Plasma anandamide and related n-acylethanolamide levels are not elevated in pregnancies complicated by hyperemesis gravidarum

Abstract

Objectives: Cannabinoids are effective antiemetics and the “endogenous cannabinoids” (endocannabinoids) are thought to modulate emesis in both humans and animal models. Endocannabinoids, their receptors and their metabolising enzymes are present in peripheral blood and a reduction in blood endocannabinoid concentration has been observed in individuals with excessive nausea and vomiting following parabolic flight manoeuvres. We tested the hypothesis that plasma endocannabinoid levels are similarly perturbed in women with hyperemesis gravidarum (HG), a condition where the aetiopathogenesis is still unknown, compared to normal pregnant controls.

Methods: Plasma N-arachidonoylethanolamine (anandamide), N-oleoylethanolamide and N-palmitoylethanolamide were quantified in women with HG (n?=?15) and matched normal pregnant controls (n?=?30) using UHPLC-ESI-MS/MS utilising an isotope dilution method and selective ion monitoring.

Results: No significant differences in anandamide, oleoylethanolamide and palmitoylethanolamide levels were observed between the two groups. There were no significant correlations between these endocannabinoids and plasma haematocrit and serum urea or sodium concentrations.

Conclusions: These results would suggest that either the circulating endocannabinoids quantified may not be key modulating factors in HG or that the expected endocannabinoid system response to the stress induced by nausea and vomiting of early pregnancy remain unchanged in women with HG.     

Anandamide Transforms Noncopulating Rats into Sexually Active Animals

IntroductionNoncopulating (NC) male rats are apparently normal and healthy animals that will not mate despite repeated exposure to sexually receptive females. Several lines of evidence suggest the involvement of endogenous opioids in this sexual inhibitory state. Endogenous opioids and endocannabinoids are neuromodulators of neurotransmitter release, although through different mechanisms.AimTo establish if the endocannabinoid anandamide was able to induce sexual behavior expression in male rats classified as noncopulators.MethodsNC male rats were intraperitoneally (i.p.) injected with anandamide or vehicle and tested for copulatory behavior with a receptive female during 120 minutes. Fourteen days after anandamide or vehicle injection, the animals were subjected to a second sexual behavior test during 60 minutes.Main Outcome MeasuresThe percentage of rats showing male sexual behavior responses: mount, intromission, ejaculation, and copulation resumption after ejaculation and the specific sexual behavior parameters were quantified.ResultsAnandamide injection induced sexual behavior expression in 50% of previously NC rats, while the NC animals injected with vehicle did not show sexual behavior. The responding animals executed several successive ejaculatory series and were still capable of showing sexual behavior 14 days after anandamide injection. Copulation in these rats (the first copulatory series) was characterized by a large number of mounts and intromissions preceding ejaculation, as well as by statistically significant increases in the latencies to mount, intromit, and ejaculate when compared with the sexual performance of sexually naïve animals copulating for the first time.ConclusionThe endocannabinoid anandamide transforms previously NC rats into sexually active animals, capable of showing sexual behavior in a long-lasting manner. Only half of the NC population responds to anandamide injection, suggesting that different mechanisms underlie the sexual inhibition of NC rats. The endocannabinoid system seems to play a role in the regulation of male rat sexual behavior expression. Canseco-Alba A and Rodríguez-Manzo G. Anandamide transforms noncopulating rats into sexually active animals. J Sex Med 2013;10:686–693.     

Circulating Endocannabinoid Concentrations and Sexual Arousal in Women

IntroductionSeveral lines of evidence point to the potential role of the endocannabinoid system in female sexual functioning. These include results from studies describing the subjective effects of exogenous cannabinoids on sexual functioning in humans and the observable effects of exogenous cannabinoids on sexual functioning in other species, as well as results from studies investigating the location of cannabinoid receptors in the brain and periphery, and the effects of cannabinoid receptor activation on neurotransmitters implicated in sexual functioning. While these lines of research suggest a role for the endocannabinoid system in female sexual functioning, no studies investigating the relationship between concentrations of endogenous cannabinoids (i.e., arachidonoylethanolamide [AEA] and 2-arachidonoylglycerol [2-AG]) and sexual functioning have been conducted in any species.AimTo measure circulating endocannabinoid concentrations in relation to subjective and physiological indices of sexual arousal in women (N = 21).MethodsSerum endocannabinoid (AEA and 2-AG) concentrations were measured immediately prior to, and immediately following, viewing of neutral (control) and erotic (experimental) film stimuli in a repeated measures design. Physiological sexual arousal was measured via vaginal photoplethysmography. Subjective sexual arousal was measured both continuously and noncontinuously. Pearson's correlations were used to investigate the relationships between endocannabinoid concentrations and sexual arousal.Main Outcome MeasuresChanges in AEA and 2-AG concentrations from pre- to post-film and in relation to physiological and subjective indices of sexual arousal.ResultsResults revealed a significant relationship between endocannabinoid concentrations and female sexual arousal, whereby increases in both physiological and subjective indices of sexual arousal were significantly associated with decreases in AEA, and increases in subjective indices of sexual arousal were significantly associated with decreases in 2-AG.ConclusionsThese findings support the hypothesis that the endocannabinoid system is involved in female sexual functioning, with implications for furthering understanding of the biological mechanisms underlying female sexual functioning. Klein C, Hill MN, Chang SCH, Hillard CJ, and Gorzalka BB. Circulating endocannabinoid concentrations and sexual arousal in women. J Sex Med 2012;9:1588–1601.     

