Rationalization is a suboptimal defense mechanism associated with clinical and forensic problems.

Cushman argues that "rationalization is rational." We show that there is reasonable empirical clinical and forensic psychological evidence to support viewing rationalization as a quite suboptimal defense mechanism. Rationalization has been found to be associated not only with poorer emotional development, but also with a broad range of antisocial behavior, including not only shoplifting, but also pedophilia and murder.

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction.

INTRODUCTION: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Terminology. Appropriate core clinical categories and sub classifications were developed to give an alphanumeric coding to each definition. An extensive process of twenty rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). RESULTS: A Terminology Report for anorectal dysfunction, encompassing over 130 separate definitions, has been developed. It is clinically based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction. Female-specific anorectal investigations and imaging (ultrasound, radiology and MRI) has been included whilst appropriate figures have been included to supplement and help clarify the text. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. CONCLUSION: A consensus-based Terminology Report for female anorectal dysfunction terminology has been produced aimed at being a significant aid to clinical practice and a stimulus for research. Neurourol. Urodynam. 36:10-34, 2017. © 2016 Wiley Periodicals, Inc., and The International Urogynecological Association.

An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction.

INTRODUCTION AND HYPOTHESIS: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Terminology. Appropriate core clinical categories and sub classifications were developed to give an alphanumeric coding to each definition. An extensive process of twenty rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). RESULTS: A Terminology Report for anorectal dysfunction, encompassing over 130 separate definitions, has been developed. It is clinically based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction. Female-specific anorectal investigations and imaging (ultrasound, radiology and MRI) has been included whilst appropriate figures have been included to supplement and help clarify the text. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. CONCLUSIONS: A consensus-based Terminology Report for female anorectal dysfunction terminology has been produced aimed at being a significant aid to clinical practice and a stimulus for research.

Erectile dysfunction and premature ejaculation: interrelationships and psychosexual factors.

INTRODUCTION: Both erectile dysfunction (ED) and premature ejaculation (PE) impair the quality of sexual intercourse for both men and their female partners. AIMS: This study aims to examine with a large representative sample the interrelationships of measures of ED, PE, typical intravaginal ejaculatory latency time (IELT), men's perceived relationship quality with their mother, and age of first being in love. METHODS: In this cross-sectional study, a nationally representative sample of 960 Czech coitally experienced men (aged 15-84), provided age, International Index of Erectile Function 5-item (IIEF-5), Index of Premature Ejaculation (IPE) scores, IELT, rating of relationship with their mother, and age at first being in love. MAIN OUTCOME MEASURES: Correlations, partial correlations adjusting for age, analysis of covariance (ANCOVA), and multiple regression statistical methods were used. RESULTS: IIEF-5, IPE, and IELT were significantly intercorrelated (IIEF-5 and IPE: r=0.64). Better IIEF-5 scores were associated with younger age at first (and ever) being in love. Poorer IPE score, shorter IELT, and mild-moderate ED were associated with poorer perceived mother relationship (which was also associated with first being in love at an older age). Multiple regression analyses revealed that: (i) greater IELT was associated with better erectile function and better mother relationship, but not with age; and (ii) IELT of <1 minute was associated with poorer perceived mother relationship and poorer IIEF-5, but marginally with age. History of homosexual activity was unrelated to IIEF-5, IPE, IELT, and perceived mother relationship scores. CONCLUSIONS: The findings suggest that degrees of ED and PE are often comorbid, and both ED and PE are associated with less favorable early experiences with women. Brody S and Weiss P. Erectile dysfunction and premature ejaculation: Interrelationships and psychosexual factors. J Sex Med 2015;12:398-404.

Sexual satisfaction, sexual compatibility, and relationship adjustment in couples: the role of sexual behaviors, orgasm, and men's discernment of women's intercourse orgasm.

