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Mahapatra C, Kumar R. Biophysical Mechanisms of Vaginal Smooth Muscle Contraction: The Role of the Membrane Potential and Ion Channels. PATHOPHYSIOLOGY 2024; 31:225-243. [PMID: 38804298 PMCID: PMC11130850 DOI: 10.3390/pathophysiology31020018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
The vagina is an essential component of the female reproductive system and is responsible for providing female sexual satisfaction. Vaginal smooth muscle contraction plays a crucial role in various physiological processes, including sexual arousal, childbirth, and urinary continence. In pathophysiological conditions, such as pelvic floor disorders, aberrations in vaginal smooth muscle function can lead to urinary incontinence and pelvic organ prolapse. A set of cellular and sub-cellular physiological mechanisms regulates the contractile properties of the vaginal smooth muscle cells. Calcium influx is a crucial determinant of smooth muscle contraction, facilitated through voltage-dependent calcium channels and calcium release from intracellular stores. Comprehensive reviews on smooth muscle biophysics are relatively scarce within the scientific literature, likely due to the complexity and specialized nature of the topic. The objective of this review is to provide a comprehensive description of alterations in the cellular physiology of vaginal smooth muscle contraction. The benefit associated with this particular approach is that conducting a comprehensive examination of the cellular mechanisms underlying contractile activation will enable the creation of more targeted therapeutic agents to control vaginal contraction disorders.
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Affiliation(s)
- Chitaranjan Mahapatra
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA 94158, USA
- Paris Saclay Institute of Neuroscience, 91440 Saclay, France
| | - Ravinder Kumar
- Department of Pathology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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Clark-Patterson GL, Buchanan LM, Ogola BO, Florian-Rodriguez M, Lindsey SH, De Vita R, Miller KS. Smooth muscle contribution to vaginal viscoelastic response. J Mech Behav Biomed Mater 2023; 140:105702. [PMID: 36764168 DOI: 10.1016/j.jmbbm.2023.105702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/22/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
Smooth muscle cells contribute to the mechanical function of various soft tissues, however, their contribution to the viscoelastic response when subjected to multiaxial loading remains unknown. The vagina is a fibromuscular viscoelastic organ that is exposed to prolonged and increased pressures with daily activities and physiologic processes such as vaginal birth. The vagina changes in geometry over time under prolonged pressure, known as creep. Vaginal smooth muscle cells may contribute to creep. This may be critical for the function of vaginal and other soft tissues that experience fluctuations in their biomechanical environment. Therefore, the objective of this study was to develop methods to evaluate the contribution of smooth muscle to vaginal creep under multiaxial loading using extension - inflation tests. The vaginas from wildtype mice (C57BL/6 × 129SvEv; 3-6 months; n = 10) were stimulated with various concentrations of potassium chloride then subjected to the measured in vivo pressure (7 mmHg) for 100 s. In a different cohort of mice (n = 5), the vagina was stimulated with a single concentration of potassium chloride then subjected to 5 and 15 mmHg. A laser micrometer measured vaginal outer diameter in real-time. Immunofluorescence evaluated the expression of alpha-smooth muscle actin and myosin heavy chain in the vaginal muscularis (n = 6). When smooth muscle contraction was activated, vaginal creep behavior increased compared to the relaxed state. However, increased pressure decreased the active creep response. This study demonstrated that extension - inflation protocols can be used to evaluate smooth muscle contribution to the viscoelastic response of tubular soft tissues.
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Affiliation(s)
| | - Lily M Buchanan
- University of Texas at Dallas, Department of Bioengineering, 800 W. Campbell Road, Richardson, TX, 75080, USA.
| | - Benard O Ogola
- Augusta University, Vascular Biology Center, Medical College of Georgia at Augusta University, 1460 Laney Walker Blvd, Augusta, GA, 30912, USA.
| | - Maria Florian-Rodriguez
- University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery and Cecil H and Ida Green Center for Reproductive Biological Sciences, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9032, USA.
| | - Sarah H Lindsey
- Tulane University School of Medicine, Department of Pharmacology, 1430 Tulane Ave, New Orleans, LA, 70112, USA.
| | - Raffaella De Vita
- Virginia Tech,Department of Biomedical Engineering and Mechanics, 330 A Kelly Hall, 325 Stanger St, Blacksburg, VA, 24061, USA.
| | - Kristin S Miller
- Tulane University, Department of Biomedical Engineering, 6823 St Charles Ave, New Orleans, LA, 70118, USA; University of Texas at Dallas, Department of Bioengineering, 800 W. Campbell Road, Richardson, TX, 75080, USA.