Sexual Satisfaction,Sexual Compatibility,and Relationship Adjustment in Couples: The Role of Sexual Behaviors,Orgasm, and Men's Discernment of Women's Intercourse Orgasm

IntroductionResearch indicated that (i) vaginal orgasm consistency is associated with indices of psychological, intimate relationship, and physiological functioning, and (ii) masturbation is adversely associated with some such measures.AimThe aim of this study was to examine the association of various dyadic and masturbation behavior frequencies and percentage of female orgasms during these activities with: (i) measures of dyadic adjustment; (ii) sexual satisfaction; and (iii) compatibility perceived by both partners.MethodsIn a sample of 85 Czech long‐term couples (aged 20–40; mean relationship length 5.4 years), both partners provided details of recent sexual behaviors and completed sexual satisfaction, Spanier dyadic adjustment, and Hurlbert sexual compatibility measures. Multiple regression analyses were used.Main Outcome MeasureThe association of sexual behaviors with dyadic adjustment, sexual compatibility, and satisfaction was analyzed.ResultsIn multivariate analyses, women's dyadic adjustment is independently predicted by greater vaginal orgasm consistency and lower frequency of women's masturbation. For both sexes, sexual compatibility was independently predicted by higher frequency of penile–vaginal intercourse and greater vaginal orgasm consistency. Women's sexual satisfaction score was significantly predicted by greater vaginal orgasm consistency, frequency of partner genital stimulation, and negatively with masturbation. Men's sexual satisfaction score was significantly predicted by greater intercourse frequency and any vaginal orgasm of their female partners. Concordance of partner vaginal orgasm consistency estimates was associated with greater dyadic adjustment.ConclusionsThe findings suggest that specifically penile–vaginal intercourse frequency and vaginal orgasm consistency are associated with indices of greater intimate relationship adjustment, satisfaction, and compatibility of both partners, and that women's masturbation is independently inversely associated with measures of dyadic and personal function. Results are discussed in light of previous research and an evolutionary theory of vaginal orgasm. Klapilová K, Brody S, Krejčová L, Husárová B, and Binter J. Sexual satisfaction, sexual compatibility, and relationship adjustment in couples: The role of sexual behaviors, orgasm, and men's discernment of women's intercourse orgasm. J Sex Med 2015;12:667–675.     

Pleasure and Pain: The Effect of (Almost) Having an Orgasm on Genital and Nongenital Sensitivity

IntroductionThe effect of sexual arousal and orgasm on genital sensitivity has received little research attention, and no study has assessed sensation pleasurableness as well as painfulness.AimTo clarify the relationship between sexual arousal, orgasm, and sensitivity in a healthy female sample.MethodsTwenty‐six women privately masturbated to orgasm and almost to orgasm at two separate sessions, during which standardized pressure stimulation was applied to the glans clitoris, vulvar vestibule, and volar forearm at three testing times: (i) baseline; (ii) immediately following masturbation; and (iii) following a subsequent 15‐minute rest period.Main Outcome MeasuresTouch thresholds (tactile detection sensitivity), sensation pleasurableness ratings (pleasurable sensitivity), and pain thresholds (pain sensitivity).ResultsPleasurableness ratings were higher on the glans clitoris than the vulvar vestibule, and at most testing times on the vulvar vestibule than the volar forearm; and at baseline and immediately after masturbation than 15 minutes later, mainly on the genital locations only. Pain thresholds were lower on the genital locations than the volar forearm, and immediately and 15 minutes after masturbation than at baseline. After orgasm, genital pleasurableness ratings and vulvar vestibular pain thresholds were lower than after masturbation almost to orgasm. Post‐masturbation pleasurableness ratings were positively correlated with pain thresholds but only on the glans clitoris. Hormonal contraception users had lower pleasurableness ratings and pain thresholds on all locations than nonusers. There were no significant effects for touch thresholds.ConclusionsMasturbation appears to maintain pleasurable genital sensitivity but increase pain sensitivity, with lower genital pleasurable sensitivity and higher vulvar vestibular pain sensitivity when orgasm occurs. Findings suggest that enhancing stimulation pleasurableness, psychological sexual arousal and lubrication mitigate normative increases in pain sensitivity during sexual activity, and underscore the importance of measuring both pleasure and pain in sensation research.     

