ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH

Abstracts of International Anatolian Congress on Neuroscience and Page | 1 Sexual Health-2015

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH

include age at first through mastur- bation and sexual intercourse, frequency of orgasm in intercourse, and orgasm during the latest sexual intercourse. Results: Of young and middle-aged women, more than 80 percent had experienced or- Page | 2 gasms through masturbation. A third of girls had their first masturbatory orgasm before upper-primary school, before the age of 13. One in two women had experienced or- gasms for at least two years before having sexual intercourse for the first time. The figure for young women was nearly two- thirds. Of women, 55 percent had an orgasm the last time they had intercourse. Twelve per- cent of women reported having multiple the last time they had sexual inter- course. In 2007, nine percent of women reported never having had an orgasm from intercourse. Women who reported considering sex cru- cial for relationship happiness and who

found it easy to discuss sex with their part-

ner were approximately twice as likely to 01. DETERMINANTS OF FEMALE SEXUAL have orgasms than women who responded ORGASMS IN FINLAND differently to those two questions. Addi- Osmo Kontula tional positive factors included experiencing Introduction: The physiological and psy- a feeling of love, considering one’s relation- chological processes that are produced by ship very happy, as well as the feeling that sexual desire and arousal are aimed in our sex was getting better and better, the longer minds at sexual gratification and ultimately, one had known one’s partner. A relationship orgasms. The pursuit of sexual pleasure is that felt good and worked well emotionally, the key motivating factor in sexual activity. and where sex was approached openly and Experiencing pleasure as well as orgasms is appreciatively, promoted orgasms. not a given, and many things can stand in Conclusion: The findings indicate that the way of sexual enjoyment, particularly women differ from one another greatly in among women. These are essential issues terms of their tendency or capacity to expe- and questions of sexual wellbeing. It is valu- rience orgasms. A significant portion of able to know more about the trends and women experienced persistent problems determinants of the orgasms. Especially having orgasms from intercourse, whereas female orgasms are a great challenge in sex- many found it easy to have multiple or- ual health promotion. gasms. The inequality in sexual enjoyment Methods: In Finland four national sex sur- among women was drastically greater than veys based on random samples from central among men. population register have been conducted:

1971, 1992, 199, and 2007. They are repre- 02.SEXUAL ACTIVITIES AMONG AGING sentative of the total population within the POPULATION IN FINLAND age range of 18-54 years in 1971 (N=2152) Osmo Kontula and 18-74 years in 1992 (N=2250), 1999 Introduction: Sexuality is an essential fea- (N=1496), and 2007 (N=2590). Measures

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH ture of human life throughout the life high value given to sexual happiness in the course. Most people are living longer than relationship. For men, other health-related preceding generations, and more are re- factors that had a positive outcome on sexu- maining sexually active later life. Sexual al activities included: not smoking, drinking issues are becoming more prominent also in heavily at least sometimes, and low body the old age care and services. Gerontologists mass index (slimness). Page | 3 and other medical experts generally agree that continued sexual interest and activity can be therapeutic for older men and wom- en. This paper presents how sexual activi- ties change in aging men and women and what are their determinants. Methods: Three national sex surveys were conducted in Finland in 1992, 1999, and 2007. Each survey’s sample was drawn from the Central Population Register, so that all Finns had an equal opportunity to be select- ed into the sample. Of these three popula- tion surveys, respondents in the age group 55 – 74 years were included in these anal- yses. Their numbers were 532 (1992), 384 (1999), and 901 (2007). The number of re- spondents was altogether 1,817, of which 1,019 were women and 798 men. Results: Among the aged population wom- en over the age of 60 have a permanent sex- ual partner less often than do men. At age 70 and older, less than half of the women in Finland have a husband or another type of steady partner. Among the males, more than four-fifths of those 70 and older lived in a couple relationships. The implication of this 03.FMRI IMAGING IN RESEARCH ON FE- observation is that men have a much better MALE AND MALE SEXUAL STIMULATION chance than women to keep up their sexual AND ORGASM activities through the aging process. Barry R. Komisaruk Frequency of intercourse was lower in the In studying the role of the nervous system in oldest age groups, who reported a mean mediating the pseudopregnancy-inducing frequency of intercourse every other week neuroendocrine reflex in laboratory rats, I compared to every week in the younger age observed that vaginal stimulation induced a groups. Even a long duration of relationship marked immobilization and blockage of is not a determinant of decreasing sexual behavioral and neurophysiological respons- activities if couples are able to stay healthy es to painful stimulation. The obvious ques- and sexually functioning. tion was whether vaginal stimulation blocks In addition to age, the most important pre- pain in women. I recruited Beverly Whipple dictors of sexual activities among aging men to test this question, and together we found were: a loving relationship, positive sexual that vaginal and cervical self-stimulation in self-esteem, easy sexual performance (erec- women produces profound analgesia, not tion), and a history of multiple partners. For anesthesia. This discovery led to my analy- women, important predictors included high sis of the sensory pathway mediating the sexual desire (own and partner’s), and a analgesia. Consequently, we analyzed wom-

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH en with complete SCI at selected levels to the auricular branch of the vagus) the clas- differentiate the role of pudendal, pelvic and sical vagus projections in the brain, includ- hypogastric nerves in mediating the analge- ing the paracentral lobule, suggests that all sia. Unexpectedly, the women with complete three types of stimulation – prostate, nipple, SCI at or above Thoracic level 10 could feel and ear – may all summate at the paracen- the vaginal and cervical stimulation, and the tral lobule (i.e., the “genital sensory cortex”) Page | 4 stimulation produced analgesia measured at to enhance sensual pleasure in able-bodied the fingers. This led to my hypothesis that and men with complete SCI, perhaps atten- the vagus nerve must therefore convey vag- uate chronic pain, and perhaps induce and inal and cervical sensation to the brain, by- enhance orgasm. passing the spinal cord. We tested and con- firmed the hypothesis by showing, with the 04.NEW RESEARCH FINDINGS AND CON- use of functional MRI (fMRI), that the vagus CEPTS IN MALE/FEMALE SEXUAL RE- projection nucleus (solitary nucleus [NTS] SPONSE: FOUR NERVE CONCEPTUALIZA- in the medulla oblongata) was activated in TION those women by vaginal or cervical self- Barry R. Komisaruk stimulation. Some of the women experi- Our research on nerve pathways involved in enced orgasms from the stimulation. This sexual response, orgasm and pain blockage finding enabled us to publish the first evi- in women has led us to analyze and concep- dence worldwide of sites where orgasm is tualize the roles of the different genital sen- represented in the brain in women. Then, sory nerves in women and men. First, it is using fMRI, we mapped the differential pro- evident that the claim by Kinsey et al (1952) jection of the clitoris, vagina and cervix to that the vagina and cervix are insensate are the sensory cortex (paracentral lobule) in totally wrong, not only by their own evi- women. In that study we also reported the dence in the very same book but by wom- unexpected finding that the nipple projec- en’s reports and our own research. We have tion is not only to the thoracic region but found that the clitoris, vagina, and cervix more significantly, overlaps with the genital project to the genital sensory cortex in dis- projection zone. We have currently extend- tinctly different regions from each other, ed those fMRI studies to able-bodied men, indicating that they receive sensory inner- mapping the projection sites to the paracen- vation by three different nerves – most like- tral lobule of penile skin – different from ly the pudendal, pelvic, and hypogastric, deep penile stimulation (apparently it is not respectively. This is consistent with wom- commonly recognized that two different en’s reports that stimulation of each of these nerves convey penile sensibility), testicles, three genital regions produces different rectum, nipples, and prostate, and how they sensory qualities and that each of these re- combine to generate orgasm. We provide gions contributes differentially to orgasm. evidence that the prostate projection is dif- We have also found evidence that a fourth ferent from the rectal projection, both to nerve, the vagus nerve, conveys vaginal and slightly different regions of the paracentral cervical (but not clitoral) sensation, on the lobule. We are now analyzing these projec- basis that complete spinal cord injury, tions in men with complete spinal cord inju- which interrupts all sensory pathways ry to ascertain whether the vagus nerve through the spinal cord, nevertheless does conveys prostate sensory activity to the not block vaginal and cervical sensibility. brain, homologous with the role of the vagus This led me to hypothesize that the vagus nerve in women, and to ascertain whether nerve conveys the vaginal and cervical sen- nipple self-stimulation has an additive or sibility, which we confirmed by showing synergistic effect. In addition, our recent that, using fMRI, the vagal sensory nucleus fMRI evidence that electrical stimulation of in the medulla of the brainstem is activated the external ear stimulates (presumably via by vaginal or cervical self-stimulation in

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH these women, and some of those women Rationale: The internet has revolutionized experienced orgasm from the stimulation. both sex education and . More recently, we have found that electrical Introduction: Two these changes are being stimulation of the vagus nerve in women presented: Distance education by MOOCS and men, accessed via its “auricular branch”, and therapy by Skype. which carries sensory activity from the ex- Methods: A live demonstration on a large Page | 5 ternal ear, also activates the genital sensory screen. cortex. This provides further evidence that (In addition to the large screen, a fast inter- the vagus nerve is a fourth genital sensory net connection, a laptop with mouse, and a nerve. Our further studies of the genital projector are required.) sensory nerves have provided evidence that Results: In the future, sex education and sex a specific pathology, “Tarlov cysts” may be therapy will reach ever larger groups of responsible for genital sensory pathologies, students and clients. e.g., Persistent Genital Arousal Disorder Conclusion: Everyone active in the area of (PGAD) and perhaps other pelvic pain syn- sexual health should become familiar with dromes, even in men. Furthermore, our the new means of electronic communica- recent findings in men provide evidence tion. that the prostate sends sensory activity to the genital sensory cortex, and that the pe- nis sends sensory activity to the genital sen- sory cortex not only via the pudendal nerve (i.e., dorsal nerve of the penis), but also via the pelvic nerve (afferents of the parasym- pathetic cavernosal nerve), the latter of which may have the greater influence on orgasm in men.

06. : WHAT ARE WE PATHOLOGIZING? Charles Moser Introduction: Various proposals to define Hypersexuality (and similar concepts) as a sexual disorder have been proposed. This presentation will analyze those proposals

and the assumptions inherent in the con- 05. SEX EDUCATION AND SEX THERAPY cept. IN THE ELECTRONIC AGE Methods: Linguistic and logical analysis. Erwin Haeberle Results: The assumption of a “normal” sex-

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH ual frequency and the concept of “normal” SEXUAL HYPNAGOGIC HALLUCINATIONS sex interests will be shown to be spurious WITH OUT-OF-BODY EXPERIENCE concepts. The ethical issues inherent in Carlos H. Schenck treating a disorder that has not been ac- In a preceding abstract, a classification of cepted as a real disorder will be discussed. sleep-related abnormal sexual behaviors Conclusion: Hypersexuality is morality and experiences was presented. In this ab- Page | 6 masquerading as evidence based scientific stract, two striking cases are presented that concept and a psychiatric diagnosis. illustrate the extreme nature of abnormal sexual behaviors and experiences that can 07.PARAPHILIC DISORDERS AND DSM-5: occur during some cases of pathological LOGICAL INCONSISTENCIES sleep (complex sleepwalking [SW]; narco- Charles Moser lepsy). The first case involves somnambulis- Introduction: Simple are no tic (Schenck CH. Paradox Lost: longer mental disorders in DSM-5, replaced Midnight In The Battleground Of Sleep And with a new term “Paraphilic Disorders.” The Dreams. Extreme-Nights, LLC: Minneapolis, present paper will analyze the diagnostic Minnesota, USA, 2005 [ISBN 0-9763734-0- criteria, language, and logical consistency of 8], pages 370-1). A 21 year-old man with this new disorder. childhood-onset, persistent SW had been Methods: Linguistic and logical analysis arrested several times late at night by the Results: The Paraphilic Disorders named in police because of indecent exposure and DSM-5 do not meet the new definition of a lewd behavior (masturbation) in public. He . The definition of a Paraphilic would be standing in front of a dark window Disorder does not meet the new DSM-5 def- (with the curtain or shade pulled down) of a inition of . Other inconsist- home in his neighborhood while fondling encies will be highlighted. The lack of ra- his genitals, with his penis exposed, and tionale for this diagnostic category will be usually masturbating. He appeared glassy- highlighted. eyed and confused while mumbling that he Conclusion: The Paraphilic Disorders de- was looking into an open window and see- scribed in DSM-5 are not evidenced based, ing a female who was either naked or else in not clinically useful, and do not help clini- the process of undressing herself, which cians make consistent diagnoses. aroused him sexually. He was convinced that the curtain or shade was pulled up, the lights in the bedroom were on, and he could clearly see inside. However, in contrast to what he perceived, the police reported that each time they found him, he was staring at a closed and shaded window that he could not see through, and there was no light turned on inside the room. On a number of other occasions (without police involve- ment), he awakened on his own during simi- lar episodes, realized he had been SW, put his penis back into his pants, zipped them up and returned home. So he was clearly sleepwalking and having sexual hallucina- tions in his sleep. He had no history of day- time sexual perversion (paraphilia). The second case involves narcolepsy (Coelho

FMS, et al. Sexual hypnagogic hallucinations 08.SOMNAMBULISTIC VOYEURISM AND and narcolepsy with cataplexy: a case re-

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH port. Sleep Science 2011;4(3):110-2). A 46 dream-enactment disorder from rapid-eye- year-old man reported a history of sexual movement [REM] sleep); sleep-related sei- hypnagogic hallucinations (HH--emerging zures; sleep related dissociative disorders; during wake-sleep transitions at bedtime) nocturnal psychotic disorders; Kleine-Levin that were triggered by the start of sex with syndrome (periodic ); severe his wife (mainly in the evenings). While chronic ; restless legs syndrome Page | 7 floating up in air, he had an out-of-body (and its variant, restless vagina syndrome); experience (OBE) in which he was seeing narcolepsy; sleep exacerbation of persistent the sex he was having with his wife in bed at sexual arousal syndrome; sleep related that moment—but he had stopped the actu- painful erections. Synonyms for sexual par- al sexual activity with his wife in bed. There- asomnias include sexsomnia, sleep-sex, and fore, he was hallucinating the sex with his sleep related abnormal sexual behaviors. wife, and not actually seeing the sex (since it Sexsomnia is a young-adult male predomi- had stopped when he started hallucinating). nant disorder, and usually emerges in the The OBE & sexual HH had been present for 6 context of either i) a longstanding, multidi- years (along with other typical narcoleptic mensional, complex history of Non-REM symptoms). His wife often complained, since sleep (2-5 separate parasom- the sexual activity with her husband would nias in reported cases), or ii) or OSA, with be interrupted when he started to have sex- the onset of sexsomnia emerging in tandem ual HH and OBE. For the husband, the sexual with snoring and other hallmark symptoms activity with his wife in bed continued with- of OSA. A full range of sleep related sexual out interruption since he had a rapid transi- behaviors with self and/or bed partners or tion from actual sex to combined sexual others have been reported, including mas- HH/OBE, as an abnormal narcoleptic brain- turbation, sexual verbalizations/ vocaliza- mind response to having sex. Therefore, in tions, fondling, sexual intercourse with cli- this repeating scenario, the husband had max, sexual assault/rape, ictal sexual hyper- continual sexual pleasure, in contrast to his arousal, ictal orgasm, and ictal automatism. wife who only experienced sexual pleasure Adverse physical and/or psychosocial ef- during the initiation of foreplay. This case fects from the sleep-sex were present in all illustrates how narcolepsy is not only asso- and sleep related seizure cases, ciated with HH (along with cataplexy and but pleasurable effects were reported by 5 sleep paralysis, i.e. paralysis in sleep-wake bed partners and by 3 patients with sleep and wake-sleep transitional states--the clas- related seizures. Forensic consequences sic "narcoleptic tetrad" together with sleep were common, including all reported cases attacks), but also with abnormal sexual ex- involving minors. No reported case involved periences and other forms of extreme disso- daytime paraphilia, or sexual deprivation. ciated states, such as OBE. All parasomnias cases reported for the sleep-sex. Polysomnography (sleep la- 09.SLEEP DISORDERS AND SEXUALITY— boratory multi-channel physiological moni- SEXSOMNIA toring of sleep) documented a Non-REM Carlos H. Schenck sleep parasomnia or OSA in most cases, and The first classification of sleep-related ab- in 3 cases there was sexual moaning from normal sexual behaviors and experiences slow wave sleep and sexual intercourse dur- was published in 2007 (Schenck CH, et al. ing stage 1 sleep/wakefulness in one case Sleep 2007;30:683-702). Many categories of (with sex provoked by the bed partner). sleep-related disorders were represented: Bedtime clonazepam therapy was effective parasomnias (confusional arous- in most cases of parasomnias, nasal contin- als/sleepwalking from Non-REM sleep, uous positive airway pressure therapy was with/without obstructive sleep apnea effective in controlling comorbid OSA in all [OSA]; REM sleep behavior disorder, viz. treated cases, and all reported treated pa-

