Opposed hemispheric specializations for human hypersexuality and orgasm?

Suffren, Sabrina; Braun, Claude M. J.; Guimond, Anik; Devinsky, Orrin

doi:10.1016/j.yebeh.2011.01.023

Cited by 21 publications

(8 citation statements)

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“…Several studies have shown a relationship between the locations of the lesion in stroke with the onset of ED. The regulation of erectile function is more influenced by the parasympathetic than the sympathetic nervous system [14]. Some studies have shown consistent results that the left hemisphere is predominantly regulating parasympathetic modulation, while the right hemisphere is dominant for sympathetic modulation [15], [16], [17].…”

Section: Introductionmentioning

confidence: 99%

Positive Correlation between Left Hemisphere Lesion and Erectile Dysfunction in Post-Stroke Patients

Purwata¹,

Andaka²,

Nuartha³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Stroke is a serious health condition and the leading cause of disability, including erectile dysfunction (ED). The mechanisms and factors that predict ED in stroke are not fully elucidated. Several studies have shown a relationship between the location of the lesion in stroke with the onset of ED. The left hemispheric lesion was believed to disrupt the parasympathetic nervous system which is responsible for the regulation of erection. Stroke attack in this region therefore can be the underlying reason for ED. However, there are still contradictory findings in this area, and very few studies attempted to look at this problem, particularly among Asian male. AIM: We would like to evaluate the association between left hemisphere lesion after ischemic stroke and the subsequent risk of developing ED. METHODS: The study was conducted in the neurology polyclinic of Sanglah and Wangaya Hospital from February to August 2013. Subjects are all post-stroke patients who visited the neurology polyclinic of Sanglah and Wangaya Hospital that met inclusion and exclusion criteria. RESULTS: There is a significant positive correlation (p < 0.05) between left hemisphere lesions and ED in stroke patients with a correlation coefficient (r) = 0.361 which means weak correlation and p = 0.032. CONCLUSION: Left hemisphere lesions positively correlated with ED in stroke patients. Further longitudinal research is needed to see whether left hemisphere lesion in post-stroke patients is a risk factor for ED.

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Section: Introductionmentioning

confidence: 99%

Positive Correlation between Left Hemisphere Lesion and Erectile Dysfunction in Post-Stroke Patients

Purwata¹,

Andaka²,

Nuartha³

et al. 2019

Open Access Maced J Med Sci

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“…29 This finding is consistent with previous studies showing right-side brain activation during orgasm 30,31 and lateralization of brain injury effects on sexuality. 32 …”

Section: Discussionmentioning

confidence: 99%

Brain Activity Unique to Orgasm in Women: An fMRI Analysis

Wise

Frangos

Komisaruk

2017

The Journal of Sexual Medicine

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Background Although the literature on imaging of regional brain activity during sexual arousal in women and men is extensive and largely consistent, that on orgasm is relatively limited and variable, owing in part to the methodologic challenges posed by variability in latency to orgasm in participants and head movement. Aim To compare brain activity at orgasm (self- and partner-induced) with that at the onset of genital stimulation, immediately before the onset of orgasm, and immediately after the cessation of orgasm and to upgrade the methodology for obtaining and analyzing functional magnetic resonance imaging (fMRI) findings. Methods Using fMRI, we sampled equivalent time points across female participants’ variable durations of stimulation and orgasm in response to self- and partner-induced clitoral stimulation. The first 20-second epoch of orgasm was contrasted with the 20-second epochs at the beginning of stimulation and immediately before and after orgasm. Separate analyses were conducted for whole-brain and brainstem regions of interest. For a finer-grained analysis of the peri-orgasm phase, we conducted a time-course analysis on regions of interest. Head movement was minimized to a mean less than 1.3 mm using a custom-fitted thermoplastic whole-head and neck brace stabilizer. Outcomes Ten women experienced orgasm elicited by self- and partner-induced genital stimulation in a Siemens 3-T Trio fMRI scanner. Results Brain activity gradually increased leading up to orgasm, peaked at orgasm, and then decreased. We found no evidence of deactivation of brain regions leading up to or during orgasm. The activated brain regions included sensory, motor, reward, frontal cortical, and brainstem regions (eg, nucleus accumbens, insula, anterior cingulate cortex, orbitofrontal cortex, operculum, right angular gyrus, paracentral lobule, cerebellum, hippocampus, amygdala, hypothalamus, ventral tegmental area, and dorsal raphe). Clinical Translation Insight gained from the present findings could provide guidance toward a rational basis for treatment of orgasmic disorders, including anorgasmia. Strengths and Limitations This is evidently the first fMRI study of orgasm elicited by self- and partner-induced genital stimulation in women. Methodologic solutions to the technical issues posed by excessive head movement and variable latencies to orgasm were successfully applied in the present study, enabling identification of brain regions involved in orgasm. Limitations include the small sample (N = 10), which combined self- and partner-induced stimulation datasets for analysis and which qualify the generalization of our conclusions. Conclusion Extensive cortical, subcortical, and brainstem regions reach peak levels of activity at orgasm.