Masturbatory Behavior in a Population Sample of German Women

BackgroundHuman masturbation is and has been a very heatedly and controversially discussed topic in human sexuality. Studies investigating aspects of human masturbatory behavior and female sexual pleasure remain scarce. This lack of knowledge opens the door to further controversies and misconceptions.AimTo conduct an explorative study on female masturbatory behavior to gain more insight into this nonreproductive sexual behavior and provide an empiric basis for future research.MethodsA total of 425 German women (mean age 26.6 years), 61.4% of whom were in a committed relationship, completed a comprehensive 76-item online survey consisting of study-specific, self-constructed questions and validated and standardized questionnaires.Main Outcome MeasureCorrelation and comparative analyses were performed. Results are presented numerically as means and percentages.ResultsThe majority (94.5%) of women indicated having masturbated at least once in their life, with a mean age at first masturbation of 14 years. 85.9% of women described masturbation as “genital self-stimulation until reaching orgasm.” The majority of women reported masturbating 2 or 3 times a week (26.8%) or once a week (26.3%). Factors independently associated with masturbation frequency were relationship status, orgasm frequency, openness to new experience, and body acceptance. Almost all women (91.5%) reported masturbating also when in a relationship. For the 5.5% of women who had never engaged in autoerotic stimulation, the 2 main reasons were “I hardly every feel sexual desire” and “sex is a partner-only thing.” 7.6% reported never experiencing an orgasm during masturbation, whereas 50.3% indicated that they always reached orgasm during autostimulation. The reasons cited for engaging in masturbation were manifold, ranging from sexual desire to relaxation and stress reduction. The most common fantasy included the partner; however, 20.7% fantasized about being “defenseless,” and 8.7% thought about a “disturbing” scenario that they chose not to elaborate further.Clinical ImplicationsFor many women, masturbation does not represent “a partner substitute” to seek sexual pleasure, but rather is a stress coping and relaxation strategy.Strengths & LimitationsThis is one of the very first studies to provide more in-depth insight into a variety of aspects related to female masturbation. The representativeness of the data is limited to this particular sample of German women.ConclusionOur findings highlight the huge diversity in terms of masturbation frequency, motivations, styles, and preferences that can be observed in this particular population sample of German women.Burri A, Carvalheira A. Masturbatory Behavior in a Population Sample of German Women. J Sex Med 2019;16:963–974.     

More Frequent Vaginal Orgasm Is Associated with Experiencing Greater Excitement from Deep Vaginal Stimulation

IntroductionResearch indicated that: (i) vaginal orgasm (induced by penile–vaginal intercourse [PVI] without concurrent clitoral masturbation) consistency (vaginal orgasm consistency [VOC]; percentage of PVI occasions resulting in vaginal orgasm) is associated with mental attention to vaginal sensations during PVI, preference for a longer penis, and indices of psychological and physiological functioning, and (ii) clitoral, distal vaginal, and deep vaginal/cervical stimulation project via different peripheral nerves to different brain regions.AimsThe aim of this study is to examine the association of VOC with: (i) sexual arousability perceived from deep vaginal stimulation (compared with middle and shallow vaginal stimulation and clitoral stimulation), and (ii) whether vaginal stimulation was present during the woman's first masturbation.MethodsA sample of 75 Czech women (aged 18–36), provided details of recent VOC, site of genital stimulation during first masturbation, and their recent sexual arousability from the four genital sites.Main Outcome MeasuresThe association of VOC with: (i) sexual arousability perceived from the four genital sites and (ii) involvement of vaginal stimulation in first-ever masturbation.ResultsVOC was associated with greater sexual arousability from deep vaginal stimulation but not with sexual arousability from other genital sites. VOC was also associated with women's first masturbation incorporating (or being exclusively) vaginal stimulation.ConclusionsThe findings suggest (i) stimulating the vagina during early life masturbation might indicate individual readiness for developing greater vaginal responsiveness, leading to adult greater VOC, and (ii) current sensitivity of deep vaginal and cervical regions is associated with VOC, which might be due to some combination of different neurophysiological projections of the deep regions and their greater responsiveness to penile stimulation. Brody S, Klapilova K, and Krej?ová L. More frequent vaginal orgasm is associated with experiencing greater excitement from deep vaginal stimulation.     

