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Introduction. The role of nipple/breast stimulation in influencing sexual arousal in men and women during lovemaking has only been the subject of opinion-based comment rather than evidence-based study. No attempt to question people about such sexual behavior has ever been undertaken. Aim. The study was designed to ascertain the effects of nipple/breast manipulation in young men and women on their sexual arousal. Methods. A short questionnaire about nipple/breast stimulation during sexual activity was administered to 301 (148 men; 153 women) sexually experienced undergraduates (age range 17–29 years, 95% between 18 and 22). Main Outcome Measures. Replies to questions in questionnaire. Results. The major findings in regard to the women were that 81.5% reported that stimulation of their nipples/breasts caused or enhanced their sexual arousal, 78.2% agreed that when sexually aroused such manipulation increased their arousal, 59.1% had asked to have their nipples stimulated during lovemaking, and only 7.2% found that the manipulation decreased their arousal. In regard to the men, 51.7% reported that nipple stimulation caused or enhanced their sexual arousal, 39% agreed that when sexually aroused such manipulation increased their arousal, only 17.1% had asked to have their nipples stimulated, and only 7.5% found that such stimulation decreased their arousal. Conclusion. Manipulation of the nipples/breasts causes or enhances sexual arousal in approximately 82% of young women and 52% of young men with only 7–8% reporting that it decreased their arousal. Levin R, and Meston C. Nipple/breast stimulation and sexual arousal in young men and women. J Sex Med 2006;3:450–454.
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J Sex Med 2006;3:450 454 © 2006 International Society for Sexual Medicine
450
Blackwell Publishing IncMalden, USAJSMJournal of Sexual Medicine1743-6095© 2006 International Society for Sexual Medicine200633450454Original ArticleBreast Stimulation in Men and WomenLevin and Meston
Nipple/Breast Stimulation and Sexual Arousal in Young Men
and Women
Roy Levin, PhD,* and Cindy Meston, PhD
*Department of Biomedical Science, University of Sheffield, Sheffield, UK; Department of Psychology, University of Texas,
Austin, TX, USA
DOI: 10.1111/j.1743-6109.2006.00230.x
ABSTRACT
Introduction. The role of nipple/breast stimulation in influencing sexual arousal in men and women during
lovemaking has only been the subject of opinion-based comment rather than evidence-based study. No attempt to
question people about such sexual behavior has ever been undertaken.
Aim. The study was designed to ascertain the effects of nipple/breast manipulation in young men and women on
their sexual arousal.
Methods. A short questionnaire about nipple/breast stimulation during sexual activity was administered to 301 (148
men; 153 women) sexually experienced undergraduates (age range 17–29 years, 95% between 18 and 22).
Main Outcome Measures. Replies to questions in questionnaire.
Results. The major findings in regard to the women were that 81.5% reported that stimulation of their nipples/
breasts caused or enhanced their sexual arousal, 78.2% agreed that when sexually aroused such manipulation
increased their arousal, 59.1% had asked to have their nipples stimulated during lovemaking, and only 7.2% found
that the manipulation decreased their arousal. In regard to the men, 51.7% reported that nipple stimulation caused
or enhanced their sexual arousal, 39% agreed that when sexually aroused such manipulation increased their arousal,
only 17.1% had asked to have their nipples stimulated, and only 7.5% found that such stimulation decreased their
arousal.
Conclusion. Manipulation of the nipples/breasts causes or enhances sexual arousal in approximately 82% of young
women and 52% of young men with only 7–8% reporting that it decreased their arousal. Levin R, and Meston
C. Nipple/breast stimulation and sexual arousal in young men and women. J Sex Med 2006;3:450–454.
Key Words. Neurophysiological Studies of Sexual Function; Central Nervous System Control; Sexual Physiology;
Sexual Biochemistry
A brief report of the study (Levin RJ, Meston C.
Nipple stimulation and sexual arousal in young
men and women [abstract]. J Sex Med 2006;3(suppl
3):247.) was presented at the European Society of
Sexual Medicine meeting at Copenhagen, Decem-
ber 2005.
