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'Complete' Spinal Cord Injury Does Not Block Perceptual Responses to Genital Self-stimulation in Women

'Complete' Spinal Cord Injury Does Not Block Perceptual Responses to Genital Self-stimulation in... Abstract Background: A priori hypothesis: vaginal and/or cervical self-stimulation will not produce perceptual responses in women with "complete" spinal cord injury (SCI) at or above the highest level of entry of the hypogastric nerves (T10-12) but will produce perceptual responses if SCI is below T-10. Design: Women with complete SCI were assigned to a group with "upper" (T-10 and/or above) (n=6) or "lower" (below T-10) (n=10) SCI; uninjured women (n=5) constituted a control group. Perceptual response to vaginal and/or cervical self-stimulation was quantified as magnitude of analgesia to calibrated finger compressive force. Setting: Rutgers, The State University of New Jersey, Human Physiology Laboratory, College of Nursing, Newark. Participants: Consecutive samples of first 16 of 34 women with SCI who responded to nationwide advertisements, met inclusion criteria, and volunteered; control group was the first 5 respondents. Intervention: Vaginal or cervical (cervix uteri) self-stimulation applied for 12 minutes, interspersed with non-stimulation periods, while measuring analgesia. Main Outcome Measure: Quantify analgesia magnitude to vaginal or cervical self-stimulation. Results: Significant analgesia was produced in the un-injured group and the group with lower SCI, supporting the hypothesis. Unexpectedly, significant analgesia was also produced in the group with upper SCI. Women in the group with upper SCI also experienced menstrual discomfort, awareness of vaginal and/or cervical stimulation per se, and orgasms. Conclusions: (1) Genitospinal visceral afferent pathways function in the women in the group with upper SCI, although unrecognized by the American Spinal Injury Association criteria, and/or (2) there exists a functional genital afferent pathway that bypasses the spinal cord and projects directly to the brain, which we propose to be via the vagus nerves. References 1. American Spinal Injury Association. Standards for Neurological and Functional Classification of Spinal Cord Injury, Revised . Chicago, Ill: American Spinal Injury Association; 1992. 2. Bonica JJ. Principles and Practices of Obstetric Analgesia and Anesthesia . Philadelphia, Pa: FA Davis Co Publishers; 1967. 3. Netter FH. Autonomic nervous system . In: The Ciba Collection of Medical Illustrations: Vol 1 Nervous System, Part I: Anatomy and Physiology . Summit, NJ: Ciba Pharmaceutical Co; 1986:89. 4. Berard EJJ. The sexuality of spinal cord injured women: physiology and pathophysiology—a review . Paraplegia . 1989;27:99-112.Crossref 5. Komisaruk BR, Adler NT, Hutchison J. Genital sensory field: enlargement by estrogen treatment in female rats . Science . 1972;178:1295-1298.Crossref 6. Peters LC, Kristal MB, Komisaruk BR. Sensory innervation of the external and internal genitalia of the female rat . Brain Res . 1987;408:199-204.Crossref 7. Berkley KJ, Hotta H, Robbins A, Sato Y. Functional properties of afferent fibers supplying reproductive and other pelvic organs in pelvic nerve of female rats . J Neurophysiol . 1990;63:256-272. 8. Komisaruk BR, Wallman J. Blockage of pain responses in thalamic neurons by mechanical stimulation of the vagina in rats . Soc Neurosci . 1973;3:315. Abstract. 9. Komisaruk BR, Wallman J. Antinociceptive effects of vaginal stimulation in rats: neurophysiological and behavioral studies . Brain Res . 1977;137:85-107.Crossref 10. Komisaruk BR, Whipple B. Evidence that vaginal self-stimulation in women suppresses experimentally induced finger pain . Soc Neurosci . 