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The breast/nipple/areola complex and human sexuality

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Abstract

The male or female breast/nipple/areola complex arises from a common mammary stem cell and develops similarly in the foetus and during infancy. At puberty the male's breasts remain rudimentary but the female's develop further, mainly through oestrogen and progesterone stimulation, and become more sensitive. Female breasts serve both nutritive and sexual functions, unlike other primates they develop at puberty before lactation is necessary. Their sexual attraction is through size, shape and their areolae but also, when unrestrained, their jiggling movements. Small breasts are more sensitive than large. Pregnancy and lactation increase their size. Breast feeding releases oxytocin (milk release) and prolactin (milk secretion), other functions have been proposed for the latter. The pigmented areola contains tubercles of Montgomery that secrete a fluid protecting the skin and creating an olfactory signal for baby and possibly lover; areola corrugation immediately after orgasm physically signals that orgasm has occurred. Male and female (non-pregnant) nipple stimulation has been claimed to induce prolactin secretion but confirmation is needed. Young adult women and men report that breast stimulation not only induces their sexual arousal but enhances it when already aroused.

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... There does not seem to be any reference in the literature that describes this feature in other female mammals during their sexual arousal and handling of ejaculated spermatozoa. 2. We are the only primate where gross female breast development is completed around puberty, in all other primates the organs develop as a consequence of the changes in hormones that occur during pregnancy (Levin, 2006). After puberty, the tactile sensitivity of all areas of the female breast becomes significantly enhanced compared to those of the male (Levin, 2006). ...
... 2. We are the only primate where gross female breast development is completed around puberty, in all other primates the organs develop as a consequence of the changes in hormones that occur during pregnancy (Levin, 2006). After puberty, the tactile sensitivity of all areas of the female breast becomes significantly enhanced compared to those of the male (Levin, 2006). Despite this, Levin and Meston (2006) reported from their survey that from the majority of both young men and women (aged 17-29 years) stimulation of their breasts and nipples induced sexual arousal and during sexual arousal could enhance it. ...
... In this context it is interesting to note that in Japanese produced erotic videos on the internet, females are often shown licking and sucking the nipples of their male sexual partner. According to Robinson (2015), no other species exhibits "breast sex", that is employing breast stimulation to induce or enhance sexual arousal (see Levin, 2006 for further references). Note that both breasts and buttocks (butts, the shortened form) are part of the sexual attraction of females for males (Dixon, 2009;Miller, 2001). ...
Article
Speculation that the release of oxytocin by orgasm in the human female during coitus facilitates fertility by enhancing uterine sperm transport has been criticised as having no unequivocal empirical human evidence. However, a counter claim that this supports human 'exceptionalism' as some form of uterine sperm transport occurs in other species. This is a misconception as it ignores that human uterine peristalsis, powered by contractions of the smooth muscle of the archimyometrium, facilitates sperm transport even without any systemic oxytocin involvement. Moreover, examination of various unique reproductive mechanisms in numerous animals also indicates that the claim is misjudged and rests on a biased interpretation of what 'exceptionalism' means in this biological context. Ten chosen aspects of our sexuality are presented as being exceptional to humans. This article is protected by copyright. All rights reserved.
... The first is their extremely early development, in comparison to other mammals (Howard and Gusterson 2000); the other is that they are permanently enlarged with adipose tissue (Arieli 2004). These two features develop at puberty, in a process stimulated by oestrogen and progesterone ( Lamote et al. 2004;Levin 2006). ...
... The glandular and adipose tissue are held together by connective tissue (Howard and Gusterson 2000), including ligaments holding the structure up and away from the chest wall (Gefen and Dilmoney 2007). Over time these ligaments stretch, causing ptosis, often causing the breast to lie against the lower ribs or stomach (Levin 2006). The glandular tissue of the breast is divided into fifteen to twenty lobes (Tortora and Grabowski 2003, Figure 1.1). ...
... The glandular tissue of the breast is divided into fifteen to twenty lobes (Tortora and Grabowski 2003, Figure 1.1). The tissue has a complex branching structure (Levin 2006). Each lobe is divided into lobules and then alveoli which are embedded in the connective tissue (Tortora and Grabowski 2003). ...
Article
Human females, uniquely among primates, develop prominent breasts during puberty, well before reproduction occurs. Adipose tissue in breasts forms part of the "gynoid" fat distribution, involving the hips, thighs, buttocks and breasts of women. Breasts are thus characterised as secondary sexual characteristics, and their evolution may be due, at least in part, to the effects of sexual selection. This partial reversal of the usual pattern of male adornment may be related to high paternal care in humans. Breast morphology is complex, so that women vary not only in the size and shape of their breasts, but also in the size, shape and pigmentation of their areolae and nipples. These traits change with reproductive status and age. Breasts are more prone to fluctuating asymmetry than many other features of human anatomy and such asymmetry may be closely related to some measures of reproductive success. This thesis used digitally altered images to investigate the impact of morphological changes on perceptions of attractiveness and other qualities. Study 1 investigated the impact of four breast sizes and three areola colours on the perceptions of two hundred participants. Breast size significantly impacted all ratings. Attractiveness and health ratings were maximised at the intermediate breast size for the lightest and original coloured areola, and at the largest breast size for the darkest areola. Ratings of nurturance, sexual maturity and estimates of age increased stepwise from the images with undeveloped breasts to the images with the largest breasts. Areola colour interacted with breast size. Darker areola were judged less attractive, less healthy and less nurturing when paired with small or intermediate breasts, but increased these ratings when paired with large breasts. There was no strong effect of areola colour on ratings of images with undeveloped breasts or on ratings of sexual maturity and age. Study 2 investigated the effect of breast asymmetry on attractiveness and health ratings using data provided by two hundred participants. Increasing levels of asymmetry, created by modifying one breast to increase the apparent volume (four levels from 102.5% to 110% of the original) or position (four levels from 1%-4% of the length of the image) resulted in progressively lower ratings. The differences in ratings between the images with extreme levels in asymmetry (107.5% vs 110% and 3% vs 4%) were smaller. Images that had been modified in the models left (and so seen on viewer's right side) were given higher ratings than those modified identically but on the other side. This may be an expression of a phenomena known as pseudoneglect, where people appear to attend more to the left. In Study 3, a diverse selection of images, taken from previously published reports on human breast morphology and attractiveness, were compiled as a single questionnaire and shown to 37 participants. The purpose of this pilot study was to assess the impact of different image types on ratings of attractiveness and health. Photographic images were rated higher than line drawings or silhouettes. Photographs may be more ecologically valid, as they are more realistic and can be tailored to match the study population. The results presented in this thesis indicate that variations in human breast size, areola colour and breast asymmetry have measurable effects on the perceptions (of both sexes) of attractiveness and health. Breast size also has significant impacts on perceptions of nurturance, reproductive status and age, whereas areola colour has less effect on these ratings. Questionnaire studies employing photographs are likely to be more effective than more stylised images. Morphological changes in the human breast may signal mate value and fertility and therefore may have been subject to sexual selection, as well as natural selection, during human evolution.
... Interestingly, the nipple has dual functions in the arousal phase. NE can occur by sexual arousal, and stimulation of the nipple can induce and increase sexual arousal (Dickinson, 1949;Masters and Johnson, 1966;Montagna, 1970Montagna, , 1974Cowie, 1974;Munarriz et al, 2002;Shepherd, 2002;Levin, 2006;Levin and Meston, 2006). It has been estimated that 50%-60% of men also show nipple erection on arousal (Masters and Johnson, 1966). ...
... According to information obtained from current sources, abundant smooth muscle is present in the structure of the NAC. Although it has been stated that erection occurs via the stimulation of sympathetic adrenergic nerves that innervate the NAC and the contraction of the smooth muscles, no comparative study has been conducted to explain erection physiology (Montagna, 1970(Montagna, , 1974Birkenfeld and Kase, 1994;Eriksson et al, 1996a;Uvnä s-Moberg and Eriksson, 1996;Levin, 2006;Gartner and Hiatt, 2007;Walker, 2009;Johnson, 2010). ...
... The presence of rich sympathetic adrenergic innervation and smooth muscle contraction mediators (eg, neuropeptide Y, galanin, and somatostatin) suggests that these systems have a role in NE. The presence of abundant amounts of smooth muscles inside the structure suggests that the contraction of these smooth muscles contributes to erection (Masters and Johnson, 1966;Montagna, 1970Montagna, , 1974Birkenfeld and Kase, 1994;Eriksson et al, 1996a; Uvnä s-Moberg and Eriksson, 1996;Franke-Radowiecka and Wasowicz, 2002;Levin, 2006;Gartner and Hiatt, 2007;Walker, 2009;Johnson, 2010); however, when NE dynamics, smooth muscle morphology, and innervation are considered, these interpretations should be reevaluated. ...
Article
The nipple is a specialized structure that can become erect by cold, sexual arousal, breast-feeding, or other tactile stimulations, which can induce the milk ejection reflex and sexual arousal because of intense sensory innervation. The studies that have been conducted thus far to identify the mechanism of nipple erection (NE) are not sufficient. It has been stated that NE occurs via activation of the sympathetic nervous system and smooth muscle contraction. The purposes of this study were to investigate the existence of nitric oxide synthase (NOS) in the nipple-areola complex (NAC) to explain the NE mechanism. Considering that smooth muscle relaxation might be effective in NE, endothelial and neuronal NOS expression and localization were investigated via immunohistochemical methods on sagittal sections from 17 human NACs. The results of this study indicate that eNOS is expressed in the vascular endothelium, ductal epithelium, and smooth muscles, whereas nNOS is expressed in the neural fibers, smooth muscles, ductal epithelium, and vascular endothelium in the NAC. Sinusoidal spaces with endothelial layers similar to those found in penile cavernosal tissue are not found in the NAC. Various mediators are known to affect the function of the NAC smooth muscles; however, this study demonstrates that enzymes (eNOS and nNOS) that synthesize nitric oxide are expressed in the NAC.