Between Pleasure and Pain: A Pilot Study on the Biological Mechanisms Associated With BDSM Interactions in Dominants and Submissives

BackgroundBDSM is an abbreviation used to reference the concepts of bondage and discipline, dominance and submission, sadism, and masochism, enacted by power exchanges between consensual partners.AimTo shed light upon the rewarding biological mechanisms associated with BDSM interactions.MethodsA group of 35 BDSM couples (dominant and submissive counterparts) were recruited and tested during a BDSM interaction, with an additional control group of 27 non-BDSM interested people tested in a normal social interaction.OutcomesWe compared the evolution of the stress and reward hormone levels of cortisol, beta-endorphins, and endocannabinoids (2AG and anandamide) in a group of BDSM practitioners before and after an active BDSM interaction with the levels in control individuals.ResultsWe showed that submissives showed increases in cortisol and endocannabinoid levels due to the BDSM interaction, with dominants only showing increased endocannabinoid levels when the BDSM interaction was associated with power play.Clinical ImplicationsThis study effectively provides a link between behavior that many think of as aberrant on one hand, and biological pleasure experience on the other, in the hope that it may relieve some of the stigma these practitioners still endure.Strengths & LimitationsIt is one of the first and largest studies of its kind, but is still limited in sample size and only represents a specific population of Flemish BDSM practitioners.ConclusionEven though this is one of the first studies of its kind, we can conclude that there is a clear indication for increased pleasure in submissives when looking at biological effects of a BDSM interaction, which was related to the increases in experienced stress.Wuyts E, De Neef N, Coppens V, et al. Between Pleasure and Pain: A Pilot Study on the Biological Mechanisms Associated With BDSM Interactions in Dominants and Submissives. J Sex Med 2020;17:784–792.     

Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD)

BackgroundOrgasm occurrence plays an important role in general sexual satisfaction for women. Until now, only few studies have focused on examining a broad spectrum of sexuality- and relationship-specific factors associated with orgasm in heterosexual women currently in a long-term relationship or on differences between the overall experience of orgasm and multiple orgasms.AimThe present study aims to understand how various sexuality- and relationship-associated factors are related to experiencing partnered orgasm among heterosexual women having stable relationships in Germany. Moreover, the study aims to differentiate between the overall experience of orgasm and the experience of multiple orgasms and shed light on their impact on general sexual satisfaction.MethodsWithin the nationwide representative survey GeSiD (German Health and Sexuality Survey), n = 1,641 sexually active women aged between 18 and 75 years in heterosexual relationships reported their experience of orgasm during the latest sexual encounter. Data on the type of sexual practices, frequency of sexual activity and of masturbation, relationship satisfaction, feelings of love, closeness, and general sexual satisfaction were analyzed.OutcomesThe overall experience of orgasm, the experience of multiple orgasms, and associations between experiencing orgasm and sexual satisfaction.ResultsFrequency of sexual activity, relationship satisfaction, feelings of love and closeness were moderately to strongly positively correlated with each other and each showed positive associations with the likelihood of orgasm. Greater number of sexual practices and frequency of sexual activity were associated with an increased likelihood of experiencing multiple orgasms, which in turn was correlated with higher sexual satisfaction.Clinical ImplicationsIn clinical and therapeutic work with women who have difficulty achieving orgasm, central issues should be the perceived relationship quality as well as regular sexual activity with the partner.Strengths & LimitationsThe present population-representative study is the first in Germany to identify significant factors associated with the experience of orgasm among heterosexual women in relationships. Further studies ought to include the frequency of orgasms in partnered sex over a longer period of time as well as the experience of orgasm during masturbation.ConclusionThe experience of orgasm for women is related to a variety of complex interpersonal mechanisms and to be associated with sexual satisfaction.Cerwenka S, Dekker A, Pietras L, et al. Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD). J Sex Med 2021;18:2028–2038.     

Sexual behavior predictors of satisfaction in a Chinese sample

IntroductionPrevious multivariate research in Europe found that sexual satisfaction was associated directly with frequency of penile–vaginal intercourse (PVI) but inversely with masturbation and some aspects of non‐PVI partnered sex.AimsTo examine the associations of sexual satisfaction in a sample from the People's Republic of China, including not only frequencies of various sexual behaviors, but also frequencies of orgasm.MethodsChinese industrial workers (N = 158, age over 24 years) completed the sexual satisfaction scale of the Multidimensional Sexuality Questionnaire (MSQ) and a short form of the Marlowe‐Crowne social desirability scale, and provided details of the one month frequencies of engaging in, and having an orgasm from, PVI, masturbation, and non‐PVI partnered sex.Main Outcome MeasuresMultiple regression prediction of sexual satisfaction from age, social desirability responding, and in separate analyses, frequencies of the sexual behaviors or the corresponding orgasm frequencies.ResultsFor men and women, sexual satisfaction was associated with frequency of PVI and of PVI orgasm (the latter for women only), but not other sexual behavior or orgasm frequency. Similar results were obtained for the MSQ satisfaction scale and for a single satisfaction item.ConclusionsDespite cultural differences (and our smaller, less diverse sample), the positive prediction of satisfaction from only PVI (and in our sample of women, PVI orgasm) frequency—but not other sexual activities—was similar to that in a Swedish sample. Future research might also examine possible occasional avoidance of ejaculation by some Chinese men. Tao P and Brody S. Sexual behavior predictors of satisfaction in a Chinese sample.     