1984;10:675. Abstract. 11. Whipple B, Komisaruk BR. Elevation of pain threshold by vaginal stimulation in women . Pain . 1985;21:357-367.Crossref 12. Whipple B, Komisaruk BR. Current Research Trends: Spinal Cord Injuries . Baltimore, Md: Brookes Publishing Co; 1992:197-207. 13. Whipple B, Komisaruk BR. Analgesia produced in women by genital self-stimulation . J Sex Res . 1988;24:130-140.Crossref 14. Whipple B, Martinez-Gomez M, Oliva-Zarate L, Pacheco P, Komisaruk BR. Inverse relationship between intensity of vaginal self-stimulation-produced analgesia and level of chronic intake of a dietary source of capsaicin . Physiol Behav . 1989;46:247-252.Crossref 15. Komisaruk BR, Larsson K. Suppression of a spinal and a cranial nerve reflex by vaginal or rectal probing in rats . Brain Res . 1971;35:231-235.Crossref 16. Pacheco P, Beyer G, Mexicano G, Larsson K. Effects of genital stimulation upon spinal reflex activity of female cats under various hormonal conditions . Physiol Behav . 1976;17:699-703.Crossref 17. Cueva-Rolon R, Munoz-Martinez EJ, Delgado-Lezama R, Raya G. Prolonged inhibition of the flexor reflex by probing the cervix uteri in the cat . Brain Res . 1993; 600:27-32.Crossref 18. Szechtman H, Adler NT, Komisaruk BR. Mating induces pupillary dilatation in female rats: role of pelvic nerve . Physiol Behav . 1985;35:295-301.Crossref 19. Whipple B, Ogden G, Komisaruk BR. Physiological correlates of imageryinduced orgasm in women . Arch Sex Behav . 1992;21:121-133.Crossref 20. Catelli JJ, Sved AF, Komisaruk BR. Vaginocervical stimulation elevates blood pressure and induces analgesia by separate mechanisms . Physiol Behav . 1987;41:609-612.Crossref 21. Whipple B, Gerdes CA, Komisaruk BR. Sexual response to self-stimulation in women with complete spinal cord injury . J Sex Res . 1996;33:231-240.Crossref 22. Cunningham ST, Steinman JL, Whipple B, Mayer AD, Komisaruk BR. Differential roles of hypogastric and pelvic nerves in the analgesic and motoric effects of vaginocervical stimulation in rats . Brain Res . 1991;559:337-343.Crossref 23. Gomora P, Beyer C, Gonzalez-Mariscal G, Komisaruk BR. Momentary analgesia produced by copulation in female rats . Brain Res . 1994;656:52-58.Crossref 24. Cueva-Rolon R, Sansone G, Bianca R, et al. Vagotomy blocks responses to vaginocervical stimulation in genitospinal-neurectomized rats . Physiol Behav . 1996; 60:19-24.Crossref 25. Erskine MS. Pelvic and pudendal nerves influence the display of paced mating behavior in response to estrogen and progesterone in the female rat . Behav-Neurosci . 1992;106:690-697.Crossref 26. Perduta-Fulginiti PS. Sexual functioning of women with complete spinal cord injury: nursing implications . Sex Disability . 1992;10:103-118.Crossref 27. Szasz G. Sexual health care . In: Zejdlik CP, ed. Management of Spinal Cord Injury . 2nd ed. Boston, Mass: Jones & Bartlett Publishers; 1992:175-201. 28. Cole T. Sexuality and physical disabilities . Arch Sex Behav . 1975;4:389-403.Crossref 29. Kettl P, Zarefoss S, Jacoby K, et al. Female sexuality after spinal cord injury . Sex Disability . 1991;9:287-295.Crossref 30. Sipski M, Alexander C. Sexual activities, response and satisfaction in women preand post-spinal cord injury . Arch Phys Med Rehabil . 1993;74:1025-1029.Crossref 31. Sipski M, Alexander C, Rosen R. Orgasm in women with spinal cord injuries: a laboratory-based assessment . Arch Phys Med Rehabil . 1995;76:1097-1102.Crossref 32. Fitting M, Davies N. Self-concept and sexuality of spinal cord injured women . Arch Sex Behav . 1978;7:143-156.Crossref 33. Bregman S, Hadley RG. Sexual adjustment and feminine attractiveness among spinal cord injured women . Arch Phys Med . 