... Since Masters & Johnson, the classical "orgasm triggering" organ was the glans clitoris (Masters & Johnson, 1966). However, other orgasm triggering erogenous zones have been defined such as, G-Spot, DVZ (Deep Vaginal Erogenous Zones) (Sayin, 2012(Sayin, , 2015Levin, 2006Levin, , 2014Chua, 1997;Morris 2004). ...
... G-Spot or DVZ may not be perceived in every woman all the time, but this variance does not exclude the possibility of the existence of other "genital hot zones". DVZ was first defined by the famous British zoologist Desmond Morris (Morris, 2004); however, the pleasurable sensitivity of anterior and posterior walls of the vagina have been reported for a long time by many researchers, since Sigmund Freud (Reich, 1973;Singer, 1973;Fisher, 1972Fisher, , 1973Kaplan, 1981;Ladas, 1982;Britten, 1983;Whipple, 1988;Bancroft, 1989;Escapa, 1989;Komisaruk, 2003Komisaruk, , 2004Komisaruk, , 2005Komisaruk, , 2006Zdrok, 2004;Carellas, 2007;Sayin, 1993Sayin, , 2012Sayin, -a,b, 2014Sayin, , 2015Sayin, -a,b, 2018Levin, 2006Levin, , 2014Chua, 1997). ...
... In vaginal-coital orgasms, there may be more components to trigger an orgasm, such as, DVZ areas with cervix and PFM or other psychological input from the brain itself. Other than clitoral orgasms and vaginal orgasms; blended orgasms have also been defined (Ladas, 1982;Levin, 2006, Sayin, 2012-a,b, 2017-a,b,c, 2018a, 2019. ...
Article
Full-text available
Pleasure is a mental and emotional state that humans and other animals experience as positive, enjoyable, satisfying, giving joy and happiness or worth seeking. It may include other mind states such as happiness, entertainment, enjoyment, ecstasy, and euphoria, with peak experiences. According to the "incentive salience model" pleasure has three components: "wanting and motivation", "learning" and "liking-pleasure". Different brain regions cooperatively work together for each of these constituents. Since most of the data to establish this model came from animal studies, for human beings a more profound and complex model needs to be established. During the onset of pleasure or sensuality, dopaminergic neurons in ventral tegmental area (VTA) fire and their projections to the nucleus accumbens (NA) release dopamine which participates in the complex psychological processes of learning and liking. Similar episodes occur during the onset of sexual pleasure and human orgasm. Some complex human phenomena, such as passionate love or expanded orgasms, can be regarded as peak experiences, which the animal kingdom does not seem to experience. During passionate love, for instance, the release of some neurotransmitters, such as dopamine, oxytocin, and norepinephrine, is enhanced, while serotonin levels drop; in some fMRI studies, it is shown that some brain regions and "hedonic hot spots" are activated. During the female orgasm, VTA, NA, anterior cingulate, insula, amygdala, hippocampus, and hypothalamus are activated. In this article neuroanatomical, neurophysiological, neurochemical components of pleasure, love, motivation and orgasm, which lead to impressive behavioral changes, are discussed. Also, the phenomenon of experiencing sexual pleasure during the sleep found with the parasomnia "Sexsomnia" and also "Epileptic Sexsomnia", both for the affected person and the bed partner will be discussed, with further research encouraged on this intriguing new clinical and clinical research area.
... According to Ottuh (2013), same sex marriage or sexual intercourse is sinful since marital sex was designed to take place in a form of penile-vaginal intercourse (PVI). Thus, it should be between a man and a woman because, it is most satisfying due to sweetness and pleasures caused by the impulses generated from sexual organs (penis and vagina) (Levin, 2006). Hence, without forgetting that "the expectation of matrimonial relations between the two married couples is all about rejoicing together" (White, 1952, p.196-197), marital sex should influence them to attain a chance of rejoicing together. ...
... Particularly, they agreed that they love sex and enjoy doing it (89.5%). Their perception is substantiated by the fact that "Penile-Vaginal penetration is the most sensitive and satisfying one emotionally, physically and sexually" (Levin, 2006). Furthermore, the finding is supported by recent research which revealed that "the pressure causing the penis and clitoris to erect, surges the sensation which makes the body comfortable and ready to attain orgasm (Li et al., 2015;Overland et al., 2016). ...
Article
Full-text available
This study sought to find how married couples perceived marital sex, using the survey Research Design. A total of 200 respondents came from selected marriages found in Kihesa Ward. Such number was obtained through the purposive sampling technique which was followed by effective distribution of questionnaires in gathering the information which was analyzed using frequencies and percentages. The study established that married couples perceived marital sex as a practice that binds them together emotionally and psychologically. It alienates prostate cancer, irregular menstrual cycles and cardiovascular diseases; it naturally communicates affection and love to the spouses, especially when done into satisfaction. It is helpful in the continuation of spouses' generation after fusion of gametes, fertilization and conception have taken place. Moreover, married couples agreed that they enjoy doing sex with their spouses. Marital sex should take place in a form of penile-Vaginal penetration, because it is proven to be the most satisfying one as designed by the creator of humanity.
... Although NE occurs in both women and men (Levin, 2006;Masters & Johnson, 1966), nipple responsiveness is more closely associated with women (see Levin & Meston, 2006). Thus, data were analyzed and are presented separately for the sexes. ...
... That there are relatively few sex differences in NE frequency in the posed nonsexual scenarios can be viewed as evidence for common, underlying autonomic control of these responses. In fact, the breast, nipple, and areola of both males and females have identical embryonic development (see Levin, 2006) and only come to differ at puberty (Robinson & Short, 1977). ...
Article
Full-text available
Previous research has largely ignored examining nipple erection in nonsexual situations. We hypothesized that both women and men experience nonsexual nipple erection under emotional and somatic (nonsexual) conditions that trigger autonomic arousal and sought to document nonsexual triggers and instances of nipple erection in various contexts. As predicted, self-reports from 181 college students indicated that individuals experience nipple erection when under stress, frightened, and anxious. Participants also reported often experiencing nipple erection concurrently with piloerection ("goose bumps"). In addition, participants reported nipple erection self-vigilance and concealment in nonsexual situations, suggesting awareness that nipple erection may communicate a target's emotional and somatic arousal. Implications and limitations to these exploratory findings are discussed.
... These muscles can be asymmetric and lose their contraction over time with pregnancy and menopause. 6,7 At least 50 % of the blood supply to the nipple is located in the periphery. The small vessels that feed the nipple arise from the internal mammary (internal thoracic) artery and lateral thoracic artery. ...
... Accessory breast and nipple tissue can lactate and develop mastitis, and is more commonly diagnosed in males at a rate of 1 in 18, whereas only 1 in 50 females are diagnosed with polythelia. 7 Romans regarded a third nipple as a sign of reinforced femininity; however, during the Salem Witch Trials an accessory nipple was thought to be used to suckle the devil and was considered as evidence of being a witch. 4,21 Other congenital anomalies include athelia, absence of the nipple, and amazia (absence of the development of the functional breast tissue beneath a normal nipple and areola). ...
Article
The nipple and areola are pigmented areas of modified skin that connect with the underlying gland of the breast via ducts. The fairly common congenital anomalies of the nipple include inversion, clefts, and supernumerary nipples. The anatomy of the nipple areolar complex is discussed as a foundation to review anatomical variants, and the physiologic development of the nipple, including changes in puberty and pregnancy, as well as the basis of normal physiologic discharge, are addressed. Skin conditions affecting the nipple include eczema, which, while similar to eczema occurring elsewhere on the body, poses unique aspects in terms of diagnosis and treatment. This article concludes with discussion on the benign abnormalities that develop within the nipple, including intraductal papilloma and nipple adenoma.
... 536 See Giles 2010: 304. On the breast and nipple, seeLevin 2006. ...
Thesis
This thesis examines the representation of the female body in Roman visual culture, exploring a range of images from mainland Italy that date between the late 1st century BC and the 2nd century AD, from three specific contexts of display: the public, domestic, and funerary. It seeks to understand how the two parts of its title – ‘the female body’ and ‘Roman visual culture’ – intersect, examining female bodies as they are represented, and how these bodies are shaped by the act of representation itself: i.e., the limitations, conventions, and priorities of their representative medium, and the context in which they were viewed. Images of female bodies could reify normative expectations of women or, alternatively, carve out space for more fantastical concepts of femininity within Roman culture. As these gendered expectations were relational, this thesis also puts the female body into dialogue with the male and sexually indeterminate body to understand how these images constructed and explored a relative spectrum of femininity and masculinity in terms of appearance, gesture, and behaviour. In this sense, this thesis is interested in Roman ideas about gender, and, critically, how gender was constructed within and through visual representation.
... As a result, the breasts of human males are much less prominent than those of females. 5 Approximately 1 in 8 women will develop invasive breast cancer in the United States, and up to 40% will require a mastectomy. 6 Breast reconstruction is a type of plastic surgery that aims to restore the shape, appearance, and size of a breast following its removal by mastectomy. ...
Article
Full-text available
Breast reconstruction is a type of surgery for women who have had a mastectomy, and involves using autologous tissue or prosthetic material to construct a natural-looking breast. Adipose tissue is the major contributor to the volume of the breast, whereas epithelial cells comprise the functional unit of the mammary gland. Adipose-derived stem cells (ASCs) can differentiate into both adipocytes and epithelial cells and can be acquired from autologous sources. ASCs are therefore an attractive candidate for clinical applications to repair or regenerate the breast. Here we review the current state of adipose tissue engineering methods, including the biomaterials used for adipose tissue engineering and the application of these techniques for mammary epithelial tissue engineering. Adipose tissue engineering combined with microfabrication approaches to engineer the epithelium represents a promising avenue to replicate the native structure of the breast.
... Both conditions create sexual dysfunctional states and can inhibit the pleasure obtained at orgasm during their contractions (pleasure dissociative orgasm disorder -PDOD Wylie and Levin, 2013). In most women pulsatile musculature contractions of the pelvic floor at and during orgasm are concomitant with each wave of pleasure and often non-verbal vocalisations accompany the contractions (Levin, 2006a). Even when trying, it is not possible to mimic consciously the exact repetitive firing pattern of contractions. ...
