Sexual satisfaction of postmenopausal women: An integrative review.

A prerequisite for interventions for sexual satisfaction in postmenopausal women is a clear, objective measurement of the concept. Despite the large number of studies on the sexual satisfaction of postmenopausal women, there is no clear definition of sexual satisfaction in menopause. This study was conducted to investigate the concept of sexual satisfaction in postmenopausal women. The present study was carried out using an integrated review of data obtained from secondary sources, utilizing Whittemore and Knafl's method of bibliographic search. A literature search was performed without any data limitations in journals and international databases. The primary inclusion criterion was relevance to sexual satisfaction in postmenopausal women. The full texts of all these articles were evaluated using the checklists of the MMAT and PRISMA. Data were analyzed using MAXQDA 10 software using a constant comparison method. Meaning units were identified and coded. The codes were classified into subgroups and categories according to the characteristics, antecedents, and consequences of sexual satisfaction in postmenopausal women. During the integrative review of the 62 articles and three books, 580 codes about sexual satisfaction in menopause were extracted. The codes were grouped into three main attributes, five main antecedents, and three main consequences of sexual satisfaction in postmenopausal women. Four attributes, symptoms, or components were identified for the concept. These attributes were as follows: Change in sexual objective and subjective dimensions of sexual satisfaction after menopause, conditional sexual consent, change in behavior, and sexual function. These dimensions distinguish sexual satisfaction in menopause from other conditions. The concept of sexual satisfaction in menopause is a subjective (emotional interaction) and objective (physical interaction) experience that is conditioned by the fulfillment of expectations and the reconstruction of sexual relations while also being influenced by the change in sexual capacity during menopause.

Personal genital satisfaction is associated with differences in perception of male and female sexual anatomy and function.

BACKGROUND: Prior studies primarily of men correlated low personal genital satisfaction (PGS) with decreased sexual activity; however, the association between PGS and genital anatomy perceptions is unknown, and there is a paucity of studies examining women. AIM: We assessed the relationship between genital satisfaction, survey respondent sexual activity, and perceptions of anatomy and function. METHODS: A 54-item REDCap survey was distributed to any-gendered volunteers ≥18 years of age through ResearchMatch from January to March 2023. Responses were split into (1) high PGS and (2) low PGS. Analysis was performed using chi-square tests on survey responses and a Mann Whitney U test on median satisfaction level. OUTCOMES: Outcomes were genital anatomy perceptions, sexual activity, and respondents' PGS. RESULTS: Of the 649 respondents who started the survey, 560 (86.3%) completed it. Median PGS was 7 of 10, forming subgroups of high (≥7 of 10) satisfaction (n = 317 of 560 [56.6%]) and low (<7 of 10) satisfaction (n = 243 of 560 [43.4%]). The mean age was 45.8 ± 16.8 years, and demographics were notable for 72.1% women (n = 404 of 560), 83.2% White (n = 466 of 560), 47.9% married (n = 268 of 560), and 75.5% bachelor's degree holders (n = 423 of 560). Comparing high- and low-PGS groups, more low-PGS respondents felt normal flaccid penis length to be <2 inches (11.1% vs 5.1%; P = .008). High-PGS respondents more often responded that it is normal for women to have orgasms over half the time (20.8% vs 13.2%; P = .0002) or to identify as being sexually active (81.1% vs 71.6%; P = .008). Women were more likely than men to report larger normal testicle sizes as 60.1 to 90 mL (24.5% vs 10.3%; P < .0001), whereas more men felt that normal testicle size was 7 to 15 mL (26.3% vs 11.4%; P < .0001). Orgasm length perceptions also differed: more women felt female orgasm length was 2.6 to 5 seconds (36.6% vs 16.7%; P < .0001), and more men believed female orgasms to be longer, at 7.6 to 10 seconds (29.5% vs 17.3%; P = .002), 10.1 to 12.5 seconds (11.5% vs 5.2%; P = .0008), and >12.5 seconds (12.2% vs 5.7%; P = .009). Respondents' views on their genitalia differed by gender, with women more likely to feel that their genitals are normal compared with men (89.4% vs 75.0%; P < .0001). CLINICAL IMPLICATIONS: PGS may be a useful screening tool given its association with sexual activity. STRENGTHS AND LIMITATIONS: Our large-scale survey assesses public perceptions of genital anatomy and function. Limitations include a lack of gender nonbinary perceptions. CONCLUSION: Gender and PGS interact with perceptions of male anatomy and female sexual activity, and the frequency of sexual activity was higher among high-PGS respondents; however, the direction of these interactions remains unclear and requires future causal analysis.