INTRODUCTION: Research indicated that (i) vaginal orgasm consistency is associated with indices of psychological, intimate relationship, and physiological functioning, and (ii) masturbation is adversely associated with some such measures. AIM: The aim of this study was to examine the association of various dyadic and masturbation behavior frequencies and percentage of female orgasms during these activities with: (i) measures of dyadic adjustment; (ii) sexual satisfaction; and (iii) compatibility perceived by both partners. METHODS: In a sample of 85 Czech long-term couples (aged 20-40; mean relationship length 5.4 years), both partners provided details of recent sexual behaviors and completed sexual satisfaction, Spanier dyadic adjustment, and Hurlbert sexual compatibility measures. Multiple regression analyses were used. MAIN OUTCOME MEASURE: The association of sexual behaviors with dyadic adjustment, sexual compatibility, and satisfaction was analyzed. RESULTS: In multivariate analyses, women's dyadic adjustment is independently predicted by greater vaginal orgasm consistency and lower frequency of women's masturbation. For both sexes, sexual compatibility was independently predicted by higher frequency of penile-vaginal intercourse and greater vaginal orgasm consistency. Women's sexual satisfaction score was significantly predicted by greater vaginal orgasm consistency, frequency of partner genital stimulation, and negatively with masturbation. Men's sexual satisfaction score was significantly predicted by greater intercourse frequency and any vaginal orgasm of their female partners. Concordance of partner vaginal orgasm consistency estimates was associated with greater dyadic adjustment. CONCLUSIONS: The findings suggest that specifically penile-vaginal intercourse frequency and vaginal orgasm consistency are associated with indices of greater intimate relationship adjustment, satisfaction, and compatibility of both partners, and that women's masturbation is independently inversely associated with measures of dyadic and personal function. Results are discussed in light of previous research and an evolutionary theory of vaginal orgasm.

More frequent vaginal orgasm is associated with experiencing greater excitement from deep vaginal stimulation.

INTRODUCTION: Research indicated that: (i) vaginal orgasm (induced by penile-vaginal intercourse [PVI] without concurrent clitoral masturbation) consistency (vaginal orgasm consistency [VOC]; percentage of PVI occasions resulting in vaginal orgasm) is associated with mental attention to vaginal sensations during PVI, preference for a longer penis, and indices of psychological and physiological functioning, and (ii) clitoral, distal vaginal, and deep vaginal/cervical stimulation project via different peripheral nerves to different brain regions. AIMS: The aim of this study is to examine the association of VOC with: (i) sexual arousability perceived from deep vaginal stimulation (compared with middle and shallow vaginal stimulation and clitoral stimulation), and (ii) whether vaginal stimulation was present during the woman's first masturbation. METHODS: A sample of 75 Czech women (aged 18-36), provided details of recent VOC, site of genital stimulation during first masturbation, and their recent sexual arousability from the four genital sites. MAIN OUTCOME MEASURES: The association of VOC with: (i) sexual arousability perceived from the four genital sites and (ii) involvement of vaginal stimulation in first-ever masturbation. RESULTS: VOC was associated with greater sexual arousability from deep vaginal stimulation but not with sexual arousability from other genital sites. VOC was also associated with women's first masturbation incorporating (or being exclusively) vaginal stimulation. CONCLUSIONS: The findings suggest (i) stimulating the vagina during early life masturbation might indicate individual readiness for developing greater vaginal responsiveness, leading to adult greater VOC, and (ii) current sensitivity of deep vaginal and cervical regions is associated with VOC, which might be due to some combination of different neurophysiological projections of the deep regions and their greater responsiveness to penile stimulation.

The quality of sexual experience in women correlates with post-orgasmic prolactin surges: results from an experimental prototype study.

INTRODUCTION: Sexual intercourse, orgasm, and sexual satisfaction are associated with well-being and improved quality of life. The pituitary hormone prolactin (PRL) may have an important role in regulating (and thus indexing) sexual satiety and satisfaction. AIM: Physiological indices to quantify the quality and resulting satisfaction from female orgasm would be valuable. Therefore we aim to validate associations of orgasm-induced PRL surges with women's orgasm quality and subsequent sexual satisfaction. METHODS: In a prospective study, with a pre-post, single-blinded, cross-over design in a naturalistic field setting, we analyzed the correlation of women's post-orgasmic serum PRL surges following sexual intercourse with women's perceived quality of orgasm and resulting sexual satisfaction, as measured by a questionnaire. MAIN OUTCOME MEASURES: PRL levels prior to and following penile-vaginal intercourse with and without orgasm, and scores from the Acute Sexual Experience Scale (ASES) on quality of orgasm and sexual satisfaction. RESULTS: An analysis of variance of the blood samples in nine women indicated large magnitude, significant effects of intercourse orgasm on PRL levels (P = 0.004, eta squared = 0.78), as well as an interaction with the effect of multiple orgasms (P = 0.008, eta squared = 0.80). PRL post/pre ratios and arithmetic difference correlated strongly with orgasm quality (r = 0.85, P = 0.016, and r = 0.69, P = 0.08) and sexual satisfaction (r = 0.75, P = 0.05 and r = 0.77, P = 0.045). CONCLUSION: Women's intercourse orgasm induced PRL surges are strongly related to the quality of orgasm and subsequent sexual satisfaction. This implies that post-orgasmic PRL surges are an objective index of orgasm and orgasm quality. PRL might be used in future studies on basic research as well as a treatment target in sexual disorders in women.