Article
The female orgasm has been examined over the years by numerous scientific disciplines yet it still has many secrets to be disclosed. Because its physiology, especially its neurophysiology, is sparingly understood its pharmacology is necessarily limited based mainly on the side effects of drugs. Few published studies have used a placebo group as controls. The paucity of focussed studies is well illustrated by the fact that there still is no approved medication to treat female orgasmic dysfunction. The present brief overview examines the mostimportant aspects of its biology and especially its physiology highlighting the many questions that need answering if we are to have a comprehensive pharmacology of the female orgasm.
... However, in recent years, a number of better-characterized studies have revealed that the female orgasm is not linked solely to stimulation of the genitalia or just to reproduction, despite the claim, unsupported by evidence, that it is the only sexual response linked by penile vaginal intercourse (PVI) to reproduction (Brody, 2010) since it is always possible for heterosexually partnered sexual arousal per se to lead to PVI. Orgasm can also arise from nipple/breast stimulation (Levin, 2006b;Levin and Meston, 2006), anal stimulation (McBride and Fortenberry, 2010;Komisaruk and Whipple, 2011), the mouth (Komisaruk and Whipple, 2011), exercise (Herbenick and Fortenberry, 2011), hypnotism (Levin, 1992;Levin and Van Berlo, 2004), tantric arousal (Lousad and Angel, 2011), drug side effects (Levin, 2014a), and even childbirth (Pranzarone, 1991;Postel 2013). Some women claim to be able to induce orgasm simply by thinking without any physical stimulation. ...
Article
This review deals critically with many aspects of the functional genital anatomy of the human female in relation to inducing sexual arousal and its relevance to procreation and recreation. Various controversial problems are discussed including: the roles of clitorally versus coitally induced arousal and orgasm in relation to the health of women, the various sites of induction of orgasm and the difficulty women find in specifically identifying them because of “'ambiguity problems” and “genital site pareidolia,” the cervix and sexual arousal, why there are so many sites for arousal, why multiple orgasms occur, genital reflexes and coitus, the sites of arousal and their representation in the brain, and identifying aspects and functions of the genitalia with appropriate new nomenclature. Clin. Anat., 2014. © 2014 Wiley Periodicals, Inc.
... Sexual arousal has been measured among heterosexual men in response to images of female breasts and buttocks (Freund, Langevin, & Zajac, 1974) and behavioral studies have reported visual orientation towards the breasts, buttocks, and areolae during judgments of attractiveness (Cornelissen, Hancock, Kiviniemi, George, & Tovée, 2009;Dixson, Grimshaw, Linklater & Dixson, 2010,2011a.Amongyoungsexuallyexperiencedwomen from the U.S., 81.5 % stated stimulation of the breasts and nipples caused or increased feelings of sexual arousal (Levin & Meston, 2006). Interestingly, while stimulation of the areolae to either initiate or as an accompaniment to sexual intercourse is common cross-culturally (Ford & Beach, 1951;Levin, 2006), analyses of ethnographic records reveal that male preferences for female breastsize and shape arehighlyvariablebetween societies (Ford& Beach,1951).Studiesin whichlinedrawingsofwomenwererated are similarly equivocal, so that among men in Western cultures attractiveness ratings were highest for small breasts (Furnham & Swami, 2007), larger than medium-sized breasts in stimuli with lowWHRs (Furnham,Dias, & McClelland, 1998;Singh & Young, 1995), or equivocal across ratings for small, medium, and large breasts (Horvath, 1981). ...
Article
Full-text available
Women's breast morphology is thought to have evolved via sexual selection as a signal of maturity, health, and fecundity. While research demonstrates that breast morphology is important in men's judgments of women's attractiveness, it remains to be determined how perceptions might differ when considering a larger suite of mate relevant attributes. Here, we tested how variation in breast size and areolar pigmentation affected perceptions of women's sexual attractiveness, reproductive health, sexual maturity, maternal nurturing abilities, and age. Participants (100 men; 100 women) rated images of female torsos modeled to vary in breast size (very small, small, medium, and large) and areolar pigmentation (light, medium, and dark) for each of the five attributes listed above. Sexual attractiveness ratings increased linearly with breast size, but large breasts were not judged to be significantly more attractive than medium-sized breasts. Small and medium-sized breasts were rated as most attractive if they included light or medium colored areolae, whereas large breasts were more attractive if they had medium or dark areolae. Ratings for perceived age, sexual maturity, and nurturing ability also increased with breast size. Darkening the areolae reduced ratings of the reproductive health of medium and small breasts, whereas it increased ratings for large breasts. There were no significant sex differences in ratings of any of the perceptual measures. These results demonstrate that breast size and areolar pigmentation interact to determine ratings for a suite of sociosexual attributes, each of which may be relevant to mate choice in men and intra-sexual competition in women.
... As already suggested, the OT mechanism mediating the sexual intimacy between male and female might have been an alteration of the mechanism underly-ing the mother-infant bonding (Ross & Young, 2009). For example, female breasts became a secondary sexual trait as an exaptation from breastfeeding; in both cases, nipple stimulation promotes the release of OT (Komisaruk & Whipple, 2011;Levin, 2006). Moreover, maximizing the view of the partner's face, which is also crucial in mother-infant interactions, humans copulate face-to-face gaining even more pleasure, resulting in higher levels of OT that foster male-female bonding which leads to an increased parental investment. ...
Article
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This is not an investigation on the sexual habits of Mötley Crüe, neither on drugs of abuse. Rather, reviewing the neuroendocrine literature on music, courtship, orgasm, and attachment, a parallel between music and love is proposed. Exapted from mother-infant interactions to mate attraction, fostering neotenization, music reduced inter-male aggression, promoted social cohesion, and had a role in human encephalization.
... The breast as a sensual organ is well recognized in clinical realms. 44,45 An increasing national mastectomy rate juxtaposed to an unparalleled era of breast cancer survival calls for a clearer understanding of breast sexuality in survivorship. Wei et al. have demonstrated that NSM patients compared with SSM with nipple reconstruction scored significantly higher in the psychosocial and sexual well-being domains, without differences in physical well-being or breast outcome satisfaction. ...
Article
Survivorship medicine is fairly new in the realm of oncology. As we broaden our focus from treatment and prevention to include survivorship there is substantial opportunity to enhance the care of the patient. Important in successful management of recovery after cancer treatment is managing the side effects of therapy and improving quality of life. This ranges from sexual dysfunction, depression to lymphedema. Guideline-based surveillance after treatment with clear communication of care plans to the patient and their providers, especially primary care, is paramount. Thoughtful pre-surgical treatment planning, which may include neoadjuvant approaches or consideration of fertility preservation, results in superior long-term patient outcomes. Understanding the importance of the teachable moment in effecting behavioral and lifestyle changes that reduce risk of recurrence is also an essential component of excellent cancer survivor patient care. We identified the following areas for focus as they represent the key areas for accreditation and patient driven needs. Development of survivorship plans, post treatment surveillance, sexuality and fertility preservation, lymphedema management and risk reduction lifestyle and behavioral changes.
... Male and female (non-pregnant) nipple stimulation also induces prolactin secretion [47]. Young adult women and men report that breast stimulation not only induces their sexual arousal but enhances it when already aroused [48]. It has been proposed that prolactin specifically released at orgasm by either coitus or masturbation inhibits sexual arousal in men and women [49], although Levin [50] noted that women are known to be able to have multiple serial orgasms, which is contradictory to this hypothesis. ...
Article
Full-text available
Breasts, including the nipple and areola, have two functions: lactation and as an erogenous area. Male breasts are much less studied that those of women. In men, breasts have only an erotic function. Because there is dense and very well organized innervation of the nipple-areola complex in men, nipple erection occurs frequently and via different mechanisms from penile erection. Although it seems to be less important for men than for women and it is poorly studied, the erotic value of breast stimulation is notable. Consequently, there is a need to include this aspect in sexological and andrological studies and to preserve breasts and their innervation or to reconstruct them in cases of surgical intervention.
... 468, 471). This size difference appears only after puberty — which isn't a reduction in male size, but rather, an increase in female nipple size related to hormone surge (Levin, 2006). The relevant differences in male and female nipples are likely to be found, rather, in the unstudied functionality of nipple ducts; male nipple ducts would be predicted to be highly variable because they are byproducts — as opposed to female nipple ducts, which would be highly selected to be functional. ...
Article
Full-text available
David Puts and Khytam Dawood's recent critique of my book, The Case of the Female Orgasm: Bias in the Science of Evolution, attempts to make plausible an adaptive account of female orgasm based on a hypothesized mechanism of uterine upsuck and sperm competition. Yet the authors fail to respond to the criticisms of such accounts that I detailed previously in my book. They raise a further concern about my definition of adaptation--a red herring--and manufacture a conceptual error regarding heritability that they then attribute to me. Most seriously, they fail to address the glaring failure of sperm competition accounts to accord with evidence from sexology. Specifically, the distribution curve of orgasm-with-intercourse--according to Dawood et al.'s own data, as well as others'--is relatively flat across the various classes. This curve needs to be tested against a well-formed multistrategy adaptive hypothesis; it cannot be explained by the adaptive account defended by Puts and Dawood in their critique.
... The nipples are a particularly sensitive and are an erogenous area of the body; stimulation can produce sexual arousal and some women report experiencing orgasm from nipple stimulation alone [108][109][110] . A 2020 study demonstrated that application of a topical cream containing an α-1 adrenergic receptor agonist to the nipple can improve female orgasmic function, as measured by FSFI, by increasing pressure sensitivity (P = 0.022) 111 . ...
Article
Given that sexual pleasure is a core component of sexual health, devices that are designed to enhance and diversify sexual pleasure are particularly useful in clinical practice. Despite their growing popularity and widespread use in various biopsychosocial circumstances, many taboos still seem to exist, as indicated by the paucity of scientific literature on the prevalence, application and effectiveness of sexual devices for therapeutic use. However, sex toys and sexual devices are commonly used and have a variety of indications to expand individual and partnered sexuality and to treat sexual difficulties. Different devices are associated with specific advantages and potential risks, opportunities, barriers and ethical challenges when used in a clinical context. Increased knowledge about the aim and functional possibilities of sexual devices might help health-care professionals overcome potential embarrassment, preconceptions and other barriers, learn which patients might benefit from which products, consider their use in treatment programmes, educate about correct use and safety issues, and facilitate open communication about sexual pleasure with their patients.