Victim Sexual Arousal During Nonconsensual Sex: A Scoping Review.

Sexual arousal in male and female victims during nonconsensual sex is an understudied phenomenon with many potential psychological, clinical, and legal implications for survivors. The aim of this scoping review was to assess the literature to determine whether we could estimate the frequency and circumstances of physiological sexual arousal (e.g., erection, lubrication, ejaculation, orgasm) among victims during nonconsensual sex. Six reference database and hand searches led to the screening of 13,894 articles and other reports. Eight articles and one book published between 1977 and 2019 included relevant data from 136 male survivors and 250 female survivors. Results confirmed that physiological sexual arousal (only genital responses were mentioned) can occur in both male and female victims during nonconsensual sex. The frequency of these responses could not be determined because of the widely different methodologies used. In addition, it was not possible to determine the circumstances in which victim sexual arousal was more likely to occur although some were inferred. The results of the scoping review highlight that physiological sexual arousal during nonconsensual sex does occur for victims but has not been studied systematically. There is a clear need to properly assess the type, circumstances, consequences, and frequency of sexual arousal during nonconsensual sex in large and diverse populations of male and female survivors.

Sexual Self-Esteem and Orgasm Consistency: Exploring the Unique Roles of Body Image and Genital Image.

We explored the unique roles that body and genital image play in behavior-specific orgasm consistency, beyond overall sexual self-esteem. US adults (N = 599; 64% women) completed questionnaires online. Hierarchical regression analyses predicted orgasm consistency during receptive oral sex and penile-vaginal intercourse (PVI) with additional clitoral stimulation (WAS) and with no additional clitoral stimulation (NAS) for the woman. Body image, genital image, and gender were entered in later steps to assess model improvement above sexual self-esteem. Models accounted for age, sexual and racial minority identities, and current relationship status. Results indicated that genital image improved all models and predicted higher orgasm consistency across all behaviors for men and women. For orgasm during receptive oral sex and PVI-NAS, sexual self-esteem was no longer significant once genital image was included. Genital image was a stronger predictor of women's versus men's orgasm during PVI-NAS; no significant gender differences were found for oral sex and PVI-WAS. Body image was not significant in any models, contrary to expectations, suggesting role overlap with sexual self-esteem. Genital image appears to play a unique role in sexual pleasure beyond overall sexual self-esteem and body image.

Feasibility Cues during a Sexual Encounter Impact the Strength of Heterosexual Women's Orgasm Goal Pursuit.

The "orgasm gap" for women who have sex with men remains a pressing gender equity issue. Recent research found that women who pursued orgasm as a goal were more likely to have one. The current research replicated this relationship between orgasm goal pursuit and orgasm frequency for heterosexual women, and found that this relationship did not exist for heterosexual men (Study 1). Then, across two experimental studies, we examined how heterosexual women vary their orgasm goal pursuit across sexual encounters. In Study 2, women who read that a hypothetical sexual encounter would be "quick" reported less intent to pursue orgasm than women who were told they could "take their time" or received no time information. In Study 3, women who read that their hypothetical sexual partner seemed selfish reported less intent to pursue orgasm than women who were given a non-selfish partner or no partner information. Importantly, these effects were mediated by women's perceived orgasm likelihood in the scenario. These results suggest that women shift their pursuit of orgasm depending on cues which signal whether orgasm will be feasible. This research used self-regulation theory to understand women's motivations for pursuing orgasm during sexual encounters with men, with implications for reducing the orgasm gap.