1976;57:448-450. 34. Jackson R. Sexual rehabilitation after cord injury . Paraplegia . 1972;10:50-55.Crossref 35. Axel SJ. Spinal cord injured women's concerns: menstruation and pregnancy . Rehabil Nurs . 1982;7:10-15.Crossref 36. Derogatis LR. SCL-90-R Administration, Scoring and Procedures Manual . Towson, Md: Clinical Psychometric Research; 1983. 37. Richards E, Tepper M, Whipple B, Komisaruk BR. Women with complete spinal cord injury: a phenomenological study of sexuality and relationship experiences. Sex Disability. In press. 38. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . Washington, DC: American Psychiatric Association; 1994. 39. Komisaruk BR, Whipple B. Complete spinal cord injury does not block perceptual responses to vaginal or cervical self-stimulation in women . Soc Neurosci . 1994;20:961. Abstract. 40. Money J. Phantom orgasm in the dreams of paraplegic men and women . Arch Gen Psychiatry . 1960:3:373-382.Crossref 41. Schachter S. The Interaction of Cognitive and Physiological Determinants of Emotional State . Orlando, Fla: Academic Press Inc; 1964. 42. Moody KM, Steinman JL, Komisaruk BR, Adler NT. Pelvic neurectomy blocks oxytocin-facilitated sexual receptivity in rats . Physiol Behav . 1994;56:1057-1060.Crossref 43. Zamir N, Maixner W. The relationship between cardiovascular and pain regulatory systems . Ann N Y Acad Sci . 1986;467:371-384.Crossref 44. Zamir N, Segal M. Hypertension-induced analgesia: changes in pain sensitivity in experimental hypertensive rats . Brain Res . 1979;184:299-310.Crossref 45. Guttmann C, Frankel H, Paeslack V. Cardiac irregularities during labour in paraplegic women . Paraplegia . 1965;3:144-151.Crossref 46. Ortega-Villalobos M, Garcia-Bazan M, Solano-Flores LP, et al. Vagus nerve afferent and efferent innervation of the rat uterus: an electrophysiological and HRP study . Brain Res Bull . 1990;25:365-371.Crossref 47. Komisaruk BR, Bianca R, Sansone G, et al. Brain-mediated responses to vaginocervical stimulation in spinal cord-transected rats: role of the vagus nerves . Brain Res . 1996;708:128-134.Crossref 48. Randich A, Aicher SA. Medullary substrates mediating antinociception produced by electrical stimulation of the vagus . Brain Res . 1988;445:68-76.Crossref 49. Ren K, Randich A, Gebhart GF. Vagal afferent modulation of a nociceptive reflex in rats: involvement of spinal opioid and monoamine receptors . Brain Res . 1988; 44:285-294.Crossref 50. Komisaruk BR, Whipple B. The suppression of pain by genital stimulation in females . Ann Rev Sex Res . 1995;6:151-186. 51. Sipski ML, Alexander CJ. Spinal cord injury and female sexuality . Ann Rev Sex Res . 1995;6:224-244. 52. Appenzeller O. Autonomic function, its pathophysiology and clinical assessment in paraplegia and tetraplegia . In: The Autonomic Nervous System: An Introduction to Basic and Clinical Concepts . 4th ed. New York, NY: Elsevier Science Inc; 1990:509-522. 53. Sun W-M, Macdonagh R, Forster D, Thomas D, Smallwood R, Read N. Anorectal function in patients with complete spinal transection before and after sacral posterior rhizotomy . Gastroenterology . 1995;108:990-998.Crossref 54. Cowey A. Blindsight in real sight . Nature . 1995;377:290-291.Crossref 55. Kolb FC, Braun J. Blindsight in normal observers . Nature . 1995;377:336-338.Crossref 56. Stoerig P. Sources of blindsight . Science . 1993;261:493.Crossref 57. Bors E, Comarr A. Neurological disturbances of sexual function with special reference to 529 patients with spinal cord injury . Urol Surv . 1960;110:191-222. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

'Complete' Spinal Cord Injury Does Not Block Perceptual Responses to Genital Self-stimulation in Women