Introduction
ipple and breast stimulation is a frequent
characteristic of human sexual activity
especially employed by men [1] during the early
stages of lovemaking (so-called foreplay) to
induce in women sexual arousal. Kinsey et al.
[2] claimed, however, that “while this stimulates
the male erotically . . . the significance for the
N
female has probably been overestimated.” It was
also claimed that “relatively few females even
try to stimulate the breasts of their partners.”
These opinions were voiced over 50 years
ago and appear to be authority-based rather
than evidence-based. There is little or nothing
in the literature on the possible enhancement of
sexual arousal in women and especially in men
created by breast or nipple manipulation. It was
thus thought useful to establish by a brief ques-
tionnaire the present status of breast/nipple
stimulation among young men and women in
relation to the induction/enhancement of sexual
arousal.
jsm_230.fm Page 450 Wednesday, April 12, 2006 12:23 PM
Breast Stimulation in Men and Women 451
J Sex Med 2006;3:450 454
Methods
Participants
A total of 371 undergraduate students (180 men,
191 women) at the University of Texas at Austin
participated in this study in exchange for course
credit. Participants were enrolled in either the
2003–2004 Fall sessions (September–December)
or the 2004 Spring session ( January–May). Data
from participants who reported being sexually
inexperienced (defined as not having ever experi-
enced sexual intercourse) were excluded from fur-
ther analyses (N = 70). The final sample size was
148 men and 153 women. Participants varied in
age from 17 to 29 years (95% between 18 and 22),
and mean age was 19.23 years (SD = 1.5) and
18.78 years (SD = 1.2) for men and women,
respectively. The sample consisted of 56% Cauca-
sian, 7% African American, 22% Hispanic, 14%
Asian American, <1% Native American, and 1%
“other ethnicity” participants. Ethnicity was
determined with the question, “What ethnicity do
you most identify with?”
Procedures
Participants were administered a brief question-
naire consisting of questions inquiring about their
sexual arousal response to breast/nipple stimula-
tion and a demographics questionnaire. Female
participants were also asked whether they had ever
received breast surgery. Participants responded
using a “Yes/No” response format.
The questionnaires were administered in small
groups of 5–10 same-sex individuals. To preserve
privacy, participants were given either partitions or
several feet of space from other participants. Par-
ticipants were informed of the sexual nature of the
study before they applied to participate. Same-sex
researchers informed participants of the sexual
material, obtained consent, administered question-
naire packets, and answered participant questions
that arose during testing. Confidentiality was pro-
tected by assigning each participant with a random-
ized code number connected to all of his or her
data, and consent forms were kept in a separate file.
To help assure anonymity, upon completion, ques-
tionnaire packets were inserted into a large “drop
box” as participants exited the testing room. This
study was approved by the Human Subjects Ethics
committee at the University of Texas at Austin.
Statistical assessments of any significant differ-
ences (P > 0.05) among the data were undertaken
using Likelihood ratios, a test used to analyze cat-
egorical data [3].
Results
One woman reported having had breast augmen-
tation surgery. Data from her questionnaire were
excluded from further analyses as it is unclear to
what degree breast augmentation surgery may
affect nipple/breast sensitivity.
Regarding women, 81.5% reported that nip-
ple/breast stimulation caused or enhanced their
sexual arousal, and that when they were sexually
aroused nipple/breast stimulation increased their
arousal. Only 7.2% reported that such stimula-
tion caused a decrease in their arousal. Some
59.1% of the women have actively asked for the
stimulation from their partners, and some 37.7%
desired to have them stimulated but were not
able to ask for it to be undertaken (presumably
from shyness, or not wanting to appear too
demanding).
In the case of men, like women, nipple stimu-
lation was excitatory for their sexual arousal but
the percentage was less than in women (51.7%
compared with 81.5%). Results from Likelihood
ratios indicated that this gender difference was
significant, L2 = 30.67, P < 0.001. Thirty-nine
percent of men (compared with 78.2% of women)
reported that nipple stimulation increased their
arousal when they were sexually aroused. This
gender difference was also significant (L2 = 46.27,
P < 0.001). Virtually, the same percentage of men
(7.5%) as women (7.2%) found that nipple stimu-
lation decreased their arousal when sexually
aroused (L2 = 1.43, P = 0.49). A significantly
smaller percentage of men than women asked for
their nipples to be stimulated (17.1% vs. 59.1%,
L2 = 61.2, P < 0.001), and a significantly smaller
percentage would like to have the stimulation but
did not want to ask for it (19.8% vs. 37.7%,
L2 = 6.03, P < 0.05) (Table 1).