Orgasm Consistency in Mixed-Gender Couples: Actor, Partner, and Discrepancy Effects from Dyadic Response Surface Analysis.

The potential link between orgasm consistency (i.e., the percentage of time an individual experiences orgasm during sexual interactions with a partner) and sexual satisfaction in mixed-gender sexual relationships remains underexamined in the literature. We combined two dyadic samples (N = 725 couples) and utilized Dyadic Response Surface Analysis (DRSA) to examine how both partners' orgasm consistency and their discrepancy of orgasm consistency predict both partners' sexual satisfaction. We found that partners' discrepancy in orgasm consistency was not uniquely connected to higher sexual satisfaction for either women or men; rather, the overall consistency of orgasm was connected to better sexual satisfaction for both partners. In addition, there was some evidence tentatively suggesting that men were more likely than women to report lower sexual satisfaction if his partner was orgasming more consistently than he was, as opposed to her reporting lower sexual satisfaction from him orgasming more consistently than she was; though this appears to be a rare scenario as only 5.9% of couples had women who orgasmed more consistently than men. This study may assist educators and clinicians as they help couples consider the sexual scripts surrounding orgasm consistency, and how they can attend to each others' desires in a way that maximizes sexual satisfaction for both partners.

Effects of Subjective Orgasm Experience in Sexual Satisfaction: A Dyadic Analysis in Same-Sex Hispanic Couples.

Subjective orgasm experience (SOE) is a component of sexual health that refers to the perception, sensation and/or appraisal of orgasm at a psychological level. This construct has scarcely been studied in non-heterosexual individuals and couples, and never before from a dyadic perspective. In this study, in which 104 same-sex Hispanic couples participated (48 male-male and 56 female-female), we explored the dyadic influence of SOE dimensions on sexual satisfaction, the mediating role of relationship satisfaction on the association of both phases of sexual response, as well as the explanatory capacity that discrepancies in these dimensions had on sexual satisfaction. The results indicated that the orgasmic dimensions that gained more prominence were Affective and Sensory. A dyadic influence of both on sexual satisfaction was observed only in male couples, as well as a detriment of sexual satisfaction when there were discrepancies in them, especially in women. Moreover, relationship satisfaction was a significant mediator between all dimensions of SOE and sexual satisfaction in both types of couples. This work highlights the need to take into account the SOE of both partners and how this individual experience can affect other dimensions of a more interpersonal nature, such as sexual or relationship satisfaction.

Development of the Italian version of the Orgasmic Perception Questionnaire (OPQ).

Orgasm is a phase of the human sexual response, and the possible discrepancies between male and female ways to experience it are still not clear in the literature. There is a lack of tools to adequately assess orgasm perception. This study aims to develop an instrument and verify possible differences between males and females. We constructed the Orgasmic Perception Questionnaire (OPQ) through different stages: first, 316 items selection was conducted on a sample of 96 people, where items came mainly from written descriptions of orgasm perception; second, an exploratory factor analysis was conducted on 674 Italian adults with a 63-item OPQ; finally, a confirmatory factor analysis was conducted on 1100 Italian adults with a 47-item OPQ. In the first study, 63 items fitted an equidistributional pattern and were to form the 63-item OPQ used for EFA. The EFA showed that five factors out of 47 explained 44.01% of the total variance and were named: Ecstasy, Contractions, Relaxation, Power, and Sensations. The confirmatory factor analyses run on the 47-item OPQ confirmed that the five-factor structure fits. Moreover, females scored higher than males with an adequate effect size in two factors: Contractions and Sensations. In conclusion, the OPQ could be a useful tool in both clinical settings and research studies to investigate the perception of orgasmic experience in its totality.

Not Who You Are, But Who You Are With: Re-examining Women's Less Satisfying Sexual Debuts.