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References (60)

Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1997.00550240063014
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Abstract

Abstract Background: A priori hypothesis: vaginal and/or cervical self-stimulation will not produce perceptual responses in women with "complete" spinal cord injury (SCI) at or above the highest level of entry of the hypogastric nerves (T10-12) but will produce perceptual responses if SCI is below T-10. Design: Women with complete SCI were assigned to a group with "upper" (T-10 and/or above) (n=6) or "lower" (below T-10) (n=10) SCI; uninjured women (n=5) constituted a control group. Perceptual response to vaginal and/or cervical self-stimulation was quantified as magnitude of analgesia to calibrated finger compressive force. Setting: Rutgers, The State University of New Jersey, Human Physiology Laboratory, College of Nursing, Newark. Participants: Consecutive samples of first 16 of 34 women with SCI who responded to nationwide advertisements, met inclusion criteria, and volunteered; control group was the first 5 respondents. Intervention: Vaginal or cervical (cervix uteri) self-stimulation applied for 12 minutes, interspersed with non-stimulation periods, while measuring analgesia. Main Outcome Measure: Quantify analgesia magnitude to vaginal or cervical self-stimulation. Results: Significant analgesia was produced in the un-injured group and the group with lower SCI, supporting the hypothesis. Unexpectedly, significant analgesia was also produced in the group with upper SCI. Women in the group with upper SCI also experienced menstrual discomfort, awareness of vaginal and/or cervical stimulation per se, and orgasms. Conclusions: (1) Genitospinal visceral afferent pathways function in the women in the group with upper SCI, although unrecognized by the American Spinal Injury Association criteria, and/or (2) there exists a functional genital afferent pathway that bypasses the spinal cord and projects directly to the brain, which we propose to be via the vagus nerves. References 1. American Spinal Injury Association. Standards for Neurological and Functional Classification of Spinal Cord Injury, Revised . Chicago, Ill: American Spinal Injury Association; 1992. 2. Bonica JJ. Principles and Practices of Obstetric Analgesia and Anesthesia . Philadelphia, Pa: FA Davis Co Publishers; 1967. 3. Netter FH. Autonomic nervous system . In: The Ciba Collection of Medical Illustrations: Vol 1 Nervous System, Part I: Anatomy and Physiology . Summit, NJ: Ciba Pharmaceutical Co; 1986:89. 4. Berard EJJ. The sexuality of spinal cord injured women: physiology and pathophysiology—a review . Paraplegia . 1989;27:99-112.Crossref 5. Komisaruk BR, Adler NT, Hutchison J. Genital sensory field: enlargement by estrogen treatment in female rats . Science . 1972;178:1295-1298.Crossref 6. Peters LC, Kristal MB, Komisaruk BR. Sensory innervation of the external and internal genitalia of the female rat . Brain Res . 1987;408:199-204.Crossref 7. Berkley KJ, Hotta H, Robbins A, Sato Y. Functional properties of afferent fibers supplying reproductive and other pelvic organs in pelvic nerve of female rats . J Neurophysiol . 1990;63:256-272. 8. Komisaruk BR, Wallman J. Blockage of pain responses in thalamic neurons by mechanical stimulation of the vagina in rats . Soc Neurosci . 1973;3:315. Abstract. 9. Komisaruk BR, Wallman J. Antinociceptive effects of vaginal stimulation in rats: neurophysiological and behavioral studies . Brain Res . 1977;137:85-107.Crossref 10. Komisaruk BR, Whipple B. Evidence that vaginal self-stimulation in women suppresses experimentally induced finger pain . Soc Neurosci . 