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH tients with sleep related sexual seizures practice(s) employed and even perhaps the responded to anticonvulsant therapy. stage of the menstrual cycle. Because of this Therefore, sexsomnia is a treatable appeti- known stimulus complexity some authors, tive parasomnia (along with sleep-related myself included, are of the opinion that to ). The literature on sexsom- name the attribution of orgasm by PVI alone nia has expanded since 2007, but further to just the vagina is now outdated and any Page | 8 research on this intriguing condition needs such orgasm should really be designated to be conducted, leading to additional cases simply as a ‘genital orgasm’ . and case series being reported from around the world, thereby enhancing awareness of 011.VAGINAL ORGASMS VS CLITORAL this condition that is associated with major ORGASMS psychosocial and legal consequences. Roy Levin Freud (1905) differentiated the sexual 010.NATURE OF VAGINAL ORGASMS arousal induced by clitoral stimulation and Roy Levin that induced from penile vaginal intercourse During penile vaginal intercourse (PVI) a (PVI) alone. He claimed, without empirical number of genital sites are stimulated by support, that the former was less mature the pressure and friction of the thrusting than the latter and that to achieve his con- penis. These include the clitoral glans, the cept of ‘normal femininity’ the clitoris had to periurethral glans (the triangular area of be de-eroticized and the vagina eroticized, a the vestibule surrounding the urethral mea- difficult but most important transfer for tus from the clitoral glans to the vaginal women. If they did not do this they could introitus), the internal clitoris (crura), the become ‘anesthetic at the vaginal orifice’. labia minora, the anterior vaginal wall , the This belief was held by him and his follow- ‘G-spot’, the urethra , Halban’s fascia (ure- ers for many years but became converted by throvaginal septum), vestibular (vaginal) others into the concept of a clitoral orgasm bulbs. Rarely is the cervix or distal (deep) and a vaginal orgasm, the latter had to be part of the anterior vaginal wall involved as created by PVI alone. The clitoris was during high sexual arousal the former is claimed to ‘undermine healthy femininity’ withdrawn up and away from axis of the (Hitschman & Bergler 1936) and was a bar- penile thrusting (vaginal tenting) and has rier to the development of adult genitality. poor sensory innervation while the vaginal The rise of biologic and feminism ballooning removes the latter from the pe- made these Freudian notions fall into disre- nile glans. The periurethral glans has erotic gard. Lately, a coterie of psychologists have sensitivity and is stimulated by being resurrected this ‘undermining concept’ us- pushed into and then pulled out of the vagi- ing questionnaires that investigated wheth- na by the penile shaft. In those women who er the woman obtained her orgasm from PVI have highly sensitive or well innervated alone or from clitoral stimulation and corre- periurethral glans, orgasms may arise from lated their responses with psychological its stimulation just by PVI alone. There are tests. They reported that the clitoral stimu- still no empirical studies in relation to the lation/orgasm was not beneficial to their erotic function of the vestibular bulbs or the physical, psychological, interpersonal or crura, they may or may not be innervated behavioral health and created ‘noxious con- for inducing erotic arousal. The so- called sequences’. A postulated mechanism for this ‘vaginal orgasm’ is thus induced by a possi- was that as PVI is the only activity that ble multiple activity of erotic sites. To try promotes the propagation of genes, evolu- and isolate particular ones yielding the most tion rewards it but ‘punishes’ any other ac- stimulation and activity for the creation of tivator of sexual arousal. However, because the orgasm will vary with the individual the generation of arousal/orgasm by PVI is a woman, with the particularities of the sexual multisite stimulus, women cannot with

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH surety specify where their arousal is gener- SION ON HEALTH ated from (the ambiguity problem) and sub- Beverly Whipple jects who try to interpret unclear/vague Introduction: In 2003 and 2007 the signals as clear and distinct employ paredio- Planned Parenthood Federation of America lia a behavior most often seen when sub- (PPFA), in cooperation with the Society for jects see images in clouds, rock faces. In this the Scientific Study of Sexuality, published a Page | 9 situation it is ascribing arousal to a specific white paper on the Health Benefits of Sexual site. The present review critically examines Expression. Dr. Whipple was a senior au- and rejects that the clitoris should become a thor on this paper. Although most reports vestigial organ by women undertaking a focus on potential negative outcomes of psychological clitoridectomy and that wom- sexual expression, this presentation based en who cannot have orgasms by PVI alone on PPFA paper and more recent research, are sexually dysfunctional or that their male will focus on the positive benefits of sexual partners are sexually inadequate because expression on health. they cannot induce such activity by their Methods and Results: An analysis of pub- penis alone. lished data demonstrate a positive effect of sexual expression on decreased mortality, 012.BEYOND THE G SPOT: RESEARCH lower frequency of fatal coronary events, CONCERNING SEXUAL RESPONSES IN and decreased risk of breast cancer in men WOMEN and women. The effects of sexual expression Beverly Whipple on general well-being, pain management, Introduction: Dr. Whipple’s research pro- and quality of life will also be addressed. gram has focused on validating women’s Conclusion: This discussion will address reports of sensual and sexual pleasure. the health benefits of sensual and sexual Methods and Results: This talk will review expressions not just benefits of sexual inter- Dr. Whipple’s interdisciplinary research course. There is a need for more research in concerning the re-discovering and naming the area of the positive health benefits of of the Grafenberg spot (G spot) and the phe- pleasure, sensual, and sexual expression. nomenon of female ejaculation. The adap- tive significance of the G spot will be dis- 014.PRACTICAL INTRODUCTION INTO cussed, that is the strong pain blocking ef- SEXOCORPOREL COUNSELING fect produced by anterior vaginal wall stim- Karoline Bischof ulation as well as during labor and child- Aim: This workshop is a practical illustra- birth. The variety of women’s sexual re- tion of the theoretical framework of Sexo- sponses will be reviewed that have been corporel. It addresses persons wishing to documented in her human physiology la- increase their competencies in sexual coun- boratory from vaginal, cervical, and image- seling. It also encourages the enrichment of ry-induced orgasm to studies concerning personal erotic abilities. orgasms in women with complete spinal Background: From childhood on, through cord injury. The various sensory pathways learning processes, most people adopt par- that are involved in female sexual respons- ticular habits to elicit and increase their es, including fMRI of the brain studies of sexual arousal (sexual arousal modes) in- orgasm will be discussed. volving precise rituals of genital stimulation, Conclusion: Ways these research findings body movement, and muscle tension. High can be used in sexual health as well as fu- tonic muscle tension is often present during ture directions of this research program will elevated sexual arousal. Coupled with shal- be discussed. low or arrested breathing and reduced am- plitude of motion, it physiologically limits the experience of sexual pleasure and can 013.THE BENEFITS OF SEXUAL EXPRES- directly cause a number of sexual dysfunc-

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH tions in both women and men, such as an- Some therapeutic approaches focus on indi- hedonic orgasm, coital , low sex- rect psychosocial causes of sexual problems. ual desire, erectile problems, early ejacula- Others, to the contrary, strictly medicalize tion, and . A therapy employing them. Sexocorporel considers all cognitive, exercises that focus on variations in move- emotional and relational components in the ment and muscle tone, deep abdominal context of the genital and neurophysiologi- Page | 10 breathing, and sensory awareness can effec- cal reality of a person. Most sexual concerns tively promote sexual functioning and the originate directly from limits in sexual sensory, emotional and relational experi- learning, and in particular, from a sexual ence of sexual pleasure. arousal mode that cuts down on the experi- Methods: Based on the theoretical frame- ence of sexual pleasure, thus restricting the work of Sexocorporel presented in my Key- development of sexual desire, and impairing note lecture, in various simple (clothes-on) the perception of oneself as an erotic man or exercises, participants can experience the woman. Sexocorporel allows a concise eval- body-brain unity, sample therapeutic inter- uation of strengths and limitations in the ventions and acquire new therapeutic skills. arousal mode and other components direct- ly affecting a person’s sexuality. It offers an 015.SEXOCORPOREL: BODY AND MIND IN effective therapy by way of individually SEXUAL PLEASURE adapted learning steps inducing new pat- Karoline Bischof terns of stimulation, movement, breathing, Sexocorporel was developed by Prof. Jean- awareness, emotion regulation, and thought. Yves Desjardins at the University of Quebec, It thereby promotes both sexual functioning Montreal, Canada. Constantly updated with and the sensory, emotional and interper- latest scientific findings, it is increasingly sonal experience of sexual pleasure. taught and applied in sex therapy in Europe and in Canada. It is a practically oriented, 016. COITAL ORGASM – CAN IT BE comprehensive model of all physiological, LEARNED? SUMMARY AND A SAD STORY emotional, cognitive and relational compo- WITH A HAPPY ENDING nents directly interacting in human sexuali- Karoline Bischof ty. At its core is the constant inseparable Rationale: Coital anorgasmia is a common neurophysiological interaction between the complaint among women consulting for brain (mind) and the body. Modifications on sexual problems, often promoting low sexu- the level of the body (motion, muscle ten- al desire. A genetic predisposition has been sion, breathing) modify our sexual function- proposed, but “environmental factors” not ing, our emotions, fantasies, how we experi- further defined are deemed to be the main ence our sexuality and how we think about agents. In this panel, we discuss the role of it. neurophysiological, emotional and cognitive From childhood on, through learning pro- factors and the person’s learning history. cesses, most people adopt particular habits This final presentation will summarize the to elicit and increase their sexual arousal core points and illustrate them with an on- (sexual arousal modes): through direct or cological case report. indirect stimulation of their genitals while Case: 53y old woman with secondary anor- moving their bodies in varying degrees, with gasmia of two years who had been orgasmic varying muscle tension. Neurophysiological through clitoral stimulation prior to an ex- findings and clinical observation evidence tensive clitoridectomy and vulvectomy for that high muscle tension, shallow or arrest- Bowen’s disease. ed breathing, and reduced amplitude of mo- Sexocorporel therapeutic interventions in- tion are less conducive to sexual pleasure cluded instructions for digital vaginal stimu- than deep breathing, varying movement and lation and mobilisation of the pelvis through muscle tone. iliopsoas and pelvic floor muscle contrac-

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH tions with abdominal breathing. of boys. Outcome: After three months’ training, the Methods: The survey I conducted ad- patient achieved satisfying orgasms through dressed recovery from sexual abuse and vaginal stimulation and pelvic movement. violence. It was administered to Finnish Discussion: As research among women respondents who had experienced sexual with genital mutilation (FGM) demon- abuse and violence. The survey was con- Page | 11 strates, the clitoris is not inevitable for or- ducted in the form of an anonymous online gasm. Indeed, the rate of orgasm through questionnaire and comprised 319 respond- penile-vaginal stimulation is higher among ents. FGM women than among women with an The questions asked about respondents’ intact clitoris. We propose that orgasmic personal skills and methods in advancing response and the favored location of stimu- their recovery as well as the support they lation depends not just on genetics, but on had received from both professional sup- the physical learning history. Clitoral re- port providers and intimates. Additionally sponse can be achieved comparatively easi- the survey compiled the thoughts, ideas and ly, but may keep a woman from exploring tools that respondents had a desire to share, and developing her vaginal sensitivity. The peer to peer, with those who have similar more remote vagina and surrounding pelvic experiences. Most respondents had experi- floor muscles require repetitive pressure enced sexual violence or abuse in childhood and extension to develop responsiveness. or adolescence at the hands of an adult per- Awareness of the vagina as an erogenous petrator. organ is enhanced through pelvic movement Results: Respondents described a number and deep abdominal breathing. Through of coping mechanisms that served as the corresponding training, as suggested in sex- first steps toward recovery. Personal, indi- ocorporel therapy, vaginal sexual response vidual mechanisms in the early stages of can be accessible to women even after de- recovery included music, nature, writing structive surgery. and the regularity of daily life, all of them Recommendations: Women consulting for serving to reinforce a feeling of hope and coital anorgasmia can be encouraged to de- the ability to see good while in the midst of a velop vaginal sexual response through re- particularly difficult life situation. Some petitive vaginal stimulation and play with respondents had also discovered character- pelvic muscles. It is important to give this istics within themselves that had helped to information to women with extensive vulval further their recovery. surgery. The significance of social support in recov- ering from sexual trauma has been previ- 017.THE ELEMENTS OF RECOVERY AC- ously acknowledged as particularly im- CORDING TO SURVIVORS OF SEXUAL portant. The issue was also strongly mani- ABUSE AND VIOLENCE fested in the responses to survey questions: Maaret Kallio the support of both intimates and profes- Introduction: Many people have experi- sional support providers was seen as key. enced sexual abuse and violence. According Conversely, respondents also described to the Finnish School Health Promotion factors that had hindered their recovery Study (2013), 20% of girls and 9% of boys when they had sought the support of inti- in the 9th grade of comprehensive school mates or professionals. Many respondents had experienced sexual violence at some described being left on their own and their point or repeatedly. Among upper second- painful experiences being rejected by both ary school students, 23% of girls and 6% of those closest to them and by professionals. boys had experienced sexual violence; Conclusion: We need more discussion among vocational school students, the cor- about sexual violence and recovery in order responding figure was 33% of girls and 11% to provide needed support and to recognize

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH violence as early as possible. Many profes- Methods: Statistical data from University sionals in the support services field and Student Health Survey 2012. Selected data many victims themselves believe that it is collected from September 2013 till april not possible to overcome such experiences 2015 in internet-based counseling services: or to move forward. This belief is not always Case examples and descriptive statistics. correct and can itself be an obstacle to re- Results: , female genital Page | 12 covery. pain and fear of any sexual activities were among the common reasons for attending in internet-based sexual health counseling. Students also needed to know, what is nor- mal in sexuality and in sexual behavior. Most students reported the contact was enough for them to get information and en- couragement to ease their concerns. In more difficult sexuality problems with a comor- bididy of mental or physical symptoms and diseases the internet- based contact served mainly as a facilitator to seek out the proper face-to-face health care in local health ser- vices. Conclusion: The secure internet-based sex- ual counseling services are an excellent al- ternative and addition to traditional ap- pointments and services especially with a cases of mild problems and in need of sup- port or evaluation of the mind-related rea- sons for sexual concerns.

019.GENITO-PELVIC PAIN/ PENETRA- 018.SEXUAL HEALTH COUNSELLING AND TION DISORDER VS SEXUAL PAIN: NEW SEXUAL THERAPY VIA VIDEO LINK OR NAME OR NEW CONCEPTUALIZATION? INTERNET FOR UNIVERSITY STUDENTS Yitzchak M. Binik IN FINNISH STUDENT HEALTH SERVICES The diagnostic definitions of dyspareunia Marjo Tossavainen and originated in the 19th cen- Introduction: According to Finnish Univer- tury and have not been significantly modi- sity Student Health Survey 2012 (N=10 000 fied or questioned until recently. In 2014, students age 19-35), sexual problems and the DSM-5 introduced the new diagnostic need for sexual health counseling are very label of Genito-Pelvic Pain/Penetration Dis- common among both male and female stu- order to replace the terms dyspareunia and dents. More than twenty percent of students vaginismus. This change constitutes more were unsatisfied with their sexual life and than a simple name switch but reflects a for ten percent their sexuality was remark- fundamental reconceptualization of these able problematic. There are fourteen Finn- diagnoses from mutually exclusive catego- ish Student Health Service (FSHS) units for ries to a relatively continuous spectrum of university students in Finland, but only five problems ranging from mild vulvar pain of them have sexual health counseling with penetration difficulties to the absence workers. Since 2013 FSHS has offered a se- of successful penile vaginal penetration ac- cure internet-based counseling service or companied by intense vulvar pain. The the- students not having it in their local Student ory and empirical research underlying this Health Service. change will be presented and critically re-

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH viewed. In addition, the implications of this change for research and clinical work will 021.GENDER EUPHORIA be discussed. Elsa Mari Almås and Esben Esther Pirelli Benestad 020.SEX THERAPY EDUCATION IN THE Gender carries a meaning to most of us, but NORDIC COUNTRIES what might be the meaning of gender? Page | 13 Elsa Mari Almas In this performance lecture, a married cou- From 2002 the Nordic countries (Denmark, ple: Professor Elsa Almås and professor Estonia, Finland, Iceland, Norway and Swe- Esben Esther Pirelli Benestad guide us den) have had common authorization of through some diverse and colourful land- sexological practitioners. The Nordic Asso- scapes of gender. Female and male genders ciation for Clinical Sexology (NACS) has are seen as the major ones, in addition five been authorizin Specialists in Sexological more are added. Counselling (NACS) and Specialist in Clinical In addition an introduction is given on how Sexology (NACS). to address gender variant children. In this presentation the Nordic model for This is a journey both into this couple’s t authorization and education will be de- personal lives and experiences, and into scribed. Based on a comparison of the Nor- multiple experiences accumulated by oth- dic model with other educational models in ers. One basic question is whether or not Europe, future development of the model gender variant individuals are disturbed as will be proposed. is still advanced by psychiatric manuals. Sexological treatment must be practiced on Could it be that the disturbance rests else- different levels and in different settings in where? accordance with the PLISSIT-model. This One of the presenters, Esben Esther, is cer- requires programs that can be adapted to tainly someone who does disturb. Who then these needs: needs therapy; Esben Esther or those that Basic sexology (P), sexological counselling are being disturbed by hir? (LI), sex therapy (SS), psychothera- py/specialized medical treatment (IT). 022.WHY IS LGBT NOT A PSYCHIATRIC There is a paradigmatic challenge in sexolo- DISORDER? gy stemming from the realization that hu- Esben Esther Pirelli Benestad man sexuality is not only a physiological In the 1960’ties the French philosopher function of procreation; it is also a cultural Michel Foucault (15 October 1926 – 25 June system of meanings, in interaction with in- 1984) introduced the analogy between reli- dividual experiences, stories, wishes and gion and therapy. Human actions that had needs. The understanding of the paradig- previously been labeled “sinful” by different matic change that is going on, implies that priesthoods were “taken over” by profes- sexological practice, and therefore also edu- sional therapists and labeled mental dis- cation, must integrate understandings of turbances rather than actions or emotions how cultural changes affect the role of sexu- of sin. ality in society. Sexological practitioners This was a lifesaving procedure since reli- must be aware of their role in the cultural gious ways of treating sins within the realm process of co-creation and interpretation of of LGBT had been cruel punishments and human sexuality. death sentences. (As is still the case in some This presentation will discuss the implica- societies). tion of these ideas for development of sexo- Many wise therapists and scientists like logical training and practice. The special Richard von Krafft-Ebing, Albert Moll and need for SAR (personal work) and practical Sigmund Freud supported the notion of ho- training in sexological education will also be mosexuality as a disease or disturbance, but discussed. interestingly enough, and this goes for a

