As a writer of fiction, D. H. Lawrence spent his career maneuvering between heterosexual and homosexual preferences. In order to make a living, he needed to use mainstream publishers. They encouraged ...his bold work but only if he censored it. What especially interested Lawrence were the differences between male and female orgasm-not just the mechanics but their meaning. Over his career (1910-1930) his views on orgasm evolved from simple release, to ambivalent forms of lust, to a challenging separation of responses: unfathomable silence for males and articulate expression for females. The sexes are privileged differently, and the categorical separation that Lawrence discovers is a revelation. This essay analyzes five of his most famous novels, from Sons and Lovers to Lady Chatterley's Lover, and, based on revisions in his texts, reaches conclusions that differ from those most readers have held. In revising, Lawrence came to reshape his characters' responses into complex, often-coded narratives.
The Orgasm Rating Scale (ORS) is one of the few self-reported measures that evaluates the multidimensional subjective experience of orgasm.
The objective of this study was to examine the psychometric ...properties of the ORS in context of sex-with-partner in a Spanish sample.
We examined a sample of 842 adults from the general Spanish population (310 men, 532 women; mean age = 27.12 years, SD = 9.8). The sample was randomly divided into two, with a balanced proportion of men and women between each sub-sample. Sub-sample 1 consisted of 100 men and 200 women (33.3% and 66.6%) with a mean age of 27.77 years (SD = 10.05). Sub-sample 2 consisted of 210 men and 332 women (38.7% and 61.3%) with a mean age of 26.77 years (SD = 9.65). The ORS, together with the Sexual Opinion Survey-6 and the Massachusetts General Hospital-Sexual Functioning Questionnaire, was administered online. The survey included a consent form, in which confidentiality and anonymity were guaranteed.
Based on exploratory factor analysis, we obtained a reduced 25-item version of the ORS, distributed along 4 dimensions (affective, sensory, intimacy, and rewards).
We performed both exploratory factor analysis and confirmatory factor analysis. The Spanish version of the ORS had adequate values of reliability that ranged from .78–.93. The 4 factors explained 59.78% of the variance. The factor structure was invariant across gender at a configural level. Scores from the ORS positively correlated with erotophilia and sexual satisfaction. The scale was useful to differentiate between individuals with orgasmic difficulties and individuals with no difficulties. We found that individuals with orgasmic difficulties showed a lower intensity in the affective, intimacy, and sensorial manifestations of orgasm.
This version of the ORS could provide an optimum measure for the clinical assessment to identify individuals with difficulties in their orgasmic capacity, thus, it could be used as screening device for orgasmic dysfunction.
The ORS is an appropriate measure for its use for both research and clinical purposes. As limitations, quota sampling implies that the extent to which the results can be generalized is modest. Measurement invariance did not reach the level of weak invariance, and it was not tested across sexual orientation because most individuals identified themselves as heterosexual. The ORS is a multidimensional measure of the subjective experience of orgasm which has adequate psychometric properties; it is a reliable and valid scale.
Arcos-Romero AI, Moyano N, Sierra JC. Psychometric Properties of the Orgasm Rating Scale in Context of Sexual Relationship in a Spanish Sample. J Sex Med 2018;15:741–749.
Orgasmic latency (OL) during partnered sex (POL) and OL during masturbatory sex (MOL) in women with and without orgasmic difficulty have received minimal attention.
To ascertain POL and MOL both ...overall and more specifically in women with and without difficulty reaching orgasm and to explore interrelationships between masturbatory and partnered latencies and sexual satisfaction.
Participants for this study were 2,304 women drawn from community–based samples in the United States and Hungary who completed an investigator–derived questionnaire regarding their sexual history and response, including items related to frequency of masturbation and partnered sex, sexual desire, sexual arousal, orgasmic response, OL, distress, partner distress, and sexual satisfaction.
Self-reported OL and related orgasmic parameters during masturbation and partnered sex in women with and without difficulty reaching orgasm were assessed.
POL were longer than those during MOL. Women experiencing difficulty reaching orgasm showed even longer latencies during partnered sex but comparable latencies during masturbation. Covariates related to POL included age, overall relationship quality, masturbation frequency, MOL, and level of distress about not reaching orgasm.
POL in women are substantially longer than men’s, suggesting the potential need for an increased repertoire of stimulatory behaviors to increase the woman’s arousal.
The study was well powered and drew from a multi-national population. However, specific types of sexual stimulation during partnered and masturbatory sex were not included in this analysis.
