study is an indication of the muscular activity of an actual, Masters and Johnson defined orgasm, but maybe it's not. We don't really know much about what exactly the brain activation indicates or whether we could count on any parts of that brain activation to accurately and reliably mark orgasm. However, if these authors really wanted to prove that these women had orgasms and that the activation seen in their brains were truly related to orgasm, then they could have just checked. It is absolutely possible to do so, but they did not.

Conclusion
And that brings me to the conclusion. I'm on board with their statements like, "In women, the Vagus nerves provide a genital (vaginal-cervical) sensory pathway that bypasses the spinal cord." I think that's fair given the data they collected in this study.

I'm not cool, however, with their conclusion that, "in cases of compromise of vagina-cervical sensory activity via the genitospinal nerves, genital sensory activity conveyed via the Vagus nerves is evidently adequate to induce orgasm in women."

I think that indicating a particular physical stimulation causes orgasm when an orgasm has not been verified is a bit irresponsible (even though tons of researchers still do it). These authors' findings of extra brain activity when a woman says she has orgasmsed is not enough to make that conclusion. This is a scientific investigation, and the bottom line is that asking a person whether or not a particular physical event happened in their body is simply not good enough. It's a start - not a conclusion.

The data they collected is certainly worthwhile, and could be important for further research, but claiming that these women stimulated their cervix to orgasm is at best contentious. There is no evidence that what these women experienced involved the rhythmic muscle activity known to be a reliable, accurate marker for an orgasm. There is not even evidence that the brain activation identified  in this study is a reliable or accurate marker of anything at all - much less orgasm.

This study, to my dismay, does as most studies about inner-vaginal stimulated orgasms do. It does not actually confirm an orgasm takes place. It's easily detectable, but too often in studies about female orgasm, the researchers simply don't bother. There is a physical thing called an orgasm, and we acknowledge that this physical thing is an orgasm when we talk about males. However, for females it seems like any time a woman says she orgasms, then we must include whatever it is that she experienced at that time within the definition of the word orgasm. It's really, like, the worst way to go about scientific inquiry, like just the worst. One person could literally be using that word to describe something completely physically different than another person. Yet, scientists are investigating, speaking about, advising on, and making conclusion about all those different 'orgasms' as if they are the same things. I mean, how could there be any confusion or miscalculations involved in that?

This lack of verification might just seem like a small experimental choice, but it is much more. If the women in this study say they orgasm, but they are actually not exhibiting rhythmic muscle spasms, then those women are experiencing something different than women who do experience the rhythmic muscle spasms - and their experiences should not be called the same thing or discussed in the same way. Some things are the same, and some things are different. The scientific community should acknowledge when things are the same and different. It's not a hard concept.  Debate about the value of these two different experiences or what to call them is absolutely valid, but if the scientists doing research in this area are intentionally refusing (as I worry some are) to even gather information about what I know they know is important to a clear understanding of how female sexual release works, then I call bullshit. This area of study, and women, deserve better.

Appendix (in case you want to know more about that cervix stimulator)
"Vaginal-cervical self stimulator was applied with a passive stimulator consisting of a handle into which a modified tampon mounted on a lucite rod was inserted at right angles. A Velcro disc was attached at the tip of the tampon. To a ring pessary (Model PRSFS, Milex Products, Chicago, IL) previously fitted to each subject by her gynecologist, was attached by suture silk a matching Velcro disc. The pessary was inserted by a registered nurse and the Velcro disc attached to the tampon stimulator was pressed against the matching Velcro disc on the pessary. This device centered the stimulator tip against the cervix through the pessary and the pessary protected the cervix."