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Sexual Arousal (sexual + arousal)
Kinds of Sexual Arousal Selected AbstractsThe Sensitivity of Continuous Laboratory Measures of Physiological and Subjective Sexual Arousal for Diagnosing Women with Sexual Arousal DisorderTHE JOURNAL OF SEXUAL MEDICINE, Issue 2pt2 2010Cindy M. Meston PhD ABSTRACT Introduction., Past findings on the diagnostic sensitivity of vaginal photoplethysmography are limited by testing among women with heterogeneous sexual dysfunctions and by the use of statistical techniques that are unable to assess how changes in subjective arousal are associated with changes in physiological arousal. Aims., The aims of this study were to: (i) test the sensitivity of vaginal photoplethysmography and continuous measures of subjective sexual arousal in differentiating between women with and without sexual arousal or orgasm dysfunction; and (ii) examine the diagnostic utility of measuring the synchrony between genital and subjective sexual responses. Methods., Sexual arousal was assessed in sexually healthy women (n = 12), women with orgasm disorder (OD; n = 12), and 38 women who met the criteria for the three subcategories of sexual arousal dysfunction described by Basson et al. (i.e., genital sexual arousal disorder [GAD; n = 9], subjective sexual arousal disorder [SAD; n = 13], and combined genital and subjective arousal disorder [CAD; n = 16]). Main Outcome Measures., Physiological sexual arousal was assessed using vaginal photoplethysmography, and subjective sexual arousal was measured continuously and using a Likert-scale in response to sexual videos. Results., Women with GAD showed the lowest and women with CAD showed the highest levels of vaginal pulse amplitude response to erotic stimuli. Women with sexual arousal disorder showed significantly lower levels of subjective sexual arousal to erotic stimuli than did sexually healthy women. Relations between subjective and physiological measures of sexual arousal were significantly weaker among women with sexual arousal disorder than sexually healthy women or women with OD. Conclusion., Preliminary support was provided for the diagnostic utility of measuring the synchrony between subjective and genital arousal in women with sexual arousal disorder. Findings do not support the sensitivity of using vaginal photoplethysmography, or continuous or Likert-scale measures of subjective arousal for differentiating between subtypes of women with sexual arousal disorder. Meston CM, Rellini AH, and McCall K. The sensitivity of continuous laboratory measures of physiological and subjective sexual arousal for diagnosing women with sexual arousal disorder. J Sex Med 2010;7:938,950. [source] The Inhibitory Effects of Nicotine on Physiological Sexual Arousal in Nonsmoking Women: Results from a Randomized, Double-Blind, Placebo-Controlled, Cross-Over TrialTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2008Christopher B. Harte BA ABSTRACT Introduction., Extensive research suggests that long-term cigarette smoking is an independent risk factor for the introduction of sexual dysfunction in men. However, results of limited data investigating this relationship in women are mixed. No studies have examined the acute effects of tobacco or nicotine on physiological sexual response in women. Controlled experimental studies examining acute effects of isolated nicotine intake on female physiological sexual responses are necessary in order to help elucidate tobacco's potential role in the development and/or maintenance of sexual impairment in women. Aim., To examine whether isolated nicotine intake acutely affects sexual arousal responses in nonsmoking women. Methods., Twenty-five sexually functional women (mean age = 20 years) each with less than 100 direct exposures to nicotine completed two counterbalanced conditions in which they were randomized to received either nicotine gum (6 mg) or placebo gum, both administered double-blind and matched for appearance, taste, and consistency, approximately 40 minutes prior to viewing an erotic film. Main Outcome Measures., Physiological (changes in vaginal pulse amplitude via vaginal photoplethysmography) and subjective (continuous self-report) sexual responses to erotic stimuli were examined, as well as changes in mood. Results., Nicotine significantly reduced genital responses to the erotic films (P = 0.05), corresponding to a 30% attenuation in physiological sexual arousal. This occurred in 11 of 18 women with valid physiological assessments. Nicotine had no significant effect on continuous self-report ratings of sexual arousal (P = 0.45), or on mood (all Ps > 0.05). Conclusions., Acute nicotine intake significantly attenuates physiological sexual arousal in healthy nonsmoking women. Our findings provide support to the hypothesis that nicotine may be the primary pharmacological agent responsible for genital hemodynamic disruption, thereby facilitating a cascade of biochemical and vascular events which may impair normal sexual arousal responses. Harte CB, and Meston CM. The inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: Results from a randomized, double-blind, placebo-controlled, cross-over trial. J Sex Med 2008;5:1184,1197. [source] ORIGINAL RESEARCH,PHYSIOLOGY: Sensation and Sexual Arousal in Circumcised and Uncircumcised MenTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2007Kimberley Payne PhD ABSTRACT Introduction., Research, theory, and popular belief all suggest that penile sensation is greater in the uncircumcised as compared with the circumcised man. However, research involving direct measurement of penile sensation has been undertaken only in sexually functional and dysfunctional groups, and as a correlate of sexual behavior. There are no reports of penile sensation in sexually aroused subjects, and it is not known how arousal affects sensation. In principle, this should be more closely related to actual sexual function. Aim., This study therefore compared genital and nongenital sensation as a function of sexual arousal in circumcised and uncircumcised men. Methods., Twenty uncircumcised men and an equal number of age-matched circumcised participants underwent genital and nongenital sensory testing at baseline and in response to erotic and control stimulus films. Touch and pain thresholds were assessed on the penile shaft, the glans penis, and the volar surface of the forearm. Sexual arousal was assessed via thermal imaging of the penis. Results., In response to the erotic stimulus, both groups evidenced a significant increase in penile temperature, which correlated highly with subjective reports of sexual arousal. Uncircumcised men had significantly lower penile temperature than circumcised men, and evidenced a larger increase in penile temperature with sexual arousal. No differences in genital sensitivity were found between the uncircumcised and circumcised groups. Uncircumcised men were less sensitive to touch on the forearm than circumcised men. A decrease in overall touch sensitivity was observed in both groups with exposure to the erotic film as compared with either baseline or control stimulus film conditions. No significant effect was found for pain