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH large number of researchers in addition to dilution are totally different form the narra- the ones mentioned, all have moved more tives met among the trans gifted. and more away from applying pathological This lecture will offer a way to meet those of labels to the love and self-conception of us who are trans gifted based not on seeing LGBT people. them as mentally disturbed, but as people One major contributor to this move from with some sets of wishes and needs that Page | 14 diagnose to human diversity was the many need to be met. encounters the researcher had with differ- ently talented people. 024.ASSESSMENT, DIAGNOSIS AND The clean bill of health arises in interactions TREATMENT OF FEMALE SEXUAL DIS- with the people in question. ORDERS This lecture will focus on the uncommon Sheryl A. Kingsberg common sense that demonstrates the awk- Women have had a long slow struggle wardness in holding on to LGBT as psychiat- against cultural taboos to reclaim their right ric disorders. to a satisfying sexual life. In 2014, the con- cept of healthy sexuality has, in theory, be- come an accepted entitlement of women 023.HOW ARE WISHES AND NEEDS OF and sexual problems have become more THE TRANSGIFTED MET IN SOCIETY widely discussed. Further, epidemiologic Esben Esther Pirelli Benestad research has now confirmed a high preva- Even though a consensus as to how to meet lence (12%) of female sexual disorders. Yet, and treat trans-gifted individuals has been for a myriad of reasons, such as lack of time, worked out and renewed by the World Pro- patient or provider embarrassment, lack of fessional Association for Transgender FDA/other international health authorities Health (WPATH), these recommendations approved treatments, physicians continue are often not followed. Offers given by to evade the topic in clinical visits which health-care systems around the world are results in a significant void in comprehen- lacking on many levels of care and on pro- sive healthcare. The World Health Organiza- fessionalism. tion considers the maintenance of sexual Trans-gendered people are met with large health to be the responsibility of the medical amounts of counter transference by straight provider. In 2001, the U.S. Surgeon General, and also by queer therapists. Health care David Satcher, in his Call to Action to pro- systems can but rarely be better than the mote sexual health as one of the goals of experts working within them. Thus have Healthy People 2010, described the role of therapists’ biases had the power to counter- health care professionals and the need for act the wishes and needs so clearly ex- better education and preparation in the field pressed by the trans gifted themselves. of sexual health. Health care professionals One great bias has been the psychiatric must first understand what constitutes dominance in the field of transgender care. functional sexuality in order for this to be Psychiatrists are trained to focus on “things addressed in the clinical setting. Unfortu- that have gone wrong in peoples’ heads”, nately, as is true for research, sexual medi- still psychiatry has clung to conditions that cine as a whole has not been given high pri- are successfully treated with hormones ority in medical education. This leaves many and/or surgery. Procedures that adjust the providers unprepared and even uncomfort- body not the mind. able, and this discomfort is, ultimately, an One argument for clinging has been that one obstacle to competency and fitness. must differ those who are genuinely Although varying models for understanding transgender from those who have gender healthy female sexual response have been incongruence as part of a dilution. This is a proposed, all generally include the elements persisting argument, even though stories of of desire, arousal, orgasm, and resolution

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH and current research also emphasizes the with/without concurrent estrogen therapy, importance of evaluating pain as a source of improves the quality of the sexual experi- sexual problems. Current models reflect the ence. In addition, other studies demonstrate biopsychosocial and multifactorial nature of therapy improves sexual well- the female sexual response. Basson’s model being in premenopausal women with HSDD. of female sexual function acknowledges the Recently we have shown transdermal tes- Page | 15 importance of emotional intimacy, psycho- tosterone improves sexual function in wom- logical factors, and sexual stimuli and posits en with SSRI/SNRI- associated sexual dys- that in women arousal often precedes de- function in a RCT. These effects appear not sire. This description updates the traditional to be mediated by aromatization of testos- linear models of Masters and Johnson as terone to estrogen. The other potential ben- well as Kaplan, in which desire precedes efits of testosterone in women include fa- arousal. Levine suggests that desire has 3 vorable effects on bone density, muscle distinct but interrelated components—drive mass, vascular endothelial function and (spontaneous biologically driven sexual cognitive function. Transdermal testos- interest), cognitive factors (expectations, terone has been found to improve verbal beliefs, and values about sex), and motiva- learning and memory in postmenopausal tion (emotional and interpersonal fac- women who are users of estrogen and non- tors)—further emphasizing the complexity users of estrogen. of female sexuality. Contrasting the favorable effects of testos- This lecture will provide an overview of the terone demonstrated in RCTs, systemic female sexual disorders, how to assess and DHEA therapy does not improve sexual diagnose female sexual disorders, and cur- function, mood or wellbeing in women. rent treatment options.. Testosterone has not been approved, other Learning Objectives than for surgically menopausal women on 1.Define the Female Sexual Disorders estrogen therapy in Europe. Despite this, the 2.Outline techniques for assessment and use of testosterone by women is wide- diagnosis of sexual disorders spread, with vast numbers of women using 3.Identify treatment options for each of the testosterone preparations developed and sexual disorders marketed for men, testosterone prepara- tions compounded on individual prescrip- 025.ENDOCRINOLOGY AND TESTOS- tions as oral lozenges and creams, and tes- TERONE USE IN WOMEN tosterone implants. Hence there is a clear Susan Davis need for a testosterone therapy delivering Androgens are vital hormones in women, an appropriate female dose to be approved, circulating in concentrations ranging from so that women have the option of using a nanomolar to micromolar. Not only are an- product formulated for women. drogens the precursor hormones for estro- gen biosynthesis in the ovaries and extra- gonadal tissues, but androgens act directly via androgen receptors throughout the body. Androgen levels decline with age in women with the greatest fall in total and free testosterone occurring before the men- opause. Large randomised placebo-controlled trials (RCTs) involving naturally and surgically postmenopausal women presenting with hypoactive sexual desire disorder (HSDD) demonstrate that testosterone therapy,

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH

bly exhale while keeping the mouth and nose closed. Applied to male patients with is helping them to overcome sexual complains. Couple’s therapy as base of sexual treat- ments Page | 16 Since the 1960’s treat sexual dys- functions within the couple has been the focus of a major group of psychotherapists. Although there are patients that do not want to treat their difficulties with the presence of a sexual partner, the use of couple’s psy- chotherapy helps more patients to over- come sexual difficulties, and also include couple’s issues that may under lay the same sexual issues. All over Latin America it has been the preferred underlying technique in psychotherapy of sexual issues. Evaluation psychosexual using interview and sexual inventories and other sexual 026.SEXUAL PSYCHOTHERAPY: INTO scales according to main problem. NEW TRENDS TO DEAL WITH SEXUALITY Sexual inventories are used since the Oswaldo M. Rodrigues, Jr 1950’s, although forms and types depends Psychotherapy applied to sexuality has dif- upon the country and historical moment. ferent approaches since its more scientific In the past few decades, in the Insti- proposals in the 1950’s. Techniques over tuto Paulista de Sexualidade, in Brazil, we processes gained more attention driving designed an special form of psychosexual health professionals away of the psycho- diagnosis in order to involve patients to therapy forms. better understand their sexual problems The need of dealing with different forms of and to evaluate the psychotherapy process. techniques from other health professionals Increasing cooperation between organic and and incorporating new techniques and psychological treatments working with those other professionals is Sexual problems may have concomi- helping to create a new understanding of a tant organic and psychological issues, and process of the psychotherapy. both approaches must be coordinated in Physiotherapy helping psychotherapy order to help patients. Physical therapists have been focus- Past decades shows best results ing sexual issues and in several countries among studies caring to deal with both are presenting ways of helping patients to trends at the same time. understand body and sexual functioning through techniques applied directly in the patients bodies. There are some ethical con- 027. THE NEW PSYCHOSEXUAL THERAPY siderations according the country and how AND MEN WITH LOW TESTOSTERONE to apply it to psychotherapy. Oswaldo M. Rodrigues, Jr New technique helping to treat premature While considering sexual health as a main ejaculation guide to a psychotherapist help a person to In the past years, an Argentinian overcome a sexual complain, there should psychologist, Julio Obst, proposed the use of be much more to work in this person’s sex- an interesting technique. The Valsalva ma- ual behavior and attitude than just the abil- neuver is performed by attempting to forci- ity to perform coitus.

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When we read that gonadotropin-deficient tion in the process of sexual treatment and hypo-pituitary men were cycled through intervention. periods of treatment with testosterone and Methods: An analysis of various masturba- gonadotropin in a research and “Two thirds tory habits among men and women who of the sample had no socio-sexual experi- were referred to the sex therapy clinic. ence” (Clopper and cols, 1993), we should Results: Based on the various manifesta- Page | 17 be able to see the need of developing sexual tions of masturbation, specific set of ques- behaviors! tions as well as a diagnostic and therapeutic When we also read about men that need to flowchart were developed. Physicians and be treated with testosterone: sex therapist may use these tools to proac-  “higher-than-expected dropout rate tively address masturbatory habits that may in the men receiving testosterone.” = result in SD, thus overcoming the discomfort 30% (Alan et all, 2007) involving this issue.  “The drop-out rate among the sub- Conclusion: Understanding the role of jects was significant.” (Sih et all, masturbation in the framework of sexual 1997) behavior and sexual function of individuals And yet, those men with organic as well as couples, who complain on SD, may factors associated to low testosterone may assist in diagnosis and treatment. Sex edu- might be also diagnosed with some sort of cation of patients, masturbation retraining states or anxieties, or even cou- and relearning may serve as important ples relationship issues. modes of intervention. This lead us, psychotherapists to an ap- proach according to this diagnosis and help 029.MEDICAL AND PSYCHIATRIC AS- to develop: PECTS OF MASTURBATION  social skills, assertiveness Itzhak Z. Ben-Zion  new cognitive schemas Masturbation has been judged as immoral  overcome cognitive distortions and a religious sin by the main religions  couple’s communication (Christianity, Judaism and Islam). In addi-  sexual techniques, sexual behaviors tion, masturbation was blamed for homo-  well-being! sexuality, insanity, sterility, and a variety of The objective is to describe and other mental and physical disorders. The guide psychotherapists through psychologi- attitude toward this sexual behavior became cal techniques in order to help organic is- gradually more tolerant throughout the sues such as low testosterone in male pa- 20th century, and it is no longer perceived tients. as a behavioral aberration. Some authorities even consider autoeroticism as a mode to 028.MASTURBATORY HABITS AS A LEAD- reduce the risk of sexually transmitted dis- ING HINT TO EVALUATE AND TREAT eases. Studies found that masturbation was SEXUAL PROBLEMS highly prevalent in the general population, Gila Bronner even among the elderly. Introduction: Masturbation is a common However, sometimes masturbatory practic- sexual behavior, reported by men and wom- es may present medical or psychological en of all ages. Masturbation is often neglect- problems. In other cases masturbation may ed in the diagnostic inquiry of people with lead to . Masturbation sexual problems, consequently missing es- among psychiatric patients may be part of sential components of a comprehensive obsessions or compulsions, dysphoria, dys- sexual history. This presentation aims to thymia or . Physical discomfort or increase the awareness of clinicians to the genital itching in diabetes, among demented importance of assessing masturbatory hab- or mentally retarded people may result in a its and understanding the role of masturba- behavior that is considered as masturbation.

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In some cases masturbation is associated ies. The most frequent concerns of women with self-harm, injuries or edema. In other in consultation are about the inability to cases, the association between masturbation reach orgiastic discharge, the inability to and religious or social sanctions is present- enjoy orgasm pleasurably, and, most fre- ed by reports of emotional trauma, feeling quently, the desire for orgasm during inter- filthy and contaminated. This presentation course. Basically, every woman can learn to Page | 18 will demonstrate the various relationships reach orgasm. The capacity for sexual found between medical and psychiatric as- arousal is innate. Women can learn and con- pects and masturbation. tinue to develop throughout their lives the ability to trigger, increase and eventually 030.UNUSUAL MASTURBATORY PRAC- enjoy arousal. This development can be lim- TICES: CASES AND DISCUSSION ited by the individual learning history, Itzhak Z. Ben-Zion and Gila Bronner which can be impeded by physical, cognitive Introduction: “Unusual masturbatory prac- and emotional factors. Accordingly, treat- tice” was previously described as “idiosyn- ment seeks to prompt learning processes cratic masturbatory style”. These two terms that are individually adapted to the refer to masturbating by using a distinctive strengths and limits of the respective pa- technique that could not easily be replaced tient as determined by a concise evaluation. by their partner’s hand, mouth, or vagina. Methods: The treatment of three women These habits may create an obstacle for with orgasm complaints will be presented. It arousal and pleasure, when the individual consists of learning steps individually tries to participate in sexual relationship. adapted to the client’s relevant strengths Methods: We describe cases of “unusual and limitations, combined with imparting masturbatory practice” among men and knowledge about the biology of the arousal women, demonstrating the use of a specific function, getting to know their own sex diagnostic flow-chart, designed for evalua- through various perception exercises, de- tion and intervention. velopment and strengthening of arousal – Results: These described masturbatory playing with the three laws of the body behaviors were associated with various SD, (tension, rhythm and amplitude of move- e.g. , low sexual desire ment). For the wish for orgasm during in- and erectile dysfunction among men, and tercourse (coital orgasm) vaginal explora- disorders of arousal and orgasm in women. tion is also important, since the perception When patients understand how their mas- of vaginal stimulation can be improved turbation affects the sexual function and through sensory training. A special focus is pleasure, a relearning training was person- placed on increasing pleasure – thus turning ally tailored for each patient. an orgiastic discharge (reflexive muscle Conclusion: The presented cases demon- contractions) into an orgasm (connected to strate that discussing masturbation as inte- a strong emotional experience). Lastly, the gral part of the sexual history taking, and ability to orgasm is improved by means of assessing exact masturbatory practices, genital release through pelvic movement as sometimes lead to better diagnosis and suc- well as emotional release through mobility cessful interventions. in the chest area. Results: In all three cases the clients were 031.TREATMENT OF ORGASM PROBLEMS able to reach the goal they aimed for within IN WOMEN – THREE CASE STUDIES a period of 15-20 sessions. Dania Schiftan and Karoline Bischof Conclusion: The three case studies demon- Introduction: Various forms of orgasm- strate the effectiveness of the sexocorporel problems can successfully be treated method for the treatment of orgasm prob- through the sexocorporel method. This shall lems. Women who are willing to actively be illustrated by means of three case stud- practice these techniques will experience

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH both a heightened perception and an in- a strong emotional experience). Lastly, the crease of pleasurable sensations. It can thus ability to orgasm is improved by means of be shown that women are able to reach or- genital release through pelvic movement as gasm, if they undergo the relevant learning well as emotional release through mobility steps. in the chest area. Results: In all three cases the clients were Page | 19 032.TREATMENT OF ORGASM PROBLEMS able to reach the goal they aimed for within IN WOMEN – THREE CASE STUDIES a period of 15-20 sessions. Dania Schiftan and Karoline Bischof Conclusion: The three case studies demon- Introduction: Various forms of orgasm- strate the effectiveness of the sexocorporel problems can successfully be treated method for the treatment of orgasm prob- through the sexocorporel method. This shall lems. Women who are willing to actively be illustrated by means of three case stud- practice these techniques will experience ies. The most frequent concerns of women both a heightened perception and an in- in consultation are about the inability to crease of pleasurable sensations. It can thus reach orgiastic discharge, the inability to be shown that women are able to reach or- enjoy orgasm pleasurably, and, most fre- gasm, if they undergo the relevant learning quently, the desire for orgasm during inter- steps. course. Basically, every woman can learn to reach orgasm. The capacity for sexual 033.BODY AND PELVIC MOVEMENT DUR- arousal is innate. Women can learn and con- ING AROUSAL PREDICTS COITAL OR- tinue to develop throughout their lives the GASM IN HETEROSEXUAL WOMEN ability to trigger, increase and eventually Peter Hilpert, Karoline Bischof and enjoy arousal. This development can be lim- Guy Bodenmann ited by the individual learning history, Introduction: Female coital orgasmic infre- which can be impeded by physical, cognitive quency is a common problem often present- and emotional factors. Accordingly, treat- ed in sexual therapy. It is frequently associ- ment seeks to prompt learning processes ated with a low level of sexual arousal and that are individually adapted to the lack of desire for intercourse. Research has strengths and limits of the respective pa- thus far rarely looked into what happens tient as determined by a concise evaluation. during vaginal intercourse – more specifi- Methods: The treatment of three women cally, what women actually do with their with orgasm complaints will be presented. It bodies to maintain and raise arousal, and consists of learning steps individually how this influences their ability to experi- adapted to the client’s relevant strengths ence coital orgasms. Clinical observations in and limitations, combined with imparting Sexocorporel sexual therapy indicate that knowledge about the biology of the arousal women utilize several different patterns of function, getting to know their own sex attaining arousal which are more or less through various perception exercises, de- conducive to achieving coital orgasms. velopment and strengthening of arousal – Movement of the body and in particular, the playing with the three laws of the body pelvis, has been identified to be the most (tension, rhythm and amplitude of move- conducive, while holding still and focusing ment). For the wish for orgasm during in- on precise stimulation of a specific genital tercourse (coital orgasm) vaginal explora- area appears to be the least conducive. tion is also important, since the perception Methods: 1237 women filled out an online- of vaginal stimulation can be improved survey. They were asked about their prefer- through sensory training. A special focus is ence of body and pelvic movement and of placed on increasing pleasure – thus turning precise stimulation of a specific genital area an orgiastic discharge (reflexive muscle during arousal with a partner. The frequen- contractions) into an orgasm (connected to cy of orgasm during three different sexual

