Advertisement

Intimacy and the Brain: Lessons from Genital and Sexual Touch

  • Janniko R. GeorgiadisEmail author
  • Morten L. Kringelbach
Chapter

Abstract

The fusion of the male and female gamete is usually preceded by intense interpersonal touch, especially involving stimulation of parts of the genital tract. However, the effects of sexual genital stimulation reach beyond fertilization and reproduction, as shown by experimental evidence that the pleasure drawn from it drives sexual desire, mediates the formation of sexual preferences, and improves general well-being. The brain processes sexual stimuli like other pleasurable stimuli, which means that they go through a cycle where they are identified, desired, consumed, and devalued. Genital receptors and nerve fibers may thus primarily serve a proximal master—pleasure. In this chapter, we outline what is known about the peripheral and central processes involved in the perception of pleasurable sexual touch and intimacy. As sexual behavior is typically social (i.e., involves human stimuli), genital afferent input might well adhere to the principles of the social touch system.

Keywords

Genitalia Small diameter fibers Central body maps Sexual pleasure cycle Erogenous zones Incentive motivation Psychophysics Neuroimaging 

References

  1. Ackerley R, Backlund Wasling H, Liljencrantz J, Olausson H, Johnson RD, Wessberg J (2014) Human C-tactile afferents are tuned to the temperature of a skin-stroking caress. J Neurosci 34:2879–2883PubMedPubMedCentralCrossRefGoogle Scholar
  2. Agmo A (2007) Functional and dysfunctional sexual behavior: a synthesis of neuroscience and comparative psychology. Academic, OxfordGoogle Scholar
  3. Agmo A, Berenfeld R (1990) Reinforcing properties of ejaculation in the male rat: role of opioids and dopamine. Behav Neurosci 104:177–182PubMedCrossRefGoogle Scholar
  4. Allison T, McCarthy G, Luby M, Puce A, Spencer DD (1996) Localization of functional regions of human mesial cortex by somatosensory evoked potential recording and by cortical stimulation. Electroencephalogr Clin Neurophysiol 100:126–140PubMedCrossRefGoogle Scholar
  5. Anzellotti F, Franciotti R, Bonanni L, Tamburro G, Perrucci MG, Thomas A, Pizzella V, Romani GL, Onofrj M (2010) Persistent genital arousal disorder associated with functional hyperconnectivity of an epileptic focus. Neuroscience 167:88–96PubMedCrossRefGoogle Scholar
  6. Ardiel EL, Rankin CH (2010) The importance of touch in development. Paediatr Child Health 15:153–156PubMedPubMedCentralGoogle Scholar
  7. Aull-Watschinger S, Pataraia E, Baumgartner C (2008) Sexual auras: predominance of epileptic activity within the mesial temporal lobe. Epilepsy Behav 12:124–127PubMedCrossRefGoogle Scholar
  8. Beric A, Light JK (1993) Anorgasmia in anterior spinal cord syndrome. J Neurol Neurosurg Psychiatry 56:548–551PubMedPubMedCentralCrossRefGoogle Scholar
  9. Berridge KC (1996) Food reward: brain substrates of wanting and liking. Neurosci Biobehav Rev 20:1–25PubMedCrossRefGoogle Scholar
  10. Berridge KC, Robinson TE (2003) Parsing reward. Trends Neurosci 26:507–513PubMedCrossRefGoogle Scholar
  11. Bindra D (1974) A motivational view of learning, performance, and behavior modification. Psychol Rev 81:199–213PubMedCrossRefGoogle Scholar
  12. Bjornsdotter M, Morrison I, Olausson H (2010) Feeling good: on the role of C fiber mediated touch in interoception. Exp Brain Res 207:149–155PubMedCrossRefGoogle Scholar
  13. Bleustein CB, Eckholdt H, Arezzo JC, Melman A (2003) Quantitative somatosensory testing of the penis: optimizing the clinical neurological examination. J Urol 169:2266–2269PubMedCrossRefGoogle Scholar