sensitivity. Conclusion., These results do not support the hypothesized penile sensory differences associated with circumcision. However, group differences in penile temperature and sexual response were found. Payne K, Thaler L, Kukkonen T, Carrier S, and Binik Y. Sensation and sexual arousal in circumcised and uncircumcised men. J Sex Med 2007;4:667,674. [source] ORIGINAL RESEARCH,PHYSIOLOGY: Thermography as a Physiological Measure of Sexual Arousal in Both Men and WomenTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2007Tuuli M. Kukkonen BA ABSTRACT Introduction., Current physiological measures of sexual arousal are intrusive, hard to compare between genders, and quantitatively problematic. Aim., To investigate thermal imaging technology as a means of solving these problems. Methods., Twenty-eight healthy men and 30 healthy women viewed a neutral film clip, after which they were randomly assigned to view one of three other video conditions: (i) neutral (N = 19); (ii) humor (N = 19); and (iii) sexually explicit (N = 20). Main Outcome Measures., Genital and thigh temperatures were continuously recorded using a TSA ImagIR camera. Subjective measures of sexual arousal, humor, and relaxation were assessed using Likert-style questions prior to showing the baseline video and following each film. Results., Statistical (Tukey HSD) post-hoc comparisons (P < 0.05) demonstrated that both men and women viewing the sexually arousing video had significantly greater genital temperature (mean = 33.89°C, SD = 1.00) than those in the humor (mean = 32.09°C, SD = 0.93) or neutral (mean = 32.13°C, SD = 1.24) conditions. Men and women in the erotic condition did not differ from each other in time to peak genital temperature (men mean = 664.6 seconds, SD = 164.99; women mean = 743 seconds, SD = 137.87). Furthermore, genital temperature was significantly and highly correlated with subjective ratings of sexual arousal (range r = 0.51,0.68, P < 0.001). There were no significant differences in thigh temperature between groups. Conclusion., Thermal imaging is a promising technology for the assessment of physiological sexual arousal in both men and women. Kukkonen TM, Binik YM, Amsel R, and Carrier S. Thermography as a physiological measure of sexual arousal in both men and women. J Sex Med 2007;4:93,105. [source] Nipple/Breast Stimulation and Sexual Arousal in Young Men and WomenTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2006Roy Levin PhD ABSTRACT Introduction., The role of nipple/breast stimulation in influencing sexual arousal in men and women during lovemaking has only been the subject of opinion-based comment rather than evidence-based study. No attempt to question people about such sexual behavior has ever been undertaken. Aim., The study was designed to ascertain the effects of nipple/breast manipulation in young men and women on their sexual arousal. Methods., A short questionnaire about nipple/breast stimulation during sexual activity was administered to 301 (148 men; 153 women) sexually experienced undergraduates (age range 17,29 years, 95% between 18 and 22). Main Outcome Measures., Replies to questions in questionnaire. Results., The major findings in regard to the women were that 81.5% reported that stimulation of their nipples/breasts caused or enhanced their sexual arousal, 78.2% agreed that when sexually aroused such manipulation increased their arousal, 59.1% had asked to have their nipples stimulated during lovemaking, and only 7.2% found that the manipulation decreased their arousal. In regard to the men, 51.7% reported that nipple stimulation caused or enhanced their sexual arousal, 39% agreed that when sexually aroused such manipulation increased their arousal, only 17.1% had asked to have their nipples stimulated, and only 7.5% found that such stimulation decreased their arousal. Conclusion., Manipulation of the nipples/breasts causes or enhances sexual arousal in approximately 82% of young women and 52% of young men with only 7,8% reporting that it decreased their arousal. Levin R, and Meston C. Nipple/breast stimulation and sexual arousal in young men and women. J Sex Med 2006;3:450,454. [source] Withdrawal of Selective Serotonin Reuptake Inhibitors (SSRIs) May Cause Increased Atrial Natriuretic Peptide (ANP) and Persistent Sexual Arousal in Women?THE JOURNAL OF SEXUAL MEDICINE, Issue 2 2006David Goldmeier MD [source] The Sensitivity of Continuous Laboratory Measures of Physiological and Subjective Sexual Arousal for Diagnosing Women with Sexual Arousal DisorderTHE JOURNAL OF SEXUAL MEDICINE, Issue 2pt2 2010Cindy M. Meston PhD ABSTRACT Introduction., Past findings on the diagnostic sensitivity of vaginal photoplethysmography are limited by testing among women with heterogeneous sexual dysfunctions and by the use of statistical techniques that are unable to assess how changes in subjective arousal are associated with changes in physiological arousal. Aims., The aims of this study were to: (i) test the sensitivity of vaginal photoplethysmography and continuous measures of subjective sexual arousal in differentiating between women with and without sexual arousal or orgasm dysfunction; and (ii) examine the diagnostic utility of measuring the synchrony between genital and subjective sexual responses. Methods., Sexual arousal was assessed in sexually healthy women (n = 12), women with orgasm disorder (OD; n = 12), and 38 women who met the criteria for the three subcategories of sexual arousal dysfunction described by Basson et al. (i.e., genital sexual arousal disorder [GAD; n = 9], subjective sexual arousal disorder [SAD; n = 13], and combined genital and subjective arousal disorder [CAD; n = 16]). Main Outcome Measures., Physiological sexual arousal was assessed using vaginal photoplethysmography, and subjective sexual arousal was measured continuously and using a Likert-scale in response to sexual videos. Results., Women with GAD showed the lowest and women with CAD showed the highest levels of vaginal pulse amplitude response to erotic stimuli. Women with sexual arousal disorder showed significantly lower levels of subjective sexual arousal to erotic stimuli than did sexually healthy women. Relations between subjective and physiological measures of sexual arousal were significantly weaker among women with sexual arousal disorder than sexually healthy women or women with OD. Conclusion., Preliminary support was provided for the diagnostic utility of measuring the synchrony between subjective and genital arousal in women with sexual arousal disorder. Findings do not support the sensitivity of using vaginal photoplethysmography, or continuous or Likert-scale measures of subjective arousal for differentiating between subtypes of women with sexual arousal disorder. Meston CM, Rellini AH, and McCall K. The sensitivity of continuous laboratory measures of physiological and subjective sexual arousal for diagnosing women with sexual arousal disorder. J Sex Med 2010;7:938,950. [source] Reduced Labial Temperature in Response to Sexual Films with Distractors among Women with Lower Sexual DesireTHE JOURNAL OF SEXUAL MEDICINE, Issue 2pt2 2010Nicole Prause PhD ABSTRACT Introduction., Sexual desire variation traditionally has been