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH stimulation situations was elicited: sexual ences the pattern of current social network- intercourse with additional stimulation of ing. The Network Pornography influences the vulva, sexual intercourse without addi- the physical and mental development to the tional stimulation of the vulva, and stimula- teenagers, the population to the sexual ad- tion of the vulva without vaginal penetra- diction is increasing, desperately indulged tion. in sexual-love making, new crimes commit Page | 20 Results: The results show several highly consequently, etc. brings up the negative significant associations: Preference of body impact to the teenagers. and pelvic movement during arousal with a Conclusion: İndeed to made the sexual partner was clearly associated with more education success, school, parents and net- frequent orgasms during intercourse both work investor need to work hand in hand to with and without additional stimulation of educate our youths the vulva, but not with the frequency of or- gasms during stimulation of the vulva alone. 035.EXPLORE THE COURSE OF THE RE- Preference of precise stimulation of a specif- LATIONSHIP IN THE FAMILY OUT OF THE ic area was highly associated with orgasms CLOSET GAY COUPLES during vulva stimulation without penetra- Lin Yen-Chin tion, and highly negatively associated with Introduction: This study aims to under- coital orgasms without additional stimula- stand (a) factors interact with family history tion of the vulva. of the closet gay couples personal percep- Conclusion: This study corroborates clini- tions and ideas (b) the relationship between cal observations that the ability of women to gay couples (c) interactive course gay cou- achieve coital orgasm is highly dependent ples and families (d) partnership interac- on their preferred pattern of raising arousal. tion. In particular, the preference for body and Methods: This study used qualitative re- pelvic movement is conducive to coital or- search orientation interpretation phenome- gasms. This has important clinical implica- nological method, with four out of the closet tions for the treatment of coital anorgasmia. for gay couple’s families for the study, col- lecting data through two companion studies 034.DISCUSSION ON THE E-GENERATION paired depth semi-structured interviews NETWORK ISSUES AND NETWORK, Chang and phenomenological analysis method Yu-Chen And CHU YUAN - HSIANG description and inductive analysis. Introduction: This paper aims to focus on Results: The main findings are divided into the Network Pornography composing of the four parts :(1).Gay couples personal percep- online dating, the network pornography, tion and ideas.(2).The interaction between and the over network, the gay couples.(3).Interaction of gay couples cyber bullying, etc. the operation on sexual and family. (4). Factors interactive partner- education currently. ship. Methods: I am a teacher also to be the in- Conclusion: The interaction relationship timate counselor, frequent investigation of between the gay couples and individuals sexual assault, sexual harassment and sexu- parents react differently and showed differ- al bullying cases. Review the trend and ent patterns in personality traits. convenience of the Internet derives the rela- 036.STUDY OF THE INTIMATE RELA- tive sexual issues over network. Refer with TIONSHIP AND SEXUAL DESIRE AMONG the statistics shows that the teenagers be- HIV-INFECTED MALE HOMOSEXUALS come the majority to this community signif- Lin Mei Chen icantly. Introduction: The purposes of homosexual Results: The finding is that the network parades in Taiwan mostly aimed at families, application to teenagers is related closely to friends, work opportunities, equal rights in the sexual issues. The on-line dating influ- politic field and homosexual identification.

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However, little was discussed on homosexu- author of the bestselling book “SLOW SEX” al daily life. Strong relationship between gay has developed a technique of clitoral stimu- and AIDS was still perceived in Taiwan lation, coined as “OMING Meditation- community. Although gay must face AIDS Orgasm Technique” (Daedone, 2011). There stigma and fear of death, which were the have been claims that this method induced major pressure sources, partner other than altered states of consciousness (ASC) in Page | 21 family members and friends wound provide some women after a certain period of time, more support about emotion, material and we have performed a descriptive study information and strengthen power against through a survey among the women, who AIDS. participated an event of “One Taste Compa- Methods: Five more than 20 years old male ny” in California-USA in March-2014. homosexual with AIDS-diagnosed were re- Introduction: It is reported that prolonged cruited from some regional medical center. orgasms induced ASC in some women (Tay- Interview was conducted. Participants de- lor, 2001; Sayin, 2012). Similar findings scripted their own life from four aspects: （ have been reported by other researchers. 1）basic dates（2）high risk behavior Recently, it has been reported that ASC was model（3）family supportive system（4） observable in some women who practiced Lust, intimate relations and sexual interac- “OMING Meditation Technique” developed tion experiences. by Nicole Daedone, as mentioned in her Results: Male homosexuals with AIDS did book “SLOW SEX”. not change their desire for intimate rela- Methods: A very short survey questionnaire tionship and were still active in sexual activ- which consisted of 3 questions was deliv- ity. But they rarely tell their sexual partner ered to the women who participated an the truth. If their medical condition was event performed by “One Taste Company”. stable and not discomfort, they wound con- 25 women, who have been practicing tinue their sexual activities without using “Oming Meditation-Orgasm Technique” for condom even that they knew this was high- at least 3 months regularly, were taken into risk behavior. Thus, 1) Family’s support the study. They also signed a form of written wound drive individual to control their statement of consent before the survey. The AIDS. 2) After AIDS was diagnosed, male technique consisted of the stimulation of homosexuals still expect intimate relation- glans clitoris using a lubricant by the help of ship. But AIDS stigma lessened the expec- a partner for at least 15 minutes. It was de- tancy to love. 3) Under stable condition, termined that the women participating the male homosexuals still had active sexual life study used this technique with an average of and multiple sexual partners. Whether con- 5.1 times a week. In the third question 85 dom or not was dependent on guys self- different forms of ASCs, which were as- perceived the concentration and transmis- sumed to be possible to occur during the sion risk of HIV. OMING orgasms, were asked to be checked Conclusion: From this study, the expectan- in a table, as described by other researchers cy to intimate relationship and sexual be- (Taylor, 2002; Sayin, 2011, 2012; King, havior model of male homosexuals were 2010). more understood. Results: Pulsating feeling (0,92); throbbing (0,8); warmth (0,84); exciting feeling (0,80); 037.ALTERED STATES OF CONSCIOUS- pleasurable (0,84); quivering (0,76); eleva- NESS (ASC) INDUCED BY A NEW METHOD tion of mood (0,84); happiness and content- OF REPEATED CLITORAL STIMULATION ness (0,80) were the most common feelings AND CLITORAL ORGASM over 80 % of the participants of the study. Ümit Sayın (Sayin-1), Justine Dawson and Least experienced consciousness states be- Nicole Daedone low a frequency of 25 % of the women prac- Rationale (Optional): Nicole Daedone, the ticing OMing Orgasm Technique were as

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH follows: flying (0,28); astral voyage (0,24); future, 59.26% asked other women with death feeling (0.08); near death experience hysterectomy experience about changes (0.04); losing the soul (0.04); traveling to after operation, 51.85% searched infor- different lands (0,24); voyage to unknown mation from Internet sources, 87.04% places (0,20). wanted to receive more information from Conclusion: Using many different tech- gynecologist. 51.85% thought they will feel Page | 22 niques of sexual stimulation including ex- less feminine without uterus, 59.26% wor- panded sexual response (ESR) and “Oming ried that partners will find them less femi- Orgasm Meditation Technique”, practiced in nine. 31.48% thought that their sexual life a regular basis, various ASC patterns may will become worse, 27.78% thought it will occur in a statistically significant number of not change, 22.22% thought it will improve. women. This phenomenon needs to be in- 68.52% had regular sexual partners, vestigated thoroughly by means of further 56.76% of them had only partly told their surveys and/or laboratory research to es- partner about operation, 24.32% had not tablish as a contributing technique to en- told at all, 18.92% had told everything. hance the pleasure and orgasms of women. 14.81% had concerns about ‘cleaning’ of the body without regular bleeding, 20.37% 038.OPINIONS OF GYNECOLOGIC PA- thought they will have earlier and more TIENTS ABOUT IMPACT OF PLANNED heavy menopausal symptoms, 29.63% HYSTERECTOMY ON THEIR REPRODUC- thought they will need to use HRT after op- TIVE FUNCTION eration, 5.56% were not sure if they can Nellija Lietuviete discontinue birth control method after hys- Rationale: Objective of this study was to terectomy. summarize opinions and concerns of wom- Conclusion: Impact of hysterectomy on en on the day before planned hysterectomy. their lives is very important for the patients. Introduction: Conclusion about scheduled They are afraid of negative effects and are hysterectomy usually brings women to not ready to talk honestly to their partners. many questions about operation and post- Myths and doubts are still present on the operative changes in their bodies. After hys- day before hysterectomy. Gynecologists terectomy woman may be influenced by should actively discuss more about planned both physiological and psychological fac- operation with patients instead of waiting tors. Losing the uterus can make women for them to ask questions. worry about feeling less womanly after op- eration, or losing their sexual attractiveness. 039.RESEARCH ON THE SEXUAL EXPERI- There is still no single view about real im- ENCES AND SATISFACTION LEVELS OF pact of hysterectomy on sexuality, data are TURKISH CYPRIOT YOUNG ADULT MALES discrepant. Mehmet Beyazsaçlı Methods: 54 patients of wide spectrum Rationale (Optional): The purpose of this Gynecology clinic were recruited to partici- research is to identify the sexual activity pate. Inclusion criteria were: age 18-50 phenomenon and observe the sexual satis- years, scheduled to undergo planned hys- faction levels. terectomy without ovarectomy due to be- Introduction: The sexual desires are said to nign indication, voluntary agreed to partici- be unstable and discontinuous by Fromm pate. Inquiry form was used to collect an- (1981:50); if not supported by strong emo- swers. Study was approved by the Commit- tional connections such as sympathy and tee of Ethics. love, they will be short lived even in their Results: All patients had been thinking densest state. Also according to Fromm, about impact of hysterectomy on their fu- sexual discontinuity cases can be seen more ture life. 75.93% had worried that hysterec- frequently with males which make this re- tomy can have a negative effect on their search about this phenomenon on the Turk-

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH ish Cypriots even more significant. tions, the level of sexual satisfaction differs Methods: The combination of the qualita- based on frequency of intercourse, orgasm tive and quantitative analysis methods of and foreplay periods, pleasure points of the the phenomenal meaning makes this study a partner, contact style and protection two part research. This phenomenal mean- (p<0.05). When the findings were evaluated ing makes the known, but not deeply ana- in the accordance of the quantitative data, it Page | 23 lyzed and understood, phenomenon more can be seen that level of sexual satisfaction clear (Yıldırım and Şimşek, 2011:72). The at the end of sexual activity differs with first stage of this research was done by ob- sleeping together and oral sex. serving the sexual activity phenomenon, Conclusion: To conclude, the need of aca- using qualitative analysis and then the se- demic programmes was suggested about cond part was illustrated by observing protection methods, sexual experiences and whether there are meaningful differences activities that affect the sexual satisfaction. within the quantitative analysis data about sexual satisfaction. 040.THE LACK OF INFORMATION OF The qualitative part of the research was VENERIAL DISEASES IN THE EDUCTION done by collecting data using open ques- SYSTEM : A SURVEY ON STUDENTS tions on certain subjects such as the experi- Asiye Kocatürk ences before, during and after intercourse. Poster For the second, quantitative, stage of the Introduction: A survey on the information analysis, Arizona Sexual Experiences Scale and general knowledge of the students of an (ASE) made suitable for Turkish examples educational school on general sexuality and by Soykan (2004) was used to determine Venereal Disease (VD) was investigated. the sexual satisfaction levels. ASE Cronbach 469 students (328 females, 69,9 % and 141 Alfa Level level was told to be 0.88.The real- males, 30.1 %)filled the forms of a specific ity correlation number is 0.53 and the end questionnaire of 38 items. Average age was point was set to be 11, which has selective 24. properties and enables the reality scale. Methods and Results: 469 students (328 120 Nicosia Turkish Municipality (NTM) females, 69,9 % and 141 males, 30.1 employees construct the universe of the %)filled the forms of a specific question- analysis. 80 suitable and appropriate and naire of 38 items. Average age was 24. 35 candidates were selected. NTM was chosen to 40 % of the students did not have any specifically because the employees are from accurate and correct information on the the all parts across the island. basic issues on sexuality, VDs, treatment of Data analysis at the qualitative stage was VDs and protection from VDs as they gave done using descriptive analysis. When the vague and inaccurate answers to various outline of the research was constructed, questions. The most common knowledge data was collected using semi-structured source was the internet (64,2 %). questions, coded under concepts and relat- Conclusion: A structured and detailed edu- ed to their frequency. SPSS was used to ana- cation on human sexuality and preventive lyze the quantitative data. The differences medicine, VDs should be given at the high within the analysis were determined by school and university levels, since there is using ANOVA. The meaningful differences no informatory education system on sexual- within the groups were determined with ity in Turkey. Sheffe test. For dual compositions t-test was used. Also the averages of the arithmetic data and standard deviation values are giv- en. Meaning level at quantitative dimen- sions is assumed to be 0.05. Results: According to the research observa-

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Introduction: The goal is the shortening of the treatment time of vaginismus, which usually takes 10 to 12 sessions with cogni- tive -behavioral therapy alone, by adding the hypnotherapy sessions in the treatment process. Page | 24 Methods: Cognitive-Behavioral Therapy and Hypnotherapy. It started with 4 sessions of Cognitive-Behavioral Therapy and followed with 2 sessions of Hypnotherapy in same day. Results: After the successful application of 4 sessions of Cognitive-Behavior Therapy by psychologist, the patient reached the point where the patient overcame the feeling “an- ything which doesn't belong to me, can't be inserted in me” with the help of her partner who is doing insertion exercises with his 041. CHEATING ON OF TURKISH WOMEN little finger into her vagina. After reaching AND TURKISH MEN? that point, hypnotherapist applied 2 hypno- Berk Karaoğlu therapy sessions in the same day. After the- Abstract of the Lecture: se 2 hypnotherapy, the couple successfully People's mind might have a few certain rea- managed sexual intercourse. As a result, sons for infidelity, but actually it is a very normal treatment of vaginismus takes 10-12 complex situation that changes depending sessions of Cognitive-Behavioral Therapy, on culture, economic conditions, psycholog- but adding Hypnotherapy decreased the ical and genetic structure. number of sessions to 6. Because of the Depending on my clinical observations, cur- same day application of hypnotherapy, it rent research, popular topics and scientific also decreases the treatment period. data, I will try to explain why Turkish wom- Conclusion: Using both cognitive and sub- en and Turkish men cheat or which reasons liminal development, under the Cognitive - cause Turkish people to cheat. Behavioral Therapy and Hypnotherapy, has In this aspect, Turkish woman’s psychology, shown to successfully treat vaginismus. To their emotion, their family and their way to further shorten this treatment period, de- evaluate sexuality are important, the Turk- creasing the number of Cognitive - Behav- ish man's relationship patterns and their ioral Therapy sessions and emphasizing on sexual attitudes are also important. subliminal objects is advised. We will explain why Turkish women and Turkish men cheat by evaluating some im- portant landmarks such as sexuality, sexual urges, sexual satisfaction, sexual infidelity, romance, personality traits, sexual demands, emotions and sexual expressions.

042. SHORTENING OF VAGINISMUS TRE- ATMENT TIME BY USING COGNITIVE- BEHAVIORAL THERAPY AND HYPNOT- HERAPY TOGETHER. Berk Karaoğlu ORAL PRESENTATION

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4 % Existentialist 11- 83 % Providing genital friendship after suggestion and exercising on their own (74 % can’t let an object in before,, 26 % can let something in), 17 % needs to exercise after suggestion ( volitional incapability). Page | 25 12- Reasons of failure: Leaving the therapy because of avoiding genital examination; decision of divorce, Not loving and taking care of the partner. 13- Average period of success: 1 day…………12- 24 hrs. 87 % 1,5 days…………..24- 36 hrs. 9 % 2,3 days…………..36- 48 hrs. 2 % Follow up from the Internet……..2 % 20 days to 30 days because of impatience to the pressure in the vagina, being coddled by the family, urinary retention. 14- Success rate 96 % , Rate of Failure 4 % 0.43 ANALYSIS OF 450 VAGINISMUS CAS- (the ones, leaving the therapy because of 12 ES RETROSPECTIVELY th item are included in this percentage). Murat Ulusoy 15-Cities where most of the clients come 1- 73 % University graduates, teachers; from are: İstanbul , İzmir, Ankara,Manisa, “English, Class” Bursa, İzmit Turkish people from the Euro- 2- 23 % High School graduates, “Accountant, pean Countries. housewife” 16- 10 % of the group can work over the 3- 4 % Primary School graduates problem with simple proposals (the number 4- Average Ages of people given support via the Internet 77 % between 20- 30 between the years 2005- 2006 was; 1440; 19 % between 30- 40 the number of successors was 140. 4 % ages < 20 and > 40 5- Average marriage durations: 4 years; ranging from 1 month to 19 years. 044. ULUSOY TECHNIQUE IN VAGINISMUS 6- Clients, coming to our therapy come as TREATMENT the third choice. Before contacting us; Dr. Ulusoy’s Hypnosis Induction Tech- they’ve consulted psychologists, psychia- nique and Preparation to Hypnotherapy trists and gynecologists. 13 % come to us as Murat Ulusoy the first choice. 1-Emphasizes mind- body relaxation. 7- 17 % are the smallest or the only child of 2- Focuses on auditory- tactile-visual struc- their family (the effect of being coddled). tures. 8- 12 % have the problem of urinary reten- 3-İncludes eye fixation, respiration, passes, tion since adolescence. changes in perception and imagination. 9- 84 5 of them have “auditory-tactile – 4-It is not obtrusive. visual” positive, 3 % of them are normative, 5-A pre- evaluation; consisting of 1 or 2 don’t give control to the others, have nega- minutes is for preparation and for living the tive “auditory,-tactile- visual”; In 13 % of experience. them either or both are positive. Preparation of the Patient 10-75 % Cognitive 1-Formulation (cognitive, behavioral, I dy- 6 % Behaviorist namic, existentialist). 15 % Dynamic 2-Samplıng and modelling.