  14. Bradley WE, Farrell DF, Ojemann GA (1998) Human cerebrocortical potentials evoked by stimulation of the dorsal nerve of the penis. Somatosens Mot Res 15:118–127PubMedCrossRefGoogle Scholar
  15. Burgdorf J, Panksepp J (2001) Tickling induces reward in adolescent rats. Physiol Behav 72:167–173PubMedCrossRefGoogle Scholar
  16. Cerkevich CM, Qi HX, Kaas JH (2013) Thalamic input to representations of the teeth, tongue, and face in somatosensory area 3b of macaque monkeys. J Comp Neurol 521:3954–3971PubMedPubMedCentralGoogle Scholar
  17. Coolen LM, Peters HJ, Veening JG (1998) Anatomical interrelationships of the medial preoptic area and other brain regions activated following male sexual behavior: a combined fos and tract-tracing study. J Comp Neurol 397:421–435PubMedCrossRefGoogle Scholar
  18. Coria-Avila GA, Ouimet AJ, Pacheco P, Manzo J, Pfaus JG (2005) Olfactory conditioned partner preference in the female rat. Behav Neurosci 119:716–725PubMedCrossRefGoogle Scholar
  19. Di Noto PM, Newman L, Wall S, Einstein G (2013) The hermunculus: what is known about the representation of the female body in the brain? Cereb Cortex 23:1005–1013PubMedCrossRefGoogle Scholar
  20. Dogiel AS (1983) Die nervenendigungen in der haut der ausserengenitalorgane des menschen. Arch Mikr Anat Forsch 41:585–612CrossRefGoogle Scholar
  21. Eickhoff SB, Jbabdi S, Caspers S, Laird AR, Fox PT, Zilles K, Behrens TE (2010) Anatomical and functional connectivity of cytoarchitectonic areas within the human parietal operculum. J Neurosci 30:6409–6421PubMedPubMedCentralCrossRefGoogle Scholar
  22. Everaert K, de Waard WI, Van Hoof T, Kiekens C, Mulliez T, D’herde C (2010) Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves. Spinal Cord 48:182–191PubMedCrossRefGoogle Scholar
  23. Feinsod M (2005) Kershman’s sad reflections on the homunculus: a historical vignette. Neurology 64:524–525PubMedCrossRefGoogle Scholar
  24. Ferretti A, Caulo M, Del Gratta C, Di Matteo R, Merla A, Montorsi F, Pizzella V, Pompa P, Rigatti P, Rossini PM, Salonia A, Tartaro A, Romani GL (2005) Dynamics of male sexual arousal: distinct components of brain activation revealed by fMRI. Neuroimage 26:1086–1096PubMedCrossRefGoogle Scholar
  25. Forss N, Salmelin R, Hari R (1994) Comparison of somatosensory evoked fields to airpuff and electric stimuli. Electroencephalogr Clin Neurophysiol 92:510–517PubMedCrossRefGoogle Scholar
  26. Friedman DP, Murray EA, O’Neill JB, Mishkin M (1986) Cortical connections of the somatosensory fields of the lateral sulcus of macaques: evidence for a corticolimbic pathway for touch. J Comp Neurol 252:323–347PubMedCrossRefGoogle Scholar
  27. Frohlich PF, Meston CM (2005) Tactile sensitivity in women with sexual arousal disorder. Arch Sex Behav 34:207–217PubMedCrossRefGoogle Scholar
  28. Gazzola V, Spezio ML, Etzel JA, Castelli F, Adolphs R, Keysers C (2012) Primary somatosensory cortex discriminates affective significance in social touch. Proc Natl Acad Sci U S A 109:E1657–66PubMedPubMedCentralCrossRefGoogle Scholar
  29. Georgiadis JR, Holstege G (2005) Human brain activation during sexual stimulation of the penis. J Comp Neurol 493:33–38PubMedCrossRefGoogle Scholar
  30. Georgiadis JR, Kringelbach ML (2012) The human sexual response cycle: brain imaging evidence linking sex to other pleasures. Prog Neurobiol 98:49–81PubMedCrossRefGoogle Scholar
  31. Georgiadis JR, Kortekaas R, Kuipers R, Nieuwenburg A, Pruim J, Reinders AATS, Holstege G (2006) Regional cerebral blood flow changes associated with clitorally induced orgasm in healthy women. Eur J Neurosci 24:3305–3316PubMedCrossRefGoogle Scholar
  32. Georgiadis JR, Reinders AA, van der Graaf FH, Paans AM, Kortekaas R (2007) Brain activation during human male ejaculation revisited. Neuroreport 18:553–557PubMedCrossRefGoogle Scholar