Gender differences in appraisals of first intercourse are among the largest in sexuality research, with women indicating less satisfying "sexual debuts" than men. Dispositional or "actor-level" explanations for this gender gap are pervasive, yet research has largely examined heterosexual debuts in which actor gender and partner gender are confounded. We assessed whether women's less satisfying sexual debuts are better explained by actor gender or partner gender, comparing experiences of women who debuted with men (WDM) with those of men and women who debuted with women (MDW, WDW). Retrospective accounts of sexual debut were collected from 3033 adults. At first intercourse, we found that WDW had equal physical and emotional satisfaction to MDW, and more satisfaction than WDM, suggesting satisfaction gaps owing to partner gender, not actor gender. This pattern did not extend to a comparison event (first masturbation), where WDW and WDM had similar satisfaction, but less satisfaction than MDW, suggesting an actor gender gap. To identify sources of satisfaction gaps, we probed for corresponding differences in the circumstances of sexual debut. Sexual circumstances were more strongly implicated than nonsexual ones, with relative deprivation of glans stimulation explaining relative dissatisfaction at first intercourse, but not first masturbation, and orgasm explaining it at both. Findings challenge the view that the satisfaction gap at first intercourse reflects an inherent difference between genders. Indeed, they demonstrate similarities when partner gender does not differ and suggest strategies for ensuring equal sexual satisfaction-and equal sexual rights realization-at (hetero) sexual debut.

Endogenous Opioid Release After Orgasm in Man: A Combined PET/Functional MRI Study.

The endogenous µ-opioid receptor (MOR) system plays a key role in the mammalian reward circuit. Human and animal experiments suggest the involvement of MORs in human sexual pleasure, yet this hypothesis currently lacks in vivo support. Methods: We used PET with the radioligand [11C]carfentanil, which has high affinity for MORs, to quantify endogenous opioid release after orgasm in man. Participants were scanned once immediately after orgasm and once in a baseline state. Hemodynamic activity was measured with functional MRI during penile stimulation. Results: The PET data revealed significant opioid release in the hippocampus. Hemodynamic activity in the somatosensory and motor cortices and in the hippocampus and thalamus increased during penile stimulation, and thalamic activation was linearly dependent on self-reported sexual arousal. Conclusion: Our data show that endogenous opioidergic activation in the medial temporal lobe is centrally involved in sexual arousal, and this circuit may be implicated in orgasmic disorders.

The Relational Nature of Gender, the Pervasiveness of Heteronormative Sexual Scripts, and the Impact on Sexual Pleasure.

This study examined how gender shapes sexual interactions and pleasure outcomes. We highlight varying expectations people have in regard to sex by combining questions about orgasm frequency and sexual pleasure. Our analysis was driven from a sample of 907 survey responses from cis women, cis men, trans women, trans men, non-binary, and intersex millennial respondents, 324 of which had gender-diverse sexual histories. The findings built upon previous literature about the orgasm gap by including those with underrepresented gender identities and expanding our conceptualization of gender's role in the gap beyond gender identity. Qualitative results indicated that individuals change their behavior based on their partner's gender and follow strong gendered scripts. Participants also relied upon heteronormative scripts and cis normative roles to set their interactions for the sexual encounter. Our findings support previous research on how gender identity impacts pleasure outcomes and has implications for how we might make gender progress in the arena of sexuality.

Neuroelectric Correlates of Human Sexuality: A Review and Meta-Analysis.