Female orgasm rates are largely independent of other traits: implications for "female orgasmic disorder" and evolutionary theories of orgasm

IntroductionThe criteria for “female orgasmic disorder” (FOD) assume that low rates of orgasm are dysfunctional, implying that high rates are functional. Evolutionary theories about the function of female orgasm predict correlations of orgasm rates with sexual attitudes and behavior and other fitness‐related traits.AimTo test hypothesized evolutionary functions of the female orgasm.MethodsWe examined such correlations in a community sample of 2,914 adult female Australian twins who reported their orgasm rates during masturbation, intercourse, and other sexual activities, and who completed demographic, personality, and sexuality questionnaires.Main Outcome MeasuresOrgasm rates during intercourse, other sex, and masturbation.ResultsAlthough orgasm rates showed high variance across women and substantial heritability, they were largely phenotypically and genetically independent of other important traits. We found zero to weak phenotypic correlations between all three orgasm rates and all other 19 traits examined, including occupational status, social class, educational attainment, extraversion, neuroticism, psychoticism, impulsiveness, childhood illness, maternal pregnancy stress, marital status, political liberalism, restrictive attitudes toward sex, libido, lifetime number of sex partners, risky sexual behavior, masculinity, orientation toward uncommitted sex, age of first intercourse, and sexual fantasy. Furthermore, none of the correlations had significant genetic components.ConclusionThese findings cast doubt on most current evolutionary theories about female orgasm's adaptive functions, and on the validity of FOD as a psychiatric construct. Zietsch BP, Miller GF, Bailey JM, and Martin NG. Female orgasm rates are largely independent of other traits: Implications for “female orgasmic disorder” and evolutionary theories of orgasm. J Sex Med 2011;8:2305–2316.     

Vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip

IntroductionRecent studies have uncovered multiple markers of vaginal orgasm history (unblocked pelvic movement during walking, less use of immature psychological defense mechanisms, greater urethrovaginal space). Other markers (perhaps of prenatal origin) even without obvious mechanistic roles in vaginal orgasm might exist, and a clinical observation led to the novel hypothesis that a prominent tubercle of the upper lip is such a marker.AimsTo examine the hypothesis that a prominent tubercle of the upper lip is associated specifically with greater likelihood of experiencing vaginal orgasm (orgasm elicited by penile–vaginal intercourse [PVI] without concurrent masturbation).MethodsWomen (N = 258, predominantly Scottish) completed an online survey reporting their frequencies of various sexual activities and corresponding orgasms, age, and the prominence of the tubercle of their upper lip. Social desirability response bias was also assessed.Main Outcome MeasuresMultivariate associations of lip tubercle prominence with vaginal orgasm (ever and past month consistency) and with orgasm by other means.ResultsA prominent and sharply raised lip tubercle was associated with greater odds (odds ratio = 12.3) of ever having a vaginal orgasm, and also with greater past month vaginal orgasm consistency (an effect driven by the women who never had a vaginal orgasm), than less prominent lip tubercle categories. Lip tubercle was not associated with social desirability responding, or with orgasm triggered by masturbation during PVI, solitary or partner clitoral or vaginal masturbation, vibrator, or cunnilingus.ConclusionsThe results are discussed in light of the unique nature of vaginal orgasm and the possibility of prenatal developmental influences. Brody S and Costa RM. prominent tubercle of the upper lip. J Sex Med 2011;8:2793–2799.     

Relationship Between Masturbation and Partnered Sex in Women: Does the Former Facilitate,Inhibit, or Not Affect the Latter?

IntroductionThe relationship between masturbation activities and their effect on partnered sex is understudied.AimThe aim of this study was to assess the alignment of activities between masturbation and partnered sex, and to determine whether different levels of alignment affect orgasmic parameters during partnered sex.Methods2,215 women completed an online survey about activities during masturbation and reasons for orgasmic difficulty during masturbation, and these were compared with activities and reasons for orgasmic difficulty during partnered sex.Main Outcome MeasureDegree of alignment between masturbation activities and partnered sex activities was used to predict sexual arousal difficulty, orgasmic probability, orgasmic pleasure, orgasmic latency, and orgasmic difficulty during partnered sex.ResultsWomen showed only moderate alignment regarding masturbation and partnered sex activities, as well as reasons for masturbation orgasmic difficulty and reasons for partnered sex orgasmic difficulty. However, those that showed greater alignment of activities showed better orgasmic response during partnered sex and were more likely to prefer partnered sex over masturbation.Clinical ImplicationsWomen tend to use less conventional techniques for arousal during masturbation compared with partnered sex. Increasing alignment between masturbation and partnered sexual activities may lead to better arousal and orgasmic response, and lower orgasmic difficulty.Strength & LimitationsThe study was well-powered and drew from a multinational population, providing perspective on a long-standing unanswered question. Major limitations were the younger age and self-selection of the sample.ConclusionWomen that align masturbation stimulation activities with partnered sex activities are more likely to experience orgasm and enhanced orgasmic pleasure, with sexual relationship satisfaction playing an important role in this process.Rowland DL, Hevesi K, Conway GR, et al. Relationship Between Masturbation and Partnered Sex in Women: Does the Former Facilitate, Inhibit, or Not Affect the Latter? J Sex Med 2020;17:37–47.     