  33. Georgiadis JR, Reinders AA, Paans AM, Renken R, Kortekaas R (2009) Men versus women on sexual brain function: prominent differences during tactile genital stimulation, but not during orgasm. Hum Brain Mapp 30:3089–3101PubMedCrossRefGoogle Scholar
  34. Georgiadis JR, Farrell M, Boessen R, Denton D, Gavrilescu M, Kortekaas R, Renken RJ, Hoogduin JM, Egan G (2010) Dynamic subcortical blood flow during male sexual activity with ecological validity: a perfusion fMRI study. Neuroimage 50:208–216PubMedCrossRefGoogle Scholar
  35. Georgiadis JR, Kringelbach ML, Pfaus JG (2012) Sex for fun: a synthesis of human and animal neurobiology. Nat Rev Urol 9:486–498PubMedCrossRefGoogle Scholar
  36. Gomora P, Beyer C, Gonzalez-Mariscal G, Komisaruk BR (1994) Momentary analgesia produced by copulation in female rats. Brain Res 656:52–58PubMedCrossRefGoogle Scholar
  37. Grefkes C, Geyer S, Schormann T, Roland P, Zilles K (2001) Human somatosensory area 2: observer-independent cytoarchitectonic mapping, interindividual variability, and population map. Neuroimage 14:617–631PubMedCrossRefGoogle Scholar
  38. Guerit JM, Opsomer RJ (1991) Bit-mapped imaging of somatosensory evoked potentials after stimulation of the posterior tibial nerves and dorsal nerve of the penis/clitoris. Electroencephalogr Clin Neurophysiol 80:228–237PubMedCrossRefGoogle Scholar
  39. Halata Z, Munger BL (1986) The neuroanatomical basis for the protopathic sensibility of the human glans penis. Brain Res 371:205–230PubMedCrossRefGoogle Scholar
  40. Helpman L, Greenstein A, Hartoov J, Abramov L (2009) Genito-sensory analysis in women with arousal and orgasmic dysfunction. J Sex Med 6:1039–1044PubMedCrossRefGoogle Scholar
  41. Hilti LM, Hanggi J, Vitacco DA, Kraemer B, Palla A, Luechinger R, Jancke L, Brugger P (2013) The desire for healthy limb amputation: structural brain correlates and clinical features of xenomelia. Brain 136:318–329PubMedCrossRefGoogle Scholar
  42. Hoffmann H (2012) Considering the role of conditioning in sexual orientation. Arch Sex Behav 41:63–71PubMedCrossRefGoogle Scholar
  43. Hull EM, Dominguez JM (2007) Sexual behavior in male rodents. Horm Behav 52:45–55PubMedPubMedCentralCrossRefGoogle Scholar
  44. Janszky J, Ebner A, Szupera Z, Schulz R, Hollo A, Szucs A, Clemens B (2004) Orgasmic aura—a report of seven cases. Seizure 13:441–444PubMedCrossRefGoogle Scholar
  45. Jiao C, Knight PK, Weerakoon P, Turman AB (2007) Effects of visual erotic stimulation on vibrotactile detection thresholds in men. Arch Sex Behav 36:787–792PubMedCrossRefGoogle Scholar
  46. Johnson RD (1988) Efferent modulation of penile mechanoreceptor activity. Prog Brain Res 74:319–324PubMedCrossRefGoogle Scholar
  47. Johnson RD, Halata Z (1991) Topography and ultrastructure of sensory nerve endings in the glans penis of the rat. J Comp Neurol 312:299–310PubMedCrossRefGoogle Scholar
  48. Johnson RD, Kitchell RL (1987) Mechanoreceptor response to mechanical and thermal stimuli in the glans penis of the dog. J Neurophysiol 57:1813–1836PubMedGoogle Scholar
  49. Johnson BM, Komisaruk BR (1996) Antinociceptive action of vaginocervical stimulation in rat spinal cord: 2-DG analysis. Physiol Behav 60:979–983PubMedCrossRefGoogle Scholar
  50. Kell CA, von Kriegstein K, Rosler A, Kleinschmidt A, Laufs H (2005) The sensory cortical representation of the human penis: revisiting somatotopy in the male homunculus. J Neurosci 25:5984–5987PubMedCrossRefGoogle Scholar
  51. Komisaruk BR, Wise N, Frangos E, Liu WC, Allen K, Brody S (2011) Women’s clitoris, vagina, and cervix mapped on the sensory cortex: FMRI evidence. J Sex Med 8(10):2822–2830PubMedPubMedCentralCrossRefGoogle Scholar