... In addition, techniques that maintains the integrity of NAC are also important in the lactation process. This is because the stimulation that the nipple receives when the baby sucks the breast also initiates the release of prolactin and oxytocin which are needed for milk production [16,17]. In the vertical scar mammaplasty technique with a superior pedicle, it only takes the tissue and glands that are located in the lower quadrant and still maintains the surrounding tissue and glands. ...
Article
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Introduction Most of patients undergo reduction mammaplasty for aesthetic or therapeutic reasons without consider the effect on breastfeeding function. Vertical scar mammaplasty with superior pedicle is expected to be a breast reduction procedure that can keep maintain the function of breastfeeding. This is the first recorded report of breastfeeding after vertical scar reduction mammaplasty with superior pedicle in Indonesia. Presentation of case A 23 years old woman presented to the outpatient clinic with enlargement of both breast for 3 years. Physical examination showed bilateral breast enlargement. No tenderness, nodules, nor axillary lymph node enlargement were found. The patient was managed with vertical scar mammaplasty with superior pedicle. The patient was followed up with complication of skin excess and scarring on the bilateral submammary folds. We performed excision and resection procedures to eliminate the skin excess and scars without further complications. The patient was married and gave birth to her first and second child after two and five years following mammaplasty. The patient was able to provide exclusive breastfeeding for both of her children. Discussion Vertical scar mammaplasty with superior pedicle surgery is a surgical technique that combines a superior pedicle for the areola and performs a central-inferior quadrant resection for breast reduction. It only takes the tissue and glands that are located in the lower quadrant and still maintains the surrounding tissue and glands. This technique also maintains the integrity of nipple-areola complex (NAC) which also important in the lactation process Conclusion Vertical scar mammaplasty with superior pedicle can be one of the superior techniques in breast reduction which can maintain the breastfeeding function thereby increasing patient satisfaction.
... Durante la fase de cazadores-recolectores, las hembras de homínidos desarrollaron pechos permanentemente agrandados para poder emplearlos para apoyar la cabeza de los bebés durante los viajes largos Levin, 2006Manning et al. 1997 Los pechos son señales honestas dado que solo aquellas mujeres con alta calidad genética pueden desarrollar pechos grandes y simétricos. Manning et al., 1997 Marlowe 1998 ...
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Resumen: Se ha considerado que la selección sexual ha tenido una fuerte repercusión en la morfología del ser humano. Uno de los caracteres que se cree sujeto a este tipo de selección es el de los pechos permanentemente agrandados de las mujeres. Sobre su origen y utilidad se han formulado casi una veintena de hipótesis sin llegar a una conclusión. En este trabajo se propone una nueva, sugiriendo que este carácter habría surgido bajo el modelo de sesgos sensoriales preexistentes. Para comprobarlo, se realizó un estudio de preferencias visuales con chimpancés. Se presentaron diversos grupos de fotografías, entre ellos imágenes de hembras de chimpancé con pechos artificialmente agrandados. Se midieron las preferencias de los sujetos en base al tiempo de latencia, el tiempo dedicado a mirar los estímulos, los acercamientos y el comportamiento asociado. Los resultados del estudio no son concluyentes y no aportan evidencias a favor ni en contra de la hipótesis. Se sugieren por lo tanto nuevas metodologías para comprobarla. Abstract: Sexual selection has been considered to have had a strong impact on human morphology. One of the characters believed to be subject to this type of selection is permanently enlarged breasts in women. About its origin and utility have been formulated almost twenty hypotheses without reaching a conclusion. In this work a new one is proposed, suggesting that this character would have arisen under the model of preexisting sensory biases. To verify this, a study of visual preferences was carried out with chimpanzees. Various sets of photographs were presented, including images of female chimpanzees with artificially enlarged breasts. Subjects' preferences were measured based on latency time, time spent looking at stimuli, zooms, and associated behavior. The results of the study are not conclusive and do not provide evidence for or against the hypothesis. Therefore new methodologies are suggested
... Some women describe aversion to and avoidance of sex or even a feeling of anger, disgust, or dissociation during sexual contact with their numb breasts after mastectomy. Nipple-areolar complex sensation is an essential component of arousal and orgasm physiology for many people and their partners (Levin, 2006). Sexual dysfunction affects as many as three quarters of women with breast cancer and is at least partially attributable to loss of breast sensation (Ganz et al., 1999;Fobair et al., 2006;American Psychiatric Association, 2013;Raggio et al., 2014;Rojas et al., 2017). ...
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Mastectomy often leads to a complete desensitization of the chest, which in turn can give rise to diminished sexual function and to disembodiment of the breasts. One approach to mitigate the sensory consequences of mastectomy is to leverage technology that has been developed for the restoration of sensation in bionic hands. Specifically, sensors embedded under the skin of the nipple-areolar complex can be used to detect touches. The output of the sensors then drives electrical stimulation of the residual intercostal nerves, delivered through chronically implanted electrode arrays, thereby eliciting tactile sensations experienced on the nipple–areolar complex. The hope is that the bionic breast will restore a woman’s sense that her breast belongs to her body so she can experience the pleasure of an embrace and derive the benefit of the sensual touch of her partner.
... Recently, other erogenous zones in the deep structures of pelvic area and vagina have been described [2][3][4][10][11][12][15][16][17][22][23][24]36,[41][42][43]. We have also investigated the possible existence of such areas in our surveys and other research projects; we have come across the description of such sensitive areas that may contribute to the development of female orgasm in some women [12,15,16]. ...
Article
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Pleasure principal" is one of the most important driving forces of the human psyche. Pleasures in human beings include various satisfactions, such as food intake for the survival, satisfaction of the ego and higher cortical cognitive functions, sexual satisfaction and orgasm, satisfaction of basic physiological needs. Female orgasm, which does not happen in other animal species (other than maybe one or two higher primates), is one of the most intriguing phenomena in female psychology. Female orgasm and female 'peak experiences' are well documented in the ancient historical literature of the Far East and India. In Tantra and also in Taoist philosophy, for centuries, prolonging the sexual pleasure of the women was regarded as an essential approach; old Chinese Taoist prescription for male sexuality was also defending males to prolong intercourse for a couple of hours, while, according to Chinese medicine men, losing semen was a bad habit or losing the yang energy. As described by Masters and Johnson, some women can attain an orgasmic state which may last for 43 seconds, coined as status orgasmus. The highest orgasm number recorded in medical literature is 134 orgasms per hour. ESR is a recently defined novel phenomenon, although it is very ancient. ESR was defined as: "being able to attain long lasting and/or prolonged and/or multiple and/or sustained orgasms and/or status orgasmus that lasted longer and more intense than the classical orgasm patterns defined in the literature". Status orgasmus are the continuous form of blended orgasms and/or clitoral/vaginal orgasms that last for starting from 1 to 15 minutes (or more). During status orgasmus a continuous orgasmic state is experienced and very few women are believed to achieve status orgasmus state, e.g. less than 1% of the whole female population. Nearly 10% to 15% of the women population has the capacity to develop ESR and prolonged orgasms. ESR is also a learned and developed phenomenon. Some non-ESR women can also develop ESR after certain trainings. Tantric and Taoist techniques are one of the training methods. ESR can also be measured by means of a psychometric ESR scale developed by Dr. Ümit Sayin.
... Recently, other erogenous zones in the deep structures of pelvic area and vagina have been described [7][8][9][10][11][47][48][49][50][51][61][62][63] We have also investigated the possible existence of such areas in our surveys and other research projects; we have come across the description of such sensitive areas that may contribute to the development of female orgasm in some women [10,11]. The descriptions of DVZs were as follows (Table 5 and Figure 5). ...
Article
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Pleasure principal" is one of the most important driving forces of the human psyche. Kinds of pleasure in human beings include various satisfactions, such as food intake for the survival, satisfaction of the ego and higher cortical cognitive functions, sexual satisfaction and orgasm, satisfaction of basic physiological needs and peak experiences, such as love, satori-like experiences, and some mystical-like experiences. Pleasure phenomenon has some neural correlates, circuitries and neurotransmitter systems involved. Some pleasure centers have been defined in both animals and humans, such as ventral tegmental area (VTA), nucleus accumbens (NA), prefrontal cortex, hypothalamus, cingulate cortex, insula, while amygdala, hippocampus and some structures of the temporal lobe may have an auxiliary role. Mainly neurotransmitters dopamine (DA) and oxytocin (OXT) are the mediators of pleasure experiences in humans. During love, sexual pleasure and orgasm, those hedonic hot spots are activated, as also shown by fMRI techniques. Recently it was proposed that sexual pleasure can be expanded and there were reports on expanded orgasms (EO or ESR). Also, some researchers have reported that there are erogenous zones other than clitoris, while some non-genital orgasms have also been reported. Pudental, pelvic, hypogastric nerves and vagus control the orgasmic reflex in females. OXT, which is also a pleasure molecule, just like DA, also has some separate pleasure pathways. The limits and extents of female pleasure and orgasms have not been investigated thoroughly until recently. One of the extremes of female pleasures, ESR, has some specific neurological mechanisms which can be explained by using current data on female sexuality. There are different types of female orgasms: clitoral, vaginal, blended orgasms, EO and status orgasmus, which are still debated in the academic circles. This review discusses the possible neurological and neuropharmacological mechanisms of EO and ESR, using the informatics theory, as well.
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The purpose of this study was to explore body image, physical attractiveness, and femininity among survivors of breast cancer and to examine the effects of the aforementioned variables on depression and quality of life. The participants comprised 70 female survivors of breast cancer, ages between 23 and 79 years. They completed a questionnaire that includes Center for Epidemiological Studies Depression Scale, Functional Assessment of Cancer Therapy, and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire--Breast Cancer, measuring depression, quality of life, and body image, respectively. On the depression scale, 56% of the participants had scores higher than 16; a score of 16 and above identifies participants with potential depression. Majority of women felt less attractive and less feminine. Low body image, attractiveness, and femininity positively correlated with depression and negatively with overall quality of life. The authors conclude that multidisciplinary health care services relevant to physical attractiveness and femininity of survivors of breast cancer may foster positive body image perceptions, reduced depression, and increased quality of life.