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3- Spiritual instrument and working princi- If it doesn’t lean on the seat (volitional re- ple in hypnotherapy (conscious- subcon- sistance) she is told to lean her back to the scious mechanisms of resistance). seat with her own volition. 4-Testing of auditory, tactile, visual qualities Tactile (Perceptual) as the personality construction. 1-The suggestion about the left hand’s re- In Dr Ulusoy HIT: laxation, lightening is given. Page | 26 1-There is heated acting 2-“The left hand, on the other hand; getting 2- What is important will be the mind- body heavier like a stone, bar, iron” is given as a relaxation (can I enter into hypnosis? There suggestion. are people who can’t enter into a hypnotic 3-She is asked to answer the question as Yes state, but everyone can experience the or No and direct the therapist. mind- body relaxation). 4-She is asked if she is sensing a perception- 3- Mind will be conscious from the begin- al difference between the arms (Yes or No). ning till the end (There may be a thought of If she doesn’t feel any difference, visual pro- either “am I in a hypnotic state or not?” but cess is applied. everything should be accepted as it is). Visual 4-A lot of thoughts may come into conscious 1-I want you to imagine a valley between mind (these are not important and can be the two mountains, where there are trees, welcomed). flowers, colorful butterflies. There’s a purl- 5-A different perceptional state will be ex- ing creek running on the ground. This is the perienced on the other hand. valley of happiness; You will experience, feel 6-We will work on a problem focused basis. and live according to this valley of happi- Dr. Ulusoy’s HIT processes: ness. Now, I want you to look around, in this Auditory: valley and tell me what you see, feel and 1-The patient sits at the corner of the seat, experience. hands are situated on the knees. 2-You’re here to solve your existing prob- 2-She is told to fix her eyes to the opposite lems. Each time you sit on this seat, you’ll wall; to the corner where the ceiling and the feel a deeper relaxation than the former, wall intersects. take the suggestions that I give you more 3-Three deep breathing is produced with comfortably, do the task that I give you the movement of the hand; each breath is more easily, make identification with suc- reinforced with a positive statement. cess as you watch the films that I present at 4-At the end of the third breath, she is told more ease and overcome your problem in a to close her eyelids volitionally. short time. 5-Eyes are closed with the right hand to If there’s no visualization, there’s a se- make a silhouette and a pass (melatonin). rious resistance; this may be because of 6-A relaxation suggestion is given; begin- excitement, fear of what will happen, lack of ning from the head to neck, shoulders, arms, sufficient heated acting, or patient’s lack of hands, from neck to the spinal column, back perception about heated acting, fear of los- muscles, hip muscles, thighs and legs, ing the self, an obsessive personality, or the through the feet and toes. desire to control everything. In these cases, 7-A suggestion about the pulling of the body a break is given. backwards with the metaphor of a magnet •The fact that either one or few of these /needle is given. systems are eminent in every person is told 8-“When your head and your back leans on to the patient, adding that the fear she expe- the seat, a deep relaxation will reach riences is because of the anxiety and her through the entire body” is given as a sug- lack of releasing himself. She is told that in gestion. the second session, when she sits on the 9- The body leans on the seat in a short seat, direct suggestions will be given and while. she is required to release her body as if she

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH is sitting on a comfortable armchair at her attacks, conversive fainting, refraining from home. the ıntercourse, refraining from fear and •Some people can’t produce imaginations, panic (cognitive approach-hypnotherapy). but can focus on thoughts. Therefore, pa- 12-Sexual abuse and rape in the past (hyp- tient is told to listen to what the therapist notherapy). tells as if she is listening to a play on the 13-Sexual pressure from the family (hypno- Page | 27 radio. therapy). •In the second session an improvement is 14-Cognitive distortions (hypnotherapy). observed in relaxation and suggestibility 15-Improving the feasibility of the tasks (imagination and tactility improves. Occa- (hypnotherapy). sionally, a focus on thought when eyes are 16-Giving competence to the partner in pe- closed is improved. nile experience and behavioral approach ….Patient takes 3 deep breathes and opens (cognitive-hypnotherapy-indirect sugges- her eyes. She is evaluated on audial (+, -), tions). tactile (+,-)and visual (+,-) basis. 17-Penis size (behavioral). 18-The effect of tolerant partner: The real Major factors affecting the course of treat- tolerant man not only perceives that this is ment in vaginismus an illness and something must be done as a 1-Bodily symptoms, originating from the treatment, but also proves this in the course mind (hypnotherapy). of the treatment and supports his partner. 2-Sensitivity to the vaginal tissue (cognitive- On the other hand, man’s accompanying his behavioral approach). wife’s fear by remaining silent in the course 3-Sensitivity in the lower abdominal area of the examination or his saying “ok honey, when an object enters into the vagina (cog- don’t worry, let’s go” makes the course of nitive- behavioral approach). the therapy harder in terms of behavioral 4-Fear and anxiety of the examination of the approach. vaginal area (hypnotherapy, cognitive ap- 19-Cultural code: avoiding being examined proach, persuasion). by a male doctor. The physician’s sufficiency 5-Problem of erection, different sexual de- and success in therapy is far more im- sire and impulses in man; e.g fetishism portant than his gender. (medical approach, hypnotherapy, sexual 20-The Tree Theory: The major factor for education). vaginismus to occur is in fact not cognitive, 6-Arguments and quarrels between the behavioral, dynamic or existentialist. These couple (short termed family therapy). are the branches and leaves of a tree. The 7-Thinking of failure (providing a positive main factor, causing the problem is the body belief system). and roots of the tree. Consider two women 8-Deformation of membrane, bleeding and from the same family, one might easily have associated pain (medical). a sexual intercourse, whereas the other 9-Different and negative treatments in the might have the problem of vaginismus. past (providing a belief of success and per- When we consider the overall qualities suasion). of women with vaginismus, we see that they 10-The effect of dominating over the man view every aspect of life in a negative way. through vagina (Dr. Ulusoy, 2009); viewing Though their belief system sees the truth the vaginal intercourse as having a domina- and experiences it, they quickly drop like a tion over man, using the effect of rewarding rock and focus on failures. Even during the and punishing man and associating the oth- exercises, they focus on not positive but er wishes and expectancies from man with negative sides. A father, who is a designer, is the intercourse and relationship (existen- drawing the posture of the genital area tialist approach- hypnotherapy). when his daughter becomes an adolescent 11-Obsessive Compulsive disorder, Panic but this daughter can be coming to us as a

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH vaginismus patient. Thus the real problem there won't be an ıntercourse after the fore- in vaginismus is the lack of giving self- play. We name this as relative calming-Dr. esteem when we rise up our daughters. This Ulusoy can be called the fear of stepping forward in every aspect of life. Another factor is the Dr. Ulusoy’s Technique in Vaginismus lack of offering an individual the ability and Dr. Ulusoy’s technique in vaginismus helps Page | 28 capability of problem solving (persuasion, the problem to be overcome in an average of reorganization of the belief system- 1 to 3 days by a step by step progress. Cog- behavioral approach, hypnotherapy). nitive, behavioral and metaphoric and imag- 21- The story of the man who trips himself inative hypnotherapy techniques specific to up: I’m afraid so much; I’ve succeeded it vaginismus are used. In case of facing with a now, but will I be able to do it again when I problem due to personality characteristics, go home? Can I do it after the menstruation this period can extend up to 3 days. If more period? serious problems due to the personal quali- 22- Reeducating the patient who has under- ties are observed and if we don’t get gone several treatments; telling her to for- through time, we maintain a supportive get everything she has learned in the past treatment through behavioral therapy. and listen to whatever I say. In our treatment: 23-Uneducated patient who sees herself as We use a technique appropriate to the cul- well informed; she reproaches everything as tural structure of the Turkish women, which if she has already known these, this makes is called Dr. Ulusoy’s technique. the learning process of the new information 1-Listening and formulating the problem harder, she ignores the clues and cues of (with a view of cognitive, behavioral, dy- knowledge you convey. namic and existentialist approach) 24-Not facing the truth in behavioral ap- Cognitive: İt will hurt, it will bleed a lot, my proach: Cognitive technique and confronta- vagina is tight—penis is big, it will tear into tion. pieces, the penis will stuck into it. 25-Princess effect (the effect of being cud- Behavioral: incest, abuse, rape histories in dled). Being the smallest- the only daughter the past, negative experiences about first of the family (Dr. Ulusoy, 2009). intercourse, first intercourse under exami- 26-Seesaw effect (Dr. Ulusoy, 2005) The nation, intercourse under anesthesia, seeing withdrawal and interaction of the man or hearing the parents’ intercourse as a little whereas the woman solves the problem. child, a process of thinking that mother is (Medical, hypnotherapy). suffering from the intercourse, hating from 27-Simulation Technique (Dr. Ulusoy, 2005) the father. through the progressive techniques during Dynamic: the protective quality of elder the treatment sessions; or through the pro- people in the family (mother, father, elder cess of intercourse imaginary suggestions brother, grandmother). for joy after the treatment (processes of Existentialist: Woman’s viewing herself as enjoyment, desire, temptation and orgasm). an object, thinking that she’ll be worthless 28-Integration of Lozanov Technique (Dr. after the intercourse, and /or her compe- Ulusoy, 2008) Communicating the plans and tence to have a dominance over man progresses in the hypnotic state (seeing, through vagina. hearing, practicing, addressing to all the 2-Modelling. senses, relaxation; all makes learning easy 3-Education. and improves the capacity of perceiving. 4-Dr. Ulusoy HIT and mınd-Imagination Learning without provides a compat- focused on body relaxation and a metaphor- ible working of body-mind functions). ic approach hypno-drama, Albrecht's ideo- 29-In cases of vaginismus, woman feels her- motor response. self relatively comfortable as she knows that 5-Using the behavioral approach as a feed-

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH back. (Dilator penetration to the vaginal I have consulted to at least 3 places but I area for three or rarely four times ) couldn’t overcome it 327 (7 %) It is an integrated and complete approach. I have consulted to at least 5 places but couldn’t overcome it 170 (4 %) Classification of vaginismus patients: I have consulted to adoctor and had over- 1-The ones, who can’t touch the big and come it …………149 (3 %) Page | 29 small vaginal lips and the area between I have consulted to more tahn one doc- them (outer genital area). torsand had overcome it 91 (2 %). 2-The ones who can touch the outer genital area but not the inner part. I CAN’T HAVE AN INTERCOURSE WİTH MY 3-The ones who can touch the outer and PARTNER BECAUSE: inner parts of the vagina and who can direct The number of people attending the inquiry the finger bur can’t have a penis experience. 194 4-The ones belonging to either one of these I have such fears as it will hurt, it will bleed, three groups and have no spasms, but who it will tear into pieces, the penis is too can’t let the penis in.(The ones who can't big….141 (73 %). provide a control over their hips, thighs and I had a sexual abuse in the past…………4 breath ) (2 %). 5-The ones belonging to either one of these My partner doesn’t love and care for me….5 three groups; have ranging spasms from (3 %). insignificant to the deepest; but who still I don’t like sexuality and don’t get a clitoral can’t let the penis in. joy … 13 (7 %). As is seen, there are different categories I have grown up with sexual prohibitions in vaginismus. These different categories and protection… .. 31 (15 %). are affected by: FOR MY VAGINISMUS PROBLEM: 1-Women’s own personality patterns (e.g.: The number of people attending the in- panic attacks, obsessive compulsive disor- quiry…… 933 ders and a perfectionist character…etc.) I go to a gynecol- 2- Lack of sexual education and information. ogist…………………………… ……138 (15 %). 3- The occurrence of cognitive, behavioral, I go to an anesthesiolo- dynamic and existentialist factors and their gist………………………….8 (1 %). effects on women on different basis. I go to a psychia- Vaginismus is shaped as ivy. Therefore, in trist…………………………………….92 (10 %). the treatment of vaginismus, all of these I go to a psycholo- details must be taken into consideration. gist………………………….. ..……69 ( %). I go to the one who can solve it in a ses- THE EVALUATION OF PROCESS AND THE sion…86 (9 %). PATİENTS REFERRED BETWEEN JANUARY- I consider the gender factor in choosing a JULY 2011- doctor and go to a female doctor..31(3 %). 75 patients have consulted and after a I go to a preacher because of spell and mag- month follow up, it’s confirmed that their ic …43 (5 %). problem is overcame. I go to an experienced and trustworthy doc- RESULTS OF THE INQUIRY tor who works on vaginismus…466 (50 %). How many places did I consult to form vagi- nismus problem? The number of people attending the inquiry: 045.OPINIONS OF GYNECOLOGIC PA- 4849 TIENTS ABOUT IMPACT OF PLANNED I haven’t had a treatment…… 3201 (65 %) HYSTERECTOMY ON THEIR REPRODUC- I had a treatment but couldn’t overcome TIVE FUNCTION it………. 829 (17 %) Ieva Briedite

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Gunta Ancane eration, 5.56% were not sure if they can Nellija Lietuviete discontinue birth control method after hys- Rationale: Objective of this study was to terectomy. summarize opinions and concerns of wom- Conclusion: Impact of hysterectomy on en on the day before planned hysterectomy. their lives is very important for the patients. Introduction: Conclusion about scheduled They are afraid of negative effects and are Page | 30 hysterectomy usually brings women to not ready to talk honestly to their partners. many questions about operation and post- Myths and doubts are still present on the operative changes in their bodies. After hys- day before hysterectomy. Gynecologists terectomy woman may be influenced by should actively discuss more about planned both physiological and psychological fac- operation with patients instead of waiting tors. Losing the uterus can make women for them to ask questions. worry about feeling less womanly after op- eration, or losing their sexual attractiveness. There is still no single view about real im- pact of hysterectomy on sexuality, data are discrepant. Methods: 54 patients of wide spectrum Gynecology clinic were recruited to partici- pate. Inclusion criteria were: age 18-50 years, scheduled to undergo planned hys- terectomy without ovarectomy due to be- nign indication, voluntary agreed to partici- pate. Inquiry form was used to collect an- swers. Study was approved by the Commit- tee of Ethics. Results: All patients had been thinking about impact of hysterectomy on their fu- ture life. 75.93% had worried that hysterec- tomy can have a negative effect on their 046. TOGETHER OR APART? future, 59.26% asked other women with A STUDY OF THE ROLE OF INTIMACY IN hysterectomy experience about changes CONFLICTS AND REASONS FOR SEPARAT- after operation, 51.85 % searched infor- ING AMONG COUPLES mation from Internet sources, 87.04% Osmo Kontula wanted to receive more information from LECTURE ABSTRACT gynecologist. 51.85% thought they will feel Background: This study examined the less feminine without uterus, 59.26% wor- strengths and conflicts among Finnish ried that partners will find them less femi- married and cohabiting couples, and the nine. 31.48 % thought that their sexual life reasons why couples separate and divorce. will become worse, 27.78% thought it will It includes information of their intimate not change, 22.22 % thought it will improve. relationship. A relationship that ends is like 68.52% had regular sexual partners, a multi-stage process leading to separation. 56.76% of them had only partly told their The aim was to survey this process and the partner about operation, 24.32 % had not role of intimacy in it. told at all, 18.92% had told everything. Method: The subjects were selected from 14.81% had concerns about ‘cleaning’ of the among those who, according to the Popula- body without regular bleeding, 20.37% tion Register Centre’s records, had formed a thought they will have earlier and more marriage or cohabitation agreement in heavy menopausal symptoms, 29.63% 2005. More than 3,000 middle-aged women thought they will need to use HRT after op- and men responded to the postal survey.