Slimmer women's waist is associated with better erectile function in men independent of age.

Previous research has indicated that men generally rate slimmer women as more sexually attractive, consistent with the increased morbidity risks associated with even mild abdominal adiposity. To assess the association of women's waist size with a more tangible measure of perceived sexual attractiveness (as well as reward value for both sexes), we examined the association of women's age and waist circumference with an index of men's erectile function (IIEF-5 scores), frequency of penile-vaginal intercourse (PVI), and sexual satisfaction in a representative sample of Czechs (699 men and 715 women) aged 35-65 years. Multivariate analyses indicated that better erectile function scores were independently associated with younger age of self and partner and women's slimmer waist. PVI frequency was independently associated with women's younger age and women's slimmer waist. Sexual satisfaction was independently associated with men's younger age and slimmer waist for both sexes. Better erectile function, greater PVI frequency, and greater sexual satisfaction were associated with women's slimmer waist, independently of both sexes' ages. Possible reasons for the waist effects were discussed, including women's abdominal body fat decreasing their own desire through neurohormonal mechanisms and decreasing their partner's desire through evolutionarily-related decreased sexual attractiveness.

Greater resting heart rate variability is associated with orgasms through penile-vaginal intercourse, but not with orgasms from other sources.

INTRODUCTION: Resting heart rate variability (HRV), a marker of parasympathetic activity, is a predictor of health and longevity. Better erectile function is associated with greater resting HRV (assessed by high frequency power [HF]), and in both sexes, penile-vaginal intercourse (PVI) is the only sexual behavior consistently associated with indices of better physical and mental health, including greater resting HRV (assessed by standard deviation [SD] of heart rate [HR]). AIMS: To examine the hypotheses that greater frequency of orgasms attained through PVI (for women, without additional simultaneous clitoral stimulation; vaginal orgasm) are associated with greater resting HRV. A differential hypothesis is that HRV measures will be unrelated to orgasmic frequency from noncoital sexual activities. METHODS: Coitally experienced men and women (N = 143) had their heart rate measured for 5 minutes and reported the frequency of various sexual behaviors and corresponding orgasms in a recent representative month. MAIN OUTCOME MEASURES: Partial correlations and analyses of covariance controlling for social desirability responding were used to examine the associations of sexual activities with time and frequency domains of HRV. RESULTS: For men, greater resting SD of HR was associated with greater PVI orgasm frequency. For women, greater resting SD of HR was associated with any vaginal orgasm. These findings remained after controlling for cohabitation. Sexual activities were unrelated to HF. Lifetime number of PVI partners was unrelated to SD of HR and HF. CONCLUSIONS: Findings are discussed in the context of orgasms through PVI enhancing HRV, and greater parasympathetic tone favoring the capacity to engage in PVI, and in the case of women, to reach vaginal orgasm. The possibility of healthier people having greater resting HRV and more frequent orgasms through specifically PVI is also considered.

Women who prefer longer penises are more likely to have vaginal orgasms (but not clitoral orgasms): implications for an evolutionary theory of vaginal orgasm.

INTRODUCTION: Research indicates that (i) women's orgasm during penile-vaginal intercourse (PVI) is influenced by fitness-related male partner characteristics, (ii) penis size is important for many women, and (iii) preference for a longer penis is associated with greater vaginal orgasm consistency (triggered by PVI without concurrent clitoral masturbation). AIMS: To test the hypothesis that vaginal orgasm frequency is associated with women's reporting that a longer than average penis is more likely to provoke their PVI orgasm. METHOD: Three hundred twenty-three women reported in an online survey their past month frequency of various sexual behaviors (including PVI, vaginal orgasm, and clitoral orgasm), the effects of a longer than average penis on likelihood of orgasm from PVI, and the importance they attributed to PVI and to noncoital sex. MAIN OUTCOME MEASURES: Univariate analyses of covariance with dependent variables being frequencies of various sexual behaviors and types of orgasm and with independent variable being women reporting vs. not reporting that a longer than average penis is important for their orgasm from PVI. RESULTS: Likelihood of orgasm with a longer penis was related to greater vaginal orgasm frequency but unrelated to frequencies of other sexual behaviors, including clitoral orgasm. In binary logistic regression, likelihood of orgasm with a longer penis was related to greater importance attributed to PVI and lesser importance attributed to noncoital sex. CONCLUSIONS: Women who prefer deeper penile-vaginal stimulation are more likely to have vaginal orgasm, consistent with vaginal orgasm evolving as part of a female mate choice system favoring somewhat larger than average penises. Future research could extend the findings by overcoming limitations related to more precise measurement of penis length (to the pubis and pressed close to the pubic bone) and girth, and large representative samples. Future experimental research might assess to what extent different penis sizes influence women's satisfaction and likelihood of vaginal orgasm.