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Abstract Female orgasm is one of the unsolved phenomena in female physiology and psychology. Most of the women do not actually know their natural capacity in attaining powerful orgasms; male biases have, most of the time, shaped the norms of the sexual behavior of women in many cultures. 50 to 65 % of women can attain multiple orgasms. In some of these women, orgasms can be prolonged and expanded. Expanded Sexual Response (ESR) is a recently defined phenomenon. ESR is defined as: “being able to attain long lasting and/or prolonged and/or multiple and/or sustained orgasms and/or status orgasmus that lasted longer and more intense than the classical orgasm patterns defined in the literature”. We have recently defined the case studies of five ESR women, as well as many other cases in the books and articles we have published. Approximately 10-15 % of female population can develop ESR, by training. In this case report, we are, for the first time, defining a novel ESR Case (Afros) with non-genital orgasms, never-ending orgasms, brain orgasms and status orgasmus. Afros had the capacity of attaining various forms of female orgasms, such as clitoral orgasms, vaginal orgasms, vaginal-coital orgasms, G-Spot orgasms, non-genital orgasms, anal orgasms, nipple orgasms, ear-lobe orgasms, blended orgasms, and status orgasmus, as long as she was stimulated and aroused. She did not suffer from persistent genital arousal disorder (PGAD), since she could control her orgasms. The most intriguing perspective of Afros was that she experienced continuous orgasms (never-ending orgasms-NEOs) as long as she was stimulated, according to our observations and her descriptions; she could stay in the orgasmic state and consciousness for hours, even as long as for a day. Her most intriguing orgasms were recorded as 3-hour non-stop orgasms, with various forms of above orgasms, mostly status orgasmus. During another episode of 2 hours we recorded her having nearly more than 250 orgasms, some of which were combined with status orgasmus, that lasted from 15 minutes to 45 minutes. Afros is the only and unique woman who could maintain orgasmic physiological state and orgasmic consciousness incessantly in the medical literature recorded up to date. Afros also experienced mental orgasms as defined by Komisaruk et al. and Sukel (2011).
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While breast cancer remains the most commonly diagnosed cancer among women in the UK, the number of those living with the residual consequences of the disease and its treatment is rising. Women are likely to undergo several different treatments, each accompanied by changes to appearance. This can impose an adverse impact on their body image. Helena Lewis-Smith reviews research in this area.
Chapter
The author discusses nipple function and the anatomy of the nipple-areolar complex (NAC) anatomy especially that of the muscles. The NAC smooth musculature is divided into outer, intermediate, and inner layers from the areola to the nipple. The inner part of the smooth musculature surrounds the infundibular region of the mammillary milk ducts in a basketlike manner. The inner muscular fibers continue into the stronger intermediate layer, which is covered by an outer layer of smooth musculature situated around the ducts of the Montgomery glands. There are muscles surrounding vessels and lactiferous ducts.
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This paper explores the apparent reluctance in the world to recognizing the sexuality of breastfeeding. It demonstrates the ways in which the experience of breastfeeding is desexualized and attempts an understanding of why this occurs. Breastfeeding is looked at from a psychobiological perspective and situates it within the complexity of female sexuality. Female sexuality is understood to have both maternal and erotic components. Maternal and erotic sexuality is examined from a hormonal, neurological, and anatomical perspective, in order to demonstrate the similarities. Resistances to experiencing breastfeeding as sexual are looked at from both an oedipal and preoedipal perspective. An attempt is made to understand the biochemical processes underlying the transformation of breastfeeding from its potentially erotic sexual position to a position of maternal sexuality. Maternal sexuality is looked at as a maturational achievement, perhaps an additional psychosexual stage following genital sexuality.
Article
Introduction The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. Aim To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) “levels of evidence” wherever relevant. Conclusion Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
Article
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The article consist of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, the pathophysiology of female sexual dysfunction but excluding hormonal aspects. Aim: To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations accordng to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant. Conclusion: Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
Article
Background Shared decision making with one’s partner and body image satisfaction may affect surgical choices of breast cancer patients. This study analyzed whether partner opinion was associated with choice of operation and whether comfort level with one’s partner was altered postoperatively. Methods A prospective anonymous survey was administered to breast cancer patients who underwent breast surgery between 2000 and 2014. Categorical variables were compared by χ 2 or Fisher’s exact test. Results Women who elected to undergo mastectomy with reconstruction (MR) placed greater emphasis on their own decision making than on input from their partner, surgeon, or others (56.5 vs. 8.3 vs. 23.2 vs. 12, respectively), whereas those who chose lumpectomy (L) placed similar weight on surgeon input and self-input (44.2 vs. 42.7 %). Only 7.5 % of all patients identified their partner as the greatest influence on their surgical choice. Preoperatively, the L group was the most comfortable with their partner seeing their chest (91.9 % L vs. 83.9 % MR vs. 75.9 % mastectomy alone (M); p = 0.01), and postoperatively, the comfort levels for all were remarkably decreased. Furthermore, if a patient was a candidate for L but chose MR, the role her chest played in intimacy dropped more compared with those who chose L (83.8 % L vs. 91.7 % MR; p = 0.3 preoperatively to 65.1 % L vs. 42.9 % MR; p = 0.01 postoperatively). Conclusions When making surgical decisions, most patients indicate that they value their own opinion over that of others. Mastectomy, regardless of reconstruction, leads to a significant reduction in comfort with one’s partner postoperatively compared with lumpectomy. This information may be helpful in counseling couples at the time of consultation for breast cancer treatment.
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The article consists of 6 sections written by separate authors that review female genital anatomy, the physiology of female sexual function and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. Aim. To review female sexual function - physiology and pathophysiology- especially since 2010 and to make specific recommendations with levels of evidence ( Oxford Centre) where relevant. Conclusion. Despite numerous lab assesssments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
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This article focuses on anti-FGM laws aiming at eliminating gender-based violence. It uses intersectionality to question the underlying conceptualization of gender-based violence, and examines how the problem is represented , and which solutions have been proposed by French, British and Italian laws, showing their inconsistencies and biases. It also considers silenced dissenting voices by focusing on the proposal of " circumcision without cutting ". The main goal is to uncover how anti-FGM laws generate new forms of vulnerability for African descent women in Europe, calling for a more complex articulation of gender at the intersection with migration status, ethnicity and neo-colonial relations.
Chapter
The human female orgasm bestows the greatest pleasure without recourse to drugs. Despite numerous studies there are many aspects of the activity that are poorly understood. These include its neurophysiology and pharmacology, while even its typology, induction, and function(s) are contentious issues. It can be induced by a variety of agencies that include genital and non-genital sites and even by exercise. While there are similarities with the male orgasm, there are a few differences, the major one being that women can have repeated multiple orgasms while males cannot. Despite recurrent speculative claims in the literature, it does not mediate or facilitate sperm transport through its uterine contractions. Brain imaging that measures cerebral regional blood flow has revealed that there is no single orgasm center, but rather specific areas are either activated, inhibited, or unaffected during orgasm. However, no consensus has yet been achieved due to experimental procedural differences and data handling by researchers.
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Introduction: Since the 1960 s, there has been debate in academia, the women’s movement, and the general public about the fact that women experience orgasms less frequently than men during heterosex as well as why, and additionally about if and how to close this gender orgasm gap. Within a bio-psycho-social model of sexuality, gender orgasm gaps are explained theoretically in very different ways. Objectives: The aim of this research review is to report the empirical findings to date on the size of the gender orgasm gap as well as to present and critically discuss the proposed practice measures intended to close it. Methods: In the course of a systematic literature search n = 20 empirical publications on the orgasm gap and an additional n = 16 original research papers promoting its closure were identified and coded (1982–2021). Results: The surveys included are based on the self-reports of N = 49 940 women and N = 48 329 men, and show that typically 30 % to 60 % of women report reaching orgasm during heterosex in contrast to 70 % to 100 % of men. Depending on the context of heterosex, the size of the orgasm gap varies from –20 % to –72 % to the disadvantage of women. The ten population-representative surveys presented yield a weighted mean orgasm gap of –30 % [95 % confidence interval: –31; –30]. The measures proposed in previous literature for closing the orgasm gap relate to personal factors, relationship factors, sexual interaction factors, and societal factors: Women are advised to strive more consciously for their own orgasm and to talk more openly about their sexual wishes in the relationship. In addition, women and men are advised to integrate more direct clitoral stimulation into heterosex and to demarginalize women’s orgasms socially. Conclusion: Based on the current state of research, there is a need to continue addressing issues around the gender orgasm gap in both research and practice. However, given the limited successes of recent decades, it also seems imperative to critically examine the approaches taken so far in the “battle for orgasm equality”. Open Access Full Text: https://www.thieme-connect.de/products/ejournals/pdf/10.1055/a-1832-4771.pdf
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The origin of clothing is a topic that arouses much argument and attracts many different answers (and opinions). In anthropology, a consensus has emerged in recent decades that not only do we have no answer, the question of why humans first invented clothes may not be answerable. This book shows that such pessimism is unfounded. The book comprises two parts; the first part explores the origins of clothing. Evidence from ethnography, thermal physiology and climatology is covered, beginning with our biological nakedness. The key proposition is that although we have no archaeological remains of clothes from the Pleistocene, we do have indirect evidence in the form of technologies linked to the manufacture of garments from animal skins – stone scrapers and blades, and bone awls and needles. When evidence from archaeology, climatology, biology and ethnography is taken into account, it would seem that our ancestors first invented clothes to keep warm. The second section looks at the impact of climate change after the last Ice Age; specifically, the problems posed by warmer and more humid conditions. The Holocene epoch witnessed a revolution in clothing technology: in many parts of the world, people changed from wearing the skins of animals to making garments from woven fabrics. The reason for changing clothes was a physiological need to manage two problems with moisture: first, increased body perspiration in the warmer weather and, second, reduced evaporation of sweat due to higher humidity levels. Porous fabrics solved these moisture issues, creating a new demand for textile fibres. The book presents evidence for production of fibres (as well as food) in early farming contexts, and shows how textiles can help resolve fundamental enigmas about the origin of agriculture. The book concludes by considering a couple of psychological aspects. One aspect is the early weaning of infants, due mainly to modesty. Reduced breastfeeding led to increased fertility and birth rates, and the demographic effect was a population explosion. At a deeper level, a new preference had emerged for being enclosed from nature, an effect of wearing clothes which may underlie both agriculture (as ecological enclosure) and sedentism as enclosure from the physical environment.