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Ågmo A, Laan E. Sexual incentive motivation, sexual behavior, and general arousal: Do rats and humans tell the same story? Neurosci Biobehav Rev 2022; 135:104595. [PMID: 35231490 DOI: 10.1016/j.neubiorev.2022.104595] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/28/2022] [Accepted: 02/24/2022] [Indexed: 12/13/2022]
Abstract
Sexual incentive stimuli activate sexual motivation and heighten the level of general arousal. The sexual motive may induce the individual to approach the incentive, and eventually to initiate sexual acts. Both approach and the ensuing copulatory interaction further enhance general arousal. We present data from rodents and humans in support of these assertions. We then suggest that orgasm is experienced when the combined level of excitation surpasses a threshold. In order to analyze the neurobiological bases of sexual motivation, we employ the concept of a central motive state. We then discuss the mechanisms involved in the long- and short-term control of that state as well as those mediating the momentaneous actions of sexual incentive stimuli. This leads to an analysis of the neurobiology behind the interindividual differences in responsivity of the sexual central motive state. Knowledge is still fragmentary, and many contradictory observations have been made. Nevertheless, we conclude that the basic mechanisms of sexual motivation and the role of general arousal are similar in rodents and humans.
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Affiliation(s)
- Anders Ågmo
- Department of Psychology, University of Tromsø, Norway.
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands
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Rodriguez FD, Camacho A, Bordes SJ, Gardner B, Levin RJ, Tubbs RS. Female ejaculation: An update on anatomy, history, and controversies. Clin Anat 2020; 34:103-107. [PMID: 32681804 DOI: 10.1002/ca.23654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/12/2020] [Accepted: 07/13/2020] [Indexed: 11/09/2022]
Abstract
Female ejaculation is a contentious topic. From a review of the literature, history indicates that it is not a modern concept; some females were aware of it in times past without understanding the role of the fluid or composition of the ejaculate. Over time, scholars experimented, mainly with anatomical studies, in an attempt to identify the source of the ejaculate and explore its physiological and anatomical benefits for the female sexual experience. Despite these studies, views about female ejaculation remain controversial and inconsistent, with no clear conclusion as to its function. This review discusses the history of studies of female ejaculation and presents various hypotheses from an anatomical and physiological perspective. After reviewing 44 publications from 1889 to 2019, it became apparent that clinical and anatomical studies conducted during recent decades provide substantial evidence in support of the female ejaculatory phenomenon. Anatomical studies have shown that the ejaculate originates in the paraurethral (Skene's) glands, but its composition has been debated. Female ejaculate differs from urine in its creatinine and urea concentrations. The fluid also contains prostate specific antigen (PSA) and could have antibacterial properties that serve to protect the urethra. While the specific function of female ejaculation remains a topic of debate, there is sufficient evidence to support the existence of the phenomenon.
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Affiliation(s)
| | - Amarilis Camacho
- University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Stephen J Bordes
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada
| | - Brady Gardner
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada
| | | | - R Shane Tubbs
- Department of Anatomical Sciences, St. George's University School of Medicine, St. George's, Grenada.,Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, Louisiana, USA.,Department of Neurology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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van Helden DF, Kamiya A, Kelsey S, Laver DR, Jobling P, Mitsui R, Hashitani H. Nerve-induced responses of mouse vaginal smooth muscle. Pflugers Arch 2017; 469:1373-1385. [DOI: 10.1007/s00424-017-1995-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 03/30/2017] [Accepted: 05/10/2017] [Indexed: 12/23/2022]
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Yeung J, Pauls RN. Anatomy of the Vulva and the Female Sexual Response. Obstet Gynecol Clin North Am 2016; 43:27-44. [DOI: 10.1016/j.ogc.2015.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
INTRODUCTION Multiple methods and devices are available for the assessment of female sexual response, each with strengths and limitations that can impact interpretation of research results. As such, it is important to have an understanding of available methodologies and instruments. AIM To review recent literature on the measurement of female sexual response, and to describe the methods and devices, and their strengths and limitations. METHODS A literature review was performed regarding methodology and instruments used to quantify female sexual response. MAIN OUTCOME MEASURES The description of currently available instruments and methods to quantify sexual response in women. RESULTS Methodologies used to examine female sexual arousal employ a variety of stimuli and instruments to elicit and record sexual response. The variation in research designs across studies highlights the importance of understanding (i) how sexual response is elicited in studies; (ii) what kinds of experimental designs are available for assessing sexual psychophysiology; and (iii) the various types of instrumentation used to collect data. CONCLUSIONS The physiological and self-reported measurement of female sexual response is crucial to our understanding of the mechanisms and factors involved with healthy sexual functioning. As such, it is important to understand the strengths and limitations associated with different stimuli, research designs, and instruments. Kukkonen TM. Devices and methods to measure female sexual arousal.
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Affiliation(s)
- Tuuli M Kukkonen
- Department of Family Relations and Applied NutritionUniversity of GuelphGuelphONCanada.