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Approximately half were still in the rela- tionship they had begun in 2005, while the rest had separated from their spouse. Results: The most common conflicts among those living together had to do with the sharing of housework and the rearing of Page | 31 children. In addition to everyday household issues, other important sources of conflict included the ways of expressing intimacy and emotion, and sex – in other words, the couple’s sense of togetherness and intimate relationship. Among the divorced, the most common sources of conflict had been differ- ences in values and lifestyles, the way they discussed things, use of free time, and ex- pressions of intimacy and emotion. The rela- tionships that had ended in divorce usually suffered from various shortcomings in the spouses’ partnership and ability to convey intimacy and understanding to one another. Conclusions: Apart from the good function- ing of the partnership aspect, relationships 047.ESR: EXPANDED SEXUAL RESPONSE: can be assessed by considering a couple’s BASIC DEFINITIONS AND PARAMETERS mutual sense of togetherness, their intimate H. Ümit Sayın (Sayin-2) relationship, the compatibility of their per- PLENARY LECTURE AND POSTER sonalities, and the various influences origi- Rationale and Methods: In the literature, nating from the outside world. An interest- lately, a new term is coined and cited as ing characteristic associated with strong expanded sexual response (ESR). To inves- relationships was that those in a happy un- tigate the main parameters of a possible ion believed their own relationship to be ESR, we have contacted some women who markedly better than that of other couples. claimed to have enhanced sexual response Strengthening this perception served as a through internet and/or making surveys by factor that helped prevent divorce. means of gathering the filled SAYIN-ESR Scale, or by making face to face interviews and by other means. Our aim was to estab- lish the main scientific basis of the defini- tions and parameters of ESR, if ever it exist- ed, and to establish an objective ESR scale out of our preliminary findings. Until 2015 we were able to pin-point nearly 60 ESR women with a comparison of 250 normal women (NESR, none-ESR women). Results: It is concluded that some aspects of the sexual response of women with ESR were different than the women without ESR (NESR): 1) The ESR women experienced vaginal, clitoral and blended orgasms, as described by Whipple et al. 2) The ESR women experienced multiple orgasms in most of their sexual activities. 3) The ESR

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH women were able to attain long lasting only clitoral orgasm, but no phenomenon and/or prolonged and/or multiple and/or called vaginal orgasm and women do not sustained orgasms and/or status orgasmus need men and sexual intercourse to attain that lasted longer than the classical single an orgasm”. Hite Report, which was a femi- orgasm and/multiple orgasm patterns de- nist report and was surveyed among femi- fined in the literature. 4) The ESR women nist women in 1974, also defended similar Page | 32 claimed to have strong pelvic floor muscles hypothesis. However, both Hite Report (PFM) compared to NESR women. 5) The (1974) and Cosmo Report (1982) reported libido of ESR women was very high com- that one third of women (30 % and 34 %, pared to NESR women. 6) ESR women de- respectively) described a phenomenon scribed a phenomenon called G-Spot or- called as “vaginal or coital orgasm”. How- gasms. 7) ESR women described sensitive ever, many physicians, sex therapists, psy- erogenous zones in their genitalia other chologists, and psychiatrists oppose the than clitoris. 8) ESR women masturbated existence of “vaginal-coital orgasms” and frequently. 9) ESR women had erotic fanta- they also add that no such thing as “G-Spot” sies more frequently than the NESR women. exists in Turkey and on the globe. This 10) ESR women admitted to have a form of presentation is aimed to prove that both “G- altered states of consciousness during some Spot and Vaginal-Coital Orgasms” exist. of their prolonged orgasms and/or status Findings: Some data of ours and other re- orgasmus. The difference between the par- searchers have proven the fact that a phe- ametric or none-parametric measures be- nomenon as “vaginal-coital orgasms” must tween the ESR and NESR women was statis- exist. tically different (see also: Sayin, H.Ü. Doors 1) The clitoral hood cannot move directly of female orgasmic consciousness: new theo- enough to stimulate the glans during coi- ries on the peak experience and mechanisms tus. If some deep erectile structures of of female orgasm and expanded sexual re- clitoris, such as bulbus or crus, are stimu- sponse, SexuS Journal and NeuroQuantology lated as well, this sensory input will not Journal, also available from the congress be carried by pudental nerve, because web site www.twincongress2015.com or most of the deep structures of clitoral www.drumitsayin.com ) complex are innervated by pelvic nerve, Conclusion: ESR is a novel phenomenon in which may cause another type of “clito- the human female which was defined re- ris-pelvic orgasm”, which is not exactly cently; however, Tantric literature and the same as “glans-pudental nerve or- Eastern history showed many samples of gasm”. ESR in women. Our survey data, which is 2) Most of the descriptions of each type of still continuing, revealed that more detailed orgasms in the literature are very differ- scientific research should be carried out on ent in terms of their physiological, neu- the possible existence of such a phenome- ropharmacological and psychological For non. The psychometric ESR-Scale is availa- instance; orgasms triggered by coitus in- ble from the author. duce 4 times fold release in the female brain compared to manual clitoral 048.THE MECHANISMS OF VAGINAL OR- orgasms, which is proposed to be a GASMS measure of satiety. H. Ümit Sayin (Sayin-3) 3) It has been reported that the women who PANEL TALK and POSTER are aware of their G-Spots and who have Introduction: There has long been a furious been responding-pleasurable G-Spots, debate on the “Vaginal vs. Clitoral Or- are more likely to attain coital vaginal gasm” since the times of Freud. Some femi- orgasms. nists opposed vaginal orgasm declaring and 4) There appears to be other deep vaginal supporting the hypothesis that “there is erogenous zones (DVZs) in some sexually

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hyper active and responsive women, DVZ, may exist! other than clitoris and G-Spot, as report- 8) Some other survey in USA, United King- ed recently. Those zones are more prom- dom and Europe as well as our prelimi- inent in women with ESR and high sexual nary research and other accumulating responsiveness, compared to none-ESR data showed that vaginal walls are not (NESR) women or average women. Near- senseless, but some women experience Page | 33 ly 99 % of ESR women were able to at- pleasure and orgasm through the stimu- tain vaginal-coital orgasms. Those areas lation of various parts of vaginal walls. are innervated by pelvic nerve and par- 9) Some of our and other researcher’s pre- tially by hypogastric nerve, similar to G- liminary data also showed that some Spot, which induce a separate orgasm re- specifically designed electronic dildo flex arch pathway; thus a very different shaped vibrators that have a rotational physiological orgasmic response builds and vibrating property at the tip may in- up. duce orgasms of vaginal origin (un- 5) Our preliminary studies by means of the published data), which may also show electrical and vibration stimulation of that stimulation of PC-muscles, O-Spot, DVZ seem to trigger orgasm patterns A-Spot and Cervix may trigger vaginal alone, without the stimulation of glans orgasms in some women. Near to these clitoris (unpublished data). Similar inter- findings, electrical stimulation of cervix esting data comes out of the research and DVZs by a TENS unit (trans- group of Komisaruk; stimulation of cer- cutaneous-electrical-nerve-stimulation vix alone induced orgasmic behavior in unit) may induce similar vaginal orgasms women who were hemiplegic, having no (unpublished data). connection of nervous input from glans 10) Recently it is reported that the fe- via pudental nerve and from vagina via male orgasm can be triggered through pelvic nerve; this is also a proof that or- the stimulation of glans clitoris, inner gasm reflexes can be triggered from the clitoris, Grafenberg’s spot, PC-Muscle, brain without the existence of input Anterior Fornix (A-Spot), Cervix, Nipples, through glans clitoris. Ear lobes, and even by only fantasizing 6) In some women, undergone clitoridec- and foreplay (Komisaruk et al. Science of tomy, some coital orgasms have been re- Orgasm. 2006) ported, which shows that without the ex- 11) Recently, “Brain Orgasms” without istence of glans clitoris, orgasms may the stimulation of any genital erogenous build up by some other mechanisms, zones have been reported. If brain or- while inner clitoral complex may have gasms can exist, than we should investi- some contributions to those kind of or- gate many other pathway systems and gasms, however they are unlikely to trig- mechanisms, such as the “ path- ger an orgasm by the stimulation of bul- way”, other than focusing only on the bus or crus of clitoris alone; there should ‘glans clitoris’! be other triggering neural pathways and 12) ZISS group from Switzerland has mechanisms that play major roles in the also devised a technique called “Sexo- development of “orgasms without clito- corporal Sex Therapy” in part of which, ris”. they also teach women how to attain vag- 7) After the definition of novel “four nerve inal-coital orgasms through various and six pathway theory of female orgasm” workshops and trainings. (see below), it was realized that at least Conclusions: There are many ongoing re- six different pathway-mediated orgasm searches on the subject. Although, today we reflex arches, some of which may con- even have enough evidence, data and find- tribute to build up “vaginal orgasms” ings, as well as scientific publications and originating from direct stimulation of literature that both “G-Spot and DVZ” and

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“vaginal-coital orgasms” EXIST, it is so en mentioned about an acute effect of sexual weird that some people still argue against arousal (50 %), while 14 women had a feel- all these academic and scientific publica- ing of rush and increase of heat at genitals tions and literature. We believe that their (38.8 %); 18 women had increased empa- concern is more ideological, rather than thy (50 %) ; 24 women described a feeling being scientific. of calmness and happiness (66.6 %); 14 Page | 34 women reported a feeling of analgesia (38.8 049.LOVE HORMONE OXYTOCIN: ACUTE %); 15 women told about a feeling of anxi- BEHAVIORAL EFFECTS OF OXYTOCIN, IN olysis (41.6 %). The main effects which A DOSE DEPENDENT MANNER were described by most of the women were H. Ümit Sayın (Sayin-4) calmness, euphoria, empathy, happiness PANEL LECTURE AND POSTER feeling, relaxation, drowsiness and sexual Introduction: The hormone and neuro- arousal. transmitter OXYTOCIN (OXY) has been pro- 2) 30 IU OXY Acute Effects (N=10): posed to take part in many behavioral pat- 9 women described an effect of euphoria terns of female behavior, including sexual (90 %); 4 women reported an effect of arousal, orgasm, LOVE, attachment to the clouding consciousness (40%); 6 women partner, birth and motherhood. It is hypoth- described a mild ASC (60 %); 18 women esized to be used in sex therapy to treat mentioned about an acute effect of sexual vaginismus, anorgasmia, arousal problems arousal (50 %), while 7 women had a feel- and others in future. We revised our former ing of rush and increase of heat at genitals study and added 10 more data in two differ- (70 %); 9 women had increased empathy ent intranasal doses of OXY (10 IU, N=36; 30 (90 %) ; 10 women described a feeling of IU, N=10) calmness and happiness (100 %); 8 women Methods: As a continuing study, we admin- reported a feeling of analgesia (80 %); 7 istered 10 IU OXY intranasally to 36 women women told about a feeling of anxiolysis and 30 IU OXY intranasally to 10 women to (70 %). assess the main acute effects of OXY on fe- male behavior. A special psychometric scale OXY prominently induced calmness, euphoria, containing 24 questions to assess the possi- empathy, happiness feeling, relaxation, ASC ble acute effects of euphoria, elevation of and sexual arousal in a dose dependent man- mind, anxiolysis, empathy, sexual arousal, ner. analgesia, altered states of consciousness Conclusion: Intranasal OXY spray DOES (ASC), happiness feeling, and effects on have some acute effects on the female be- general psychology, SUBJECTIVELY was havior and consciousness at the doses of 10 used within 10 minutes after the admin- and 30 IU in a dose dependent manner. In istration. Along with OXY, a placebo spray future intranasal OXY sprays can be used was used intranasally before or after OXY both in sex therapy and psychiatry success- administration in a double blind research fully, since its effect is very sharp and acute design, to compare the effects of OXY with within seconds. However, OXY degrades in placebo. There was a time lapse of two the brain very fast, thus the administration hours between the two administrations. should be repeated. Results: The acute effects of OXY were con- troversial and altered from women to wom- en. 1) 10 IU OXY Acute Effects (N=36): 24 women described an effect of euphoria (66.6 %); 13 women reported an effect of clouding consciousness (36.1%); 15 wom- en described a mild ASC (41.6 %); 18 wom-

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are increasing day by day. For healthy sexu- ality and sexual behavior, structured and healthy education on human sexuality is essential. During the last decades, some SFD’s such as vaginismus, anorgasmia, erec- tile dysfunction (ED), premature ejaculation Page | 35 and lack of sexual desire increased a great deal. There are neither structured nor de- tailed sex therapy education systems for the health professionals, or MSc and PhD pro- grammes of Sex Therapy at the universities. Findings and Description: According to our latest surveys, vaginismus increased to around 12-15 %; anorgasmia has increased to more than 25-30 % among educated & middle class women in the Turkish popula- tion. Lack of sexual interest in men and women also peaked during the last decades. Among women, lack of sexual interest is around 35-40 %, even at younger ages. One

of the reasons of this social transformation is that the women are not getting education about their bodies and sexuality since Turk- ish society has become very religious, dog- matic and conservative during the last 2 or 3 decades. Another reason is the increasing taboos and myths of the society, besides “the fear of sexuality” and political precautions against sex education. Discussion and Conclusion: The sexual behavior, attitudes, taboos and trends of Turkish women and men are changing, and diverting from the European sexual behav- ioral system and life styles. Structured Sex- ual Education for the public, as well as, the health professionals, should be started as soon as possible and the associations, such as ASEHERT, which have been established to give education mainly to the public, should be supported and funded by interna-

tional and national funds.

050.PROBLEMS IN SEXUAL EDUCATION 051.NEW TRENDS IN SEX THERAPY: AND SEX THERAPY IN TURKEY PLEASURE AND ORGASM ORIENTED H. Ümit Sayin (Sayin-5) TREATMENT OF VAGINISMUS AND WORKSHOP LECTURE and POSTER ANORGASMIA Introduction: In Turkey there is no sex H. Ümit Sayin (Sayin-6) education at the levels of high schools and WORKSHOP LECTURE and POSTER universities. Maybe that is why sexual prob- Introduction: Vaginismus is an increasing lems and sexual function disorders (SFD) sexual function disorder (SFD) in the Turk-

NeuroQuantology | June 2015 | Supplement 1 Volume 13: Issue 2 DOI Number: 10.14704/nq.2015.13.2.856

ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH ish female population, as well as anor- STEP-6-PLEASURE & ORGASM Oriented gasmia. Since there is a chaos about the Vaginismus Therapy: Learning orgasm ori- treatment of vaginismus and anorgasmia ented treatment. among the Turkish Sex Therapists and STEP-7: DEFLOWERING-Surgical or other health professionals, most of the classical methods. behavioral and cognitive therapy models are STEP-8: Learning to use vibrating dilators. Page | 36 not used. For the behavioral therapy, dila- STEP-9: Vibration-Pleasure-Orgasm-Dilator tors are not mainly available in Turkey. Transfer. Near to this, “masturbation and tech- STEP-10: VIBRATING DILATORS: First vi- niques for reaching orgasms” are not brating dilator and bullet vibe taught properly to the patients, since mas- STEP-11: Second dilator and bullet vibe and turbation and orgasm is a kind of growing masturbation. taboo. Most of the time vaginismus is over- STEP-12: Third dilator and orgasm without come by “the legal rape” of the husband in bullet vibe. some countries like, Turkey. STEP-13: Fourth and fifth dilators. Method and Technique: In this treatment STEP-14: Last dilators, sex toys method, a 15 step vaginismus self-treatment STEP-15: INTERCOURSE: First trials for is taught using masturbation techniques and intercourse with the partner. also bullet vibrators, vibrating dilators and specifically designed normal silicone dila- 052.GLOBAL NEUROPHARMACOLOGICAL tors at various sizes (7 different sizes are CASTRATION OF HUMAN SEXUALITY recommended). This technique is called SSRI’S AND ANTI-PSYCHOTICS “pleasure and orgasm oriented vaginis- Psychopharmacology of Psychiatric Med- mus treatment”. ications and Sexual Function Disorders Discussion and Conclusion: Before passing Due to Psychiatric Drugs to the intercourse session with the partner, H. Ümit Sayin (Sayin-7) the vaginismus patient should be trained to WORKSHOP and POSTER get pleasure from sex and should learn how Introduction: Most of the psychiatric drugs to reach a clitoral orgasm. This training may used in the treatment of depression, anxiety take a long time, as long as 2-3 months. Be- and , mania and fore, the patient experiences pleasure and influence sexual behavior, libido and the orgasm from sexual intimacy, foreplay- potency to get pleasure and to attain or- pleasure, fantasy, masturbation, mutual gasm. Because of lack of proper control in masturbation with the partner and achieves Turkey, many anti-depressive SSRI’s and to attain a clitoral orgasm, no treatment of agents impairing dopaminergic system, do- intrusion (penile or dilators) or intercourse pamine receptors and pathways are widely should be started. Today, in Turkey, such an used without warning the side effects of this approach is not applied and effective in psychiatric medication. many therapy clinics. Findings and Scope: STEP-1: SEXUAL MIND: Creating a sexual SSRIs can cause various types of sexual dys- mind function such as anorgasmia, erectile dys- STEP-2: DISCOVERY: Discovering your function, diminished libido, genital body. Gaining information by reading, numbness, and sexual (pleas- watching, talking. ureless orgasm) (Bahrick, Audrey (2008). STEP-3: Masturbation-1: Learning clitoral "Persistence of Sexual Dysfunction Side orgasm manually. Effects after Discontinuation of Antide- STEP-4-Masturbation-2: Learning clitoral pressant Medications: Emerging Evi- orgasm using vibes. dence". The Open Psychology Journal 1: 42– STEP-5- PC-MUSCLES: Improving PC Mus- 50. doi: 10.2174/ 1874350100801010042) cles. Learning to control PC muscles. Initial studies found the incidence of sexual