Many reviews on sexual arousal in humans focus on different brain imaging methods and behavioral observations. Although neurotransmission in the brain is mainly performed through electrochemical signals, there are no systematic reviews of the electrophysiological correlates of sexual arousal. We performed a systematic search on this subject and reviewed 255 studies including various electrophysiological methods. Our results show how neuroelectric signals have been used to investigate genital somatotopy as well as basic genital physiology during sexual arousal and how cortical electric signals have been recorded during orgasm. Moreover, experiments on the interactions of cognition and sexual arousal in healthy subjects and in individuals with abnormal sexual preferences were analyzed as well as case studies on sexual disturbances associated with diseases of the nervous system. In addition, 25 studies focusing on brain potentials during the interaction of cognition and sexual arousal were eligible for meta-analysis. The results showed significant effect sizes for specific brain potentials during sexual stimulation (P3: Cohen's d = 1.82, N = 300, LPP: Cohen's d = 2.30, N = 510) with high heterogeneity between the combined studies. Taken together, our review shows how neuroelectric methods can consistently differentiate sexual arousal from other emotional states.

The complexity of female orgasm and ejaculation.

The anatomy and physiology of the female orgasm are often neglected. The female orgasm is a normal psychophysiological function to all women, and some even can achieve ejaculation as part of the normal physiological response at the height of sexual arousal. The complexity of female sexuality requires a deep understanding of genital anatomy. The clitoris is the principal organ for female pleasure. The vaginal stimulation of the anterior vaginal wall led women to orgasm due to the stimulation of the clitourethrovaginal complex and not due to stimulation of a particular organ called the G spot in the anterior distal vaginal wall. Female ejaculation follows orgasm. It consists of the orgasmic expulsion of a smaller quantity of whitish fluid produced by the female prostate. Squirting can be differentiated from female ejaculation because it is the orgasmic transurethral expulsion of a substantial amount of diluted urine during sexual activity, and it is not considered pathological. The female orgasm is influenced by many aspects such as communication, emotional intimacy, long-standing relationship, adequate body image and self-esteem, proper touching and knowledge of the female body, regular masturbation, male sexual performance, male and female fertility, chronic pain, and capacity to engage in new sexual acts. Stronger orgasms could be achieved when clitoral stimulation, anterior vaginal wall stimulation, and oral sex is involved in the same sexual act.

The self-assessment of genital anatomy, sexual function, and genital sensation (SAGASF-M) questionnaire in a Belgian Dutch-speaking male population: A validating study.

INTRODUCTION: Penile and genital surgery for congenital or acquired conditions is daily practice in reconstructive urology. These procedures, which carry the risk of disrupting nerves and blood vessels, may impair the genital sensation, and affect the capacity for sexual pleasure. Self-reported tools are needed to systematically assess the male genitalia before and after reconstructive surgeries in terms of genital sensation and sexual experience. AIM: This study validated the Dutch translation of the "self-assessment of genital anatomy and sexual functioning in male" (SAGASF-M) questionnaire and investigated the perceptions of healthy men regarding their genital anatomy and sensory function. METHODS: Eight hundred and eight sexually active men with a median age of 39 years (18-79 years) and no history of genital procedures other than circumcision filled out an online version of the questionnaire. Twenty-four participants were randomly recruited to confirm the responses of the "self-assessment of genital anatomy and sexual functioning in male" questionnaire by a clinical evaluation. MAIN OUTCOME MEASURES: The "self-assessment of genital anatomy and sexual functioning in male" questionnaire comprises of multiple-choice questions and clarifying illustrations asking men to rate their genital appearance, overall sexual sensitivity, and pain perception as well as the intensity and the effort to reach orgasm. Prespecified regions of the glans, penile shaft, scrotum, perineum, and anus are evaluated through this questionnaire. RESULTS: Only slight variability in anatomical ratings was observed. Overall discrimination between different genital areas in terms of genital sensation was significant. The bottom of the glans or frenular area was rated the highest contributor to "sexual pleasure," followed by the other regions of the glans and shaft. The same distribution was found for "orgasm intensity" and "orgasm effort." The anal region was generally rated the lowest. "Discomfort/pain" was rated lower than any of the other sensory function indicators and the top of the glans and anal region were rated most likely to perceive this unpleasant sensation. Participants reported significantly more sexual pleasure and intense orgasms when stimulated by a sexual partner than self-stimulation. Homosexual and bisexual men reported a higher contribution of the perineal and anal regions in sexual pleasure and orgasm. No significant difference between circumcised and uncircumcised individuals regarding overall genital sensation could be found. CONCLUSION: The Dutch translation of the SAGASF-M questionnaire is a valuable and reliable tool for self-assessment of genital anatomy and sensation, providing a site-specific attribution of a patient's perceived sexual function. Further prospective research with this questionnaire could aid in the patient-centered improvement of genital surgery.