MOL for women and POL differ significantly, with latencies during partnered sex being substantially longer than masturbation, although women reporting the greatest difficulty reaching orgasm have the longest latencies and are likely to find masturbation more satisfying than women who do not.
Rowland DL, Sullivan SL, Hevesi K, et al. Orgasmic Latency and Related Parameters in Women During Partnered and Masturbatory Sex. J Sex Med 2018;15:1463–1471.
Subjective orgasm experience (SOE) is a component of sexual health that refers to the perception, sensation and/or appraisal of orgasm at a psychological level. This construct has scarcely been ...studied in non-heterosexual individuals and couples, and never before from a dyadic perspective. In this study, in which 104 same-sex Hispanic couples participated (48 male-male and 56 female-female), we explored the dyadic influence of SOE dimensions on sexual satisfaction, the mediating role of relationship satisfaction on the association of both phases of sexual response, as well as the explanatory capacity that discrepancies in these dimensions had on sexual satisfaction. The results indicated that the orgasmic dimensions that gained more prominence were Affective and Sensory. A dyadic influence of both on sexual satisfaction was observed only in male couples, as well as a detriment of sexual satisfaction when there were discrepancies in them, especially in women. Moreover, relationship satisfaction was a significant mediator between all dimensions of SOE and sexual satisfaction in both types of couples. This work highlights the need to take into account the SOE of both partners and how this individual experience can affect other dimensions of a more interpersonal nature, such as sexual or relationship satisfaction.
Many reviews on sexual arousal in humans focus on different brain imaging methods and behavioral observations. Although neurotransmission in the brain is mainly performed through electrochemical ...signals, there are no systematic reviews of the electrophysiological correlates of sexual arousal. We performed a systematic search on this subject and reviewed 255 studies including various electrophysiological methods. Our results show how neuroelectric signals have been used to investigate genital somatotopy as well as basic genital physiology during sexual arousal and how cortical electric signals have been recorded during orgasm. Moreover, experiments on the interactions of cognition and sexual arousal in healthy subjects and in individuals with abnormal sexual preferences were analyzed as well as case studies on sexual disturbances associated with diseases of the nervous system. In addition, 25 studies focusing on brain potentials during the interaction of cognition and sexual arousal were eligible for meta-analysis. The results showed significant effect sizes for specific brain potentials during sexual stimulation (P3: Cohen’s
d
= 1.82,
N
= 300, LPP: Cohen’s
d
= 2.30,
N
= 510) with high heterogeneity between the combined studies. Taken together, our review shows how neuroelectric methods can consistently differentiate sexual arousal from other emotional states.
Marriage is an important adult relationship, and recent research indicates that sexual mindfulness, awareness and non-judgment, may be an important tool in helping maintain relational and sexual ...well-being. Using a nationally representative U.S. sample of newly married, mixed-sex couples (women’s age
M
= 29.70 years; men’s age
M
= 31.76 years;
N
= 1473 couples), we evaluated whether the two factors of sexual mindfulness, awareness and non-judgment, were linked with relational flourishing, sexual harmony, and orgasm consistency. We utilized an actor–partner interdependence model within a structural equation modeling framework to evaluate how husbands’ and wives’ awareness and non-judgment were associated with relational flourishing, sexual harmony, and orgasm consistency. Results indicated that both wives’ and husbands’ awareness was positively associated with relational flourishing, sexual harmony, and orgasm consistency. Partner effects were found for all outcomes. However, no partner effects were found between non-judgment and orgasm consistency. Therapists, educators, and couples may consider the use of sexual mindfulness skills when addressing marriage and sexual relationships.
Altered perception of orgasm, orgasm‐associated pain, penile sensory changes, urinary incontinence (UI) during sexual activity, penile shortening (PS), and penile deformity following radical ...prostatectomy (RP) have received increasing attention from researchers.
The aim of this study is to describe the prevalence and predictors of the above‐mentioned side effects.
This was a cross‐sectional questionnaire‐based study among men who had undergone RP between 3 and 36 months prior to study inclusion. Predicting factors were identified through logistic regression analyses.
The primary outcome measures were prevalence rates of the above‐mentioned side effects.