Discussion
The majority of women surveyed (81.5%)
reported that stimulation of their nipples/breasts
caused or enhanced sexual arousal and increased
their arousal once they were already sexually
aroused. Although a comparatively lower propor-
tion compared with women, the majority of men
(51.7%) also reported enhanced sexual arousal
with nipple stimulation and only a small propor-
tion reported the activity decreased arousal. A sig-
nificantly smaller percentage of men would like to
have had the stimulation during lovemaking but
did not want to ask for it. This gender difference
could feasibly be due to a number of factors
jsm_230.fm Page 451 Wednesday, April 12, 2006 12:23 PM
452 Levin and Meston
J Sex Med 2006;3:450 454
including gender differences in reporting biases or
social desirability, or gender roles ascribed to this
behavior. These results clearly do not support the
comments on nipple/breast stimulation by Kinsey
et al. [2] quoted in the Introduction section.
Exactly how nipple/breast stimulation influ-
ences sexual arousal is poorly understood. The
female nipple/areola is well innervated [4–6] and
when stimulated the nipple becomes erect and the
areola engorged [7]. The innervation of the male
nipple/areola, although similar to that of the
female nipple/areola [8], has been less well stud-
ied. It has been estimated that 50–60% of men also
show nipple erection on arousal [7]. The tactile
sensibility of the areola is regarded as protopathic
(primitive) as compared with epicritic (discrimina-
tory) sensitivity of the skin [4]. In relation to tactile
stimuli, Robinson and Short [9] reported that after
puberty the sensitivity of all areas of the female
breast becomes significantly greater than that of
the male breast. While there have been a number
of brain imaging studies during sexual arousal in
men and women by visual sex stimulation indicat-
ing what areas become activated or inhibited [10–
14], as far as we know, there have been no similar
studies where just stimulating the breast or nipple
is the mode of arousal. We are thus ignorant of
how such stimulation activates sexual arousal in
the brain.
It has been proposed that prolactin specifically
released at orgasm by either coitus or masturba-
tion inhibits sexual arousal in men and women
[15], although Levin [16] has pointed out that
women are known to be able to have multiple
serial orgasms. Although studies in men employ-
ing pharmacological methods of raising and low-
ering prolactin levels have shown that raised
prolactin inhibited subjective sexual arousal [17],
only some aspects of the arousal, such as the ejac-
ulatory latency, were influenced by the induced
hyperprolactinemia with only small reductions in
sexual drive and functions. The new conclusion
was that although prolactin was important in the
postorgasmic regulation of sexual behavior, the
results did not “demonstrate a role for prolactin as
a simple and direct negative feedback mechanism.”
It is likely to be but “one signal within a network
of psycho-endocrine regulation of the sexual expe-
rience.” Sexual arousal in the brain occurs through
a complex interaction of multiple neurotransmit-
ters (norepinephrine, acetylcholine, dopamine,
oxytocin, vasopressin, vasoactive intestinal pep-
tide, and opioids) and sex steroids and is poorly
understood. Bancroft [18], reviewing the endocri-
nology of human sexual arousal, also commented
on its complexity and on the as yet uncertain
role(s) of the peptides prolactin and oxytocin. He
argued that the prolactin release at orgasm is an
“epiphenomenon of post-orgasmic inhibition of
dopamine activity, and not a hormonal mechanism
of functional importance.”
Experiments on the release of prolactin during
nipple/breast stimulation in nonlactating women
have given conflicting results. Kolodney et al. [19]
reported that it was increased in nine nonlactating
women either by self-stimulation or by manipula-
tion from their husbands. Plasma prolactin levels
were not increased when men self-stimulated
themselves but when the stimulation was under-
taken by their wives there was an immediate four-
fold increase in the plasma prolactin levels of men.
