Clitoral Priapism with No Known Risk Factors
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ALPHA ADRENOCEPTORS and HUMAN SEXUAL FUNCTION Alan
8 1995 Elsevier Science B. V. All rights reserved. The Pharmacology of Sexual Function and Dysfunction J. Bancroft, editor 307 ALPHA ADRENOCEPTORS AND HUMAN SEXUAL FUNCTION Alan J Riley Field Place, Dunsmore, Buckinghamshire, HP22 6QH, UK Introduction Sexual functioning involves complex physiological processes which rely on the interplay of many central and peripheral neurotransmitter systems. Disturbances in any one of these systems might be associated with disturbed sexual function which, when recognised, may be alleviated by appropriate pharmacological manipulation, although at the present time this is more hypothesis than reality, The sympathetic nervous system is involved actively at various levels in the normal control of sexual responses. The effects of sympathetic activation are mediated by the release of noradrenaline from nerve terminals and the increased secretion of adrenaline from the adrenal medulla. These catecholamines selectively activate specific cellular sites in target tissues known as adrenoceptors (previously termed adrenergic receptors) to mediate responses. Almost fifty years ago, Alquist realised that tissue responses to catecholamines were mediated through two distinct types of receptors which he designated a and/? [1]. This review focuses on the involvement of a-adrenoceptors in human sexual functioning and dysfunction. Alpha adrenoceptors are located both pre- and post- synaptically and they were classified as either ar or af adrenoceptors according to location; or, being postsynaptic and az presynaptic. This classification continues to be used in some texts. However, as highly specific and selective pharmacological tools became available, this locational subclassification is found not always to be appropriate. Nowadays, classification of a-adrenoceptors is more appropriately based on pharmacological activity and additional subtypes of a-adrenoceptors have been identified by radioligand binding and molecular biological techniques [2]. -
What Every Woman Needs to Know About Her Genitals
Pussypedia RFSU What every woman needs P.O. Box 4331, 102 67 Stockholm, Sweden to know about her genitals tel +46 8 692 07 00, fax +46 8 653 08 23 www.rfsu.se ISBN 978-91-85188-10-9 RFSU’s aim since it was founded in 1933 has been to give people the means to change their lives for the Content: Tina Nevin better. RFSU is a non-profit organisation independent of any political party or religion. We are dedicated Text: Tina Nevin to promoting a well-informed, open-minded attitude to sexuality and relationship issues. RFSU is founded Editors: Anna Knöfel Magnusson, Maria Andersson on a firm belief that sexuality and relationships are central to the individual and to society. By informing Content review: Christina Brihmer and educating people and shaping opinion, RFSU aims to break down prejudices, overcome ignorance and English translation: Tom Ellett for Exacta översättningar AB improve sexual health in Sweden and abroad. RFSU views sexuality as a matter of individual liberty and Photos: Elisabeth Ohlson Wallin human rights, in which all of us have the freedom to be ourselves, the freedom to choose and the freedom Illustrations: Bo Söderberg to enjoy. By buying our products, becoming a member, working with us or supporting RFSU’s work, you can Graphic design: RGB Grafisk produktion AB help us continue to change people’s lives. © RFSU 2008 Pussypedia Why Pussypedia? Since not every woman uses the word pussy to refer to her genitals, some people might think I have chosen this title to be provocative. Which is partly true. -
The Effects of Yohimbine Plus L-Arginine Glutamate on Sexual Arousal in Postmenopausal Women with Sexual Arousal Disorder1