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Puppo V, Puppo G. Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease. Clin Anat 2015; 29:111-9. [DOI: 10.1002/ca.22655] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 10/09/2015] [Indexed: 01/23/2023]
Affiliation(s)
| | - Giulia Puppo
- Department of Biology; University of Florence; Sesto Fiorentino Italy
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Puppo V, Puppo G. Anatomy of sex: Revision of the new anatomical terms used for the clitoris and the female orgasm by sexologists. Clin Anat 2014; 28:293-304. [DOI: 10.1002/ca.22471] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 08/30/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Vincenzo Puppo
- Centro Italiano di Sessuologia (CIS); Via Regnoli 74 40138 Bologna Italy
| | - Giulia Puppo
- Department of Biology; University of Florence; Sesto Fiorentino Italy
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Abstract
INTRODUCTION Women may expel various kinds of fluids during sexual arousal and at orgasm. Their origins, quantity, compositions, and expulsion mechanisms depend on anatomical and pathophysiological dispositions and the degree of sexual arousal. These are natural sexual responses but may also represent symptoms of urinary incontinence. AIM The study aims to clarify the etiology of fluid leakage at orgasm, distinguish between associated physiological sexual responses, and differentiate these phenomena from symptoms of illness. METHODS A systematic literature review was performed. EMBASE (OvidSP) and Web of Science databases were searched for the articles on various phenomena of fluid expulsions in women during sexual arousal and at orgasm. MAIN OUTCOME MEASURES Articles included focused on female ejaculation and its variations, coital incontinence (CI), and vaginal lubrication. RESULTS Female ejaculation orgasm manifests as either a female ejaculation (FE) of a smaller quantity of whitish secretions from the female prostate or a squirting of a larger amount of diluted and changed urine. Both phenomena may occur simultaneously. The prevalence of FE is 10-54%. CI is divided into penetration and orgasmic forms. The prevalence of CI is 0.2-66%. Penetration incontinence occurs more frequently and is usually caused by stress urinary incontinence (SUI). Urodynamic diagnoses of detrusor overactivity (DOA) and SUI are observed in orgasmic incontinence. CONCLUSIONS Fluid expulsions are not typically a part of female orgasm. FE and squirting are two different physiological components of female sexuality. FE was objectively evidenced only in tens of cases but its reported high prevalence is based mostly on subjective questionnaire research. Pathophysiology of squirting is rarely documented. CI is a pathological sign caused by urethral disorder, DOA, or a combination of both, and requires treatment. An in-depth appreciation of these similar but pathophysiologically distinct phenomena is essential for distinguishing normal, physiological sexual responses from signs of illness.
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Affiliation(s)
- Zlatko Pastor
- Obstetrics and Gynaecology Department, 2nd Medical Faculty, Teaching Hospital Motol, Charles University, Prague, Czech Republic.
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Puppo V. International online survey: female ejaculation has a positive impact on women's and their partners' sexual lives. BJU Int 2013; 111:E263-4. [DOI: 10.1111/bju.12128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vincenzo Puppo
- Centro Italiano di Sessuologia (CIS); Via Regnoli 74; 40138; Bologna; Italy
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Anatomy and physiology of the clitoris, vestibular bulbs, and labia minora with a review of the female orgasm and the prevention of female sexual dysfunction. Clin Anat 2012; 26:134-52. [DOI: 10.1002/ca.22177] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 09/10/2012] [Indexed: 12/31/2022]
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Levin RJ. The deadly pleasures of the clitoris and the condom – a rebuttal of Brody, Costa and Hess (2012)1. SEXUAL AND RELATIONSHIP THERAPY 2012. [DOI: 10.1080/14681994.2012.732261] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Does the G-spot exist? A review of the current literature. Int Urogynecol J 2012; 23:1665-9. [PMID: 22669428 DOI: 10.1007/s00192-012-1831-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 05/10/2012] [Indexed: 10/28/2022]
Abstract
In 1950, Gräfenberg described a distinct erotogenic zone on the anterior wall of the vagina, which was referred to as the Gräfenberg spot (G-spot) by Addiego, Whipple (a nurse) et al. in 1981. As a result, the G-spot has become a central topic of popular speculation and a basis of a huge business surrounding it. In our opinion, these sexologists have made a hotchpotch of Gräfenberg's thoughts and ideas that were set forth and expounded in his 1950 article: the intraurethral glands are not the corpus spongiosum of the female urethra, and Gräfenberg did not report an orgasm of the intraurethral glands. G-spot amplification is a cosmetic surgery procedure for temporarily increasing the size and sensitivity of the G-spot in which a dermal filler or a collagen-like material is injected into the bladder-vaginal septum. All published scientific data point to the fact that the G-spot does not exist, and the supposed G-spot should not be identified with Gräfenberg's name. Moreover, G-spot amplification is not medically indicated and is an unnecessary and inefficacious medical procedure.
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Carvalho S, Moreira A, Rosado M, Correia D, Maia D, Pimentel P. Female premature orgasm: Does this exist? SEXOLOGIES 2011. [DOI: 10.1016/j.sexol.2011.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Carvalho S, Moreira A, Rosado M, Correia D, Maia D, Pimentel P. L’orgasme prématuré chez la femme existe-t-il ? SEXOLOGIES 2011. [DOI: 10.1016/j.sexol.2011.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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