Neurobiology of Sexual Response in Men and Women

Abstract

Sexual desire, arousal, and orgasm are mediated by complex—and as yet not fully understood—interactions of the somatic and autonomic nervous systems, operating at cerebral, spinal, and peripheral levels. Furthermore, neural activity within these systems is modulated by the presence of steroid and peptide hormones, which affect male and female response differentially. At the central level, dopaminergic and serotonergic systems appear to play a significant role in various components of sexual response, although adrenergic, cholinergic, nitergic, γ-aminobutyric acidergic, and other neuropeptide transmitter systems may contribute as well. At the peripheral level, adrenergic, cholinergic, and nitergic activation mechanisms control vascular changes that underlie vaginal lubrication and penile erection. In addition, these systems respond to descending brain and spinal influences that generate orgasmic response. Disruption of endocrine, neural, or vascular response—caused by aging, disease, surgery, or medication—has the potential to lead to sexual inadequacy. At the same time, psychological and relationship factors play an important role in healthy sexual response and may enhance or impair sexual functioning.

Toward an understanding of the cerebral substrates of woman's orgasm

“…The neurobiological research of the physiological control of orgasm provides a great opportunity to better understand the interaction between peripheral and central mechanisms of female orgasm in a meaningful way. Because the role of the spinal cord in orgasm and its related neuropharmacology has already been described in depth in previous elegant studies and reviews, we will not review them in the present article (e.g., Mah & Binik, 2001;McKenna, 1999McKenna, , 2002Meston et al, 2004;Rowland, 2006). Nevertheless, a brief summary will be provided to highlight the most important findings.…”

“…Several studies have reviewed the influence of other endocrine factors (such as estradiol) and neurotransmitters on human sexual function, and notably on women orgasm (e.g., Ellison, 1998;Mah & Binik, 2001;Meston et al, 2004;Rowland, 2006). However, the role of particular hormones in orgasm is discussed.…”

“…(e.g., Bancroft et al, 2003;Basson, 2000;Heaton & Adams, 2003;Kaplan, 1974Kaplan, , 1979Mah & Binik, 2005;Masters & Johnson, 1966;Meston et al, 2004;Whipple & Brash-McGreer, 1997). By specifying the brain areas involved in these mechanisms, contemporary neuroimaging studies throw considerable light on brain activity related to woman's orgasm, as it has been done previously in men (such as Graber, Rohrbaugh, Newlin, Varner, & Ellingson, 1985;Heath, 1972;Heaton & Adams, 2003;Holstege, 2005;Holstege & Georgiardis, 2004;Holstege et al, 2003;McKenna, 1999;Mosovich & Tallaferro, 1954;Rowland, 2006;Tiihonen et al, 1994). This is of particular importance in the field of neuropsychology where patients who suffer from a brain injury may have impaired or affected orgasms.…”

“…Because the neuropharmacology, neuro-endocrinology and the spinal-driven components of orgasm have been addressed in depth previously (e.g., Argiolas & Melis, 2003;Heaton & Adams, 2003;Levin, 1981;Mah & Binik, 2001;McKenna, 1999McKenna, , 2002Meston et al, 2004;Rowland, 2006), we will not review them in the present article. Rather, our article aims to examine and provide a critical review of the current knowledge about the cerebral network of woman's orgasm.…”

Correlation between insula activation and self-reported quality of orgasm in women

“…Only recently has the complexity of female orgasm become a focus for neuroscience Komisaruk et al, 2004;Levin and van Berlo, 2004;Binik, 2001, 2005;McKenna, 1999;Meston et al, 2004;Ortigue and Bianchi-Demicheli, 2006;Rowland, 2006). To date, only one published fMRI study has reported preliminary evidence for a specific neural network of women's orgasm while participants were submitted to passive cervical self-stimulations during scanner sessions (Komisaruk et al, 2004).…”