Article
Purpose: More early-staged breast cancer patients are choosing mastectomy. No studies have addressed breast-specific sensuality (BSS), defined as the breast's role during intimacy. We explored BSS among women undergoing lumpectomy (L), mastectomy alone (M), or with reconstruction (MR) and analyzed the association of surgical modality with sexual function. Methods: Women undergoing breast cancer surgery between 2000 and 2013 were eligible for survey using investigator-generated questions and the Female Sexual Function Index (FSFI). Demographic and surgical data were collected by chart review. The Kruskal-Wallis test was used to analyze FSFI scores, and χ (2) or Fisher's exact tests were used for categorical data. Results: Of 453 invited participants, 268 (59%) completed the survey. Of these, 69.4, 22.4, and 8.2% underwent L, MR, or M, respectively. The importance of the breast/chest wall during intimacy declined significantly regardless of surgical modality (L 83-74%, p = 0.0006; M 95-47%, p = 0.003; MR 93-77%, p = 0.002). No difference in sexual function was found between L, MR, and M (median FSFI score 28.2, 27.5, 25.9, respectively; p = 1.0). Comparing L versus MR, higher FSFI scores resulted with appearance satisfaction (29.0 vs. 22.6 p = 0.002) and preserved BSS as pleasurable breast caress (28.8 vs. 26.5, p = 0.04) and the breast as part of intimacy (28.8 vs. 24.8, p = 0.1). Conclusions: Breast cancer surgery is associated with lowered BSS. However, BSS and appearance satisfaction scores are better for L and appear to correlate with improved sexual function postoperatively. These data may guide surgical counseling and contribute to survivorship outcomes.
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İçindekiler Önsöz 1-Cinsellik Nedir? 2-Cinsel Beyin-Cinsel Zihin 3-Cinsel Zihinde Beynin Nöroanatomisi, Nörofizyolojisi, Psiko-Farmakolojisi, Nöro-Kimyası 4-Cinsel Beynin, Hazzın ve Orgazmın Nörobilimi 5-Duygusal Zeka (EQ) ve Cinsel Zeka (SQ) 6-Cinsel Nesneler; Cinsel Haz Nesneleri: Normal Nedir? Anormal Nedir? 7-Kendi Cinsel Beyninizi Keşfedin! Cinsel Beyin ve Cinsel Zekanızı Geliştirin! Yazar Hakkında Bilgi Referanslar Çıkmış ve Çıkacak Kitaplar Duygusal Zeka Testinin Anahtarı Tanıtımlar-CİSEATED Eğitimleri CİNSEL BEYİN ve CİNSEL ZİHİN, Türkiye’de ve Türkçe’de pek işlenmemiş kavramlardır. Bu kitap bu konuda yazılan ilk kitaplardan birisidir. Cinsel Beyin, bir bütün olarak beynin nasıl cinselliği etki-lediğini, cinselliğin beyin kökenli fizyolojisini anlatan bir konudur. Cinsel Zihin (Sexual Mind) ise cinselliğin gelişmesinde insan psi-kolojisinin, zihnin dinamiğinin, içgüdülerin, bilinçdışının nasıl geliştiğini araştırır. Aslında kitabın temel konusu, hem cinsel beyin, hem de cinsel zihindir. Cinsel Beynin çalışma prensiplerinin çoğu bugünkü tıp ve fizyoloji tarafından bilinmektedir. Cinsel Beyin’de metafizik olgu-lara yer yoktur. Ruha veya ölçülemeyen ne olduğu belirsiz enerjilere yer yoktur. Cinsel beynin sinir sistemi, ölçülebilen ve ne olduğu bilinen moleküler olaylarla çalışır. Kullandığı enerji ise ATP’dir; hiçbir metafizik enerji yoktur. Beyin ve sinirler biyoelektrik potan-siyeller olan aksiyon potansiyelleri sayesinde haberleşir, bilgiyi saklar. Bunun gerçekleşmesi için ise oksijen ve glikozun varlığına ihtiyaç vardır; oksijen ve glikozun olmadığı yerde bilinç ve düşünce, hafıza olamaz. Bu konuda kitabın bir bölümünden kısa bir alıntı yapmakta fayda vardır: … “Görebileceğiniz gibi aşk, cinsel uyarım, libido, orgazm, hor-monlar konusunda pek çok bilimsel gerçek açığa çıkmıştır. Bunların hiç birisi metafizik olgular değillerdir! Bilinç, beyin, hafıza, haz, çoşku, dü-şünce, ekstaz halleri, çeşitli farklı orgazmlar, cinsel haz hepsi biyoelektrisel potansiyellere, hormonlara ve nörotransmitterlere bağlıdır. Ama bu bilgiye ulaşamayan ve özümsemeyen “sokaktaki insan” bu olguları hep ne olduğunu kendisinin bile hayalinde canlandıramadığı CHAKRA’lara, Kundalini enerjisine, 3000 yıl önceki “kadim” dediği tutarsız ve bilim dışı teorilere bağlamaktadırlar. Bu bilgiler üç sayfalık bir “kişisel gelişim merkezi” broşürüyle açıklanmaktadır; öğrenmek kolaydır, akılda tutmak kolaydır, insanları kandırmak kolaydır! Ama gerçek bilginin arkasındaki milyonlarca sayfalık tıp araş-tırmaları ve tıp bilgisi “sokaktaki adam ve onu kandıran kişisel gelişimci-ler” veya “Tantracılar” tarafından göz ardı edilmekte ve sadece para kazanma amaçlı şarlatanlık planları sıradan halkı kandırmak ve soymak için kullanılmaktır. Her workshopta söylediğim bir gerçek vardır: “ Tıp olmadan, Cinsel Terapi olmaz! Tıp olmadan, Tantra olmaz! Herkes, düzeyini ve seviyesini bilecek…” İçinde yaşadığımız Post Modern Delilik Çağında, herkes şarlatan terapist, sağaltıcı ve eğitmen olmuştur, ne yazık ki! Tantracılar, cinsel terapistler, psikologlar, kişisel gelişimciler arasında o kadar çok şarlatan mevcuttur ki! Son olarak Amerika’da satılamayan Koçluk, Kuantum Koçluğu, yaşam koçluğu gibi eğitimler Türkiye’de pek çok alıcı bulmaktadır. Haya-tında tek psikoloji veya tıp kitabı okumamış kişiler neyin Koçluğundan (COACH) bahsetmektedirler? Ama artık Türkiye’de üç kelime uzak doğu felsefesi, birkaç kelime Chakra, Kundalini gibi lakırdılar edenler, üç sayfa-lık broşür bilgileriyle halka sağaltım dağıtmakta ve Tantra ve cinsel da-nışmanlık konusunda uzman kesilmektedirler!” Birkaç haftalık eğitimle 5-6 bin TL bastırıp koç olanlar mı ararsınız? Koç kelimesinin önüne, ne anlama geldiğini kendisinin de bilmediği Kuantum kelimesini ekleyenler mi ararsınız? Birkaç haftada metafizik reiki sağaltıcısı, reiki master olanlar mı ararsınız? Kendi egosunu ve narsizmini tatmin etmek isteyen bir sürü psikotik deli mi ararsınız? Herkes piyasada üç kuruşluk ve beş sayfalık bilgileriyle hekimlik yapmaktadır. Bu aslında 2000’li yılların başından beri Türkiye’deki toplum mühendisliğiyle değiştirilen ve ruhani, metafizik olgulara aşırı değer veren sistemin ve inançlar topluluğunun bir ürünü ve yansımasıdır! Türkiye 2000’lerden sonra toplum olarak delirtilmiştir. Evet! Delirtilmiş, hasta, şizofre-nik ve psikotik bir toplumda yaşıyoruz. Bu hasta toplumun ne yazık ki cinselliği de ağır biçimde hasta ve psikotiktir! Bu kitap ise size gerçekleri anlatmaktadır! Saf bilimsel gerçekleri! Beyninizin, cinsel beyninizin, cinsel zihninizin nasıl çalıştığını binlerce referansa dayandırarak size sunmaktadır. Uma-rız, gerçeklere gözlerinizi kapamazsınız!
Chapter
More women are becoming cancer «survivors». The side effects of treatment, and the existential threat of cancer, can have physical and psychological consequences. Psychological distress is a natural response to breast cancer and can dissipate over time. However, clinically significant levels of depression and anxiety are common. Two specific patient factors are discussed in more detail which can increase the likelihood of significant distress, poor body image and childhood adversity, although other factors are also important (e.g. fear of recurrence). The proposed mechanisms by which childhood adversity might affect adjustment to breast cancer, and ability to be supported by the clinical team, are described. There follows a discussion of some key findings from research investigating the factors patients find helpful in the contact they have with clinicians involved in their care.
Article
The Nipple is a specialized structure which can be erected by various stimulations and provides induction of milk ejection reflex and sexual arousal due to its intense sensory innervation. Smooth muscles in its structure have been found to be related with the nipple erection mechanism. However, studies aimed at explaining nipple erection mechanism are insufficient. Smooth muscle morphology were investigated by Masson's trichrome staining on sagittal sections performed in 17 different human nipple-areola complex (NAC) samples. According to the results, NAC smooth muscles that have longitudinal and horizontal course are associated with epidermis, lactiferous ducts and blood vessels. Besides, areola is richer compared to nipples in terms of horizontal muscle fibers. Despite being erectile textured, NAC are different from penis in its structure. Contrary to available data, when the NAC smooth muscle morphology evaluated together with erection dynamics, smooth muscle relaxation should also be considered to have an effect.