1984;10:675. Abstract. 11. Whipple B, Komisaruk BR. Elevation of pain threshold by vaginal stimulation in women . Pain . 1985;21:357-367.Crossref 12. Whipple B, Komisaruk BR. Current Research Trends: Spinal Cord Injuries . Baltimore, Md: Brookes Publishing Co; 1992:197-207. 13. Whipple B, Komisaruk BR. Analgesia produced in women by genital self-stimulation . J Sex Res . 1988;24:130-140.Crossref 14. Whipple B, Martinez-Gomez M, Oliva-Zarate L, Pacheco P, Komisaruk BR. Inverse relationship between intensity of vaginal self-stimulation-produced analgesia and level of chronic intake of a dietary source of capsaicin . Physiol Behav . 1989;46:247-252.Crossref 15. Komisaruk BR, Larsson K. Suppression of a spinal and a cranial nerve reflex by vaginal or rectal probing in rats . Brain Res . 1971;35:231-235.Crossref 16. Pacheco P, Beyer G, Mexicano G, Larsson K. Effects of genital stimulation upon spinal reflex activity of female cats under various hormonal conditions . Physiol Behav . 1976;17:699-703.Crossref 17. Cueva-Rolon R, Munoz-Martinez EJ, Delgado-Lezama R, Raya G. Prolonged inhibition of the flexor reflex by probing the cervix uteri in the cat . Brain Res . 1993; 600:27-32.Crossref 18. Szechtman H, Adler NT, Komisaruk BR. Mating induces pupillary dilatation in female rats: role of pelvic nerve . Physiol Behav . 1985;35:295-301.Crossref 19. Whipple B, Ogden G, Komisaruk BR. Physiological correlates of imageryinduced orgasm in women . Arch Sex Behav . 1992;21:121-133.Crossref 20. Catelli JJ, Sved AF, Komisaruk BR. Vaginocervical stimulation elevates blood pressure and induces analgesia by separate mechanisms . Physiol Behav . 1987;41:609-612.Crossref 21. Whipple B, Gerdes CA, Komisaruk BR. Sexual response to self-stimulation in women with complete spinal cord injury . J Sex Res . 1996;33:231-240.Crossref 22. Cunningham ST, Steinman JL, Whipple B, Mayer AD, Komisaruk BR. Differential roles of hypogastric and pelvic nerves in the analgesic and motoric effects of vaginocervical stimulation in rats . Brain Res . 1991;559:337-343.Crossref 23. Gomora P, Beyer C, Gonzalez-Mariscal G, Komisaruk BR. Momentary analgesia produced by copulation in female rats . Brain Res . 1994;656:52-58.Crossref 24. Cueva-Rolon R, Sansone G, Bianca R, et al. Vagotomy blocks responses to vaginocervical stimulation in genitospinal-neurectomized rats . Physiol Behav . 1996; 60:19-24.Crossref 25. Erskine MS. Pelvic and pudendal nerves influence the display of paced mating behavior in response to estrogen and progesterone in the female rat . Behav-Neurosci . 1992;106:690-697.Crossref 26. Perduta-Fulginiti PS. Sexual functioning of women with complete spinal cord injury: nursing implications . Sex Disability . 1992;10:103-118.Crossref 27. Szasz G. Sexual health care . In: Zejdlik CP, ed. Management of Spinal Cord Injury . 2nd ed. Boston, Mass: Jones & Bartlett Publishers; 1992:175-201. 28. Cole T. Sexuality and physical disabilities . Arch Sex Behav . 1975;4:389-403.Crossref 29. Kettl P, Zarefoss S, Jacoby K, et al. Female sexuality after spinal cord injury . Sex Disability . 1991;9:287-295.Crossref 30. Sipski M, Alexander C. Sexual activities, response and satisfaction in women preand post-spinal cord injury . Arch Phys Med Rehabil . 1993;74:1025-1029.Crossref 31. Sipski M, Alexander C, Rosen R. Orgasm in women with spinal cord injuries: a laboratory-based assessment . Arch Phys Med Rehabil . 1995;76:1097-1102.Crossref 32. Fitting M, Davies N. Self-concept and sexuality of spinal cord injured women . Arch Sex Behav . 1978;7:143-156.Crossref 33. Bregman S, Hadley RG. Sexual adjustment and feminine attractiveness among spinal cord injured women . Arch Phys Med . 