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

Abstract

The way women experience orgasm is of interest to scientists, clinicians, and laypeople. Whereas the origin and the function of a woman's orgasm remains controversial, the current models of sexual function acknowledge a combined role of central (spinal and cerebral) and peripheral processes during orgasm experience. At the central level, although it is accepted that the spinal cord drives orgasm, the cerebral involvement and cognitive representation of a woman's orgasm has not been extensively investigated. Important gaps in our knowledge remain. Recently, the astonishing advances of neuroimaging techniques applied in parallel with a neuropsychological approach allowed the unravelling of specific functional neuroanatomy of a woman's orgasm. Here, clinical and experimental findings on the cortico-subcortical pathway of a woman's orgasm are reviewed and compared with the neural basis of a man's orgasm. By defining the specific brain areas that sustain the assumed higherorder representation of a woman's orgasm, this review provides a foundation for future studies. The next challenge of functional imaging and neuropsychological studies is to understand the hierarchical interactions between these multiple cortical areas, not only with a correlation analysis but also with high spatio-temporal resolution techniques demonstrating the causal necessity, the temporal time course and the direction of the causality. Further studies using a multi-disciplinary approach are needed to identify the spatio-temporal dynamic of a woman's orgasm, its dysfunctions and possible new treatments.

Activation of sensory cortex by imagined genital stimulation: an fMRI analysis

“…In addition to these primary and secondary somatosensory cortical activations, the left thalamus, left insula, left hippocampus, left nucleus accumbens, bilateral amygdala, cerebellum, medulla, and the medial frontal cortex were activated in the imagine dildo stimulation>imagine speculum stimulation comparison. Consistent with the present findings of an involvement of the left insula, Ortigue, Grafton, and Bianchi-Dimichell (2007) and Bianchi-Demichell and Ortigue (2007) reported the activation of the left anterior insula in relation to the memory of sexual stimulation. We concur with their interpretation that ‘… the left anterior insula plays a pivotal role in autonomic, emotional, and reward processes….’ (Bianchi-Demichell & Ortigue, 2009, p. 549).…”

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

“…Current models of women's sexual function incorporate the importance of a variety of interpersonal, contextual and psychological factors, such as emotional intimacy, relationship satisfaction, sexual stimuli and previous sexual experiences (e.g., Bancroft, 1989Bancroft, , 2003Basson, 2000Basson, , 2001Basson, , 2002Basson, , 2005Bianchi-Demicheli and Ortigue, 2007;Kaplan, 1974Kaplan, , 1979Masters and Johnson, 1966;Binik, 2001, 2005;Whipple and Brash-McGreer, 1997). Bancroft et al (2003) found in a national survey of 987 women, that emotional well-being and the quality of a relationship with a partner had more effects on sexuality than aging.…”

“…In this framework of a partner-related network, we thus assessed the potential overlapping substrates for subliminal partner-related neural responses, women's representation of orgasm quality ratings (as assessed by self-report questionnaires about satisfaction, frequency and ease), intensity of love and satisfaction of emotional closeness with their partner. Even if it is of course clear that being in a stable relationship or being in love is not a prerequisite to reach orgasm, a growing body of evidence suggests that a partner-related cerebral network may involve brain areas that have been also reported to be recruited in the orgasm-related cerebral network (Aron et al, 2005;Bartels and Zeki, 2000;Bianchi-Demicheli and Ortigue, 2007;Komisaruk et al, 2004;Ortigue et al, 2007). Thus, we hypothesize that a significant relationship may exist between the cerebral correlates of self-report partnered orgasm quality ratings, and at least one of the brain regions located within the putative partner-related neural network.…”

Do rats have orgasms?

“…Orgasms produce a similar signature of brain activation in women and men undergoing functional magnetic resonance imaging (fMRI) scans, including deactivations of left ventromedial and orbitofrontal cortices, and activations of anterior cingulate, insula, parietal lobe, hippocampus, amygdala, basal ganglia (especially the putamen), nucleus accumbens (NAc), bed nucleus of the stria terminalis-preoptic area, hypothalamic PVN nucleus, cerebellum (including the anterior lobe of the cerebellar vermis and deep cerebellar nuclei), and lower brainstem (central gray, mesencephalic reticular formation, and nucleus of the solitary tract), with a slight bias for more activation of the central gray in men (Bianchi-Demicheli & Ortigue, 2007; Georgiadis, Kringelbach, & Pfaus, 2012; Georgiadis, Reinders, Paans, Renken, & Kortekaas, 2009; Komisaruk & Whipple, 2005; Stoléru, Fonteille, Cornélis, Joyal, & Moulier, 2012). Using positron emission tomography to analyze regional cerebral blood flow, Huynh, Willemsen, Holstege et al (2013) found a greater activation of the pituitary following masturbation to orgasm in women relative to men.…”