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The aim of this study is to gain a systematic overview of all existing studies on parental sexuality during pregnancy and the postpartum period (months 1–6). Investigations of psychological and medical data banks and cross-references revealed 59 relevant studies published in English or German between 1950 and 1996. These primary studies were metacontent analyzed, according to the following categories: methodology (samples, designs); type of descriptive data researched (sexual activity, interest, enjoyment, orgasm, problems); and type of correlational data researched (sexual variables and pregnancy outcome, maternal physical and psychological health, sociodemographic data, biographical data, partnership data). On average, female sexual interest and coital activity declines slightly in the first trimester of pregnancy, shows variable patterns in the second trimester, and decreases sharply in the third trimester. Most couples do not practice intercourse for about 2 months around the delivery. Afterwards, sexual interest and activity tends to be reduced for several months as compared with the prepregnancy level, and sexual problems occur relatively often. But most remarkable is the interindividual variability concerning sexual responsiveness, orgasm, activity, and enjoyment. Descriptive research is focused on coital activity of (expectant) mothers. Data about fathers, noncoital activities, and sexual feelings are scarce. Data analysis is focused on three questions: (1) Does sexual activity in pregnancy harm the fetus? (if there are no risk factors: no); (2) Are physical and mental symptoms or data about the delivery and sexual variables correlated? (in some cases: yes); (3) Are sociodemographic data and sexual variables correlated? (mostly not). Research deficits (e.g., conceptual reductionism “sexuality=intercourse,” neglect of the male partners, validity, reliability, neglect of the nonsexual partnership and of biographical influences) are critically discussed. Medical, counseling, and psychotherapeutic implications are derived.
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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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This review is intended to give an overview of current knowledge on human breast development. It focuses on the limitations of our understanding on the origins of human breast cancer in the context of this mainly morphological and static assessment of what is known about human breast development. The world literature is very limited and caution is needed in drawing analogies with the mouse. There is an increasing emphasis on research to understand normal stem cells in the breast on the assumption that these are the targets for the initiation of breast cancer. It is thus a priority to understand normal human breast development, but there are major obstacles to such studies mainly due to ethical considerations and to tissue acquisition.
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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 volume of the left and right breasts was measured daily in four nulliparous women during normal menstrual cycles and after the use of oral contraceptives. Breast volume increased significantly in the second half of both normal and contraceptive-controlled cycles. The mean total change in volume throughout the cycle was 100 ml under natural conditions and 66 ml on oral contraceptives.
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Recognition of sexual behaviours and needs is essential for all doctors in diagnosis, care after major illness, and humane management of social needs. The majority of adults are heterosexually active from adolescence into old age, while a minority of individuals have homosexual relationships throughout their lives, or during shorter periods. Among adults aged 16–44 years, a third of men and a fifth of women report a new partnership in the past year, and this proportion is higher among younger adults and men who have sex with men (MSM). Anal intercourse is practised by a significant minority of heterosexuals, as well as among MSM for whom it is a major route of HIV transmission. A small minority of individuals have large numbers of partners (a ‘core group’), and contribute disproportionately to the transmission of STIs and HIV. Behavioural interventions to reduce sexual risk among MSM can be effective, as in other groups, but attention to wider social determinants is also important in controlling STI and HIV transmission.
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An adaptationist programme has dominated evolutionary thought in England and the United States during the past 40 years. It is based on faith in the power of natural selection as an optimizing agent. It proceeds by breaking an oragnism into unitary 'traits' and proposing an adaptive story for each considered separately. Trade-offs among competing selective demands exert the only brake upon perfection; non-optimality is thereby rendered as a result of adaptation as well. We criticize this approach and attempt to reassert a competing notion (long popular in continental Europe) that organisms must be analysed as integrated wholes, with Baupläne so constrained by phyletic heritage, pathways of development and general architecture that the constraints themselves become more interesting and more important in delimiting pathways of change than the selective force that may mediate change when it occurs. We fault the adaptationist programme for its failure to distinguish current utility from reasons for origin (male tyrannosaurs may have used their diminutive front legs to titillate female partners, but this will not explain why they got so small); for its unwillingness to consider alternatives to adaptive stories; for its reliance upon plausibility alone as a criterion for accepting speculative tales; and for its failure to consider adequately such competing themes as random fixation of alleles, production of non-adaptive structures by developmental correlation with selected features (allometry, pleiotropy, material compensation, mechanically forced correlation), the separability of adaptation and selection, multiple adaptive peaks, and current utility as an epiphenomenon of non-adaptive structures. We support Darwin's own pluralistic approach to identifying the agents of evolutionary change.
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Because of an intimate relation between body fat and reproductive function in human females, it is hypothesized that breast enlargement serves to advertise ovulatory potential, and as such compensates for the existence of concealed ovulation. The implications of this hypothesis are examined in light of optimal reproductive strategies for males, and it is shown that various sexual preferences appear consistent with this analysis.
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: Journal of the American Society of Plastic and Reconstructive Surgeons, Inc.; Official Organ of the American Association of Plastic Surgeons; the American Society for Aesthetic Plastic Surgery, Inc.; the American Society of Maxillofacial Surgeons (C)1999American Society of Plastic Surgeons
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Methods of assessing and measuring female genital functions are reviewed and their roles in research and current clinical evaluation of dysfunction discussed.
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Levels of oxytocin (OT) and PRL were measured in plasma drawn before and during intermittent mechanical pump and tactile stimulation of the breast in five normal cycling women and 19 women in the third trimester of pregnancy. OT was significantly increased above baseline in response to breast stimulation in two of five cycling women and PRL increased in one of the two OT responders. In pregnant women, mean OT post nipple stimulation was significantly higher than pre nipple stimulation whereas PRL did not increase significantly. The response of OT to nipple stimulation occurred in 18 of 19 pregnant women compared to only two of five normal cycling women but the magnitude of the OT response in pregnant women was less than in cycling women or post-partum lactating women previously studied in this laboratory. In one non post-partum woman who induced lactation for the purpose of breast-feeding an adopted infant, OT and PRL were measured before and during mechanical pump and tactile stimulation before initiation of breast-feeding. OT increased during mechanical pump and tactile stimulation of the breast, as well as suckling, whereas PRL increased only in response to suckling. Levels of LH were measured in plasma every 20 min for 160 min at the following times: before initiation of breast-feeding, during induced lactation while breast-feeding, and 30 d after discontinuation of breast-feeding. Despite the development of oligomenorrhoea during the period of breast-feeding, levels of progesterone were not suppressed and LH was released in a normal pulsatile fashion.
An adaptationist programme has dominated evolutionary thought in England and the United States during the past 40 years. It is based on faith in the power of natural selection as an optimizing agent. It proceeds by breaking an oragnism into unitary 'traits' and proposing an adaptive story for each considered separately. Trade-offs among competing selective demands exert the only brake upon perfection; non-optimality is thereby rendered as a result of adaptation as well. We criticize this approach and attempt to reassert a competing notion (long popular in continental Europe) that organisms must be analysed as integrated wholes, with Baupläne so constrained by phyletic heritage, pathways of development and general architecture that the constraints themselves become more interesting and more important in delimiting pathways of change than the selective force that may mediate change when it occurs. We fault the adaptationist programme for its failure to distinguish current utility from reasons for origin (male tyrannosaurs may have used their diminutive front legs to titillate female partners, but this will not explain why they got so small); for its unwillingness to consider alternatives to adaptive stories; for its reliance upon plausibility alone as a criterion for accepting speculative tales; and for its failure to consider adequately such competing themes as random fixation of alleles, production of non-adaptive structures by developmental correlation with selected features (allometry, pleiotropy, material compensation, mechanically forced correlation), the separability of adaptation and selection, multiple adaptive peaks, and current utility as an epiphenomenon of non-adaptive structures. We support Darwin's own pluralistic approach to identifying the agents of evolutionary change.
Article
Skin reflectance was measured at the areola, breast, and inner arm among samples of White, Black, Chinese, and American Indian women. Population differences in areolar reflectance, and in the ratios of areolar/breast and areolar/arm reflectance, were examined. For a subset of the White women in our sample, we also considered differences according to the women's state of pregnancy or nonpregnancy, stage of menstrual cycle, and parity. Skin reflectance was measured using a Photovolt 670 reflection colorimeter with blue, green, and amber tristimulus filters. The following observations were made: 1. Among White women, there is an apparent trend towards lighter pigmentation in older, post menopausal individuals. 2. Just as populations differ in the overall degree of skin pigmentation, they also differ in degree of areolar pigmentation. 3. The ratios of areolar/breast and areolar/inner arm reflectance do not appear to follow the same pattern of interpopulation variation as does simple skin reflectance, suggesting some population differences in the activity of gonadal hormones. 4. Areolas are darker in pregnant than in nonpregnant women. In addition, areolas were darker in nonpregnant women about to menstruate than in those at other stages of the menstrual cycle.
Article
Papilla (nipple) development was studied in 230 males (119 black, 111 white) aged 3-29 years to compare this development to the established criteria for sexual maturation. Comparison was also made with a previous study of female nipple development to determine whether or when any differences between male and female nipple development occurred. Our male subjects were further assessed to determine if nipple size differed in the presence or absence of gynecomastia. Significant nipple development occurred between pubic hair stages PH1 (diameter 2.8 mm), PH4 (4.4 mm), and PH5 (5.4 mm). Similarly, there was significant incremental growth between genital stages G1 (3.0 mm), G3 (4.6 mm), and G5 (5.5 mm). Nipple development was similar in both sexes through stage PH3, but significantly diverged at stage PH4 (p less than 0.000001) because of a marked increase in female nipple diameter. Boys with gynecomastia had a significantly larger nipple size than boys who had none (p less than 0.001). Differences in nipple diameter between the sexes and between boys with and without gynecomastia probably result from differences in estrogen levels. Perhaps in the future, it will be possible on the basis of nipple diameter to predict which adolescent boys will have persistent gynecomastia.