Interestingly, no sexual arousal was reported by
any of the men during either self-stimulation or
stimulation by their wives. This difference sug-
gested to Kolodney et al. [19] that psychological
concepts play a role in the release of prolactin in
men. A later study [20] in 11 nonpostpartum
women, however, did not show any increase in
prolactin during either solitary or multiple epi-
sodes of nipple stimulation over 24 hours.
Even in the case of breast-feeding when prolac-
tin is definitely known to be released, there are
conflicting views on the effect on women’s sexual-
ity. Newton [21] claimed that breast-feeding
women (who would be releasing prolactin at each
feed) were often interested in a quick return to
sexual intercourse but other authors suggest that
breast-feeding by new nursing women is a possible
cause of their low or absent libido [22]. Because of
these conflicting reports, it is not possible to come
Table 1 Response frequencies by gender (% Yes)
Item Women Men
1. Does stimulation of your nipples or breasts
cause or enhance sexual arousal?
81.5 51.7
2. When you are sexually aroused, does
stimulation of your nipples or breasts
increase your arousal?
78.2 39.0
3. When you are sexually aroused, does
stimulation of your nipples or breasts
decrease your arousal?
7.2 7.5
4. Have you ever asked to have your nipples or
breasts stimulated during lovemaking?
59.1 17.1
5. Would you like to have your nipples or
breasts stimulated during lovemaking but do
not want to ask for it to be done?*
37.7 19.8
N = 153 for women; N = 148 for men.
*Frequencies are calculated on those women (N = 61) and men (N = 24) who
answered “No” to question 4.
jsm_230.fm Page 452 Wednesday, April 12, 2006 12:23 PM
Breast Stimulation in Men and Women 453
J Sex Med 2006;3:450 454
to any conclusion about the action of prolactin
release during breast stimulation on human sexual
response. It is unfortunate but at our present level
of understanding little can be usefully said about
the nipple and central brain mechanisms of
arousal. There is a clear need for functional mag-
netic resonance imaging or positron-emission
tomography study on brain activity during nipple/
breast stimulation in both men and women.
Finally, a possible minor limitation of using a
“Yes/No” response format to the asked questions
(namely 1 and 2) is that some of the “No”
responses could reflect respondents indicating
“No” because they had never experienced the
behavior, rather than “No” because it was not
arousing. However, even if this postulate were so,
it should be stressed that this would necessarily
increase the proportion of our “Yes” responses,
rendering the data we report here a conservative
estimate of the enhancing effects of nipple stimu-
lation on sexual arousal.
Conclusions
Manipulation of the nipple/breast during love-
making causes or enhances sexual arousal for a
majority of both young women (81.5%) and men
(51.7%) and when experienced during sexual
arousal such manipulation further increased their
arousal. Only a very small minority of either sex
(approximately 7%) found that such manipulation
decreased their arousal.
Corresponding Author: Roy Levin, PhD, University
of Sheffield, Department of Biomedical Science,
Western Bank, Sheffield, S10 2TN, UK. Tel:
(0114) 2222320; Fax: (0114) 276541; E-mail: r.j.levin
@sheffield.ac.uk
Conflict of Interest: None.
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... Studies [9,10] indicate that sexual behavior decreases pain perception by stimulating the release of endogenous opioids (EOs) peptides, potentially to prevent intense sexual arousal from becoming unpleasant, thereby making it more valuable and rewarding. There are many types of EOs, but the three peptide linkages, namely β-endorphins (which associate with mu-μ-receptors), met-enkephalins (which associate with delta-δ -receptors), and dynorphins A and B (which associate with kappa-κ-receptors) are the most important ones involved in analgesia. ...
... [12] However, the biological mechanism through which EOs are released is poorly understood, but considering the two main effects of morphine, EOs are emitted when the physiological process of analgesia and reward (feeling of pleasure and euphoria) are activated simultaneously, as during sexual behavior. [9,10] Evidence has shown that sexual intercourse is associated with analgesia in humans and rats [13][14][15] and is also rewarding. [16] Moreover, to confirm the influence of EOs on sexual performance, opioid receptors were further blocked with narcotic antagonists, and it was observed that sexual performance decreased by extending postejaculatory intervals (time to resume copulation after ejaculation). ...