treated as due to variance in affective response to sexual stimulation, but differences in attention to the stimuli may better account for differences in sexual desire. Aim., Determine whether sexual desire varies due to attention biases towards sexual stimuli. Main outcome measures., Sexual arousal was quantified by physiological (labia minus temperature) and experienced (continuously adjusting a potentiometer) indicators. Methods., Twenty-two women who varied in their level of sexual desire attended one laboratory session during which they viewed a neutral nature film, a sexual film, and a sexual film with distractors while their labial temperature and self-reported sexual arousal were recorded. Results., Participants reported and displayed lower sexual arousal during the sexual stimulus with distractors as compared to the sexual film without distractors. While all women reported lower sexual arousal to the sexual film with distractors, women with relatively lower sexual desire also reported lower sexual arousal to the sexual film with no distractors than women with higher sexual desire. Physiologically, women with lower sexual desire exhibited lower labial temperature. Conclusions., Since the predicted lower self-reported and physiological sexual arousal to the sexual stimulus with distractors for the women with lower sexual desire did not emerge, this study does not support that sexual desire levels vary due to differential attention to sexual stimuli. Prause N, and Heiman J. Reduced labial temperature in response to sexual films with distractors among women with lower sexual desire. J Sex Med 2010;7:951,963. [source] ORIGINAL RESEARCH,PHYSIOLOGY: Sensation and Sexual Arousal in Circumcised and Uncircumcised MenTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2007Kimberley Payne PhD ABSTRACT Introduction., Research, theory, and popular belief all suggest that penile sensation is greater in the uncircumcised as compared with the circumcised man. However, research involving direct measurement of penile sensation has been undertaken only in sexually functional and dysfunctional groups, and as a correlate of sexual behavior. There are no reports of penile sensation in sexually aroused subjects, and it is not known how arousal affects sensation. In principle, this should be more closely related to actual sexual function. Aim., This study therefore compared genital and nongenital sensation as a function of sexual arousal in circumcised and uncircumcised men. Methods., Twenty uncircumcised men and an equal number of age-matched circumcised participants underwent genital and nongenital sensory testing at baseline and in response to erotic and control stimulus films. Touch and pain thresholds were assessed on the penile shaft, the glans penis, and the volar surface of the forearm. Sexual arousal was assessed via thermal imaging of the penis. Results., In response to the erotic stimulus, both groups evidenced a significant increase in penile temperature, which correlated highly with subjective reports of sexual arousal. Uncircumcised men had significantly lower penile temperature than circumcised men, and evidenced a larger increase in penile temperature with sexual arousal. No differences in genital sensitivity were found between the uncircumcised and circumcised groups. Uncircumcised men were less sensitive to touch on the forearm than circumcised men. A decrease in overall touch sensitivity was observed in both groups with exposure to the erotic film as compared with either baseline or control stimulus film conditions. No significant effect was found for pain sensitivity. Conclusion., These results do not support the hypothesized penile sensory differences associated with circumcision. However, group differences in penile temperature and sexual response were found. Payne K, Thaler L, Kukkonen T, Carrier S, and Binik Y. Sensation and sexual arousal in circumcised and uncircumcised men. J Sex Med 2007;4:667,674. [source] Alcohol expectancies in convicted rapists and child molestersCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2001Anu S. Aromäki PhD Background Previous findings suggest that cognitive factors and expectancies related to drinking can mediate subjective sexual arousal as well as aggression in men. Our aim was to investigate the drinking habits and alcohol-related expectancies that might predispose men to sexually aggress in two groups of sexual offenders. Method Men convicted of rape (n = 10) were compared with men convicted of child molesting (n = 10) and with control subjects (n = 31). Current drinking habits (while not in prison) were assessed by self-report, and the extent of alcohol abuse was mapped by the Michigan Alcoholism Screening Test (MAST; Selzer, 1971). Cognitive expectancies related to alcohol use were explored by the standard Alcohol Expectancy Questionnaire (AEQ; Brown et al., 1980). Results The majority of the men who committed rape (70%) but only a third of the men convicted of child molesting were diagnosed with antisocial personality disorder. Alcohol abuse was common in men convicted of both rape and child molesting and the men convicted of rape expected significantly more positive effects from drinking than the control group. Both sex offender groups were the only groups to express significant alcohol-related cognitive expectancies linked to arousal and aggression. Expectancy patterns were directly linked to the antisocial personality characteristics. Conclusion Alcohol abuse is common in men who commit both rape and child molesting. Heavy drinking and the anticipation of alcohol effects such as sexual enhancement, arousal and aggression may facilitate sexual aggression in offenders with antisocial personality disorder. Copyright © 2001 Whurr Publishers Ltd. [source] Comparative study of sexuality-related characteristics in young adults with schizophrenia treated with novel neuroleptics and in normal young adultsACTA PSYCHIATRICA SCANDINAVICA, Issue 2002P. Fortier This study compared characteristics related to sexual history, sexual activities, sexual functioning and psychological tendencies associated with sexuality in 45 young adults with schizophrenia treated with novel neuroleptics and 61 control young adults. A smaller proportion of young adults with schizophrenia currently had a sexual partner or had ever engaged in sexual relations. They also had sexual relations and sexual desires less often. Whether affected by schizophrenia or not, a smaller proportion of women had ever masturbated. They felt less sexual desire and desired sexual relations less often. Compared to controls, a higher proportion of men with schizophrenia treated with Risperidone or Olanzapine had at least one sexual dysfunction, lacked sexual desire and reported problems with sexual arousal and ejaculation. Women with schizophrenia were more likely to report problems with sexual arousal and galactorrhea. Finally, young adults with schizophrenia develop more negative psychological tendencies associated with sexuality than were normal young adults. Sexual problems are highly prevalent among young adults with schizophrenia. Sexuality should occupy the space it deserves within psychosocial rehabilitation