Greater Tactile Sensitivity and Less Use of Immature Psychological Defense Mechanisms Predict Women's Penile-Vaginal Intercourse Orgasm

IntroductionPrevious research has suggested that diminished tactile sensitivity might be associated with reduced sexual activity and function. Research has also demonstrated significant physiological and psychological differences between sexual behaviors, including immature psychological defense mechanisms (associated with various psychopathologies) impairing specifically women's orgasm from penile-vaginal intercourse (PVI).AimsTo examine the extent to which orgasm triggered by PVI (distinguished from other sexual activities) is associated with both greater tactile sensitivity and lesser use of immature psychological defenses.MethodsSeventy French-Canadian female university students (aged 18–30) had their finger sensitivity measured with von Frey type microfilaments, completed the Defense Style Questionnaire and a short form of the Marlowe-Crowne social desirability scale, and provided details of the 1 month (and ever) frequencies of engaging in, and having an orgasm from, PVI, masturbation, anal intercourse, partner masturbation, and cunnilingus.Main Outcome MeasuresLogistic and linear regression prediction of orgasm triggered by PVI from tactile sensitivity, age, social desirability responding, and immature psychological defenses.ResultsHaving a PVI orgasm in the past month was associated with greater tactile sensitivity (odds ratio = 4.0 for each filament point) and less use of immature defense mechanisms (odds ratio = 5.1 for each scale point). Lifetime PVI orgasm was associated only with less use of immature defense mechanisms (and lower social desirability responding score). Orgasms triggered by other activities were not associated with either tactile sensitivity or immature defense mechanisms. Tactile sensitivity was also associated with greater past month PVI frequency (inclusion of PVI frequency in a logistic regression model displaced tactile sensitivity), and lesser use of immature defenses was associated with greater past month PVI and PVI orgasm frequencies.ConclusionsBoth diminished physical sensitivity and the presence of specific psychological impairments might decrease the likelihood of women's orgasm from specifically PVI, but not other sexual activities. Brody S, Houde S, and Hess U. Greater tactile sensitivity and less use of immature psychological defense mechanisms predict women's penile-vaginal intercourse orgasm.     

Accuracy of 30‐Day Recall for Components of Sexual Function and the Moderating Effects of Gender and Mood

IntroductionDespite the ubiquity of 1‐month recall periods for measures of sexual function, there is limited evidence for how well recalled responses correspond to individuals' actual daily experiences.AimTo characterize the correspondence between daily sexual experiences and 1‐month recall of those experiences.MethodsFollowing a baseline assessment of sexual functioning, health, and demographic characteristics, 202 adults from the general population (101 women, 101 men) were recruited to complete daily assessments of their sexual function online for 30 days and a single recall measure of sexual function at day 30.Main Outcome MeasuresAt the baseline and 30‐day follow‐ups, participants answered items asking about sexual satisfaction, sexual activities, interest, interfering factors, orgasm, sexual functioning, and use of therapeutic aids during the previous 30 days. Participants also completed a measure of positive and negative affect at follow‐up. The main outcome measures were agreement between the daily and 1‐month recall versions of the sexual function items.ResultsAccuracy of recall varied depending on the item and on the gender and mood of the respondent. Recall was better (low bias and higher correlations) for sexual activities, vaginal discomfort, erectile function, and more frequently used therapeutic aids. Recall was poorer for interest, affectionate behaviors (e.g., kissing), and orgasm‐related items. Men more than women overestimated frequency of interest and masturbation. Concurrent mood was related to over‐ or underreporting for six items addressing the frequency of masturbation and vaginal intercourse, erectile function, and orgasm.ConclusionsA 1‐month recall period seems acceptable for many aspects of sexual function in this population, but recall for some items was poor. Researchers should be aware that concurrent mood can have a powerful biasing effect on reports of sexual function. Weinfurt KP, Lin L, Dombeck CB, Broderick JE, Snyder DC, Williams MS, Fawzy MR, and Flynn KE. Accuracy of 30‐day recall for components of sexual function and the moderating effects of gender and mood. J Sex Med 2014;11:678–696.     