... Studies [9,10] indicate that sexual behavior decreases pain perception by stimulating the release of endogenous opioids (EOs) peptides, potentially to prevent intense sexual arousal from becoming unpleasant, thereby making it more valuable and rewarding. There are many types of EOs, but the three peptide linkages, namely β-endorphins (which associate with mu-μ-receptors), met-enkephalins (which associate with delta-δ -receptors), and dynorphins A and B (which associate with kappa-κ-receptors) are the most important ones involved in analgesia. ...
... [12] However, the biological mechanism through which EOs are released is poorly understood, but considering the two main effects of morphine, EOs are emitted when the physiological process of analgesia and reward (feeling of pleasure and euphoria) are activated simultaneously, as during sexual behavior. [9,10] Evidence has shown that sexual intercourse is associated with analgesia in humans and rats [13][14][15] and is also rewarding. [16] Moreover, to confirm the influence of EOs on sexual performance, opioid receptors were further blocked with narcotic antagonists, and it was observed that sexual performance decreased by extending postejaculatory intervals (time to resume copulation after ejaculation). ...
... Oxytocin might therefore contribute indirectly to genital and self-reported sexual arousal by a positive feedback loop (Meston and Stanton, 2019). Moreover, according to Robinson (2015), oxytocin plays a role in the stimulation of the nipple-areola-breast complex (breast-sex), considered an erogenous bodily part relevant for sexual arousal (Levin and Meston, 2006), and orgasm (Masters and Johnson, 1966). ...
... According to the authors, excluding genitalia or perigenital areas, the mouth-lips complex, the neck, the nipple, and the breast were assessed as erogenous by women. According to Levin and Meston (2006), most women report that the stimulation of the nipple-breast complex can facilitate sexual arousal. According to Turnbull et al. (2014), the insula represents one of the best regions in which the elaboration of erogenous zones can be processed to facilitate sexual arousal. ...
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Sensitivity to pain and touch was measured in the nipple, areola, and cutaneous breast tissue of prepubertal boys and girls, postpubertal men and nuliparous women before and after delivery. Before puberty there were no differences between the sexes, but after puberty the tactile sensitivity of all areas of the women's breast was significantly greater than the men's. Tactil sensitivity of all areas also varied during the menstrual cycle, with maximal sensitivity at midcycle and at menstruation; the mid-cycle peak was absent when the women were taking oral contraceptives. But the most dramatic changes occured within 24 hours of parturition, when there was a great increase in breast sensitivity. This may be the key event for activating the suckling-induced discharge of oxytocin and prolactin and inhibiting ovulation during lactation.
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The brain plays a central role in sexual motivation. To identify cerebral areas whose activation was correlated with sexual desire, eight healthy male volunteers were studied with functional magnetic resonance imaging (fMRI). Visual stimuli were sexually stimulating photographs (S condition) and emotionally neutral photographs (N condition). Subjective responses pertaining to sexual desire were recorded after each condition. To image the entire brain, separate runs focused on the upper and the lower parts of the brain. Statistical Parametric Mapping was used for data analysis. Subjective ratings confirmed that sexual pictures effectively induced sexual arousal. In the S condition compared to the N condition, a group analysis conducted on the upper part of the brain demonstrated an increased signal in the parietal lobes (superior parietal lobules, left intraparietal sulcus, left inferior parietal lobule, and right postcentral gyrus), the right parietooccipital sulcus, the left superior occipital gyrus, and the precentral gyri. In addition, a decreased signal was recorded in the right posterior cingulate gyrus and the left precuneus. In individual analyses conducted on the lower part of the brain, an increased signal was found in the right and/or left middle occipital gyrus in seven subjects, and in the right and/or left fusiform gyrus in six subjects. In conclusion, fMRI allows to identify brain responses to visual sexual stimuli. Among activated regions in the S condition, parietal areas are known to be involved in attentional processes directed toward motivationally relevant stimuli, while frontal premotor areas have been implicated in motor preparation and motor imagery. Further work is needed to identify those specific features of the neural responses that distinguish sexual desire from other emotional and motivational states.