programs and the treatment of schizophrenia. [source] Masturbation and Discourse on Female Sexual Practices in Early Modern JapanGENDER & HISTORY, Issue 1 2009Anne Walthall Much of the discourse on female sexual practices in early modern Japan centred on masturbation, usually with a dildo, deemed necessary for a woman's mental and physical health when the male member was unavailable. References to female same-sex relations suggest that they too made sense in situations where men were absent. Some sex manuals treated female sexual arousal within the context of conjugal relations, while a text written for wives in polygamous marriages places female sexual practice at the service of male interests. The texts analysed here show not only that early modern Japanese held different attitudes toward sex than their western counterparts, but also that they could hold multiple attitudes at the same time. [source] The physiological basis of human sexual arousal: neuroendocrine sexual asymmetryINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 2 2005ION G. MOTOFEI Summary Normal sexual arousal and response suppose an integrated process involving both physiological and psychological processes. However, the current understanding of sexual arousal does not provide a coherent model that accounts for the integration of multiple physiological systems that subsequently generate a coordinated sexual response at both the spinal peripheral and cerebral central levels. Herein we suggest a model that involves both sympathetic and parasympathetic activation during sexual arousal via the two classes of gonadal hormones, androgens and oestrogens. We discuss the manner in which gonadal hormones may activate such a system, transforming pre-pubertal (non-erotic) genital stimulation to post-pubertal erogenization of stimulation and subsequent sexual arousal. Finally, we indicate that the different balance of androgens and oestrogens in men and women may generate asymmetric effects on each of the components of the autonomic nervous system, thereby explaining some of the differences in patterns of sexual arousal and the responses cycle across the sexes. [source] The heat of the moment: the effect of sexual arousal on sexual decision makingJOURNAL OF BEHAVIORAL DECISION MAKING, Issue 2 2006Dan Ariely Abstract Despite the social importance of decisions taken in the "heat of the moment," very little research has examined the effect of sexual arousal on judgment and decision making. Here we examine the effect of sexual arousal, induced by self-stimulation, on judgments and hypothetical decisions made by male college students. Students were assigned to be in either a state of sexual arousal or a neutral state and were asked to: (1) indicate how appealing they find a wide range of sexual stimuli and activities, (2) report their willingness to engage in morally questionable behavior in order to obtain sexual gratification, and (3) describe their willingness to engage in unsafe sex when sexually aroused. The results show that sexual arousal had a strong impact on all three areas of judgment and decision making, demonstrating the importance of situational forces on preferences, as well as subjects' inability to predict these influences on their own behavior. Copyright © 2005 John Wiley & Sons, Ltd. [source] The Motivation Behind Serial Sexual Homicide: Is It Sex, Power, and Control, or Anger?,JOURNAL OF FORENSIC SCIENCES, Issue 4 2006Wade C. Myers M.D. ABSTRACT: Controversy exists in the literature and society regarding what motivates serial sexual killers to commit their crimes. Hypotheses range from the seeking of sexual gratification to the achievement of power and control to the expression of anger. The authors provide theoretical, empirical, evolutionary, and physiological support for the argument that serial sexual murderers above all commit their crimes in pursuit of sadistic pleasure. The seeking of power and control over victims is believed to serve the two secondary purposes of heightening sexual arousal and ensuring victim presence for the crime. Anger is not considered a key component of these offenders' motivation due to its inhibitory physiological effect on sexual functioning. On the contrary, criminal investigations into serial sexual killings consistently reveal erotically charged crimes, with sexual motivation expressed either overtly or symbolically. Although anger may be correlated with serial sexual homicide offenders, as it is with criminal offenders in general, it is not causative. The authors further believe serial sexual murderers should be considered sex offenders. A significant proportion of them appear to have paraphilic disorders within the spectrum of sexual sadism. "sexual sadism, homicidal type" is proposed as a diagnostic subtype of sexual sadism applicable to many of these offenders, and a suggested modification of DSM criteria is presented. [source] The relationship between women's subjective and physiological sexual arousalPSYCHOPHYSIOLOGY, Issue 1 2005Alessandra H. Rellini Abstract Previous literature presents discordant results on the relationship between physiological and subjective sexual arousal in women. In this study, the use of hierarchical linear modeling (HLM) revealed a significant concordance between continuous measures of physiological and subjective sexual arousal as assessed during exposure to erotic stimuli in a laboratory setting. We propose that past studies that have found little or no association between the two measures may have been in part limited by the methodology and statistical analyses employed. [source] Modulation of spinal reflexes by aversive and sexually appetitive stimuliPSYCHOPHYSIOLOGY, Issue 2 2003Stephanie Both Abstract In this study, modulation of spinal tendinous (T) reflexes by sexual stimulation was investigated. T reflexes are augmented in states of appetitive and defensive action and modified by differences in arousal intensity. Reflexes were expected to be facilitated by both pleasant (sexual) and unpleasant (anxiety) stimuli. Subjects were exposed to a sexual, an anxiety-inducing, a sexually threatening, and a neutral film excerpt. Genital arousal, emotional experience, subjective action tendencies, and T reflexes were monitored. Self-report and genital data confirmed the affective states as intended. T reflex amplitude significantly increased during viewing of emotionally arousing film excerpts as compared with a neutral film excerpt. T reflexes were facilitated by the sex stimulus to the same extent as by the anxiety and sexual threat stimuli. The results support the view of sexual arousal as an emotional state, generating sex-specific autonomic and general somatic motor system responses, which prepare the organism for action. [source] ORIGINAL RESEARCH,BASIC SCIENCE: Neuroanatomical Evidence for a Role of Central Melanocortin-4 Receptors and Oxytocin in the Efferent Control of the Rodent Clitoris and VaginaTHE JOURNAL OF SEXUAL MEDICINE, Issue 6 2010Helene Gelez PhD ABSTRACT Introduction., The clitoris and the vagina are the main peripheral anatomical structures involved in physiological changes related to sexual arousal and orgasm. Their efferent control and, more particularly, the