Third Annual Female Sexual Function Forum: New Perspectives in the Management of Female Sexual Dysfunction

Lorraine Dennerstein, AO, MBBS, PhD, DPM, FRANZCP

Disclosures

December 05, 2000

In This Article

Anatomy

Masters and Johnson were able to assess anatomic changes occurring with physiologic arousal in women by using an artificial penis and a transparent speculum.[9] The development of new technologies has enabled scientists for the first time to obtain a true depiction of the relative positions of female and male genital organs during coitus in different positions. Dr. Antoine Faix of the Clinique Beausoleil, Montpellier, France, presented actual anatomic visualizations of sexual intercourse using magnetic resonance imaging (MRI) to the awestruck audience. He was able to compare images obtained between missionary and rear-entry positions with the same couple. The male took 50 mg of sildenafil to enhance the erection. Interesting observations in the missionary position were the 75% lengthening of the vaginal wall and vaginal tenting and the boomerang shape of the penis inside the vagina. In the missionary position, there is a preferential contact of the penis and its glans with the anterior vaginal fornix and wall, with upward and forward movement of the uterus and a raising of the bladder neck and the urethra. In the rear-entry position, there is a preferential contact of the penis with the posterior wall of the vagina, the rectum, the cervix, and probably the posterior fornix.

Clearly, further research evidence is needed to replicate the findings of Dr. Faix and the postulated implications for clinicians.

Blood-oxygenated level-dependent functional MRI was used by Dr. Kwansung Park[19] of the Chonnam National University Medical School, Kwangju, Korea, to find the cerebral centers activated by female sexual arousal. The 6 healthy women volunteers were visualized in this technique while they viewed both erotic and nonerotic films. The visual cortex was activated by both types of films. During erotic stimulation, two thirds of the subjects showed activation in the areas of inferior frontal lobe, cingulate gyrus, insula gyrus, corpus callosum, thalamus, caudate nucleus, globus pallidus, and inferior temporal lobe.

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