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Objectives: To evaluate, for the first time, the cerebral regions associated with female sexual arousal evoked by visual stimulation using noninvasive blood-oxygenation-level-dependent (BOLD) functional magnetic resonance imaging (fMRI). Methods: A total of 6 healthy right-handed female volunteers (mean age 33 years, range 25 to 41) underwent fMRI on a 1.5-T MR scanner, in which the BOLD technique was used to create fMR images reflecting local brain activities. Real-time visual stimulation was performed with alternatively combined erotic and nonerotic films to identify the activated brain regions associated with sexual response. The perceived sexual arousal response was assessed using a scale ranging from 1 (no change) to 5 (maximal increase). Results: The mean score for perceived sexual arousal by erotic visual stimulation was 2.7 on the 5-point scale and was unchanged by nonerotic stimulation. During the visual task, the occipital cortex was activated by both the erotic and the nonerotic films; however, the following cerebral areas were significantly (P <0.05) activated, varying from 4 of 6 to 6 of 6 women: inferior frontal lobe, cingulate gyrus, insula gyrus, corpus callosum, thalamus, caudate nucleus, globus pallidus, and inferior temporal lobe. Conclusions: This study is the first to evaluate noninvasive BOLD-fMRI in identifying cerebral regions associated with sexual arousal response evoked by visual stimulation in women.
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VARIOUS afferent neurogenic stimuli to the chest wall or breast have been associated with galactorrhoea in man. Non-puerperal lactation has been reported following mechanical trauma, surgery, or burns of the chest wall or breast1-4 following herpes zoster of the chest wall3; and induced by poorly fitting garments4 or breast manipulation3,4. Lactation has occurred in men in association with prolonged suckling of the breast1,3 and may occur in nulliparous and post-menopausal women in response to a suckling stimulus5,6.
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This paper examines the theory that breastfed and bottlefed infants are psychological equivalents. There are 2 patterns of breastfeeding most often encountered, unrestricted and token breastfeedings. There are maternal differences between those who breastfeed and those who do not. The initial experience of breastfeeding is culturally dependent. A mother who practices unretricted breastfeeding is receiving sustained stimulation to her nipples and experiences a generalized body response. Likewise such a breastfeeding mother experiences other long-term psychophysiologic reactions such as lactation amenorrhea and changes in hormonal balance. Breastfeeding women are often interested in a quick return to sexual intercourse and display a more general attitude towards men. A mother's personality and her ability to adjust to life situations often varies with the choice of feeding. 1 study found that mothers who breastfed displayed significantly less neuroticism than those who did not. Breastfeeding behavior appears to be sensitive to even minor variations in the social milieu. The type of breastfeeding practiced is likewise a significant variable for the infant. The initial feeding of an unrestricted breastfed infant is usually smooth unlike the situation for the token breastfed. Both feeding patterns involve assuagement of hunger needs but are dependent on social setting. For the breastfed infant, comfort as well as nourishment are presented with the mother as part of the package. These 2 experiences are often split in bottlefed and token breastfed infants. The 2 sucking patterns resemble each other superficially and the breastfed infant seems to develop more interest in sucking. Different activity levels manifest themselves by the 3rd day postpartum with the breastfed showing a greater propensity toward activity. Intelligence scores are also related to feeding patterns, with those exclusively breastfed for 4-9 months displaying the highest scores in relation to their age.
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The effect of acute and chronic stimulation of the breast was studied in 11 nonpostpartum women in both follicular and luteal phases of menstruation. In no subject did an increase in secretion of prolactin (PRL) result from either solitary or multiple episodes of stimulation of the breast over 24 hours. After 2 weeks of stimulation, three patients noted increased secretion; however, on rechallenge, this was found to be the result of testing in luteal versus follicular phase, rather than of the stimulation of breast itself. We concluded that breast stimulation, either acute or chronic, had no appreciable impact on secretion of PRL, but, rather, the phase of menstruation may influence basal secretion of PRL. Normal ranges may have to be recalculated to take this into account after larger numbers of women are studied.