neurochemical phenotype of these descending neuronal pathways remain largely uncharacterized. Aim., To examine if brain neurons involved in the efferent control of the clitoris and the vagina possess melanocortin-4 receptor (MC4-R) and/or contain oxytocin (OT). Methods., Neurons involved in the efferent control of the vagina and clitoris were identified following visualization of pseudorabies virus (PRV) retrograde tracing. PRV was injected into the vagina and clitoris in adult rats in estrous. On the fifth day postinjection, animals were humanely sacrificed, and brains were removed and sectioned, and processed for PRV visualization. The neurochemical phenotype of PRV-positive neurons was identified using double or triple immunocytochemical labeling against PRV, MC4-R, and OT. Double and triple labeling were quantified using confocal laser scanning microscopy. Main Outcome Measure., Neuroanatomical brain distribution, number and percentage of double-labeled PRV/MC4-R and PRV-/OT-positive neurons, and triple PRV-/MC4-R-/OT-labeled neurons. Results., The majority of PRV immunopositive neurons which also expressed immunoreactivity for MC4-R were located in the paraventricular and arcuate nuclei of the hypothalamus. The majority of PRV positive neurons which were immunoreactive (IR) for OT were located in the paraventricular nucleus (PVN), medial preoptic area (MPOA), and lateral hypothalamus. PRV positive neurons were more likely to be IR for MC4-R than for OT. Scattered triple-labeled PRV/MC4-R/OT neurons were detected in the MPOA and the PVN. Conclusion., These data strongly suggest that MC4-R and, to a less extent, OT are involved in the efferent neuronal control of the clitoris and vagina, and consequently facilitate our understanding of how the melanocortinergic pathway regulates female sexual function. Gelez H, Poirier S, Facchinetti P, Allers KA, Wayman C, Alexandre L, and Giuliano F. Neuroanatomical evidence for a role of central melanocortin-4 receptors and oxytocin in the efferent control of the rodent clitoris and vagina. J Sex Med 2010;7:2056,2067. [source] Post-translational Regulation of Endothelial Nitric Oxide Synthase (eNOS) by Estrogens in the Rat VaginaTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2010Biljana Musicki PhD ABSTRACT Introduction., Estrogens control vaginal blood flow during female sexual arousal mostly through nitric oxide (NO). Although vascular effects of estrogens are attributed to an increase in endothelial NO production, the mechanisms of endothelial NO synthase (eNOS) regulation by estrogens in the vagina are largely unknown. Aims., Our hypothesis was that estrogens regulate eNOS post-translationally in the vagina, providing a mechanism to affect NO bioavailability without changes in eNOS protein expression. Methods., We measured eNOS phosphorylation and eNOS interaction with caveolin-1 and heat shock protein 90 (HSP90) in the distal and proximal vagina of female rats at diestrus, 7 days after ovariectomy and 2 days after replacement of ovariectomized rats with estradiol-17, (15 µg). Main Outcome Measures., Molecular mechanisms of eNOS regulation by estrogen in the rat vagina. Results., We localized phospho-eNOS (Ser-1177) immunohistochemically to the endothelium lining blood vessels and vaginal sinusoids. Estrogen withdrawal decreased phosphorylation of eNOS on its positive regulatory site (Ser-1177) and increased eNOS binding to its negative regulator caveolin-1 (without affecting eNOS/HSP90 interaction), and they were both normalized by estradiol replacement. Protein expressions of phosphorylated Akt (protein kinase B) and extracellular signal-regulated protein kinase 1/2 (ERK1/2) were not affected by estrogen status, suggesting that the effect of estrogens on eNOS (Ser-1177) phosphorylation was not mediated by activated AKT or ERK1/2. eNOS phosphorylation on its negative regulatory site (Ser-114) was increased in the vagina by estrogen withdrawal and normalized by estradiol replacement, implying that the maintenance of low phosphorylation of eNOS on this site by estradiol may limit eNOS interaction with caveolin-1 and preserve the enzyme's activity. Total eNOS, inducible NOS, caveolin-1, and HSP90 protein expressions were not affected by ovariectomy or estradiol replacement in the distal or proximal vagina. Conclusions., These results define novel estrogen signaling mechanisms in the vagina which involve eNOS phosphorylation and eNOS,caveolin-1 interaction. Musicki B, Liu T, Strong TD, Lagoda GA, Bivalacqua TJ, and Burnett AL. Post-translational regulation of endothelial nitric oxide synthase (eNOS) by estrogens in the rat vagina. J Sex Med 2010;7:1768,1777. [source] The Sensitivity of Continuous Laboratory Measures of Physiological and Subjective Sexual Arousal for Diagnosing Women with Sexual Arousal DisorderTHE JOURNAL OF SEXUAL MEDICINE, Issue 2pt2 2010Cindy M. Meston PhD ABSTRACT Introduction., Past findings on the diagnostic sensitivity of vaginal photoplethysmography are limited by testing among women with heterogeneous sexual dysfunctions and by the use of statistical techniques that are unable to assess how changes in subjective arousal are associated with changes in physiological arousal. Aims., The aims of this study were to: (i) test the sensitivity of vaginal photoplethysmography and continuous measures of subjective sexual arousal in differentiating between women with and without sexual arousal or orgasm dysfunction; and (ii) examine the diagnostic utility of measuring the synchrony between genital and subjective sexual responses. Methods., Sexual arousal was assessed in sexually healthy women (n = 12), women with orgasm disorder (OD; n = 12), and 38 women who met the criteria for the three subcategories of sexual arousal dysfunction described by Basson et al. (i.e., genital sexual arousal disorder [GAD; n = 9], subjective sexual arousal disorder [SAD; n = 13], and combined genital and subjective arousal disorder [CAD; n = 16]). Main Outcome Measures., Physiological sexual arousal was assessed using vaginal photoplethysmography, and subjective sexual arousal was measured continuously and using a Likert-scale in response to sexual videos. Results., Women with GAD showed the lowest and women with CAD showed the highest levels of vaginal pulse amplitude response to erotic stimuli. Women with sexual arousal disorder showed significantly lower levels of subjective sexual arousal to erotic stimuli than did sexually healthy women. Relations between subjective and physiological measures of sexual arousal were significantly weaker among women with sexual arousal disorder than sexually healthy women or women with OD. Conclusion., Preliminary support was provided for the diagnostic utility of measuring the synchrony between subjective and genital arousal in women with sexual arousal disorder. Findings do not support the sensitivity of using vaginal photoplethysmography, or continuous or Likert-scale measures of subjective arousal for differentiating between subtypes of women with sexual arousal disorder. Meston CM, Rellini AH, and McCall K. The sensitivity of continuous laboratory measures of physiological and subjective sexual arousal for diagnosing women with