Quality of life and sexual health after sex reassignment surgery in transsexual men

IntroductionAlthough sexual health after genital surgery is an important outcome factor for many transsexual persons, little attention has been attributed to this subject.AimsTo provide data on quality of life and sexual health after sex reassignment surgery (SRS) in transsexual men.MethodsA single‐center, cross‐sectional study in 49 transsexual men (mean age 37 years) after long‐term testosterone therapy and on average 8 years after SRS. Ninety‐four percent of the participants had phalloplasty.Main Outcome MeasuresSelf‐reported physical and mental health using the Dutch version of the Short Form‐36 Health Survey; sexual functioning before and after SRS using a newly constructed specific questionnaire.ResultsCompared with a Dutch reference population of community‐dwelling men, transsexual men scored well on self‐perceived physical and mental health. The majority reported having been sexually active before hormone treatment, with more than a quarter having been vaginally penetrated frequently before starting hormone therapy. There was a tendency toward less vaginal involvement during hormone therapy and before SRS. Most participants reported an increase in frequency of masturbation, sexual arousal, and ability to achieve orgasm after testosterone treatment and SRS. Almost all participants were able to achieve orgasm during masturbation and sexual intercourse, and the majority reported a change in orgasmic feelings toward a more powerful and shorter orgasm. Surgical satisfaction was high, despite a relatively high complication rate.ConclusionResults of the current study indicate transsexual men generally have a good quality of life and experience satisfactory sexual function after SRS. Wierckx K, Van Caenegem E, Elaut E, Dedecker D, Van de Peer F, Toye K, Weyers S, Hoebeke P, Monstrey S, De Cuypere G, and T'Sjoen G. Quality of life and sexual health after sex reassignment surgery in transsexual men. J Sex Med **;**:**–**.     

Sexual Satisfaction and Frequency of Orgasm in Women With Chronic Pelvic Pain due to Endometriosis

BackgroundDyspareunia, one of the main symptoms of the chronic gynecological pelvic pain disorder endometriosis, may interfere with the likelihood of reaching an orgasm, yet for women with dyspareunia, no data on orgasm rates in different sexual activities are available.AimThe aim of this study was to evaluate the ability to reach an orgasm and its association with sexual satisfaction during different sexual activities in women with a chronic pelvic pain disorder and in healthy control women.MethodsA set of questionnaires including the brief index of sexual functioning and global sexual functioning was used to evaluate sexuality in women affected with endometriosis (n = 434) and a nonaffected control group (n = 434) recruited in German-speaking countries.OutcomesThe primary outcome measure of this study was the orgasm rate during different types of sexual activities.ResultsOnly the ability to have an orgasm during sexual intercourse (P = .002) but not during masturbation (P = .509) or partnered noncoital sexual activities (P = .229) is affected by endometriosis. Dyspareunia was associated with a reduced ability to experience an orgasm during intercourse for endometriosis patients (P = .020) and control women (P = .006). The ability to orgasm during noncoital sexual activities (P = .006) and sexual intercourse (P = .038) was associated with a higher sexual satisfaction in women with endometriosis. For controls, only the ability to achieve an orgasm with sexual intercourse was associated with sexual satisfaction (P = .038).Clinical implicationsSexual counselling as part of medical support could help couples living with chronic pelvic pain of the female partner integrate noncoital sexual activities in their sex lives, leading to fewer sex-related problems and higher sexual desire and satisfaction.Strengths and limitationsThis study is the first to examine different ways of achieving an orgasm and sexual satisfaction in a large group of women with endometriosis and a matched control group. The breadth of the questionnaire allowed a differentiated analysis of factors influencing the likelihood of achieving an orgasm and overall sexual satisfaction. The one limitation is that the length and the intimate nature of the questionnaire possibly resulted in reluctance to answer this part of the questionnaire.ConclusionPartnered noncoital sexual activities may represent an alternative to reach orgasm for women with endometriosis-related chronic pelvic pain or anorgasmia during sexual intercourse.Hämmerli S, Kohl-Schwartz A, Imesch P, et al. Sexual Satisfaction and Frequency of Orgasm in Women With Chronic Pelvic Pain due to Endometriosis. J Sex Med 2020;17:2417–2426.     

Functional Characterization of Nonadrenergic Noncholinergic Neurotransmitter Release via Endocannabinoids: An in Vitro Study in Rabbit Corpus Cavernosum