Female orgasm(s): one, two, several.

INTRODUCTION: There is general agreement that it is possible to have an orgasm thru the direct simulation of the external clitoris. In contrast, the possibility of achieving climax during penetration has been controversial. METHODS: Six scientists with different experimental evidence debate the existence of the vaginally activated orgasm (VAO). MAIN OUTCOME MEASURE: To give reader of The Journal of Sexual Medicine sufficient data to form her/his own opinion on an important topic of female sexuality. RESULTS: Expert #1, the Controversy's section Editor, together with Expert #2, reviewed data from the literature demonstrating the anatomical possibility for the VAO. Expert #3 presents validating women's reports of pleasurable sexual responses and adaptive significance of the VAO. Echographic dynamic evidence induced Expert # 4 to describe one single orgasm, obtained from stimulation of either the external or internal clitoris, during penetration. Expert #5 reviewed his elegant experiments showing the uniquely different sensory responses to clitoral, vaginal, and cervical stimulation. Finally, the last Expert presented findings on the psychological scenario behind VAO. CONCLUSION: The assumption that women may experience only the clitoral, external orgasm is not based on the best available scientific evidence.

Brief report: self-harm is associated with immature defense mechanisms but not substance use in a nonclinical Scottish adolescent sample.

It has been unclear whether adolescent deliberate self-harm (DSH) is more associated with substance use or with characterological impairments. Multivariate determination of (N = 114 Scottish adolescents) ever engaging in DSH (Youth Risk Behavior Survey) from alcohol use, other substance use, and immature defense mechanism use (Defense Style Questionnaire; DSQ-40) revealed that a history of DSH was associated with more use of immature defense mechanisms by not with substance use or recent alcohol use. More research and clinical attention might be given to immature defense mechanisms in cases of DSH.

Vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip.

INTRODUCTION: Recent studies have uncovered multiple markers of vaginal orgasm history (unblocked pelvic movement during walking, less use of immature psychological defense mechanisms, greater urethrovaginal space). Other markers (perhaps of prenatal origin) even without obvious mechanistic roles in vaginal orgasm might exist, and a clinical observation led to the novel hypothesis that a prominent tubercle of the upper lip is such a marker. AIMS: To examine the hypothesis that a prominent tubercle of the upper lip is associated specifically with greater likelihood of experiencing vaginal orgasm (orgasm elicited by penile-vaginal intercourse [PVI] without concurrent masturbation). METHODS: Women (N = 258, predominantly Scottish) completed an online survey reporting their frequencies of various sexual activities and corresponding orgasms, age, and the prominence of the tubercle of their upper lip. Social desirability response bias was also assessed. MAIN OUTCOME MEASURES: Multivariate associations of lip tubercle prominence with vaginal orgasm (ever and past month consistency) and with orgasm by other means. RESULTS.: A prominent and sharply raised lip tubercle was associated with greater odds (odds ratio = 12.3) of ever having a vaginal orgasm, and also with greater past month vaginal orgasm consistency (an effect driven by the women who never had a vaginal orgasm), than less prominent lip tubercle categories. Lip tubercle was not associated with social desirability responding, or with orgasm triggered by masturbation during PVI, solitary or partner clitoral or vaginal masturbation, vibrator, or cunnilingus. CONCLUSIONS: The results are discussed in light of the unique nature of vaginal orgasm and the possibility of prenatal developmental influences.

Anxious and avoidant attachment, vibrator use, anal sex, and impaired vaginal orgasm.