sexual arousal disorder. J Sex Med 2010;7:938,950. [source] Reduced Labial Temperature in Response to Sexual Films with Distractors among Women with Lower Sexual DesireTHE JOURNAL OF SEXUAL MEDICINE, Issue 2pt2 2010Nicole Prause PhD ABSTRACT Introduction., Sexual desire variation traditionally has been treated as due to variance in affective response to sexual stimulation, but differences in attention to the stimuli may better account for differences in sexual desire. Aim., Determine whether sexual desire varies due to attention biases towards sexual stimuli. Main outcome measures., Sexual arousal was quantified by physiological (labia minus temperature) and experienced (continuously adjusting a potentiometer) indicators. Methods., Twenty-two women who varied in their level of sexual desire attended one laboratory session during which they viewed a neutral nature film, a sexual film, and a sexual film with distractors while their labial temperature and self-reported sexual arousal were recorded. Results., Participants reported and displayed lower sexual arousal during the sexual stimulus with distractors as compared to the sexual film without distractors. While all women reported lower sexual arousal to the sexual film with distractors, women with relatively lower sexual desire also reported lower sexual arousal to the sexual film with no distractors than women with higher sexual desire. Physiologically, women with lower sexual desire exhibited lower labial temperature. Conclusions., Since the predicted lower self-reported and physiological sexual arousal to the sexual stimulus with distractors for the women with lower sexual desire did not emerge, this study does not support that sexual desire levels vary due to differential attention to sexual stimuli. Prause N, and Heiman J. Reduced labial temperature in response to sexual films with distractors among women with lower sexual desire. J Sex Med 2010;7:951,963. [source] Vaginal Dryness: A Comparison of Prevalence and Interventions in 11 CountriesTHE JOURNAL OF SEXUAL MEDICINE, Issue 9 2009Sandra R. Leiblum PhD ABSTRACT Introduction., There is limited research comparing cross-cultural differences in women's experiences of vaginal dryness. Aim., To examine international differences in the prevalence of vaginal dryness, the degree to which it is experienced as problematic or bothersome, the use of lubricants to alleviate it, and women's discussion of this problem with physicians. Main Outcome Measures., Questionnaire measuring the level of vaginal dryness and degree to which it is perceived as bothersome. Methods., The Global Survey of Sexual Attitudes and Practices was administered to 6,725 women from 11 countries: UK, Germany, Japan, Australia, Canada, Spain, Italy, Mexico, Argentina, Brazil and Thailand. Results., Prevalence of self-reported vaginal dryness varied from a minimum of 5.8% in Italy to a maximum of 19.7% in Brazil. The proportion of women with self-reported vaginal dryness who found it very bothersome varied as well (e.g., 5.6% UK, 26.4% Germany). Pain during intercourse ranged from a reported low of 3.6% in Australia to 18.6% in Brazil. Older women (50,65 years) as compared with younger women (18,34 years) reported significantly more vaginal dryness in the UK, Australia, Canada, Italy, Spain, Argentina, and Thailand (P values <0.02). The majority of women under 50 attributed vaginal dryness to inadequate sexual arousal while women over 50 believed it was because of aging or menopause. Cross-culturally, women differed substantially in the likelihood of discussing their sexual life/concerns with a physician. Conclusion., Women from different countries differ substantially in their experiences, concerns, and reports of vaginal dryness/sexual pain, as well as their familiarity with personal lubricants as a treatment. Researchers should assess the prevalence and degree of the bother of vaginal dryness in order to make international comparisons of the burden of this condition. Leiblum SR, Hayes RD, Wanser RA, and Nelson JS. Vaginal dryness: A comparison of prevalence and interventions in 11 countries. J Sex Med 2009;6:2425,2433. [source] Psychophysiological Assessment of Sexual Function in Women After Radiotherapy and Total Mesorectal Excision for Rectal Cancer: A Pilot Study on Four PatientsTHE JOURNAL OF SEXUAL MEDICINE, Issue 4 2009Stephanie O. Breukink MD ABSTRACT Introduction., The potential contribution of psychological and anatomical changes to sexual dysfunction in female patients following short-term preoperative radiotherapy (5 × 5 Gy) and total mesorectal excision (TME) is not clear. Aim., In this study we assessed female sexual dysfunction in patients who underwent radiotherapy and TME for rectal cancer. Main Outcome Measures., Genital arousal was assessed using vaginal videoplethysmography. Methods., Sexual functioning was examined in four patients who had rectal cancer and underwent radiotherapy and TME. All investigations were done at least 15 months after treatment. The results were compared with an age-matched group of 18 healthy women. Results., The patients and healthy controls showed comparable changes in vaginal vasocongestion during sexual arousal, though three out of four patients showed a lower mean spectral tension (MST) of the vaginal pulse compared with healthy controls. Subjective sexual arousal was equivalent between the two groups. Conclusions., In this study the changes of genital and subjective sexual arousal after erotic stimulus condition between patients and healthy controls were not different, though lower MST of the vaginal pulse was found in three out of four patients compared with healthy women. Additional work, however, must be performed to clarify the mechanisms of sexual dysfunction following treatment of rectal cancer. Breukink SO, Wouda JC, van der Werf - Eldering MJ, van de Wiel HBM, Bouma EMC, Pierie JP- EN, Wiggers T, Meijerink JWJHJ, and Weijmar Schultz WCM. Psychophysiological assessment of sexual function in women after radiotherapy and total mesorectal excision for rectal cancer: A pilot study on four patients. J Sex Med **;**:**,**. [source] The Inhibitory Effects of Nicotine on Physiological Sexual Arousal in Nonsmoking Women: Results from a Randomized, Double-Blind, Placebo-Controlled, Cross-Over TrialTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2008Christopher B. Harte BA ABSTRACT Introduction., Extensive research suggests that long-term cigarette smoking is an independent risk factor for the introduction of sexual dysfunction in men. However, results of limited data investigating this relationship in women are mixed. No studies have examined the acute effects of tobacco or nicotine on physiological sexual response in women. Controlled experimental studies examining acute effects of isolated nicotine intake on female physiological sexual responses are necessary in order to help elucidate tobacco's potential role in the development and/or maintenance of sexual impairment in women. Aim., To examine whether isolated nicotine intake acutely affects sexual arousal responses in nonsmoking women. Methods., Twenty-five sexually functional women (mean age = 20 years) each with less than 100 direct exposures