Overall, 316 questionnaires were available for analyses. Of the sexually active patients (n = 256), 12 (5%) reported anorgasmia, whereas 153 (60%) reported decreased orgasm intensity. Delayed orgasms were reported by 146 (57%). Twenty‐three patients (10%) had experienced pain during orgasm. UI during sexual activity were reported by 99 patients (38%). Out of the whole population, 77 patients (25%) reported sensory changes in the penis. A total of 143 patients (47%) reported a subjective loss of penile length of >1 cm. An altered curvature of the penis was reported by 30 patients (10%). Patients had increasing risk of UI during sexual activity (odds ratio OR 1.17; 95% confidence interval CI 1.10–1.25) and orgasmic dysfunction (OR 1.09; 95% CI 1.01–1.16) with increasing International Consultation on Incontinence Questionnaire scores. Erectile dysfunction (OR 1.81; 95% CI 1.07–3.10) and a high body mass index (OR 1.10; 95% CI 1.02–1.19) increased the risk of PS after RP. Nerve‐sparing (OR 0.32; 95% CI 0.16–0.95) reduced the risk of PS.
Orgasm‐associated problems, UI during sexual activity, penile sensory changes, PS, and penile deformity are common side effects to RP. Daytime UI, erectile dysfunction, and nerve‐sparing status can help identify patients at risk. Frey A, Sønksen J, Jakobsen H, and Fode M. Prevalence and predicting factors for commonly neglected sexual side effects to radical prostatectomies: Results from a cross‐sectional questionnaire‐based study. J Sex Med 2014;11:2318‐2326.
Post-orgasmic illness syndrome (POIS) is a rare disorder associated with a debilitating symptoms post-ejaculation associated with significant impairment in quality of life. The mechanism of the ...disease is unclear, but hypersensitivity to semen and/or seminal fluid has been postulated. We present a case of POIS successfully treated with omalizumab suggesting a possible role for this therapy in POIS treatment and management.
Orgasm-associated incontinence, climacturia, is one of the lesser studied radical prostatectomy (RP) complications. Little is known about patient bother related to this condition, specifically, its ...prevalence and predictors.
To ascertain the prevalence and predictors of patient bother associated with climacturia.
Patients presenting for the evaluation of sexual dysfunction after RP at a single center were queried on various domains of sexual dysfunction. This included orgasmic dysfunction and sexual incontinence (including climacturia and arousal incontinence). Patients were specifically asked about the frequency and amount of climacturia. In addition, questions addressed patient bother and the perceived bother of their partners. Descriptive statistics were used for patient characteristics. A t-test was used for comparing the frequency of patient and partner bother, and the Pearson correlation test compared relationships between bother and predictors. Multivariable analysis was conducted to define predictors of climacturia-associated bother.
The main outcome measures was the prevalence and predictors of climacturia-associated patient bother and perceived partner bother.
Climacturia was reported by 23% of 3,207 consecutive men analyzed. Bother of any degree was experienced by 45% of these patients, and 14% reported partner bother related to this condition. Patient bother was associated with perceived partner bother (P < .001) and inversely correlated with relationship duration (P < .001). The overall frequency and quantity of climacturia were also predictive (P < .001 for both). In the adjusted model, all of these factors remained significant.
Given the prevalence of this condition and the bother associated with it, this complication should be discussed with patients preoperatively.
Strengths include a large study population and specific questions on climacturia-associated bother. Limitations include the fact that it is a single-center study and no direct partner questioning occurred.
Climacturia and its associated bother are common after RP. The predictors of patient bother include perceived partner bother, shorter relationship duration, and increasing frequency and quantity of climacturia. Salter CA, Bach PV, Miranda E, et al. Bother Associated With Climacturia After Radical Prostatectomy: Prevalence and Predictors. J Sex Med 2020;17:731-736.
Research and clinical data have shown that couples with sexual problems report a lack of sexual communication. However, no published meta-analyses have evaluated the relationship between sexual ...communication and sexual function. This meta-analysis examines the correlation between couples' sexual communication and dimension of sexual function across 48 studies. Sexual communication was positively associated with sexual desire (r = .16), sexual arousal (r = .21), lubrication (r = .17), orgasm (r = .23), erectile function (r = .19), less pain (r = .12), and overall sexual function (r = .35). The effect sizes for sexual desire (r = .21; r = .12) and orgasm (r = .26; r = .16) were higher for women than for men. For overall sexual function, studies with married participants (r = .47) had a larger effect size than studies with participants with multiple relationship types (r = .31) or than studies with dating participants (r = .11). Effect sizes were larger for studies conducted outside of the United States (r = .39) compared to studies conducted in the United States (r = .12). We discuss the importance of addressing the relationship between sexual communication and sexual function, as well as future directions for research in this area.
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