P1: GVG/FZN/GCY P2: GCV Archives of Sexual Behavior pp527-aseb-375624 July 4, 2002 13:29 Style file version July 26, 1999 Archives of Sexual Behavior, Vol. 31, No. 4, August 2002, pp. 323–332 (C 2002) The Effects of Yohimbine Plus L-arginine Glutamate on Sexual Arousal in Postmenopausal Women with Sexual Arousal Disorder1 , Cindy M. Meston, Ph.D.,2 4 and Manuel Worcel, M.D.3 Received August 17, 2001; revision received November 30, 2001; accepted December 31, 2001 This study examined the effects of the nitric oxide-precursor L-arginine combined with the 2-blocker yohimbine on subjective and physiological sexual arousal in postmenopausal women with Female Sex- ual Arousal Disorder. Twenty-four women participated in three treatment sessions in which self-report and physiological (vaginal photoplethysmograph) sexual responses to erotic stimuli were measured following treatment with either L-arginine glutamate (6 g) plus yohimbine HCl (6 mg), yohimbine alone (6 mg), or placebo, using a randomized, double-blind, three-way cross-over design. Sexual responses were measured at approximately 30, 60, and 90 min postdrug administration. The com- bined oral administration of L-arginine glutamate and yohimbine substantially increased vaginal pulse amplitude responses to the erotic film at 60 min postdrug administration compared with placebo. Sub- jective reports of sexual arousal were significantly increased with exposure to the erotic stimuli but did not differ significantly between treatment groups. KEY WORDS: yohimbine; L-arginine; female sexual arousal; photoplethysmography; nitric oxide; adrenergic. INTRODUCTION lubrication-swelling response of sexual excitement” which causes “marked distress or interpersonal difficulty.” Physiological sexual arousal in women involves Prevalence estimates of FSAD vary widely between an increase in pelvic vascular blood flow and resultant studies, likely due to different operational definitions of pelvic vasocongestion, vaginal engorgement, swelling of the disorder. -
(12) United States Patent (10) Patent No.: US 6,809,079 B2 Southard Et Al
USOO6809079B2 (12) United States Patent (10) Patent No.: US 6,809,079 B2 Southard et al. (45) Date of Patent: Oct. 26, 2004 (54) COMPOSITIONS AND METHODS FOR Sunil Wimalawansa, “Calcitonin: Molecular biology, physi TREATING FEMALE SEXUAL AROUSAL ology, pathophysiology and its therapeutic uses, 121-160, DSORDER USING HYDROPHOBC not dated. CALCITONIN GENE RELATED PEPTIDE Sunil Wimalawansa, “Isolation, purification, and biochemi cal characterisation of calcitonin gene-related peptide (75) Inventors: Jeffrey L. Southard, Olathe, KS (US); receptors,” Annals New York Academy of Science, 657 Gerald L. Yewey, Overland Park, KS (1992) 70–87. (US); Gary J. Rosenthal, Louisville, “Medical Management of Erectile Dysfunction: A Primary CO (US) Care Manual', Harin Padma-Nathan, MD, Professional Communications, Inc., Ed., First edition, Copyright 1999. (73) Assignee: VasoGenix Pharmaceuticals, Inc., “Erectile Dysfunction: A Clinical Guide', Roger Kirby, et Lenexa, KS (US) al., Isis Medical Media Ltd., Ed., 1999. (*) Notice: Subject to any disclaimer, the term of this Jean McEwan, et al. “Calcitonin gene-related peptide: a patent is extended or adjusted under 35 potent dilator of human epicardial coronary arteries, Cir U.S.C. 154(b) by 97 days. culation, 74:6 (Dec. 1986) 1243–1247. Michael G. Rosenfeld, et al. “Production of a novel neu ropeptide encoded by the calcitonin gene Via tissue-specific (21) Appl. No.: 10/041,244 RNA processing.” Nature, 304:14 (Jul. 1983) 129-135. (22) Filed: Jan. 8, 2002 Howard R. Morris, et al. “Isolation and characterization of human calcitonin gene-related peptide,” Nature, 308:19 (65) Prior Publication Data (Apr. 1984) 746–748. P.H. Steenberg, et al. -
Sexual Arousal: Similarities and Differences Between Men and Women the Journal of Men’S Health & Gender, 1 (2-3): 215-223, 2004
Graziottin A. Sexual arousal: similarities and differences between men and women The Journal of Men’s Health & Gender, 1 (2-3): 215-223, 2004 DRAFT COPY – PERSONAL USE ONLY Sexual arousal: similarities and differences between men and women Alessandra Graziottin MD Centre of Gynaecology and Medical Sexology, Milan, Italy Abstract Sexual arousal encompasses activation of physiological systems that coordinate sexual function in both sexes and can be divided into central arousal, peripheral non-genital arousal, and genital arousal. Genital arousal leads to erection in men and to vaginal lubrication and clitoral/vulvar (vestibular bulb) congestion in women. Persisting biases in the understanding of the pathophysiology of sexual arousal are exemplified by the current differences in definitions. In men, sexual arousal disorders are identified with erectile disorders. In women, a more sophisticated set of definitions is described. It includes the subjective arousal disorder, the genital arousal disorder, the mixed arousal disorder, and the persistent sexual arousal disorder. Painful arousal, although not officially included in current nosology, should be considered. A preliminary critical consideration of similarities and differences in the definitions of arousal disorders, in the physiology of sexual arousal, in the causes of arousal disorders, and the influence of arousal disorders on satisfaction with the partner and happiness will be presented. In contrast to popular opinion, women’s arousal disorders influence their physical (OR= 7.04 (4.71-10.53) more than their emotional satisfaction (OR= 4.28 (2.96-6.20). Furthermore such disorders are reported to have a greater effect on women’s physical satisfaction (OR= 7.04 (4.71-10.53) than erectile dysfunction has on men’s physical satisfaction (OR= 4.38 (2.46-7.82). -