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH side effects from SSRIs not significantly dif- sion, by means of interfering sexual func- ferent from placebo, but since these studies tions and inducing anorgasmia. Today, sex- relied on unprompted reporting, the fre- ual function disorders due to the psychiatric quency was underestimated. In more recent medications are very widespread around studies, doctors have specifically asked the globe and also in Turkey. about sexual difficulties, and found that they Page | 37 are present in most patients. 053.THE USE OF SEX TOYS AND VIBRA- Sexual dysfunction occasionally persists TORS IN SEX THERAPY after discontinuing SSRIs. The frequency H. Ümit SAYIN (Sayin-8) with which this happens is unknown. LECTURE, PANEL TALK AND POSTER SSRI’s: It is well known that many anti- Introduction: Sex Toys (STs) and vibrators depressant drugs and SSRI’s (e.g. Fluoxe- (VBs) have been used in Europe and Ameri- tine-Prozac; Citalopram-Cipram, Celexa, cas successfully in sex therapy, since the Seropram etec.; Paroxetine-Paxils Seroxat, dawn of direct-current electric motor, Loxamine etc.; Fluvoxamine-Luvox, Fevarin around 1880s. The famous comedy-history Facvoxil etc.; Sertraline-Zolof, Lustral, film “HISTERIA” summarizes how the VBs Asentra etc.; and others) and increase of were started to be used by physicians and serotonin in the brain totally blocks pleas- sex therapist by the end of 19th Century in ure and orgasm in most of the females USA. However, although the STs and VBs (Komisaruk et al. The Science of Orgasm. have been used for more than 120 years in 2006). the West by either individuals independent- Anxiolytics: A widely used anxiolytic, such ly and/or by sex therapists, the frequency as alprazolam (Xanax) also blocks pleasure, of using VBs by women in Turkey is less reaching to orgasm and decreases the quali- than 1 % (Kadınca Report-KR, 1993 and ty sexual satisfaction. Hülya Report-HR, 2003) compared to the Anti-Psychotics: Some anti-psychotic med- frequency of 52,5 % in USA (Reference: ications which interfere with the Articles of Herbenick and Rosenberger). receptors, dopaminergic pathways also de- There is strong resistance to use STs and crease pleasure and block orgasm in fe- VBs in the Turkish population as well as males. among the physicians, psychologists, psy- Discussion and Conclusion: Around the chiatrists and sex therapists because of globe and also in Turkey, above drugs are many cultural reasons. used widely; however, most of the time the Background and Findings: Our surveys patient is not acknowledged about the nega- both on women (KR-1993; HR-2003; İstan- tive side effects of these drugs. By using bul Report-IR-2013) and also some short SSRI’s, depressive mood can be treated; surveys on the study of VB usage by some however, sexual potential of the patients Turkish women volunteers have shown the may be impaired, and this is a long term fact that STs and VBs are both very effective effect, which even persists after quitting the in inducing orgasm and giving pleasure to treatment; the long term outcome is un- the Turkish females. Our surveys on women known. It is well documented that above and other interview results have revealed psychiatric medications may totally block that only around 1 % of the female popu- orgasm, sexual pleasure and induce anhe- lation in Turkey is willing to use and/or donia. The physicians should be careful be- continue using STs and Vs. It is also ob- fore prescribing anti-depressants, anxiolyt- served that more than 50 % of Turkish ics and anti-psychotics; because, the long women were wondering about the effects of term side effects of these drugs are not in- STs and VBs; however, they were too shy vestigated well enough, and they may in- and intimidated to try them on themselves duce an iatrogenic (drug induced) depres- or use them with their partners. Some

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH women buy these devices discreetly from and Hülya Report-HR, 2003) compared to the internet by ordering some unknown the frequency of 52,5 % in USA (Refer- devices from the erotic shops. Our survey ence: Articles of Herbenick and Rosen- with 32 women, using and assessing VBs berger). There is strong resistance to use and filling in a questionnaire and our face to STs and VBs in the Turkish population as face interviews with around 50 women also well as among the physicians, psychologists, Page | 38 revealed the fact that, VBs improved a) psychiatrists and sex therapists because of Their orgasm consistency b) Induced or- many cultural reasons. gasms c) Improved their sexual lives with Methods and Results: Our survey (which and/or without a partner d) Improved the still continues) with 32 women, using and pleasure during masturbation with VBs or assessing VBs and filling in a questionnaire without VBs e) Enhanced the pleasure and our face to face interviews with around they were taking from sexual encounters, 50 women supplied the main data (N=82). foreplay, sexual contentness and pleasure The survey questionnaire had 50 questions & orgasm during masturbation. (multiple choice or fill in the blanks, or Discussion and Conclusions: Since the chose using a likert-scale). The problems reaction and resistance of Turkish male and the assessments of STs and VBs that partners and also the sex therapists & psy- were sold in Turkey were asked. The ques- chologists-psychiatrists is very harsh and tions and the top ten evaluations were: reactive against STs and VBs; the Turkish A- What is your opinion about the society should be trained on the effects of problems and bad designs of current VBs VBs. In Turkey the frequency of anorgasmia and STs? How to you evaluate their ef- cases varies from social strata to strata, in fects? 1990s and in the beginning of 2000s, the 1-Their vibration frequency is anorgasmia frequency was 15-19 % in the sometimes too low. (Highest re- educated and middle class women; in 2015, sponse) this ratio increased to 30 to 35 % in the 2-Their vibration frequency should same age and social group. In the whole have been modulated and they society and among the uneducated women, should be in a larger vibration anorgasmia ratio may be even higher. Turk- span. (Highest response) ish society (public and health professionals) 3-Vibration frequencies should needs some structured education systems have had more options and more both on SFDs, sexual physiology and also adjustments. (Highest response) STs & VBs. In a society where anorgasmia 4-The devices should not have been frequency can be expected as high as from activated by batteries, but 25 to 40 % of the female population, it charges and city electricity, such should be noted that VBs can be very suc- that no power problem, after a cessful in improving sexual life styles and while, should have been faced. orgasm consistencies of Turkish women. (Highest response) 5-Those toys do not seem to be a 054.THE EVALUATION OF SEX TOYS AND manufacture of thorough and de- VIBRATORS BY TURKISH FEMALE USERS: tailed research and engineering HOW TO IMPROVE THEM or investigation. (High response) H. Ümit Sayin (Sayin-9) 6-The devices are not suitable for POSTER the women’s body and are not Introduction: Sex Toys (STs) and vibrators designed as ergonomic. (VBs) have been used in Europe and Ameri- 7-These devices have not been tried cas successfully in sex therapy. The fre- on women properly and in con- quency of using VBs by women in Turkey trolled experiments; poor design is less than 1 % (Kadınca Report-KR, 1993 and poor engineering. (High re-

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sponse) males. (High response) 8-The toys sold in Turkey are very 10-They should be marketed with cheap and junk Chinese devices. more detailed information. (High (Moderate response) response) 9-Their packages, marketing and Discussion and Conclusions: Women who way of commercializing is very use STs and VBs know what they need bet- Page | 39 poor and bad. (Moderate re- ter than men. The current designs and engi- sponse) neering of the VBs are too bad and clumsy. 10-There no information about how They should be redesigned according to the to use them and no detailed in- demands of women and structured scientific formation on the web sites of research and detailed experimentation ac- erotic shops. They are not well cording to the directions of women. defined. (Moderate response)

B- When you look at the STs and VBs sold in Turkey what would be your sug- 055.ELECTROPHYSIOLOGICAL EFFECTS gestions to improve them to function OF CHILDHOOD EPILEPSIES AND TRAU- more properly and effectively? MA ON THE ADULT HIPPOCAMPUS; 1-Their shapes and designs should ELECTROPHYSIOLOGICAL EVIDENCE OF be better. (Highest response) NEO-FREUDIEN THEORIES 2-Driven by batteries is a bad char- H. Ümit Sayin (Sayin-10) acteristic, they should be manu- POSTER factured with charges which Introduction: Author’s research which plugged in. (Highest response) lasted nearly for 12 years on the long term 3-The vibration frequencies should effects of childhood epilepsies and traumas be increased. (Highest response) on the electrophysiology of the adult hippo- 4-The engineers and designers who campus and learning (Sayin, Epilepsia, 45 manufactured them have never (12) 1539-1548, 2004) clearly showed that asked women the effects’ of the- a kind of strong trauma or childhood epilep- se devices, they should be de- sy (febrile seizures or others) may have long signed on the demands of wom- term electrophysiological effects and alters en. (Highest response) the GABAergic circuitry of the child-hood- 5-They should be designed after traumatized hippocampus at the stage of long research by the doctors and being adults, making them more prone to physicians after structured and develop anxiety, have altered personality long experiments. (Highest re- traits, impaired learning, susceptible to sei- sponse) zures. These reports are one of the few pub- 6-Vibration frequencies should go lications on this topic. As Sigmund Freud from the lower to the very high had pointed out 100 years ago, there may be with gradually increasing many some specific “critical periods” during the steps. (High response) developmental stages (Oral, Anal, Phallic, 7-The adjustment buttons and other Genital etc.) functions and vibration pro- Methods and Results: Electrophysiological grams should be more and they investigation of the rat hippocampus of the should be adjusted. (High re- pups who had strong traumas (or epileptic sponse) seizures, e.g. in febrile seizures, PTZ, kainic 8-They should be designed as ergo- acid and kindling models) revealed the fact nomic. (High response) that, there are long term electrophysiologi- 9-They should be redesigned ac- cal and plastic changes in the adult rats’ cording to the physiology of fe- hippocampus, parahipocampal gyrus, and

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH temporal lobe, such as impaired GABAergic epochs were observed in which seizures inhibition which results in the decrease of resulted in distinct long-term structural inhibitory circuits and induces hyper- and functional outcomes at PP95. Seizures excitation states of the brain. Especially the prior to P20 resulted in DTI abnormalities traumas or childhood epilepsies at the de- in CC and hippocampus in the absence of velopmental stage of 20-30 postnatal days gross cerebral atrophy, and increased Page | 40 in the pups after birth (which corresponds paired-pulse inhibition (PPI) in the den- to the first 3-7 years in the human beings) tate gyrus (DG) at PP95. Seizures after there is a critical period of the nervous sys- P30 induced a different pattern of DTI tem, which makes the cerebrum more sus- abnormalities in the fimbria and hippo- ceptible to many changes. The abstract of a campus accompanied by gross cerebral 2015-Neuroscience Journal article summa- atrophy with increases in lateral ventricu- rizes the condition as: lar volume, as well as increased PPI in the DG at PP95. In contrast, seizures between AGE-DEPENDENT LONG-TERM P20 and P30 did not result in cerebral STRUCTURAL AND FUNCTIONAL EF- atrophy or significant imaging bnormali- FECTS OF EARLY-LIFE SEIZURES: EVI- ties in the hippocampus or white matter, DENCE FOR A HIPPOCAMPAL CRITI- but irreversibly decreased PPI in the DG CAL PERIOD INFLUENCING PLASTICI- compared to normal adult controls. These TY IN ADULTHOOD age-specific long-term structural and Abstract— Neuroscience 288 (2015) functional outcomes identify P20–30 as a 120–134 . H. Ü. Sayin, E. Hutchinson, ME. potential critical period in hippocampal Meyerand, T. Sutula development defined by distinctive long- Neural activity promotes circuit for- term structural and functional properties mation in developing systems and during in adult hippocampal circuitry, including critical periods permanently modifies loss of capacity for seizure-induced plas- circuit organization and functional prop- ticity in adulthood that could influence erties. These observations suggest that epileptogenesis and other hippocampal- excessive neural activity, as occurs during dependent behaviors and functional seizures, might influence developing neu- properties. 2015 IBRO. Published by Else- ral circuitry with long-term outcomes that vier Ltd. depend on age at the time of seizures. We systematically examined long-term struc- Discussion and Conclusions: These are the tural and functional consequences of sei- first electrophysiological evidence which zures induced in rats by kainic acid, pen- proves that at the critical certain ages of the tylenetetrazol, and hyperthermia across postnatal development, a strong trauma or postnatal ages from birth through postna- epileptiform discharges may result in long tal day 90 in adulthood (P90). Magnetic term changes in the excitatory and inhibito- resonance imaging (MRI), diffusion tensor ry circuitry of the hippocampus, impaired imaging (DTI), and electrophysiological learning and memory, hence some possible methods at PP95 following seizures in- psychological changes, as well. More struc- duced from P1 to P90 demonstrated con- tured and detailed electrophysiology studies sistent patterns of gross atrophy, micro- should be carried on the reveal other de- structural abnormalities in the corpus tails. callosum (CC) and hippocampus, and 056.EFFECTS OF VIBRATORS ON THE functional alterations in hippocampal ORGASM PATTERNS & SEXUAL LIFE circuitry at PP95 that were independent STYLES OF TURKISH WOMEN: DIFFER- of the method of seizure induction and ENT CLASSIFICATIONS varied systematically as a function of age POSTER at the time of seizures. Three distinct H. Ümit Sayin (Sayin-11)

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Asiye Kocatürk and Taner Arisal (Sky women) = 15 %; Group 5 (Venus wom- Background and Introduction: The use of en) = 1 %. vibrators (VBs) is not very widespread 2- “Did bullet vibrators or other vibes affect among women in Turkey. A survey was your sexual response and capability to attain made after the use of VBs (bullet vibes) clitoral orgasm?” among Turkish women to understand the 0 (very badly)= 0.0 %; 1 (badly)= 0.0 %; 2 (No Page | 41 reactions against VBs and the effects of VBs effect)= 14 %; 3 (Little effect)= 0.0 %; 4 in female sexual response. (moderate effect)= 14 %; 5 (much effect)= 32 Methods: We have recently made a survey %; 6 (very much effect)= 42 %. on 32 women, part of which has been real- 3- “Did bullet vibrators or other vibes affect ized in the women who had never used a VB your general sexual response positively?” before (N= 9). The survey and study is still 0 (very badly)= 0.0 %; 1 (badly)= 0.0 %; 2 continuing. These women were all given (No effect)= 11 %; 3 (Little effect)= 0.0 %; 4 bullet VBs (3000 RPM, frequencies at differ- (moderate effect)= 4 %; 5 (much effect)= 45 ent potentiometer grades of 2, 2.5 and 3 %; 6 (very much effect)= 40 %. volts, frequency levels: 40 Hz, 50 Hz and 60 4-“By Using bullet vibe or other vibrators did Hz) and the survey questions were collected you attain a clitoral orgasm?” 3 months after delivering the bullet vibes. 69 %= Yes, every time; 18 %= Yes, usually; 7 The bullets (and other vibrators) were sup- %= Yes, sometimes; 3 %= Yes, very rarely; 3 plied by CENSAN Company Ltd. The ques- %= No, never. tionnaire consisted of 50 questions about 5- “By Using bullet vibe or other vibrators the sexual behavior of women and the ef- how was your libido affected?” fects of various vibrators, including bullet 0 (very badly)= 0.0 %; 1 (badly)= 0.0 %; 2 vibes to the participants. The determination (No effect)= 8 %; 3 (Little positive effect)= of the classification of women was realized 0.0 %; 3 (moderate positive effect)= 8 %; 5 by some preliminary studies. Group-1: (much positive effect)= 46 %; 6 (very much Women who can achieve clitoral orgasms by positive effect)= 38 %. means of very low stimulation frequency Discussion and Conclusions: This study (25-40 Hz). Group-2: They can attain clito- group could attain orgasms by low frequen- ral orgasms by higher frequencies such as cy bullet vibrators and reached to clitoral 40-60 Hz. Group-3: They can attain clitoral orgasms easier (87 %); their sexual life orgasms by 50-80 Hz moderate stimula- styles were improved by bullet vibes posi- tions. Group-4: They can be stimulated and tively (85 %); also bullet vibes improved attain orgasms by a wider range of stimula- their libido (79 %). Despite the fact that tion frequencies (40-100 Hz). Group-5: there is resistance against the use of VBs in They need very powerful vibrations such as the Turkish society by both the public and massage vibrators, which are around 80- the professional therapists and doctors, VBs 100 Hz. 0-6 likert scale included the choices can be used in the treatment of anorgasmia of effects on their clitoral orgasms and sex- and other sexual function disorders in Tur- ual behavior: 0-very badly; 1-badly; 2- No key. effect; 3-little positively; 4-moderately; 5- IN SEX THERAPY WHICH VIBE CAN BE USED much in a positive way; 6- very much in a TO DEVELOP WHICH REFLEX positive way. Bullet-vibe ● massage gadgets ● clitoral part of Results: 1-The distribution of the subjective Learning and rabbit vibe ● Butterfly ● butterflies that can be developing clitoral harnessed by specially designed underwear or evaluation of women according to their re- orgasm belts sponses to the bullet vibrators and/or other G-Spot discovery Curved G-Spot vibes ● anterior fornix stimula- vibrators which they have used before for and stimulation, tors ● Sybian learning and the study were (N= 32): Group 1 (Moon developing G-Spot women) = 15 %; Group 2 (Sun women) = 26 orgasm reflex %; Group 3 (Earth women) = 43 %; Group 4

