Monday, September 1, 2008

Dr. Gräfenberg's area: The "Grave-Spot" ?

Mindboggling. Absolutely unbelievable. BBC World News website article:

The G-spot 'doesn't appear to exist', say researchers
The elusive erogenous zone said to exist in some women may be a myth, say researchers who have hunted for it. Their study in the Journal of Sexual Medicine is the biggest yet, involving 1,800 women, and it found no proof.

The King's College London team believe the G-spot may be a figment of women's imagination...

Pardon my ironic language, but I'll be happy to draw those "researchers" a F***ING MAP !!!
This isn't philosophy, religion, or social commentary, the issue here is basic human sexual physiology. Let me lay out some facts from a medical background, from widespread knowledge, and from personal experience.
1. In men, the prostate gland is, for some, a definite erogenous zone. Some men can reach climax by having their prostate gland stimulated. This simply factual, common knowledge. For complicated psycho-sexual-social reasons, this fact is widely acknowledged among gay males but remains true also true for many heterosexual men.
2. Some men don't find prostate stimulation to be arousing. This should not be surprising. Some men are aroused by nipple stimulation, some aren't. I'm sure there are men and women who can achieve climax by having their foreheads rubbed. Some women, and maybe a very few men, can achieve climax by mental activity alone, with no physical stimulation whatsoever.
3. Therefore, to say "erogenous zone X doesn't exist, it's a myth," is utter absurdity. There is a lot of individual variation in sexuality. There may be some people who get aroused by having their second left toe stroked. If there's more than a few such people, it's reasonable to speak of the "SLT-spot." To show that the SLT-spot doesn't exist, you'd have to work individually with many, many people and determine whether arousal happens in some through stimulation of this spot. Nobody has ever done such a study on any erogenous zone.
4. Back to the G-spot in particular. The anterior vaginal wall where this area is located is EXACTLY where a woman's prostate gland would be, if she had one. That prostatic glandular tissue isn't present here (just below the bladder neck) doesn't mean that the same nerve cells a man has in this area don't exist in a woman. It just means they don't have a prostate gland in particular to innervate.
5. Under sexual arousal, pelvic tissues in both sexes can be engorged, beyond just the penis and clitoris. For example, the prostate gland can swell with sexual stimulation. Presumably, specific autonomic nerves cause blood vessels in specific areas to dilate.
6. As a doctor, I've performed hundreds of "bimanual pelvic exams." This means feeling a woman's pelvic anatomy from my fingers in her vagina. I've also had, under completely different circumstances, the opportunity to feels these same tissues in a few women during intense sexual arousal. In some women (not all), the labia and areas in the lower vagina become engorged. They just don't feel like they do during a clinical exam, when a woman is (generally) not aroused.
Some of this striking, palpable engorgement is inside the anterior, lower vagina, just below the bladder neck, exactly where a woman's prostate gland would be, if she had one. Not all women seem to have tissue here that becomes engorged during arousal. Stroking this area commonly is experienced as intensely pleasurable by many women. Some of these women have no apparent tissue engorgement here at all, but still find the stimulation pleasurable.
The BBC article conflates "female ejaculation" with the G-spot. These are different issues, but not unrelated. In my experience, a women who achieves climax with stimulation of her G-spot commonly has prodigious release of vaginal secretions. Sometimes, this is in a sudden rush. Whether some of these experiences might be urination is commonly debated. It's clear to me, though, that many experience of large fluid volume release have nothing to do with urine. I strongly suspect a rough correlation in women among the tendency of this tissue to become engorged, the degree to which simtulation of this area is pleasurable, the amount of vaginal secretions released in total, and the likelihood for a rush release to happen that corresponds to "female ejaculation." In essence, though women don't have an actual prostate gland, some seem to come fairly close to having some of the functions of one, including the area being erogenously sensitive and involved in release of secretions during arousal and orgasm.
The quality of the stimulation is of some relevance. Stroking the mucosal surface here with minimal pressure doesn't seem to do much. Somewhat firmer pressure of the deeper tissue is what arouses. This is, again, exactly as with the prostate. Lightly stroking the anterior mucosal surface of the rectum doesn't do much for a man with a sensitive prostate; massaging the gland itself with deep pressure is what arouses (so I've heard, anyway).
The very same woman who typically has a lot of fluid release around orgasm with stimulation of her G-spot may have very little fluid release with orgasm achieved mostly through clitoral stimulation. Women fairly commonly report that they experience different kinds of orgasms depending on what kind of stimulation is used. There is no reason to doubt that this kind of personal experience corresponds to sexual physiology, though the physiological details aren't clear.
So, for the "researchers" in London: there most certainly is a G-spot in many women. It either doesn't exist or is of no importance for some women. It is intensely sensitive and important to many others. The location is in the tissues just below the bladder neck, exactly where a man's prostate would be. Note that this area is not well stimulated by intercourse for most women. When adequately engorged, however, stimulation during intercourse could definitely happen, but I doubt many women experience that degree of engorgement of these tissues. (Bladder prolapse might promote stimulation of this area with intercourse--perhaps one mechanism for a few older women becoming more sexual with advanced age). The only commonplace way that this area becomes fully stimulated is with skilled human fingers. Appropriate physiological studies to prove the importance of the G-spot are feasible. However, attempting to demonstrate the sexual physiology of the G-spot through questionaires is simply ridiculous.
The study described by the BBC compared rates of self-reporting of "I have a G-spot" in women with twins, either identical or not. If identical and fraternal twins share the same rates, then identical genes do not add to the probability of a trait, and genetics are probably unimportant. This method is appropriate for determining the contributions of genes and environment to complex human traits, like mental illnesses or athletic ability.
However, the hypothesis they have failed to exclude, and which is plainly true, is that the majority of women have a G-spot, but that most have never "discovered" it, because they've never had it stimulated by appropriately skilled fingers (their own or another person's). Thus, genetic influences in the probability of "having" a G-spot (really, having "discovered" it), truly has almost nothing to do with genetics, and almost everything to do with personal experience. This is exactly what the researchers found, and they have utterly misinterpreted plain, simple facts.
The human species has been obsessed with sex for all of recorded history. How can these basic, simple, clear, straightforward facts about human sexual physiology not be clear to science? It is all simply mind-boggling.