Assessing and conceptualizing orgasm after a spinal cord injury

Abstract

• Responses to the questionnaire were divided into four categories: cardiovascular, muscular, autonomic and dysreflexic sensations. RESULTS• Significantly more sensations were described at ejaculation than with sexual stimulation alone.• Men with SCI who experienced AHR at ejaculation reported significantly more cardiovascular, muscular, autonomic and dysreflexic responses than those who did not.• There was no difference between men with complete and those with incomplete lesions. CONCLUSIONS• The findings show that the questionnaire is a useful tool to assess orgasm and to guide patients in identifying the bodily sensations that accompany or build up to orgasm.• The findings also support the hypothesis that orgasm may be related to the presence of AHR in individuals with SCI. Data from able-bodied men also suggest that AHR could be related to orgasm, as increases in blood pressure are observed at ejaculation along with cardiovascular, autonomic and muscular sensations. OBJECTIVES• To provide a questionnaire for assessing the sensations characterizing orgasm.• To test the hypothesis that orgasm is related to autonomic hyperreflexia (AHR) in individuals with a spinal cord injury (SCI). SUBJECTS AND METHODS• A total of 97 men with SCI, of whom 50 showed AHR at ejaculation and 39 showed no AHR, were compared.• Ejaculation was obtained through natural stimulation, vibrostimulation or vibrostimulation combined with midodrine (5-25 mg).• Cardiovascular measures were recorded before, at, and after each test.

Neural Control and Physiology of Sexual Function: Effect of Spinal Cord Injury

“…Since the definition and interpretation of orgasm remains neurophysiologically unclear, most studies of orgasm in persons with SCI are reliant on subject self-report, physiological measures (particularly of heart rate and blood pressure), or documented phenomenological experiences. 16 Genitally induced orgasm appears to require an intact sacral reflex, but orgasm can be experienced from stimulation outside the genital region (nongenital stimulation, such as nipples and ears) and with psychogenic fantasy alone (as in sleep). The perceptual experience of orgasm, once achieved, does not vary much between men and women and can be modulated by several factors, primarily psychological as opposed to physical, such as emotional intimacy.…”

Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

“…Somatic sensations may be diminished or absent after SCI, but diffuse autonomic sensations may be experienced and should be highlighted so the person can acknowledge the similarities with preinjury orgasm. Two questionnaires are available in the literature to assess the perceptual sensations of pleasure and orgasm: Courtois et al's 58,59 questionnaire on genital, cardiovascular, muscular, and autonomic sensations associated with sexual stimulation and climax in individuals with SCI (and recently validated on able-bodied controls), 60 and Mah and Binik's 61 questionnaire on sensoryemotional sensations characterizing orgasm in the able-bodied population. These questionnaires can be helpful in bringing the patients' attention to the range of sensations -genital, nongenital, or sensory-emotional -that can build up and characterize sexual pleasure and climax.…”

Premature ejaculation associated with lumbosacral lesions

“…Lost climactic sensation during ejaculation might also be explained by the fact that these men with lumbosacral lesions cannot experience even mild autonomic hyperreflexia which has been associated with climactic responses in men with SCI. 12,13,18 Yet, the premature nature of ejaculation following lower SCI remains a mystery.…”