1976;57:448-450. 34. Jackson R. Sexual rehabilitation after cord injury . Paraplegia . 1972;10:50-55.Crossref 35. Axel SJ. Spinal cord injured women's concerns: menstruation and pregnancy . Rehabil Nurs . 1982;7:10-15.Crossref 36. Derogatis LR. SCL-90-R Administration, Scoring and Procedures Manual . Towson, Md: Clinical Psychometric Research; 1983. 37. Richards E, Tepper M, Whipple B, Komisaruk BR. Women with complete spinal cord injury: a phenomenological study of sexuality and relationship experiences. Sex Disability. In press. 38. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition . Washington, DC: American Psychiatric Association; 1994. 39. Komisaruk BR, Whipple B. Complete spinal cord injury does not block perceptual responses to vaginal or cervical self-stimulation in women . Soc Neurosci . 1994;20:961. Abstract. 40. Money J. Phantom orgasm in the dreams of paraplegic men and women . Arch Gen Psychiatry . 1960:3:373-382.Crossref 41. Schachter S. The Interaction of Cognitive and Physiological Determinants of Emotional State . Orlando, Fla: Academic Press Inc; 1964. 42. Moody KM, Steinman JL, Komisaruk BR, Adler NT. Pelvic neurectomy blocks oxytocin-facilitated sexual receptivity in rats . Physiol Behav . 1994;56:1057-1060.Crossref 43. Zamir N, Maixner W. The relationship between cardiovascular and pain regulatory systems . Ann N Y Acad Sci . 1986;467:371-384.Crossref 44. Zamir N, Segal M. Hypertension-induced analgesia: changes in pain sensitivity in experimental hypertensive rats . Brain Res . 1979;184:299-310.Crossref 45. Guttmann C, Frankel H, Paeslack V. Cardiac irregularities during labour in paraplegic women . Paraplegia . 1965;3:144-151.Crossref 46. Ortega-Villalobos M, Garcia-Bazan M, Solano-Flores LP, et al. Vagus nerve afferent and efferent innervation of the rat uterus: an electrophysiological and HRP study . Brain Res Bull . 1990;25:365-371.Crossref 47. Komisaruk BR, Bianca R, Sansone G, et al. Brain-mediated responses to vaginocervical stimulation in spinal cord-transected rats: role of the vagus nerves . Brain Res . 1996;708:128-134.Crossref 48. Randich A, Aicher SA. Medullary substrates mediating antinociception produced by electrical stimulation of the vagus . Brain Res . 1988;445:68-76.Crossref 49. Ren K, Randich A, Gebhart GF. Vagal afferent modulation of a nociceptive reflex in rats: involvement of spinal opioid and monoamine receptors . Brain Res . 1988; 44:285-294.Crossref 50. Komisaruk BR, Whipple B. The suppression of pain by genital stimulation in females . Ann Rev Sex Res . 1995;6:151-186. 51. Sipski ML, Alexander CJ. Spinal cord injury and female sexuality . Ann Rev Sex Res . 1995;6:224-244. 52. Appenzeller O. Autonomic function, its pathophysiology and clinical assessment in paraplegia and tetraplegia . In: The Autonomic Nervous System: An Introduction to Basic and Clinical Concepts . 4th ed. New York, NY: Elsevier Science Inc; 1990:509-522. 53. Sun W-M, Macdonagh R, Forster D, Thomas D, Smallwood R, Read N. Anorectal function in patients with complete spinal transection before and after sacral posterior rhizotomy . Gastroenterology . 1995;108:990-998.Crossref 54. Cowey A. Blindsight in real sight . Nature . 1995;377:290-291.Crossref 55. Kolb FC, Braun J. Blindsight in normal observers . Nature . 1995;377:336-338.Crossref 56. Stoerig P. Sources of blindsight . Science . 1993;261:493.Crossref 57. Bors E, Comarr A. Neurological disturbances of sexual function with special reference to 529 patients with spinal cord injury . Urol Surv . 1960;110:191-222.

Journal

Archives of Neurology – American Medical Association

Published: Dec 1, 1997

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