  52. Kortekaas R, Nanetti L, Overgoor M, De Jong BM, Georgiadis JR (2015) Central somatosensory networks respond to a de novo innervated penis in spina bifida J Sex Med 12:1865–1877Google Scholar
  53. Kringelbach ML, Stein A, van Hartevelt TJ (2012) The functional human neuroanatomy of food pleasure cycles. Physiol Behav 106:307–316PubMedCrossRefGoogle Scholar
  54. Lahuerta J, Bowsher D, Lipton S, Buxton PH (1994) Percutaneous cervical cordotomy: a review of 181 operations on 146 patients with a study on the location of “pain fibers” in the C-2 spinal cord segment of 29 cases. J Neurosurg 80:975–985Google Scholar
  55. Lee PA, Houk CP, Husmann DA (2010) Should male gender assignment be considered in the markedly virilized patient with 46, XX and congenital adrenal hyperplasia? J Urol 184:1786–1792PubMedCrossRefGoogle Scholar
  56. Lefaucheur JP, Yiou R, Salomon L, Chopin DK, Abbou CC (2000) Assessment of penile small nerve fiber damage after transurethral resection of the prostate by measurement of penile thermal sensation. J Urol 164:1416–1419PubMedCrossRefGoogle Scholar
  57. Leiblum SR, Nathan SG (2001) Persistent sexual arousal syndrome: a newly discovered pattern of female sexuality. J Sex Marital Ther 27:365–380PubMedCrossRefGoogle Scholar
  58. Leknes S, Tracey I (2008) A common neurobiology for pain and pleasure. Nat Rev Neurosci 9:314–320PubMedCrossRefGoogle Scholar
  59. Levin RJ (2009) Revisiting post-ejaculation refractory time-what we know and what we do not know in males and in females. J Sex Med 6:2376–2389PubMedCrossRefGoogle Scholar
  60. Mäkelä JP, Illman M, Jousmaki V, Numminen J, Lehecka M, Salenius S, Forss N, Hari R (2003) Dorsal penile nerve stimulation elicits left-hemisphere dominant activation in the second somatosensory cortex. Hum Brain Mapp 18:90–99PubMedCrossRefGoogle Scholar
  61. Marson L (1995) Central nervous system neurons identified after injection of pseudorabies virus into the rat clitoris. Neurosci Lett 190:41–44PubMedCrossRefGoogle Scholar
  62. Marson L, Murphy AZ (2006) Identification of neural circuits involved in female genital responses in the rat: A dual virus and anterograde tracing study. Am J Physiol Regul Integr Comp Physiol 291:R419–R428PubMedPubMedCentralCrossRefGoogle Scholar
  63. McDonald JW, Sadowsky C (2002) Spinal-cord injury. Lancet 359:417–425PubMedCrossRefGoogle Scholar
  64. McGlone F, Wessberg J, Olausson H (2014) Discriminative and affective touch: sensing and feeling. Neuron 82:737–755PubMedCrossRefGoogle Scholar
  65. Mehnert U, Boy S, Svensson J, Michels L, Reitz A, Candia V, Kleiser R, Kollias S, Schurch B (2008) Brain activation in response to bladder filling and simultaneous stimulation of the dorsal clitoral nerve—an fMRI study in healthy women. Neuroimage 41:682–689PubMedCrossRefGoogle Scholar
  66. Michels L, Mehnert U, Boy S, Schurch B, Kollias S (2010) The somatosensory representation of the human clitoris: an fMRI study. Neuroimage 49:177–184PubMedCrossRefGoogle Scholar
  67. Morrison I, Bjornsdotter M, Olausson H (2011) Vicarious responses to social touch in posterior insular cortex are tuned to pleasant caressing speeds. J Neurosci 31:9554–9562PubMedCrossRefGoogle Scholar
  68. Morrissette DL, Goldstein MK, Raskin DB, Rowland DL (1999) Finger and penile tactile sensitivity in sexually functional and dysfunctional diabetic men. Diabetologia 42:336–342PubMedCrossRefGoogle Scholar
  69. Moulier V, Mouras H, Pelegrini-Issac M, Glutron D, Rouxel R, Grandjean B, Bittoun J, Stoleru S (2006) Neuroanatomical correlates of penile erection evoked by photographic stimuli in human males. Neuroimage 33:689–699PubMedCrossRefGoogle Scholar
  70. Nakagawa H, Namima T, Aizawa M, Uchi K, Kaiho Y, Yoshikawa K, Orikasa S, Nakasato N (1998) Somatosensory evoked magnetic fields elicited by dorsal penile, posterior tibial and median nerve stimulation. Electroencephalogr Clin Neurophysiol 108:57–61PubMedCrossRefGoogle Scholar