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Stimulation of inner Specially designed anterior fornix stimulators tasies was: 81,7 % (combined KR-1993 and clitoris, DVZ and ● rabbit dolphin vibrator-dildos with two units learning and that has a rotating tip ● COITUS MACHINES HR-2003, N= 2241 women, at the ages of 17 developing vaginal ●SYBIAN to 60), and having no fantasy was 18,1 % in reflex New generation vibes with special design ● the whole combined group. In 2013-2015, Learning vaginal Rabbit-Dolphin type vibes with rotating tip and orgasm reflex clitoral stimulator unit ● variety of dildos with “imagining a sexual fantasy” dropped to or without vibration ● COITUS MACHINES ● SYBIAN 53 % and “having no fantasy” increased to Kegel Perineometer ● Jade Eggs containing Page | 42 weight ● Ben-Wa Balls ● Vaginal Dildos with 44,3 % (IR-pilot-preliminary, 2013-2015; Developing and inflatable tip ● New generation Rabbit- stimulating PC- Dolphin dildo vibes with two functions and a N= 1139). Among the educated and middle muscles rotating tip ● cushions with powerful vibrati- class women the tendency of fantasizing ons ● pillows with special vibration and motion ● SYBIAN dropped statistically significantly during last decade. 057. İSTANBUL REPORT: PRELIMINARY b) Between 10 to 20 years ago, the ratio of FINDINGS; THE DECLINE OF THE FANTA- the women who never masturbated was SY PATTERNS AND THE FREQUENCY OF 35.1 % (combined KR-1993 and HR-2003, MASTURBATION IN TURKISH WOMEN N= 2241 women, at the ages of 17 to 60); in DURING THE LAST DECADES 2013-2015, this ratio increased to 63.3 % H. Ümit Sayin (Sayin-12) and Asiye (IR-pilot-preliminary, 2013-2015; N= Kocaürk 1139). In 20 years, an increase of the num- POSTER ber of none-masturbating women was mul- Introduction: Our surveys on the sexual tiplied by 1.8 times. behavior of Turkish women on both young c) Conclusion: In Turkey, 20 years ago, Female University Students (FUS,ages of 17 among 1000 middle class and educated to 23) and all ages (17 to 60) have showed a Turkish women, 817 women were having pattern that the sexual behavior of Turkish sexual fantasies and 649 women were women have altered a great deal during the experiencing masturbation. In Turkey, in last decades. Our surveys Kadınca Report 2015; among 1000 middle class and edu- (KR, 1993, N= 1536), Hülya Report (HR, cated Turkish women, only 530 women 2003, N=709) and preliminary findings in are having sexual fantasies, and only 367 İstanbul Report (IR-2013-2015, N=1139), women are masturbating. Both masturba- which is still continuing, have shown such tion and fantasy behavior declined signifi- tendency. In this report we present the lat- cantly. est findings on the decline of female fantasy Discussion: Sexual fantasy and masturba- patterns and masturbation frequencies dur- tion are the basic, natural and healthy sexu- ing last 20 years. al behaviors. Also, sexual education and sex Methods: The data of 1139 forms of İstan- therapy starts with teaching the healthy bul Report (939 FUS in 2013-2015 at the masturbation techniques to the patients. age interval of 17-23 and 200 new data form Fantasy patterns are also indispensable at the age intervals of 23 to 60) and our counterpart of masturbation and sexual former reports of KR (1993, N=1536) & HR behavior. Our various surveys have shown (2003, N=709; total N= 2245 women) were that the frequency of sexual fantasy, mas- compared in the SPSS program. Appropriate turbation and orgasm patterns decreased analysis and statistical comparison is made and declined during the last 20 years among by using SPSS and Sigma-stat statistics pro- educated and middle class women in Tur- grams. The surveys were realized in some key. The reason of this decline is the trans- different women’s magazines and also using formation of the Turkish society during the the internet and face to face interviews. The last decades into a conservative and very target group was educated, secular, liberat- religious social system, and banning many ed, middle class women, (ages: 17 to 60). attitudes as well as books, media, cultural Results: a) In our former surveys, 10 and rights etc. in the society. As well as political 20 years ago, the ratio of having sexual fan- means, another factor is the lack of sexual

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ABSTRACTS OF INTERNATIONAL ANATOLIAN CONGRESS ON NEUROSCIENCE AND SEXUAL HEALTH education on sexuality at any education Very Content 41 % 26 % * level, including universities and post- Sometimes, less content 21 % 22 % doctoral education. Not Content 23 % 47 %*

Not interested Rest Rest 058.İSTANBUL REPORT: PRELIMINARY FINDINGS Do you attain orgasm? Page | 43 THE DECLINE OF THE ORGASMIC BEHAV- KR-HR-1993-2003 IR-2013 N= 2245 women N= 1139 women IOUR IN TURKISH WOMEN DURING THE Yes, frequently 49 % 26 %* LAST DECADES Sometimes/Seldom 32 % 39 % H. Ümit Sayın (Sayin-13) Asiye Kocatürk and Hacer Canatan NO Orgasm 19 % 35 % * POSTER Multiple Orgasm Do you attain multiple orgasms? Introduction: Our surveys on the orgasmic KR-HR-1993-2003 IR-2013 N= 2245 women N= 1139 women behavior of Turkish women on both young Only 1 32 % 37 % Female University Students (FUS; ages of 17 to 23; N=939) and all ages (17 to 60; N=200; 2-5 Orgasms 27 % 13 %* total N=1139) have showed a pattern that >5 Orgasms 28 % 16 %* orgasmic frequency and consistency of NO Orgasm 13 % 34 %*

Turkish women have altered and declined a Do you attain vaginal-coital orgasms? great deal during the last decades. Our sur- KR-HR-1993-2003 IR-2013 veys Kadınca Report (KR, 1993, N= 1536), N= 2245 women N= 1139 women Hülya Report (HR, 2003, N=709; combined Vaginal Orgasm 17 % 18 % total KR+HR, N= 2245) and preliminary Clitoral or other stimu- 66% 62 % lation findings in İstanbul Report (IR-2013-2015, NO Orgasm 15% 32%* N=1139), which is still continuing, have shown such a decline. In this report we pre- Discussion and Conclusions: Reaching to sent the latest findings on the decline of orgasm, experiencing multiple orgasms and orgasmic frequency, multiple orgasms and being content of present sexual life was de- other orgasmic attitudes of Turkish women clined a great deal, significantly. Experienc- during the last 20 years. ing vaginal-coital orgasm ratio stayed at the Methods: Comparison of the data of 1139 similar ratio of 16-19 % in both of the study forms of İstanbul Report (939 FUS in 2013- groups. The possible reasons of the findings 2015 at the age interval of 17-23 and 200 can be summarized as follows: new data form at the age intervals of 23 to  The Turkish society became more con- 60) and our former reports of KR (1993, servative and religious during the last N=1536) & HR (2003, N=709) is made in the 20 years. SPSS program. Appropriate analysis and  The inhibitions and taboos increased statistical comparison is carried out by us- during the last 20 years. ing SPSS and Sigma-stat statistics programs.  Education and training on sexuality The surveys were realized in some different dropped during the last 20 years. women’s magazines and also using the in-  Political system and social conditioning. ternet and face to face interviews. The tar-  The social insecurities, instabilities and get group was educated, secular, liberated, political system’s social impact. middle class women, (ages: 17 to 60). Con-  Increased use of SSRI anti-depressants tent from sexual life; orgasmic behavior & in the whole society. consistency, orgasmic frequency & number,  A possible effect of widely used GMO multiple orgasms were asked. food. Results:  Too much exposure to electromagnetic Are you content of your current sexual life? radiation due to high magnetic effects

KR-HR-1993-2003 IR-2013 of smart cellular phones. N= 2245 women N= 1139 women

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physical violence was, 7.5 %; verbal vio- 059.İSTANBUL REPORT: Preliminary Re- lence towards children was 7.1 %, while sults of a Survey on the 398 Postpartum physical violence was 3.4 %. Women in İstanbul: 4-In group B (where the women had unhap- SEXUAL SATISFACTION, SEXUAL FUNC- py and unsatisfactory sexual relationship TION DISORDERS, VERBAL AND PHYSI- with the spouse); verbal violence towards Page | 44 CAL VIOLENCE IN THE TURKISH FAMILY the women was 27.7 %, physical violence STRUCTURE was, 14.7 %; verbal violence towards chil- Asiye Kocatürk and H. Ümit Sayin (Sayin- dren was 13.2 %, while physical violence 14) was 7.8 %. When both groups are compared Introduction: The authors started a series there is a significant difference in terms of of surveys, named as İstanbul Report (IR) on the attitude of the fathers. Violence attitude Female Sexuality. This study was a sub- is nearly doubled. group of the survey series of IR. The corre- 5-66 % of the group stated that they experi- lation of domestic violence towards the enced orgasms, always or generally or spouse and children were investigated sometimes in their sexual relations with among post-partum women. their husbands. 68.2 % of them experienced Methods: The survey was realized among clitoral orgasms always or generally or the post-partum women after their giving sometimes; while coital-vaginal orgasm births in various hospitals in İstanbul. There frequency was 17.9 % (always) and 11.3 % were 58 questions. 398 responses were (generally). 47.8 % stated that they never or collected and analyzed in SPSS. The educa- rarely or sometimes experienced coital- tion distribution in the group was: Elemen- vaginal orgasms. 32.3 % of the group expe- tary: 29 %; High School: 53.4 %; University: rienced only ONE orgasm at each love mak- 16.6 %; MSc &PhD: 0.8 %. The group was ing, while 47.9 % said they experienced or- divided into two according to their respons- gasms between 2-10. Compared to the other es: sexually content, satisfied and happy (A, data of the İstanbul Report, these ratios N=295); sexually non-content, not satisfied were consistent with other frequencies in and having sexual problems with their hus- the other data of women of IR-2013 bands (B, N=103). Verbal and physical vio- (N=1130). The general vaginal-coital or- lence by the husbands towards the women gasm consistency was not changed as it was and the children, at different degrees, were in Turkish population (between 16 % and investigated. This data was compared with 17 %, data obtained during last 20 years). Kadınca Report (KR-1993; N=2245), Hülya Anorgasmic women doubled in both of the Report (HR-2003; N=1139), İstanbul Report 2013-IR groups compared to KR and HR. (IR-2013; N=1139). Do you attain orgasm? Results: KR-HR-1993- IR-2013 IR-Postpartum- 2003 N= 1139 2013 1- There is verbal and physical violence to N= 2245 women N=398 women women some degree in the Turkish family structure. Yes, frequently 49 % 26 %* 32,3 %* 2-Among the 398 post-partum women, the SFD frequency encountered at least once (or Sometimes/Seldom 32 % 39 % 33.7% NO Orgasm 19 % 35 % * 34 %* more) in their entire lives was 42.3 %, while Anorgasmia the most common specific SFDs were as: 6-Overall data stated that a good sexual Vaginismus: 10.3 %; Dyspareunia: 12.8 %; relationship and attaining an orgasm de- Anorgasmia: 14.2 %; Lack of sexual interest: creased the verbal or physical violence of 6.8 %; Lubrication problems during inter- the husband to the spouse and the children. course: 2.5 %. Or in problematic and sexually none satis- 3-In group A (where the women had a good factory relationships with violence, the or- sexual relationship with the spouse) verbal gasm and sexual satisfaction ratios dropped violence towards the women was 16.8 %, significantly.

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Conclusion: In the Turkish family structure (precursor of testosterone). Such incidences sexual function disorders, sexual dissatisfac- may result in decrease in libido, sexual ap- tion, anorgasmia and verbal-physical vio- petite and fertility. lence is one of the important factors that contribute to the happiness of the marriage. -62. Hypogonadism and erectile dysfunc- The less violence, the more sexual satisfac- tion associated with soy product con- Page | 45 tion is observed; or sexually suitable and sumption. satisfactory relationships decrease the ver- Siepmann T1, Roofeh J, Kiefer FW, Edel- bal or physical violence. This study obvious- son DG. ly reveals that there is a sexual relationship Abstract: Previous research has focused on problem in the Turkish family structure. To the beneficial effects of soy and its active overcome this problem, the families or the ingredients, isoflavones. For instance, soy wives or husbands should be both given a consumption has been associated with low- structured education about relationships, er cardiovascular and breast cancer risks. conflict resolution, their bodies and sexuali- However, the number of reports demon- ty, starting from high school and universi- strating adverse effects of isoflavones due to ties. their estrogenlike properties has increased. We present the case of a 19-y-old type 1 060.EFFECTS OF GENETICALLY MODI- diabetic but otherwise healthy man with FIED ORGANISMS (GMOs) ON HUMAN sudden onset of loss of libido and erectile SEXUAL REPRODUCTION AND FERTILITY dysfunction after the ingestion of large POSTER-Review quantities of soy-based products in a vegan- Levent Kartal style diet. Blood levels of free and total tes- Introduction: Genetically modified organ- tosterone and dehydroepiandrosterone isms (GMOs) have been widely used in (DHEA) were taken at the initial presenta- many countries during last decades. The tion for examination and continuously mon- long term biological effects of GMOs are not itored up to 2 y after discontinuation of the well investigated and documented. After vegan diet. Blood concentrations of free and 2000s, it has been debated in some academ- total testosterone were initially decreased, ic and scientific circles that GMOs have some whereas DHEA was increased. These pa- long term hazardous biological effects on rameters normalized within 1 y after cessa- human sexuality and fertility. tion of the vegan diet. Normalization of tes- Background and Findings: There are some tosterone and DHEA levels was paralleled reports that GMOs influence the human sex- by a constant improvement of symptoms; uality. In 2001, a California biotech compa- full sexual function was regained 1 y after ny, EPICYTE, engineered a GM corn genet- cessation of the vegan diet. This case indi- ically. It has been reported that males eating cates that soy product consumption is relat- this EPICYTE GMO (GM-corn) develop anti- ed to hypogonadism and erectile dysfunc- bodies to their own sperms and become tion. To the best of our knowledge, this is IRREVERSIBLY infertile. The females who the first report of a combination of de- eat this EPICYTE gene loaded corn develop creased free testosterone and increased anti-bodies to either their own ovum or to DHEA blood concentrations after consuming the foreign spermatozoa. EPICYTE-gene is a soy-rich diet. Hence, this case emphasizes only one example of the possible long term the impact of isoflavones in the regulation of irreversible hazardous effects of GMOs. Also sex hormones and associated physical alter- it is reported that GMO-soy beans induce a ations. decrease in libido and impaired sexual Discussion and Conclusion: In this poster drive; research shows that the consumption presentation, GM-corn and GM-soy bean are of GMO-soy beans induced low levels of tes- only two examples, about which the devas- tosterone with increased levels of DHEA tating effects of GMOs have been proven.

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There is much other GM food which is sandalwood, lemon, patchouli, violet, amber, served on our dinner tables all over the garden rose, tobacco, orange, crème cara- globe. In Turkey, during the last decade, mel, musc, vanilla, lavender, jasmin, and “original and natural heirloom” seeds of mint were prepared. In the similar set and many plants that are used as food products settings with a relaxing classical music (Vi- have been banned to sell commercially and valdi, Seasons), the solutions of fragrances Page | 46 it was compulsory to use patented hybrid were sprayed on gauges and smelled for 3 seeds that the government decides on. Also minutes through a surgical mask, when eyes in some food, GM-plants are also used. In were blindfolded. Before and after the ex- Turkey, infertility cases tripled during the periment, a scale and a questionnaire were last 2 decades; sexual function disorders asked to be filled by the women. Their (SFDs) such as lack of sexual desire, de- statement of written consent was also taken. crease of libido, anhedonia, anorgasmia in- The preliminary data from 20 women (ages creased a great deal. A long term investiga- from 18 to 50) were collected and analyzed. tion of the comparison of GMOs and SFDs The study is continuing. should be carefully carried out with cohort Results and Conclusion: The main psycho- long term surveys on the Turkish popula- logical effects of most of the basic note fra- tion, to investigate whether the increment in grances were: relaxing; soothing; anxiolysis; SFDs and infertility cases have any correla- feeling calm; sexual arousal; increase in libi- tion with the consumption of GM-food of do; remembering childhood, past or recent any kind (corn, soy and others). memories; feeling; brief and mild altered states of consciousness; happiness; feelings 061. ACUTE EFFECTS OF 15 MAIN BASIC of peace; elevation of mind. Also, when eyes NOTE PARFUME FRAGRANCES ON MOOD, were blindfolded and they smelled the fra- SEXUAL AROUSAL, LIBIDO AND SUB- grances, almost all of the women perceived CONSCIOUSNESS IN WOMEN some geometric shapes such as concentric Ümit Sayın (Sayin-15), Hacer Canatan, circles, solid circles, ellipses, square, trian- Aydan Taşkınlar and Burcu Karavelioğlu gle, round shapes, rectangles, honeycombs, Introduction: It is reported that perfumes spirals. The scale also consisted of the prints and fragrances have effects on mood, con- and tables of entoptic images; 80 % of the sciousness, childhood memories, recent or women stated that when smelling some of distant memories, anxiety, sexual arousal, the fragrances they perceived some entoptic and libido. It is also hypothesized that fra- images when their eyes were blindfolded. grances and perfumes have direct effect on Sandalwood, patchouli, tobacco, orange, the limbic system, temporal lobe and also crème caramel, musc, vanilla and jasmin subconsciousness & collective unconscious- were most sexually arousing fragrances in ness, association of memories and flashing this study group. The effects of the 15 basic of some geometric shapes and entoptic im- note fragrances are summarized in the ta- ages. A preliminary double blind study on ble. More detailed studies on the effects of the effects of basic 15 notes of fragrances on perfumes and fragrances should be made. It mood, sexual arousal, libido, memory and is also concluded that they directly stimu- consciousness in women was designed. late memory functions of the brain, as well Methods: Different pleasant and attractive as the sub-consciousness and collective un- solutions of the fragrances of honeysuckle, consciousness (entoptic images).

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PRESENTATIONS FROM ASEHERT-

CİSEATED Page | 47 www.ciseated.org

Some of the presentations and posters in the Anatolian Congress were as follows.

The contributors and authors of these posters were: DR. ÜMIT SAYIN DR. ASİYE KOCATÜRK DR. HACER CANATAN LEVENT KARTAL TANER ARISAL AYDAN TASKINLAR BURCU KARAVELIOGLU

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