Neuropsychologia 45 (2007) 2645–2659
Reviews and perspectives
Toward an understanding of the cerebral
substrates of woman’s orgasm
Francesco Bianchi-Demicheli
a,b
, Stephanie Ortigue
c,d,∗
a
Psychosomatic Gynaecology and Sexology Unit, Emergency and Liaison Services, Geneva University Psychiatric Centre, Switzerland
b
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, University Hospital of Geneva, Switzerland
c
Dartmouth Brain Imaging Center, Department of Psychology and Brain Sciences, Center for Cognitive Neuroscience, Dartmouth College, NH, USA
d
Sage Center for the Study of the Mind, Department of Psychology, University of California Santa Barbara, Santa Barbara, CA, USA
Received 1 June 2006; received in revised form 7 April 2007; accepted 13 April 2007
Available online 4 May 2007
Abstract
The way women experience orgasm is of interest to scientists, clinicians, and laypeople. Whereas the origin and the function of a woman’s
orgasm remains controversial, the current models of sexual function acknowledge a combined role of central (spinal and cerebral) and peripheral
processes during orgasm experience. At the central level, although it is accepted that the spinal cord drives orgasm, the cerebral involvement
and cognitive representation of a woman’s orgasm has not been extensively investigated. Important gaps in our knowledge remain. Recently,
the astonishing advances of neuroimaging techniques applied in parallel with a neuropsychological approach allowed the unravelling of specific
functional neuroanatomy of a woman’s orgasm. Here, clinical and experimental findings on the cortico-subcortical pathway of a woman’s orgasm
are reviewed and compared with the neural basis of a man’s orgasm. By defining the specific brain areas that sustain the assumed higher-
order representation of a woman’s orgasm, this review provides a foundation for future studies. The next challenge of functional imaging and
neuropsychological studies is to understand the hierarchical interactions between these multiple cortical areas, not only with a correlation analysis but
also with high spatio-temporal resolution techniques demonstrating the causal necessity, the temporal time course and the direction of the causality.
Further studies using a multi-disciplinary approach are needed to identify the spatio-temporal dynamic of a woman’s orgasm, its dysfunctions and
possible new treatments.
© 2007 Elsevier Ltd. All rights reserved.
Keywords: Social cognitive neuroscience; Women; Sexual function; Orgasm; Functional imaging; Brain; Gender differences; Cognitive functions
Contents
1. Introduction ........................................................................................................... 2646
2. Definition of a woman’s orgasm ......................................................................................... 2646
3. Manifestations of a woman’s orgasm ..................................................................................... 2646
4. Inter- and intra-individual differences of a woman’s orgasm: a cognitive differentiation?....................................... 2647
5. Spinal and supraspinal influences on the mediation of a woman’s orgasm .................................................... 2648
5.1. Modulation of woman’s orgasm response by the spinal cord .......................................................... 2649
5.2. Modulation of spinal reflexes by supraspinal sites ................................................................... 2649
6. Neuroendocrine influences on a woman’s orgasm.......................................................................... 2649
7. The cortex and limbic system ........................................................................................... 2650
7.1. Neurological case reports ......................................................................................... 2650
7.2. Functional brain imaging in healthy participants .................................................................... 2653
∗
Corresponding author at: Sage Center for the Study of the Mind, Department of Psychology, University of California Santa Barbara, Santa Barbara, CA, USA.
E-mail address: ortigue@psych.ucsb.edu (S. Ortigue).
0028-3932/$ – see front matter © 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.neuropsychologia.2007.04.016