  71. Normandin JJ, Murphy AZ (2011) Somatic genital reflexes in rats with a nod to humans: anatomy, physiology, and the role of the social neuropeptides. Horm Behav 59:656–665PubMedPubMedCentralCrossRefGoogle Scholar
  72. Overgoor ML, Kon M, Cohen-Kettenis PT, Strijbos SA, de Boer N, de Jong TP (2006) Neurological bypass for sensory innervation of the penis in patients with spina bifida. J Urol 176:1086–90; discussion 1090PubMedCrossRefGoogle Scholar
  73. Overgoor ML, de Jong TP, Cohen-Kettenis PT, Edens MA, Kon M (2013) Increased sexual health after restored genital sensation in male patients with spina bifida or a spinal cord injury: the TOMAX procedure. J Urol 189:626–632PubMedCrossRefGoogle Scholar
  74. Paick JS, Jeong H, Park MS (1998) Penile sensitivity in men with premature ejaculation. Int J Impot Res 10:247–250PubMedCrossRefGoogle Scholar
  75. Parada M, Chamas L, Censi S, Coria-Avila G, Pfaus JG (2010) Clitoral stimulation induces conditioned place preference and fos activation in the rat. Horm Behav 57:112–118PubMedCrossRefGoogle Scholar
  76. Parada M, Sparks LM, Censi S, Pfaus JG (2014) Clitoral anesthesia disrupts paced copulation in the female rat. Physiol Behav 123:180–186PubMedCrossRefGoogle Scholar
  77. Paredes-Ramos P, Miquel M, Manzo J, Pfaus JG, Lopez-Meraz ML, Coria-Avila GA (2012) Tickling in juvenile but not adult female rats conditions sexual partner preference. Physiol Behav 107:17–25PubMedCrossRefGoogle Scholar
  78. Paterson LQ, Amsel R, Binik YM (2013) Pleasure and pain: the effect of (almost) having an orgasm on genital and nongenital sensitivity. J Sex Med 10:1531–1544PubMedCrossRefGoogle Scholar
  79. Penfield W, Kristiansen K (1951) Epileptic seizure patterns. Charles C. Thomas, SpringfieldGoogle Scholar
  80. Penfield W, Rasmussen T (1950) The cerebral cortex of man. A clinical study of localization of function. The Macmillan Comp, New YorkGoogle Scholar
  81. Pfaus JG (2009) Pathways of sexual desire. J Sex Med 6:1506–1533PubMedCrossRefGoogle Scholar
  82. Pfaus JG, Kippin TE, Coria-Avila GA, Gelez H, Afonso VM, Ismail N, Parada M (2012) Who, what, where, when (and maybe even why)? How the experience of sexual reward connects sexual desire, preference, and performance. Arch Sex Behav 41(1):31–62PubMedCrossRefGoogle Scholar
  83. Pitchers KK, Vialou V, Nestler EJ, Laviolette SR, Lehman MN, Coolen LM (2013) Natural and drug rewards act on common neural plasticity mechanisms with DeltaFosB as a key mediator. J Neurosci 33:3434–3442PubMedPubMedCentralCrossRefGoogle Scholar
  84. Ploner M, Gross J, Timmermann L, Schnitzler A (2002) Cortical representation of first and second pain sensation in humans. Proc Natl Acad Sci U S A 99:12444–12448PubMedPubMedCentralCrossRefGoogle Scholar
  85. Pukall CF, Strigo IA, Binik YM, Amsel R, Khalife S, Bushnell MC (2005) Neural correlates of painful genital touch in women with vulvar vestibulitis syndrome. Pain 115:118–127PubMedCrossRefGoogle Scholar
  86. Ramachandran VS, Blakeslee S (1998) Phantoms in the brain: probing the mysteries of the human mind. William Morrow, New YorkGoogle Scholar
  87. Redouté J, Stoleru S, Gregoire MC, Costes N, Cinotti L, Lavenne F, Le Bars D, Forest MG, Pujol JF (2000) Brain processing of visual sexual stimuli in human males. Hum Brain Mapp 11:162–177PubMedCrossRefGoogle Scholar
  88. Remillard GM, Andermann F, Testa GF, Gloor P, Aube M, Martin JB, Feindel W, Guberman A, Simpson C (1983) Sexual ictal manifestations predominate in women with temporal lobe epilepsy: a finding suggesting sexual dimorphism in the human brain. Neurology 33:323–330PubMedCrossRefGoogle Scholar