The female orgasm and the homology concept in evolutionary biology.

The definition of homology and its application to reproductive structures, external genitalia, and the physiology of sexual pleasure has a tortuous history. While nowadays there is a consensus on the developmental homology of genital and reproductive systems, there is no agreement on the physiological translation, or the evolutionary origination and roles, of these structural correspondences and their divergent histories. This paper analyzes the impact of evolutionary perspectives on the homology concept as applied to the female orgasm, and their consequences for the biological and social understanding of female sexuality and reproduction. After a survey of the history of pre-evolutionary biomedical views on sexual difference and sexual pleasure, we examine how the concept of sexual homology was shaped in the new phylogenetic framework of the late 19th century. We then analyse the debates on the anatomical locus of female pleasure at the crossroads of theories of sexual evolution and new scientific discourses in psychoanalysis and sex studies. Moving back to evolutionary biology, we explore the consequences of neglecting homology in adaptive explanations of the female orgasm. The last two sections investigate the role played by different articulations of the homology concept in evolutionary developmental explanations of the origin and evolution of the female orgasm. These include the role of sexual, developmental homology in the byproduct hypothesis, and a more recent hypothesis where a phylogenetic, physiological concept of homology is used to account for the origination of the female orgasm. We conclude with a brief discussion on the social implications for the understanding of female pleasure derived from these different homology frameworks.

The influence of sexual arousal on subjective pain intensity during a cold pressor test in women.

BACKGROUND & OBJECTIVES: Pain can be significantly lessened by sex/orgasm, likely due to the release of endorphins during sex, considered potent analgesics. The evidence suggests that endorphins are also present during sexual arousal (that is, prior to sex/orgasm). It follows then that pain can be modulated during sexual arousal, independent of sex/orgasm, too. Accordingly, sexual arousal induced by erotic slides has been demonstrated to lessen pain in men, but not in women. One explanation could be that for women, the erotic slides were not potent enough to elicit a lasting primed state of sexual arousal by the time pain was induced. Thus, the current study aims to optimize the means of inducing a potent state of sexual arousal and subsequently examine the potentially analgesic influence of sexual arousal on pain in women. As a subsidiary aim, the study also assesses whether the anticipated analgesic effect of sexual arousal would be stronger than that of distraction or generalized (non-sexual) arousal. METHODS: Female participants (N = 151) were randomly distributed across four conditions: sexual arousal, generalized arousal, distraction, neutral. Mild pain was induced using a cold pressor while participants were concurrently exposed to film stimuli (pornographic, exciting, distracting, neutral) to induce the targeted emotional states. A visual analogue scale was utilized to measure the subjective level of pain perceived by the participants. RESULTS: Sexual arousal did not reduce subjective pain. Generalized arousal and distraction did not result in stronger analgesic effects than the neutral condition. CONCLUSION: The present findings do not support the hypothesis that sexual arousal alone modulates subjective pain in women. This might be due to the possibility that genital stimulation and/or orgasm are key in pain reduction, or, that feelings of disgust may inadvertently have been induced by the pornographic stimulus and interfered with sexual arousal in influencing pain.

Enhanced visualization of female squirting.