Morphological Modifications in Clitoris and Vagina in Spontaneously Hypertensive Rats
International Journal of Impotence Research (2003) 15, 166–172 & 2003 Nature Publishing Group All rights reserved 0955-9930/03 $25.00 www.nature.com/ijir Morphological modifications in clitoris and vagina in spontaneously hypertensive rats AJ Bechara1, G Cao2, AR Casabe´1, SV Romano1 and JE Toblli2* 1Sexual Dysfunction Section, Urology Division, Hospital Durand, Buenos Aires, Argentina; and 2Laboratory of Experimental Medicine, Hospital Alema´n, CONICET, Buenos Aires, Argentina We evaluated possible morphological alteration in clitoris and vagina from spontaneous hypertensive rats (SHR) and normotensive WKY rats. Clitoris and vagina were processed by Masson’s trichrome, anti-a-smooth-muscle actin, anticollagen type I (COL I) and type III (COL III), and anti-TGFb1. SHR presented higher amount of clitoral cavernous smooth muscle (CSM), vascular smooth muscle; TGFb1 in clitoral vessel wall; higher wall/lumen ratio in both vaginal and clitoral vessels; and remarkable interstitial fibrosis, expressed by a higher amount in interstitial COL I and III in both clitoris and vagina, compared to WKY rats. Nerve fibers from clitoral and vaginal tissue in SHR showed important fibrosis at perineurium. SHR showed positive correlation between systolic blood pressure (SBP) and clitoral CSM; SBP and fibrosis in clitoris; and SBP and COL I and III in clitoris, respectively. Similar findings were observed between SBP and COL I and III in vagina. In conclusion, SHR present morphologic changes in clitoral vessels as well as in clitoral cavernous space, which have a high positive correlation with the high blood pressure level. Moreover, the increase in extracellular matrix affects not only the clitoral and vaginal interstitium but also the nerve structures from both clitoris and vagina. -
Anatomy and Physiology of the Clitoris, Vestibular Bulbs, and Labia Minora with a Review of the Female Orgasm and the Prevention of Female Sexual Dysfunction
Clinical Anatomy 26:134–152 (2013) REVIEW Anatomy and Physiology of the Clitoris, Vestibular Bulbs, and Labia Minora With a Review of the Female Orgasm and the Prevention of Female Sexual Dysfunction VINCENZO PUPPO* Centro Italiano di Sessuologia (CIS), Via Regnoli 74, Bologna, Italy This review, with 21 figures and 1 video, aims to clarify some important aspects of the anatomy and physiology of the female erectile organs (triggers of orgasm), which are important for the prevention of female sexual dysfunction. The clitoris is the homologue of the male’s glans and corpora cavernosa, and erection is reached in three phases: latent, turgid, and rigid. The vestibular bulbs cause ‘‘vaginal’’ orgasmic contractions, through the rhythmic contraction of the bulbocavernosus muscles. Because of the engorgement with blood during sexual arousal, the labia minora become turgid, doubling or tripling in thickness. The corpus spongiosum of thefemaleurethrabecomescongestedduring sexual arousal; therefore, male erection equals erection of the female erectile organs. The correct anatomical term to describe the erectile tissues responsible for female orgasm is the female penis. Vaginal orgasm and the G-spot do not exist. These claims are found in numerous articles that have been written by Addiego F, Whipple B, Jannini E, Buisson O, O’Connell H, Brody S, Ostrzenski A, and others, have no scientific basis. Orgasm is an intense sensation of pleasure achieved by stimulation of erogenous zones. Women do not have a refractory period after each orgasm and can, therefore, ex- perience multiple orgasms. Clitoral sexual response and the female orgasm are not affected by aging. Sexologists should define having sex/love making when orgasm occurs for both partners with or without vaginal intercourse. -
Vasculogenic Female Sexual Dysfunction: the Hemodynamic Basis for Vaginal Engorgement Insuf®Ciency and Clitoral Erectile Insuf®Ciency