  89. Robinson TE, Berridge KC (1993) The neural basis of drug craving: an incentive-sensitization theory of addiction. Brain Res Brain Res Rev 18:247–291PubMedCrossRefGoogle Scholar
  90. Rowland DL, Leentvaar EJ, Blom JH, Slob AK (1991) Changes in penile sensitivity following papaverine-induced erection in sexually functional and dysfunctional men. J Urol 146:1018–1021PubMedGoogle Scholar
  91. Sakuma Y, Pfaff DW (1979) Facilitation of female reproductive behavior from mesensephalic central gray in the rat. Am J Physiol 237:R278–R284PubMedGoogle Scholar
  92. Scorolli C, Ghirlanda S, Enquist M, Zattoni S, Jannini EA (2007) Relative prevalence of different fetishes. Int J Impot Res 19:432–437PubMedCrossRefGoogle Scholar
  93. Shih C, Cold CJ, Yang CC (2013) Cutaneous corpuscular receptors of the human glans clitoris: descriptive characteristics and comparison with the glans penis. J Sex Med 10:1783–1789PubMedCrossRefGoogle Scholar
  94. Spiering M, Everaerd W, Elzinga B (2002) Conscious processing of sexual information: interference caused by sexual primes. Arch Sex Behav 31:159–164PubMedCrossRefGoogle Scholar
  95. Stoleru S, Fonteille V, Cornelis C, Joyal C, Moulier V (2012) Functional neuroimaging studies of sexual arousal and orgasm in healthy men and women: a review and meta-analysis. Neurosci Biobehav Rev 36:1481–1509PubMedCrossRefGoogle Scholar
  96. Taylor JR (2007) Fine-touch pressure thresholds in the adult penis. BJU Int 100:218PubMedCrossRefGoogle Scholar
  97. Turnbull OH, Lovett VE, Chaldecott J, Lucas MD (2014) Reports of intimate touch: Erogenous zones and somatosensory cortical organization. Cortex 53:146–154PubMedCrossRefGoogle Scholar
  98. Vallbo A, Olausson H, Wessberg J, Norrsell U (1993) A system of unmyelinated afferents for innocuous mechanoreception in the human skin. Brain Res 628:301–304PubMedCrossRefGoogle Scholar
  99. Veening JG, Coolen LM (1998) Neural activation following sexual behavior in the male and female rat brain. Behav Brain Res 92:181–193PubMedCrossRefGoogle Scholar
  100. Von Frey M (1894) Beitrage zur physiologie des schmerzsinns. zweite mitt. Akad Wiss Leipzig Math -Nat Kl Ber 46:283–296Google Scholar
  101. Waldinger MD, Schweitzer DH (2009) Persistent genital arousal disorder in 18 dutch women: Part II. A syndrome clustered with restless legs and overactive bladder. J Sex Med 6:482–497PubMedCrossRefGoogle Scholar
  102. Waldinger MD, de Lint GJ, Venema PL, van Gils AP, Schweitzer DH (2010) Successful transcutaneous electrical nerve stimulation in two women with restless genital syndrome: the role of adelta- and C-nerve fibers. J Sex Med 7:1190–1199PubMedCrossRefGoogle Scholar
  103. Waldinger MD, Venema PL, van Gils AP, de Lint GJ, Schweitzer DH (2011) Stronger evidence for small fiber sensory neuropathy in restless genital syndrome: two case reports in males. J Sex Med 8:325–330PubMedCrossRefGoogle Scholar
  104. Whipple B, Komisaruk BR (1998) Analgesia produced in women by genital self-stimulation. J Sex Res 24:130–140CrossRefGoogle Scholar
  105. Yarnitsky D, Sprecher E, Vardi Y (1996) Penile thermal sensation. J Urol 156:391–393PubMedCrossRefGoogle Scholar
  106. Yilmaz U, Aksu M (2000) The postejaculatory refractory period: a neurophysiological study in the human male. BJU Int 85:1093–1096PubMedCrossRefGoogle Scholar
  107. York GK, Gabor AJ, Dreyfus PM (1979) Paroxysmal genital pain: an unusual manifestation of epilepsy. Neurology 29:516–519PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Janniko R. Georgiadis
    • 1
    Email author
  • Morten L. Kringelbach
    • 2
  1. 1.Anatomy Section, Department of NeuroscienceUniversity Medical Center GroningenGroningenThe Netherlands
  2. 2.Department of PsychiatryWarneford HospitalOxfordUK

Personalised recommendations