IntroductionCorporal smooth muscle relaxation is mediated mainly but not completely by nitric oxide. Endocannabinoids modulate the various neurotransmitter systems.AimIn the present study, a possible role of endocannabinoids on non-nitrergic nonadrenergic noncholinergic (NANC)-mediated relaxations was investigated.MethodsIn precontracted tissues, control electrical field stimulation (EFS)-induced NANC relaxation responses were obtained using varying frequencies of stimulation in the presence of L-arginine methyl ester (L-NAME), guanethidine, and atropine. To investigate the effects of cannabinoids on EFS-evoked non-nitrergic NANC relaxation responses, a similar experimental procedure was applied in the presence of cannabinoid receptor antagonists AM251 or AM630; vanilloid receptor antagonist capsazepine; or cannabinoid receptor agonists anandamide, arachidonyl-2-chloroethylamide (ACEA), or JHW015.Main Outcome MeasuresEffects of cannabinoid receptor antagonists and agonists on EFS-evoked non-nitrergic NANC relaxation responses.ResultsL-NAME abolished EFS-induced relaxation responses at lower frequencies (2–4 Hz) and inhibited the relaxation responses at higher frequencies (8–32 Hz). AM251 and AM630 either together or separately inhibited, whereas anandamide, ACEA, and JHW015 enhanced non-nitrergic NANC relaxation responses. Anandamide did not alter EFS-induced non-nitrergic NANC relaxations in the presence of AM251 and AM630. Capsazepine enhanced non-nitrergic NANC relaxation responses.ConclusionThese results suggest that non-nitrergic NANC relaxations may be mediated partially by cannabinoid-like neuronal factors acting at both cannabinoid CB₁ and cannabinoid CB₂ receptors. Vural IM, Ozturk GS, and Sarioglu Y. Functional characterization of nonadrenergic noncholinergic neurotransmitter release via endocannabinoids: An in vitro study in rabbit corpus cavernosum. J Sex Med 2009;6:717–729.     

Determinants of Sexual Satisfaction in a Sample of German Women

IntroductionThe literature provides little information about the meaning of sexual satisfaction in women despite debates on new concepts of female sexual experience and on modifications in the classification systems of female sexual dysfunction. Often, not even a differentiation is made between satisfaction with one's sex life or sexual relationship in general and sexual satisfaction related to a specific sexual activity.AimTo differentiate between satisfaction with sex life in general and sexual satisfaction from sexual intercourse, petting, or masturbation. To gain a deeper understanding of the meaning and experience of sexual satisfaction derived from these specific sexual activities.MethodsA self-administered questionnaire was completed by 102 German women of different age groups (median age group: 31–35) and education levels.Main Outcome MeasuresA multidimensional questionnaire addressing the subjective feelings that constitute sexual satisfaction in women.ResultsThe analysis of sexual satisfaction from sexual intercourse yielded two dimensions: (i) feeling close to one's partner; and (ii) positive bodily and emotional experiences. Regarding satisfaction with one's sex life in general, 70% of the variance could be explained by sexual satisfaction through sexual intercourse and frequency of sexual intercourse. Sexual satisfaction and orgasm frequency proved to be interdependent but not identical.ConclusionsAs a contribution to a better understanding of the complex nature of female sexual satisfaction, our results indicate that sexual intercourse is a far more important activity and source of satisfaction in female sexual life than petting or masturbation. Philippsohn S, and Hartmann U. Determinants of sexual satisfaction in a sample of German women. J Sex Med **;**:**–**.     

Women Who Prefer Longer Penises Are More Likely to Have Vaginal Orgasms (but Not Clitoral Orgasms): Implications for an Evolutionary Theory of Vaginal Orgasm

IntroductionResearch indicates that (i) women's orgasm during penile–vaginal intercourse (PVI) is influenced by fitness‐related male partner characteristics, (ii) penis size is important for many women, and (iii) preference for a longer penis is associated with greater vaginal orgasm consistency (triggered by PVI without concurrent clitoral masturbation).AimsTo test the hypothesis that vaginal orgasm frequency is associated with women's reporting that a longer than average penis is more likely to provoke their PVI orgasm.MethodThree hundred twenty‐three women reported in an online survey their past month frequency of various sexual behaviors (including PVI, vaginal orgasm, and clitoral orgasm), the effects of a longer than average penis on likelihood of orgasm from PVI, and the importance they attributed to PVI and to noncoital sex.Main Outcome MeasuresUnivariate analyses of covariance with dependent variables being frequencies of various sexual behaviors and types of orgasm and with independent variable being women reporting vs. not reporting that a longer than average penis is important for their orgasm from PVI.ResultsLikelihood of orgasm with a longer penis was related to greater vaginal orgasm frequency but unrelated to frequencies of other sexual behaviors, including clitoral orgasm. In binary logistic regression, likelihood of orgasm with a longer penis was related to greater importance attributed to PVI and lesser importance attributed to noncoital sex.ConclusionWomen who prefer deeper penile–vaginal stimulation are more likely to have vaginal orgasm, consistent with vaginal orgasm evolving as part of a female mate choice system favoring somewhat larger than average penises. Future research could extend the findings by overcoming limitations related to more precise measurement of penis length (to the pubis and pressed close to the pubic bone) and girth, and large representative samples. Future experimental research might assess to what extent different penis sizes influence women's satisfaction and likelihood of vaginal orgasm. Costa RM, Miller GF, and Brody B. Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): Implications for an evolutionary theory of vaginal orgasm. J Sex Med 2012;9:3079–3088.