International Journal of Impotence Research (1997) 9, 27±37 ß 1997 Stockton Press All rights reserved 0955-9930/97 $12.00 Vasculogenic female sexual dysfunction: The hemodynamic basis for vaginal engorgement insuf®ciency and clitoral erectile insuf®ciency K Park, I Goldstein, C Andry, MB Siroky, RJ Krane and KM Azadzoi Department of Urology, Boston University School of Medicine and Boston Veteran's Administration Hospital, Boston, MA, USA Objective: Organic female sexual dysfunction may be related in part to vasculogenic impairment of the hypogastric-vaginal/clitoral arterial bed. The aim was to develop an animal model of vaginal engorgement insuf®ciency and clitoral erectile insuf®ciency. Methods: Pelvic nerve stimulated vaginal engorgement and clitoral erection were achieved in control (normal diet, n 8) and atherosclerotic (balloon injury of aorto-iliac arteries and 0.5% cholesterol diet, n 7) New Zealand White female rabbits. After 16 weeks, novel hemodynamic variables including vaginal wall and clitoral blood ¯ow, vaginal wall and clitoral intracavernosal pressure, vaginal length, vaginal luminal pressure, blood levels of cholesterol and triglycerides, aorto-iliac angiography and vaginal wall and clitoral erectile tissue histology were recorded in the two groups. Results: Concerning pelvic nerve stimulated vaginal hemodynamic changes, there was signi®cantly less increase in blood ¯ow (ml/min/100 gm tissue), wall pressure (mmHg) and length changes (mm) in atherosclerotic (9.3 Æ 3.7, 4.8 Æ 3.8, 67.3 Æ 8.3) compared to control (13.9 Æ 4.5, 5.5 Æ 2.6, 74.1 Æ 10.0) animals respectively. Histologic examination of clitoral erectile tissue demonstrated cavernosal artery atherosclerotic changes and diffuse vaginal and clitoral ®brosis. -
(6) EP''neee Dysfunction in a Female, Including the Vasculogenic Symp
USOO6756407B2 (12) United States Patent (10) Patent No.: US 6,756,407 B2 Heaton et al. (45) Date of Patent: Jun. 29, 2004 (54) METHOD AND COMPOSITIONS FOR THE 5,770,606 A 6/1998 El-Rashidy et al. ........ 514/284 TEYN2, E2 or (List continued on next page.) FOREIGN PATENT DOCUMENTS (75) Inventors: Jeremy P. W. Heaton, Gananoque EP O 172 697 A2 2/1986 A61K/31/435 (CA); Michael A. Adams, Kingston EP O 579 435 A1 1/1994 ... A61K/47/48 (CA) WO WO 87/04621 8/1987 .......... A61K/31/50 WO WO 93/23035 11/1993 .......... A61 K/31/40 (73) Assignee: Queen's University at Kingston, WO WO 94/22445 10/1994 .......... A61 K/31/48 Kingston (CA) OTHER PUBLICATIONS (*) Notice: Subject to any disclaimer, the term of this Davis, SR, “The role of androgens and the menopause in the patent is extended or adjusted under 35 female Sexual response', in International Journal of Impo U.S.C. 154(b) by 0 days. tence Research (1998 Stockton Press) vol. 10, Suppl. 2, S82-S83. (21) Appl. No.: 10/126,933 (List continued on next page.) (22) Filed: Apr. 22, 2002 Primary Examiner Thurman K. Page O O Assistant Examiner-Konata M. George (65) Prior Publication Data (74) Attorney, Agent, or Firm-Stephen J. Scribner; Carol US 2002/0193442 A1 Dec. 19, 2002 Miernicki Steeg Related U.S. Application Data (57) ABSTRACT (6)60 EP''NEEE- - - dysfunctionThe present ininvention a female, provide including a method the vasculogenic of treating symp.Sexual part of application No. 09/102987 filed on Jun. -
Neurologic Factors in Female Sexual Function and Dysfunction
www.kjurology.org DOI:10.4111/kju.2010.51.7.443 Review Article Neurologic Factors in Female Sexual Function and Dysfunction Kazem M. Azadzoi, Mike B. Siroky Department of Urology, Veterans Affairs Boston Healthcare System and Boston University School of Medicine, Boston, Massachusetts, USA Sexual dysfunction affects both men and women, involving organic disorders, psycho- Article History: logical problems, or both. Overall, the state of our knowledge is less advanced regarding received 17 June, 2010 30 June, 2010 female sexual physiology in comparison with male sexual function. Female sexual dys- accepted function has received little clinical and basic research attention and remains a largely untapped field in medicine. The epidemiology of female sexual dysfunction is poorly understood because relatively few studies have been done in community settings. In the United States, female sexual dysfunction has been estimated to affect 40% of women in the general population. Among the elderly, however, it has been reported that up to 87% of women complain of sexual dissatisfaction. Several studies have shown that the prevalence of female sexual arousal disorders correlates significantly with increas- ing age. These studies have shown that sexual arousal and frequency of coitus in the female decreases with increasing age. The pathophysiology of female sexual dysfunc- tion appears more complex than that of males, involving multidimensional hormonal, neurological, vascular, psychological, and interpersonal aspects. Organic female sex- ual disorders may include a wide variety of vascular, neural, or neurovascular factors that lead to problems with libido, lubrication, and orgasm. However, the precise etiology and mechanistic pathways of age-related female sexual arousal disorders are yet to be determined. -