INTRODUCTION: Disturbances in intimate relationships are among the risk factors for female sexual dysfunction. Insecure styles of anxious attachment (preoccupations about abandonment) and avoidant attachment (avoidance of closeness in relationships) are robustly associated with sexual problems, relationship difficulties, and several indices of poorer physical and mental health. Similar indices of poorer sexual, relationship, and health functioning are associated with impairment of orgasm triggered by penile-vaginal stimulation (vaginal orgasm), but unrelated or related to greater frequency of other sexual behaviors. However, research examining the differential association of sexual activities with insecure attachment styles has been lacking. AIMS: The aim of this study was to test the hypotheses that insecure attachment styles are associated with lesser vaginal orgasm consistency, and are unrelated or directly related to greater frequency of other sexual behaviors. METHOD: Seventy coitally experienced women recruited at a Scottish university completed the Revised Experience in Close Relationships scale, and reported their frequency of various sexual behaviors (and corresponding orgasms) in a recent representative month. MAIN OUTCOME MEASURES: The main outcome measures for this study are multivariate correlations of various sexual activities with insecure attachment styles, age, and social desirability response bias. RESULTS: Anxious attachment was associated with lesser vaginal orgasm consistency, but with higher frequency of vibrator and anal sex orgasms. Avoidant attachment was associated with higher frequency of vibrator orgasms. Neither anxious nor avoidant attachment was associated with lifetime number of penile-vaginal intercourse partners. CONCLUSIONS: The results provide evidence that inability to attain a vaginal orgasm is associated with anxious attachment, among other indices of poorer mental health and relatedness. Vaginal orgasm might be the relevant sexual activity for the maintenance of a secure attachment style with a sexual partner and/or more insecurely attached women might have difficulties in attaining vaginal orgasms and be more inclined to sexual activities characterized by more emotional and physical detachment, as part of a characterological discomfort with intimacy.

International Index of Erectile Function (IIEF) scores generated by men or female partners correlate equally well with own satisfaction (sexual, partnership, life, and mental health).

INTRODUCTION: Erectile dysfunction has adverse implications for both men and their female partners. The International Index of Erectile Function (IIEF) is a widely used self-report measure. It was unclear whether scores generated by women on behalf of men are comparable to self-reports, and how IIEF scores are associated with satisfaction for both sexes in both sexual and nonsexual realms (e.g., mental health). AIMS: To examine sex differences in IIEF-5 scores generated by both sexes, and to examine associations of IIEF-5 scores with satisfaction aspects (sexual, life, own mental health, partnership) and with women's vaginal orgasm consistency (VOC). METHODS: A representative sample of Czechs (787 men and 720 women not from the same couple) aged 35-65 years completed the IIEF-5, LiSat satisfaction scale items, and provided penile-vaginal intercourse (PVI) frequency, and for women, VOC. MAIN OUTCOME MEASURES: Correlations between satisfaction measures and IIEF-5 scores separately by sex. To examine sex differences: t-test for IIEF-5 score and tests for difference of a correlation for associations of IIEF-5 with satisfaction measures. Analysis of covariance examined the association of IIEF-5 scores and VOC. Multiple regression calculated satisfaction scores from IIEF-5, PVI frequency, age, and for women: VOC. RESULTS: IIEF-5 scores generated by men and by women were similar, and similarly positively correlated with all satisfaction measures (r: 0.41-0.45 with sexual, 0.23-0.34 with other; all P < 0.001). IIEF-5 correlated positively with VOC. Multivariate analyses indicated IIEF-5 scores; PVI frequency (and for women, VOC) make independent contributions to aspects of satisfaction for both sexes. CONCLUSIONS: In this representative sample, women generated IIEF-5 scores similar to men-generated scores. For both sexes, greater IIEF-5 scores and PVI frequency (plus VOC for women) are associated with greater sexual and nonsexual satisfaction. Better erectile function was associated with greater VOC. Greater support for optimizing specifically PVI function, frequency, and quality is warranted.

Simultaneous penile-vaginal intercourse orgasm is associated with satisfaction (sexual, life, partnership, and mental health).

INTRODUCTION: Previous multivariate research found that satisfaction was associated positively with frequency of specifically penile-vaginal intercourse (PVI; as opposed to other sexual activities) as well as with vaginal orgasm. The contribution to satisfaction of simultaneous orgasm produced by PVI merited direct examination in a large representative sample. AIMS: To examine the associations of aspects of satisfaction (sexual, life, own mental health, partner relationship) with consistency of simultaneous orgasm produced by PVI (as well as with PVI frequency and vaginal orgasm consistency). METHODS: A representative sample of Czechs (N = 1,570) aged 35-65 years completed a survey on aspects of satisfaction, PVI frequency, vaginal orgasm consistency, and consistency of simultaneous orgasm produced by PVI (the latter being a specially timed version of vaginal orgasm for women). MAIN OUTCOME MEASURES: Analysis of variance of satisfaction components (LiSat scale items) from age and the sexual behaviors. RESULTS: For both sexes, all aspects of satisfaction were associated with simultaneous PVI orgasm consistency and with PVI frequency (except female life satisfaction). All aspects of satisfaction were also associated with vaginal orgasm consistency. Multivariate analyses indicated that PVI frequency and simultaneous orgasm consistency make independent contributions to the aspects of satisfaction for both sexes. CONCLUSIONS: For both sexes, PVI frequency and simultaneous orgasm produced by PVI (as well as vaginal orgasm for women) are associated with greater life, sexual, partnership, and mental health satisfaction. Greater support for these specific aspects of sexual activity is warranted.