INTRODUCTION: Squirting is the involuntary expulsion of fluid from the female urethra following stimulation of the anterior vaginal wall before or during orgasm. The mechanism underlying squirting has not been established. PURPOSE: To elucidate the mechanism of squirting. METHODS: The subjects in the current study were women who were able to squirt. They were not sex workers. A urethral catheter was inserted before sexual stimulation and the bladder was emptied. Then, a mixture of indigo carmine (10 ml) and saline (40 ml) was injected into the bladder. Sexual stimulation was provided to facilitate squirting, which was videotaped and verified. The secretions were collected in sterile cups, and prostate specific antigen (PSA) and glucose levels were measured. RESULTS: Five women (2 in the 30s, 2 in the 40s, and 1 in the 50s) participated in this study. All women were able to squirt; three squirted only with manual sexual stimulation and two with penetrative sexual stimulation. The discharged fluid was blue in all cases, confirming the bladder as the source. The fluid was PSA-positive in four patients. CONCLUSIONS: The main component of squirt fluid is urine, but may also contain fluid from Skene's glands (female prostate). This is the first report in which visualization of squirting was enhanced.

Orgasm Rating Scale and Bodily Sensations of Orgasm Scale: Validation for Use With Pre, Peri, and Post-Menopausal Women.

BACKGROUND: Orgasm, particularly in older women, remains a poorly understood aspect of female sexual response partly because of a lack of validated self-report measures. AIM: To evaluate the Orgasm Rating Scale (ORS) and Bodily Sensations of Orgasm Scale (BSOS) for use with pre, peri, and post-menopausal women and between solitary and partnered orgasm contexts. METHODS: Participants (solitary context, 252 pre, 139 peri, 190 post; partnered context, 229 pre, 136 peri, and 194 post-menopausal women, aged 18-82 years) were asked to complete an online questionnaire based on most recent solitary and partnered orgasm. Principal components analysis with Varimax rotation summarized the data into interpretable baseline models for all groups. Multi-Group Confirmatory Factor Analysis tested for multi-group measurement invariance. Adjustments to the models were made, and final model structures were presented. MAIN OUTCOME MEASURES: ORS and BSOS measuring solitary and/or masturbation and partnered orgasm. RESULTS: For the ORS, 10 factor solutions were preferred, explaining 81% (pre), 80% (peri), and 81% (post) of the variance for the solitary and 83% (pre), 86% (peri), and 84% (post) of the variance for the partnered context. Factors included pleasurable satisfaction, ecstasy, emotional intimacy, relaxation, building sensations, flooding sensations, flushing sensations, shooting sensations, throbbing sensations, and general spasms. For the BSOS, 3 factor solutions were preferred, explaining 55% (pre), 60% (peri), and 56% (post) of the variance for the solitary and 56% (pre), 61% (peri), and 60% (post) of the variance for the partnered context. Factors included extragenital sensations, genital sensations and spasms, and nociceptive sensations and sweating responses. Divergent validity was observed (solitary r = -.04; partnered r = -.11) and configural, metric and scalar invariance for the solitary and partnered versions of the ORS and BSOS were found, suggesting the measures were interpreted similarly by all women. CLINICAL IMPLICATIONS: With valid measurement tools, women's varying orgasm experiences can be investigated more systematically and compared to address gaps and conflicts in the existing literature. Ultimately, these additions may assist with improved interventions for women who are unsatisfied with their orgasm experiences. STRENGTHS AND LIMITATIONS: Strengths include gaining the ability to compare age and menopausal status groups using empirically validated measures of orgasm experience. Limitations include cross-sectional design and lack of test-retest reliability measurement. CONCLUSION: The ORS and BSOS are supported for use with women across adulthood in solitary and partnered orgasm contexts and can be used concurrently to provide a comprehensive assessment. Webb AE, Reissing ED, Huta V. Orgasm Rating Scale and Bodily Sensations of Orgasm Scale: Validation for Use With Pre, Peri, and Post-Menopausal Women. J Sex Med 2022;19:1156-1172.

Medical Treatment of Disorders of Ejaculation.

Ejaculation and orgasm are complex phenomena within the male sexual response cycle. Disordered ejaculation commonly presents as premature or delayed ejaculation, although issues with painful ejaculation, retrograde ejaculation, or postorgasmic illness syndrome are also seen. This article will review the pathophysiology of these conditions as well as the current pharmacologic treatments available.