The Cavernoso-Anal Reflex: Response of the Anal Sphincters to Cavernosus Muscles' Stimulation
Asian J Androl 2006; 8 (3): 331–336 DOI: 10.1111/j.1745-7262.2006.00126.x .Original Article . The cavernoso-anal reflex: response of the anal sphincters to cavernosus muscles’ stimulation Ahmed Shafik1, Ismail Shafik1, Ali A. Shafik1, Olfat El Sibai2 1Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo 11121, Egypt 2Department of Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt Abstract Aim: To prove the hypothesis that cavernosus muscles’ contraction during coitus affects the reflex contraction of anal sphincters. Methods: Electromyographic response of external and internal anal sphincters to ischiocavernosus and bulbocavernosus muscle stimulation was studied in 17 healthy volunteers (10 men, 7 women, mean aged 38.3 ± 11.6 years). The test was repeated after individual anesthetization of anal sphincters and the two cavernosus muscles, and after using saline instead of lidocaine. Results: Upon stimulation of each of the two cavernosus muscles, external and internal anal sphincters recorded increased electromyographic activity. Anal sphincters did not respond to stimulation of the anesthetized cavernosus muscles nor did anesthetized anal sphincters respond to cavernosus muscles’ stimulation. Saline infiltration did not affect anal sphincteric response to cavernosal muscles’ stimulation. Conclusion: Cavernosus muscles’ contraction is suggested to evoke anal sphincteric contraction, which seems to be a reflex and mediated through the “cavernoso-anal reflex”. Anal sphincteric contraction during coitus presumably acts to close the anal canal to thwart flatus or fecal leak. (Asian J Androl 2006 May; 8: 331–336) Keywords: bulbocavernosus muscle; ischiocavernosus muscle erection; sexual act; orgasm; erectile dysfunction 1 Introduction duce reflex cavernosus muscles’ contraction. -
Chapter 19 Anatomy and Physiology of Women's Sexual Function
Graziottin A. Giraldi A. Anatomy and physiology of Women’s Sexual Function in: Porst H. Buvat J. (Eds), ISSM (International Society of Sexual Medicine) Standard Committee Book, Standard practice in Sexual Medicine, Blackwell, Oxford, UK, 2006, p. 289-304 Chapter 19 Anatomy and physiology of Women’s Sexual Function Alessandra Graziottin and Annamaria Giraldi This chapter summarizes the anatomy and physiology of women’s sexual response with a clinical perspective. The neurobiology of sexual function in women will be only briefly mentioned for sake of concision. More attention will instead be given to the anatomy and physiology of external genitalia and female organs, which will be summarized focusing on what clinicians should consider while examining the patient complaining of FSD. The sexual brain The limbic system and the neo-cortex A normal sexual response requires the anatomic and functional integrity of the brain’s entire limbic system, rather than a particular anatomic structure within it [1]. The limbic system is part of the so called ”paleo-cortex” : a comprehensive network involving the hypothalamus and the thalamus (both within the diencephalon), the anterior cingulate gyrus, and many structures of the temporal lobes, including the amygdala, the mammillary bodies, the fornix, and the hippocampus, a phylogenetically ancient type of cortex [1 -4]. Together with the prefrontal lobe, which has a predominantly inhibitory role over the basic instinctual drives, the limbic system is essential in both sexes for the initiation of sexual desire and related sexual phenomena [1,5-7]. Its function activates sexual fantasies, sexual daydreams, erotic dreams, mental sexual arousal, and the initiation of the cascade of neurovascular events triggering all of the somatic and genital responses of sexual function as well as the associated socially appropriate behaviors [7-9].