to nicotine completed two counterbalanced conditions in which they were randomized to received either nicotine gum (6 mg) or placebo gum, both administered double-blind and matched for appearance, taste, and consistency, approximately 40 minutes prior to viewing an erotic film. Main Outcome Measures., Physiological (changes in vaginal pulse amplitude via vaginal photoplethysmography) and subjective (continuous self-report) sexual responses to erotic stimuli were examined, as well as changes in mood. Results., Nicotine significantly reduced genital responses to the erotic films (P = 0.05), corresponding to a 30% attenuation in physiological sexual arousal. This occurred in 11 of 18 women with valid physiological assessments. Nicotine had no significant effect on continuous self-report ratings of sexual arousal (P = 0.45), or on mood (all Ps > 0.05). Conclusions., Acute nicotine intake significantly attenuates physiological sexual arousal in healthy nonsmoking women. Our findings provide support to the hypothesis that nicotine may be the primary pharmacological agent responsible for genital hemodynamic disruption, thereby facilitating a cascade of biochemical and vascular events which may impair normal sexual arousal responses. Harte CB, and Meston CM. The inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: Results from a randomized, double-blind, placebo-controlled, cross-over trial. J Sex Med 2008;5:1184,1197. [source] ORIGINAL RESEARCH,BASIC SCIENCE: Immunohistochemical Description of Cyclic Nucleotide Phosphodiesterase (PDE) Isoenzymes in the Human Labia MinoraTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2007Stefan Ückert PhD ABSTRACT Introduction., Up until now, only minimal research has been carried out on those female genital organs known to contribute to the normal cycle of sexual arousal and orgasm. Some findings indicated that there might be a significance of cyclic nucleotide-mediated pathways in the control of the normal function of female genital tissues. Aim., To elucidate, by means of immunohistochemistry, the distribution of the phosphodiesterase (PDE) isoenzymes 1, 3, 4, 5, 10, and 11 in the human labia minora. Main Outcome Measures., The amount of immunohistochemical staining specific for cyclic adenosine monophosphate (cAMP)- and/or cyclic guanosine monophosphate (cGMP)-degrading PDE isoenzymes was detected. Methods., Human labial tissue was obtained from four female cadavers (age at death: 18,42 years). Vibratome sections prepared from formaldehyde-fixated tissue specimens were incubated with primary antibodies directed against the respective PDE isoenzymes. Sections were then incubated with fluorochrome (fluorescein isothiocyanate, Texas Red)-labeled secondary antibodies. Visualization was commenced by means of a laser fluorescence microscope. Results., Immunostaining indicating the expression of PDE4 and PDE5 was abundantly observed in the smooth musculature of vessels interspersing the tissue. Immunoreactions specific for PDE3 were recognized in epithelial and subepithelial layers, sebaceous glands, and interstitial or neuroendocrine-like single cells located in the epithelium. Signals related to PDE10 and PDE11 were limited to the epithelium or glandular-like structures, respectively. Conclusions., Our results, for the first time, demonstrate the presence of cAMP- and cGMP-PDE isoenzymes in the human labia minora and give a hint to a significance of PDE4 and PDE5 in the control of labial vascular tissue function. Ückert S, Oelke M, Albrecht K, Stief C, Jonas U, and Hedlund P. Immunohistochemical description of cyclic nucleotide phosphodiesterase (PDE) isoenzymes in the human labia minora. J Sex Med 2007;4:602,608. [source] ORIGINAL RESEARCH,PHYSIOLOGY: Sensation and Sexual Arousal in Circumcised and Uncircumcised MenTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2007Kimberley Payne PhD ABSTRACT Introduction., Research, theory, and popular belief all suggest that penile sensation is greater in the uncircumcised as compared with the circumcised man. However, research involving direct measurement of penile sensation has been undertaken only in sexually functional and dysfunctional groups, and as a correlate of sexual behavior. There are no reports of penile sensation in sexually aroused subjects, and it is not known how arousal affects sensation. In principle, this should be more closely related to actual sexual function. Aim., This study therefore compared genital and nongenital sensation as a function of sexual arousal in circumcised and uncircumcised men. Methods., Twenty uncircumcised men and an equal number of age-matched circumcised participants underwent genital and nongenital sensory testing at baseline and in response to erotic and control stimulus films. Touch and pain thresholds were assessed on the penile shaft, the glans penis, and the volar surface of the forearm. Sexual arousal was assessed via thermal imaging of the penis. Results., In response to the erotic stimulus, both groups evidenced a significant increase in penile temperature, which correlated highly with subjective reports of sexual arousal. Uncircumcised men had significantly lower penile temperature than circumcised men, and evidenced a larger increase in penile temperature with sexual arousal. No differences in genital sensitivity were found between the uncircumcised and circumcised groups. Uncircumcised men were less sensitive to touch on the forearm than circumcised men. A decrease in overall touch sensitivity was observed in both groups with exposure to the erotic film as compared with either baseline or control stimulus film conditions. No significant effect was found for pain sensitivity. Conclusion., These results do not support the hypothesized penile sensory differences associated with circumcision. However, group differences in penile temperature and sexual response were found. Payne K, Thaler L, Kukkonen T, Carrier S, and Binik Y. Sensation and sexual arousal in circumcised and uncircumcised men. J Sex Med 2007;4:667,674. [source] Hormonal Changes in Menopause and Implications on Sexual HealthTHE JOURNAL OF SEXUAL MEDICINE, Issue 2007Anneliese Schwenkhagen MD ABSTRACT Introduction., The menopause is characterized by an array of changes to the female body caused by modulations which occur in the production of estrogens and androgens. The ovaries are important sites of testosterone production in the peri- and postmenopausal women, but the contribution of testosterone pro-hormones from the adrenal glands falls precipitously to the extent where the ovaries cannot correct the deficit. This results in a net decline in circulating testosterone levels. Aims., This paper gives an overview of this interesting subject area. Researchers have cogitated on the relationship between the physical effects of the menopause and the observed declines in testosterone levels, but it is now much clearer that falling testosterone levels cannot explain all of these changes. Main Outcome Measures., The cessation of follicular functioning results in a steep decline in the production of estrogens. This modulation is responsible for the physical manifestations of the menopause,hot flushes, sleep disturbances, mood