Sexual behavior predictors of satisfaction in a Chinese sample.

INTRODUCTION: Previous multivariate research in Europe found that sexual satisfaction was associated directly with frequency of penile-vaginal intercourse (PVI) but inversely with masturbation and some aspects of non-PVI partnered sex. AIMS: To examine the associations of sexual satisfaction in a sample from the People's Republic of China, including not only frequencies of various sexual behaviors, but also frequencies of orgasm. METHODS: Chinese industrial workers (N=158, age over 24 years) completed the sexual satisfaction scale of the Multidimensional Sexuality Questionnaire (MSQ) and a short form of the Marlowe-Crowne social desirability scale, and provided details of the one month frequencies of engaging in, and having an orgasm from, PVI, masturbation, and non-PVI partnered sex. MAIN OUTCOME MEASURES: Multiple regression prediction of sexual satisfaction from age, social desirability responding, and in separate analyses, frequencies of the sexual behaviors or the corresponding orgasm frequencies. RESULTS: For men and women, sexual satisfaction was associated with frequency of PVI and of PVI orgasm (the latter for women only), but not other sexual behavior or orgasm frequency. Similar results were obtained for the MSQ satisfaction scale and for a single satisfaction item. CONCLUSIONS: Despite cultural differences (and our smaller, less diverse sample), the positive prediction of satisfaction from only PVI (and in our sample of women, PVI orgasm) frequency-but not other sexual activities-was similar to that in a Swedish sample. Future research might also examine possible occasional avoidance of ejaculation by some Chinese men.

Women's clitoris, vagina, and cervix mapped on the sensory cortex: fMRI evidence.

INTRODUCTION: The projection of vagina, uterine cervix, and nipple to the sensory cortex in humans has not been reported. AIMS: The aim of this study was to map the sensory cortical fields of the clitoris, vagina, cervix, and nipple, toward an elucidation of the neural systems underlying sexual response. METHODS: Using functional magnetic resonance imaging (fMRI), we mapped sensory cortical responses to clitoral, vaginal, cervical, and nipple self-stimulation. For points of reference on the homunculus, we also mapped responses to the thumb and great toe (hallux) stimulation. MAIN OUTCOME MEASURES: The main outcome measures used for this study were the fMRI of brain regions activated by the various sensory stimuli. RESULTS: Clitoral, vaginal, and cervical self-stimulation activated differentiable sensory cortical regions, all clustered in the medial cortex (medial paracentral lobule). Nipple self-stimulation activated the genital sensory cortex (as well as the thoracic) region of the homuncular map. CONCLUSION: The genital sensory cortex, identified in the classical Penfield homunculus based on electrical stimulation of the brain only in men, was confirmed for the first time in the literature by the present study in women applying clitoral, vaginal, and cervical self-stimulation, and observing their regional brain responses using fMRI. Vaginal, clitoral, and cervical regions of activation were differentiable, consistent with innervation by different afferent nerves and different behavioral correlates. Activation of the genital sensory cortex by nipple self-stimulation was unexpected, but suggests a neurological basis for women's reports of its erotogenic quality.

Heterosexual anal intercourse: increasing prevalence, and association with sexual dysfunction, bisexual behavior, and venereal disease history.

Representative samples of the Czech population were surveyed with regard to sexual behavior in 1993, 1998, 2003, and 2008 (N = 7,720). Lifetime prevalence of Heterosexual Anal Intercourse increased from 1993 to 2008 (16.6% to 19.7% among women, 15.7% to 25.3% among men). Anal intercourse was associated with lifetime number of sex partners, current masturbation, and histories (prevalence of which increased from 1993 to 2008) of homosexual sex, prostitution, venereal disease (adjusted for number of sex partners), and women's sexual dysfunction. The authors discuss the possible reasons for the increasing prevalence and the associations. Multivariate predictors of ever having a sexual dysfunction or a venereal disease are also presented.