Physiology of normal sexual function
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
Genital arousal Physiological sexual arousal in both humans and animals can be defined as an increase of autonomic activation that prepares the body for sexual activity and decreases the amount of sexual stimulation necessary to induce orgasm. In women, first studies focused on extragenital measures such as heart rate, respiration, blood pressure, sweat production, and body temperature, considered as indexes of sexual arousal.2 Then, methods measuring vaginal temperature30 and monitoring changes in clitoral and vaginal blood flow such as photoplethysmography measuring vaginal pulse amplitude,31 oxygenation-temperature method,32 and clitoral color Doppler ultrasonography33 have been developed. It has been shown that genital arousal results in an increase in blood flow to the vagina, clitoris, and labia mediated by the parasympathetic nervous system. The erectile tissue of the clitoris shows vasocongestion and tumescence, in the same way as does the penis. Sexual arousal is also associated with vaginal lubrication resulting from blood engorgement and increased epithelial capillary tufts permeability, also mediated by the parasympathetic nervous system.
Physical Aspects of the Sex Response
Philipa A Brough, Margaret Denman in Introduction to Psychosexual Medicine, 2019
There are six recognised phases of the male erectile process (Figure 5.6): Flaccid: The baseline, inactive, resting state. The penile blood content is largely venous in character.Latent (filling): This phase is evident in the early stages of arousal or pre-arousal. Some increased flow is evident in the pudendal artery. Some penile lengthening occurs.Tumescent: With increasing stimulus and arousal, the penis expands, elongates and may pulsate.Full erection: The penile blood content is now largely arterial in character, with intracavernosal pressure approaching systolic blood pressure.Skeletal or rigid: This phase occurs during orgasm and ejaculation and is of short duration. The ischiocavernosus muscle contracts and intracavernous pressure may exceed systolic blood pressure.Detumescent: This final phase occurs shortly after ejaculation, or more slowly following removal or cessation of erotic stimuli. Sympathetic nerve activity causes the contraction of smooth muscle surrounding the cavernosal sinusoids and arterioles. This phase ends with the return to the flaccid phase.
Erectile Dysfunction
Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh in Male Infertility in Reproductive Medicine, 2019
This neurovascular event results in dilatation of the arteries, expansion of the sinusoidal spaces, and an overall reduction in the peripheral vascular resistance. This results in a net inflow of blood into the penis, resulting in expansion or tumescence. The thick tunica albuginea surrounding the corporal bodies limits expansion and, therefore, increases intracorporal pressure. As pressure increases, venous outflow reduces, and once the emissary veins between the inner circular and outer longitudinal layers of the tunica are compressed, the full-erection stage is reached. Further increases in pressure are achieved by the contraction of the ischiocavernosus muscle [5].
Liposuction for large facial involuted infantile hemangiomas in children: clinical evaluation and management strategies
Published in Journal of Dermatological Treatment, 2021
Wei Gao, Yajing Qiu, Yunbo Jin, Xiaoxi Lin
Preoperatively, the incision and facial zones to be corrected by liposuction were marked. After induction with general anesthesia, a traditional tumescent technique was applied. The tumescence (20 ml of 2% lidocaine, 5 ml of epinephrine diluted 1:10,000, and 500 ml of saline solution) was infiltrated into the areas to be liposuctioned subcutaneously via cannulas through a small (1–3 mm) incisions. The total volume infused varied from one case to another, depending on the patient’s age, size, and estimated final aspirate. Proper tumescence will ensure smooth aspiration. Syringe-assisted liposuction with blunt-tipped 2- or 3-mm cannulas was performed in the subcutaneous plane above superficial musculoaponeurotic system (SMAS). The cannula was inserted into the lesion and swept through the zones to be corrected until clinical parameters such as symmetry were achieved (Figure 1, left). During the aspiration, surgeons gently palpated the skin to feel the tip position, while maintaining the depth of the cannula within the subcutaneous plane. To prevent contour irregularities, the cannula moved along a smooth, uniform, and radial pattern. Thus, we can sculpt the face and quantitate the amount of fat removed so that symmetry can be maintained (Figure 2(a,b)).
Quality of Life, Sexual Functioning and Chronic Disease: A Comparative Study with Portuguese Women without Chronic Disease, and Women with Diabetes Type 1 and 2, and Arterial Hypertension
Published in International Journal of Sexual Health, 2022
Maria Manuela Peixoto, Júlia Lopes, Ana Luísa Rodrigues
DM appears to put women at greater risk for sexual dysfunction (Bak et al., 2018; Bąk et al., 2021; Giraldi & Kristensen, 2010; Mezones-Holguin et al., 2008), as it can impair sexual arousal and, consequently, vaginal lubrication (Enzlin et al., 2003; Mezones-Holguin et al., 2008; Rutherford & Collier, 2005). Given the influence of DM on penile tumescence (Enzlin et al., 1998; Giraldi & Kristensen, 2010; Kizilay et al., 2017; Rutherford & Collier, 2005; Schiavi et al., 1995; Schreiner-Engel et al., 1985), it is possible that it also influences clitoral tumescence. However, the negative physiological influence is more significant in men (Rutherford & Collier, 2005), and less conclusive in women (Kizilay et al., 2017). Different pathophysiological mechanisms such as hyperglycemia (reduced hydration of mucous membranes in the vagina), microvascular damages and neuropathies may impair women’s sexual response (Enzlin, Mathieu, & Demytteanere, 2003; Giraldi & Kristensen, 2010; Rutherford & Collier, 2005; Schreiner-Engel et al., 1985).
Back to Stir It Up: Erectile Dysfunction in an Evolutionary, Developmental, and Clinical Perspective
Published in The Journal of Sex Research, 2019
Ylenia Nicolini, Antonella Tramacere, Stefano Parmigiani, Harold Dadomo
Human males lack a baculum (De Tejada, Goldstein, Azadzoi, Krane, & Cohen, 1989) or penile bone (or os penis), a particular bone formed by the ossification of the distal region of the corpora cavernosa and located above the distal end of the urethra (Romer & Parsons, 1962) (see Appendix A in the online supplementary files). Lacking the baculum, human penile erection relies essentially on a coordinated and arranged series of vascular events, a complex of interactions which works at multiple levels for achieving tumescence (Dean & Lue, 2005). The presence of multiple levels of control, from the central nervous system (CNS) to peripheral nerves, is common to many systems important for reproduction, as relying on a single process would make the species vulnerable to extinction (De Tejada et al., 1988).
Related Knowledge Centers
- Vasocongestion
- Clitoris
- Blood
- Erectile Tissue
- Sexual Arousal
- Sexual Activity
- Penis
- Bulb of Vestibule
- Erection
- Clitoral Erection