changes, bleeding problems, local urogenital problems, vaginal changes, etc. Methods., A review of the pertinent literature was conducted to investigate hormonal changes around the menopause. A précis of the salient information is presented here. Results., Although the most obvious and well-known effects of the menopause are due to the decline of estrogen levels, the effects of falling testosterone levels are subtle, but by no means less significant. Reductions in sexual motivation, sexual arousal, vaginal lubrication, etc. are all associated with plummeting androgen levels. Conclusions., Today, several options exist for the treatment of the endocrinological changes associated with the menopause. Estrogen deficiency can be corrected with hormone replacement therapy and topical preparations for the genitalia. A new transdermal system for the administration of testosterone shows a great deal of potential for the treatment of androgen deficiency. Schwenkhagen A. Hormonal changes in menopause and implications on sexual health. J Sex Med 2007;4(suppl 3):220,226. [source] ORIGINAL RESEARCH,PHYSIOLOGY: Thermography as a Physiological Measure of Sexual Arousal in Both Men and WomenTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2007Tuuli M. Kukkonen BA ABSTRACT Introduction., Current physiological measures of sexual arousal are intrusive, hard to compare between genders, and quantitatively problematic. Aim., To investigate thermal imaging technology as a means of solving these problems. Methods., Twenty-eight healthy men and 30 healthy women viewed a neutral film clip, after which they were randomly assigned to view one of three other video conditions: (i) neutral (N = 19); (ii) humor (N = 19); and (iii) sexually explicit (N = 20). Main Outcome Measures., Genital and thigh temperatures were continuously recorded using a TSA ImagIR camera. Subjective measures of sexual arousal, humor, and relaxation were assessed using Likert-style questions prior to showing the baseline video and following each film. Results., Statistical (Tukey HSD) post-hoc comparisons (P < 0.05) demonstrated that both men and women viewing the sexually arousing video had significantly greater genital temperature (mean = 33.89°C, SD = 1.00) than those in the humor (mean = 32.09°C, SD = 0.93) or neutral (mean = 32.13°C, SD = 1.24) conditions. Men and women in the erotic condition did not differ from each other in time to peak genital temperature (men mean = 664.6 seconds, SD = 164.99; women mean = 743 seconds, SD = 137.87). Furthermore, genital temperature was significantly and highly correlated with subjective ratings of sexual arousal (range r = 0.51,0.68, P < 0.001). There were no significant differences in thigh temperature between groups. Conclusion., Thermal imaging is a promising technology for the assessment of physiological sexual arousal in both men and women. Kukkonen TM, Binik YM, Amsel R, and Carrier S. Thermography as a physiological measure of sexual arousal in both men and women. J Sex Med 2007;4:93,105. [source] ORIGINAL RESEARCH,ENDOCRINOLOGY: Transdermal Testosterone Gel prn Application for Hypoactive Sexual Desire Disorder in Premenopausal Women: A Controlled Pilot Study of the Effects on the Arizona Sexual Experiences Scale for Females and Sexual Function QuestionnaireTHE JOURNAL OF SEXUAL MEDICINE, Issue 1 2007Bella Chudakov MD ABSTRACT Introduction., Several studies suggest that increased plasma testosterone can improve sexual function and desire in post-oophorectomy or postmenopausal women. However, side effects of chronic daily testosterone raise questions about the generalizability of this treatment approach. Sublingual testosterone was reported to cause testosterone levels to peak after 15 minutes and then decline to baseline levels within 90 minutes. Three to 4 hours after reaching testosterone peak, increased genital sensations and sexual lust were reported. Aim., We hypothesized that a singe dose of testosterone given 4,8 hours prior to planned intercourse in women with hypoactive sexual desire disorder (HSDD) might increase desire without side effects associated with chronic use. Methods., The design was randomized double-blind crossover. Premenstrual women with HSDD received eight packets of gel or identical placebo for use before intercourse twice weekly for 1 month. For a second month, the alternate treatment was given. Main Outcome Measures., Ratings were performed using the patient-rated Arizona Sexual Experiences Scale for females and the clinician-rated Sexual Function Questionnaire (SFQ-V1). Results., Ten patients completed the study. On the five-item self-report Arizona, the item "How easily are you aroused?" was significantly improved on testosterone gel vs. placebo, P = 0.03. There were similar trends on the physician-rated SFQ-V1 "arousal,sensation" cluster. Conclusions., These preliminary results suggest that testosterone gel given prn before intercourse has effects on sexual arousal, and further research is needed to define dosage and time schedule to optimize this effect and determine its clinical relevance. Chudakov B, Ben Zion IZ, and Belmaker RH. Transdermal testosterone gel prn application for hypoactive sexual desire disorder in premenopausal women: A controlled pilot study of the effects on the Arizona Sexual Experiences Scale for females and Sexual Function Questionnaire. J Sex Med 2007;4:204,208. [source] Nipple/Breast Stimulation and Sexual Arousal in Young Men and WomenTHE JOURNAL OF SEXUAL MEDICINE, Issue 3 2006Roy Levin PhD ABSTRACT Introduction., The role of nipple/breast stimulation in influencing sexual arousal in men and women during lovemaking has only been the subject of opinion-based comment rather than evidence-based study. No attempt to question people about such sexual behavior has ever been undertaken. Aim., The study was designed to ascertain the effects of nipple/breast manipulation in young men and women on their sexual arousal. Methods., A short questionnaire about nipple/breast stimulation during sexual activity was administered to 301 (148 men; 153 women) sexually experienced undergraduates (age range 17,29 years, 95% between 18 and 22). Main Outcome Measures., Replies to questions in questionnaire. Results., The major findings in regard to the women were that 81.5% reported that stimulation of their nipples/breasts caused or enhanced their sexual arousal, 78.2% agreed that when sexually aroused such manipulation increased their arousal, 59.1% had asked to have their nipples stimulated during lovemaking, and only 7.2% found that the manipulation decreased their arousal. In regard to the men, 51.7% reported that nipple stimulation caused or enhanced their sexual arousal, 39% agreed that when sexually aroused such manipulation increased their arousal, only 17.1% had asked to have their nipples stimulated, and only 7.5% found that such stimulation decreased their arousal. Conclusion., Manipulation of the nipples/breasts causes or enhances sexual arousal in approximately 82% of young women and 52% of young men with only 7,8% reporting that it decreased their arousal. Levin R, and Meston C. Nipple/breast stimulation and sexual arousal in young men and women. J Sex Med 2006;3:450,454. [source] |