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“…18,19,37,38 In addition to decreased sexual functioning in PWE, sexual auras and ictal hypersexuality have been reported. 39,40 Though prevalence rates for physical and sexual abuse associated with PNES is well-researched, 41,42 there are no prevalence rates reported for sexual dysfunction in patients with PNES. Hypertension has negative effects on vascular function and structure resulting in significant sexual dysfunction (erectile dysfunction and impotence in men) with: (1) approximately two-fold increased prevalence when comparing hypertensive patients with normotensive individuals 26,43 and (2) large epidemiologic studies revealing increased relative risk range for developing erectile dysfunction in hypertension of 1.3-6.9.…”

Section: Discussionmentioning

confidence: 99%

Lamotrigine-induced sexual dysfunction and non-adherence: case analysis with literature review

et al. 2017

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BackgroundOptimal anti-epileptic drug (AED) treatment maximises therapeutic response and minimises adverse effects (AEs). Key to therapeutic AED treatment is adherence. Non-adherence is often related to severity of AEs. Frequently, patients do not spontaneously report, and clinicians do not specifically query, critical AEs that lead to non-adherence, including sexual dysfunction. Sexual dysfunction prevalence in patients with epilepsy ranges from 40 to 70%, often related to AEDs, epilepsy or mood states. This case reports lamotrigine-induced sexual dysfunction leading to periodic non-adherence.AimsTo report lamotrigine-induced sexual dysfunction leading to periodic lamotrigine non-adherence in the context of multiple comorbidities and concurrent antidepressant and antihypertensive pharmacotherapy.MethodCase analysis with PubMed literature review.ResultsA 56-year-old male patient with major depression, panic disorder without agoraphobia and post-traumatic stress disorder was well-controlled with escitalopram 20 mg bid, mirtazapine 22.5 mg qhs and alprazolam 1 mg tid prn. Comorbid conditions included complex partial seizures, psychogenic non-epileptic seizures (PNES), hypertension, gastroesophageal reflux disease and hydrocephalus with patent ventriculoperitoneal shunt that were effectively treated with lamotrigine 100 mg tid, enalapril 20 mg qam and lansoprazole 30 mg qam. He acknowledged non-adherence with lamotrigine secondary to sexual dysfunction. With lamotrigine 300 mg total daily dose, he described no libido with impotence/anejaculation/anorgasmia. When off lamotrigine for 48 h, he described becoming libidinous with decreased erectile dysfunction but persistent anejaculation/anorgasmia. When off lamotrigine for 72 h to maximise sexual functioning, he developed auras. Family confirmed patient’s consistent monthly non-adherence for 2–3 days during the past year.ConclusionsSexual dysfunction is a key AE leading to AED non-adherence. This case describes dose-dependent lamotrigine-induced sexual dysfunction with episodic non-adherence for 12 months. Patient/clinician education regarding AED-induced sexual dysfunction is warranted as are routine sexual histories to ensure adherence.Declaration of interestNo financial interests. K.R.K. is Editor of BJPsych Open; he took no part in the peer-review of this work.Copyright and usage© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

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Opposed hemispheric specializations for human hypersexuality and orgasm?

Cited by 21 publications

References 94 publications

Positive Correlation between Left Hemisphere Lesion and Erectile Dysfunction in Post-Stroke Patients

Positive Correlation between Left Hemisphere Lesion and Erectile Dysfunction in Post-Stroke Patients

Brain Activity Unique to Orgasm in Women: An fMRI Analysis

Lamotrigine-induced sexual dysfunction and non-adherence: case analysis with literature review

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