Article
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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Conflicting impressions regarding the anatomy of Montgomery's areolar tubercle exist. Twelve modified radical mastectomy specimens provided 1,536 serial sections of areolar tubercles. In 34 of 35 tubercles (97%), a mammary lactiferous duct was associated with a sebaceous apparatus. This lactiferous duct ascended from deeper mammary parenchyma and entered the sebaceous gland. Histopathologic changes identified included featured of fibrocystic disease, atypical intraductal hyperplasia, and carcinoma in situ. Because the areolar tubercle has two components, a sebaceous gland and a mammary duct arising from deeper breast parenchyma, diseases of the breast may also involve the areola independent of papilla-nipple involvement. Areolar preservation may best be used with the knowledge that diseases underlying the areola may also involve the areola.
Article
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.
Article
This hypothesis proposes that carcinogens in the breast are generated by the action of superoxide free radicals released when acinal gland distension, under the influence of unopposed prolactin, causes microvessel ischaemia. Inadequate nipple care in the at-risk years leads to ductal obstruction preventing the elimination of carcinogens from the breast. The regular production of oxytocin (OT) from nipple stimulation would cause contraction of the myoepithelial cells, relieving acinal gland distension and aiding the active elimination of carcinogenic fluid from the breast. Mechanical breast pump stimulation causes an increase in plasma OT levels in the luteal but not in the follicular phase of the menstrual cycle. OT production upon nipple stimulation in the luteal phase of premenopausal, non-lactating women may be protective against the high rates of mitotic breast cell division noted at this time via the potential to block the effect of oestrogen. The epidemiology of breast cancer suggests that lengthy lactation time is beneficial. Sexual activity in nulliparous women also protects and OT levels have been shown to rise with orgasm in women and in men. OT systems in the brain are intricately linked to oestrogen and progesterone levels, and it is possible that these hormones may modify the OT secretory response both centrally and through an effect on the sensitivity of the breast. OT production with nipple care and in sex and lactation, and the reduction in cycling ovarian hormones that occurs with pregnancy, may all be important preventative factors in the development of breast cancer both pre- and post-menopausally.
Article
A search of the literature has been prepared to determine how oxytocin may affect sexual and reproductive in women. Many animal studies suggest that oxytocin induces a variety of reproductive behaviors, including grooming, sexual arousal, orgasm, gamete transport, nesting, birthing, and specific maternal behaviors such as breast-feeding and bonding between mother and infant. These actions are apparently facilitated by the 'priming' effect on certain cells by sex and steroid hormones - as the brief case report would also suggest. However, no adequate double-blind trial has confirmed the observations from this report in women. Only animal studies have been performed, albeit over a wide range of species. A variety of other causes and effects of sexual interest and arousal relating to oxytocin are considered, including some of those in males. More research is needed to clarify the role of oxytocin in human reproductive behaviors, including its potential 'aphrodisiac' or prosexual effect in women in the presence of the sex-steroid hormones.
Article
There are widely differing accounts in the literature of the origin, course, and distribution of the nerves to the breast and especially to the nipple and areola. This, together with our own findings at operation, led us to investigate whether the accounts are inaccurate or the nerve supply is very variable or both. 15 breast specimens from dissecting room cadavers, 12 female and 3 male, were dissected to study the nerve supply of the breast in detail. In the female, the breast received its innervation from the lateral and anterior cutaneous branches of the second to the sixth intercostal nerves and from the supraclavicular nerves. On the lateral side in the 12 females, branches from the third (9/12), fourth (12/12) and fifth (4/12), and on the medial side branches from the second (3/12), the third (6/12), the fourth (4/12) and the fifth (2/12) intercostal nerves were traced to a plexus under the areola. Branches from the sixth intercostal nerve supplied the lower part of the breast but there was no direct branch to the nipple. The nerves to the nipple lay in the superficial fascia and passed through the subdermal tissue of the areola to form a plexus under it. The extent of the contribution by each nerve was variable, and it differed even on the left and right of the same cadaver. The nerve often described as passing through the inferolateral part of the breast to reach the nipple is a deep branch from the anterior division of the fourth lateral cutaneous nerve. This was present in 11/12 of the female breasts but it is not the only nerve to reach the plexus under the areola as sometimes claimed. The male breast had a similar nerve supply but the nerves were lying close together, whereas in a female breast they are spread out more widely.
Article
Cooper in 1840 described mammary branches from the 2nd-6th intercostal nerves, and noticed that the nipple was supplied by branches which lay close to the surface of the gland. Eckhard (1850) divided the mammary branches into superficial branches to the skin and nipple, and deep branches to the glandular tissue and nipple, but many later authors ignored those findings. After the second World War, cosmetic surgery of the breast made further research critical, as surgeons strove to design operations which would retain its shape and preserve postoperative sensation. Craig and Sykes (1970) described mainly anterior branches from the 3rd, 4th and 5th intercostal nerves passing through the glandular tissue of the breast and along the line of the ducts to the nipple, while Farina et al. (1980) concluded that the nipple was supplied solely by superficial lateral branches of the 4th nerve. Using improvements in dissecting technique learned from microsurgery, Sarhadi et al. (1996) found that the nipple was innervated by the lateral cutaneous branch of the 4th intercostal nerve, by two branches, one passing superficial to the gland, and the other through the retromammary space, and by variable lateral and medial additional branches from the 2nd-5th nerves. These branches came to lie superficially and formed a subdermal plexus under the areola. This account is uncannily close to Cooper's original description; it is a reassuring, if sobering, conclusion that his early account remains one of the most reliable.
Article
Many surgical procedures performed in the thoracic region can easily damage cutaneous nerves important for the sensory innervation of the female breast. A better understanding of the distribution of these cutaneous nerves will help prevent impaired sensation after breast surgery. Therefore an anatomical study was performed on the cutaneous innervation of 12 breasts of 7 female cadavers. Special emphasis was placed on the nipple-areola complex. The origin, course and final destination of each cutaneous nerve was established and the contribution of each branch was determined by the area it innervated. Differences were evaluated using analysis of variance. The cutaneous innervation of the female breast is derived medially from the anterior cutaneous branches of the Ist-VIth intercostal nerves and laterally from the lateral cutaneous branches of the IInd-VIIth intercostal nerves. The nipple-areola complex is consistently supplied by the anterior and lateral cutaneous branches of the IVth intercostal nerve, with additional innervation by cutaneous branches of the IIIrd and Vth intercostal nerves. This study shows an equal importance of both the anterior and the lateral cutaneous branches of the intercostal nerves. During surgical procedures one should try to avoid damage to the anterior and lateral cutaneous branches of the IIIrd, IVth and Vth intercostal nerves, with special attention to the IVth intercostal nerve which is the consistent nerve to the nipple-areola complex.
Article
A total of 150 healthy women were studied to determine normal values for breast sensibility and to investigate the influence of breast size and ptosis on breast sensation. Cutaneous pressure thresholds were evaluated bilaterally in six areas including the nipple, the areola, and the skin of the breast using the Semmes-Weinstein monofilaments. We found that the skin of the superior quadrant was the most sensitive part of the breast, the areola was less sensitive, and the nipple was the least sensitive part. The cutaneous sensibility of all tested areas decreased significantly with increasing breast size and increasing breast ptosis. The nipple was less sensitive in women who had a previous pregnancy. Age, smoking history, or hormonal contraception had no significant influence on breast sensation. The study shows that the Semmes-Weinstein test is an adequate method for assessing sensation in the breast.
Article
Human infants are particularly responsive to olfactory cues emanating from their mother's nipple/areola region. Beginning within minutes after birth, maternal breast odors elicit preferential head orientation by neonates and help guide them to the nipple. Such odors also influence babies' general motor activity and arousal, which may contribute further to successful nipple localization and sucking. The role of maternal olfactory signals in the mediation of early breast-feeding is functionally analogous to that of nipple-search pheromone as described in nonhuman mammals. To some extent, the chemical profile of breast secretions overlaps with that of amniotic fluid. Therefore, early postnatal attraction to odors associated with the nipple/areola may reflect prenatal exposure and familiarization. Although newborns are generally attracted to breast odors produced by lactating women, breast-fed infants rapidly learn their mother's characteristic olfactory signature while sucking at her breasts and can subsequently recognize her by that unique scent alone. Early odor-based recognition may be an important factor in the development of the infant-mother bond.
Article
Although preservation of the sensitivity of the nipple and areola is an important goal in breast surgery, only scant and contradictory information about the course and distribution of the supplying nerves is found in the literature. The existing controversy might be due to the difficulty in dissecting the thin nerves and to frequent anatomic variations that bias the results if only a small number of cadavers are dissected. We dissected 28 female cadavers and found that the nipple and areola were always innervated by the lateral and anterior cutaneous branches of the 3rd, 4th, and 5th intercostal nerves. The most constant innervation pattern was by the 4th lateral cutaneous branch (79 percent) and by the 3rd and 4th anterior cutaneous branches (57 percent). The anterior cutaneous branches took a superficial course within the subcutaneous tissue and terminated at the medial areolar border in all dissected breasts. The lateral cutaneous branches took a deep course within the pectoral fascia and reached the nipple from its posterior surface in 93 percent of the dissected breasts. In 7 percent of the dissected breasts, the lateral cutaneous branches took a superficial course within the subcutaneous fat and reached the nipple from the lateral side. These findings suggest that the nerves innervating the nipple and areola are best protected if resections at the base of the breast and skin incisions at the medial areolar border are avoided.
Article
In 1979, Lewontin and I borrowed the architectural term "spandrel" (using the pendentives of San Marco in Venice as an example) to designate the class of forms and spaces that arise as necessary byproducts of another decision in design, and not as adaptations for direct utility in themselves. This proposal has generated a large literature featuring two critiques: (i) the terminological claim that the spandrels of San Marco are not true spandrels at all and (ii) the conceptual claim that they are adaptations and not byproducts. The features of the San Marco pendentives that we explicitly defined as spandrel-properties-their necessary number (four) and shape (roughly triangular)-are inevitable architectural byproducts, whatever the structural attributes of the pendentives themselves. The term spandrel may be extended from its particular architectural use for two-dimensional byproducts to the generality of "spaces left over," a definition that properly includes the San Marco pendentives. Evolutionary biology needs such an explicit term for features arising as byproducts, rather than adaptations, whatever their subsequent exaptive utility. The concept of biological spandrels-including the examples here given of masculinized genitalia in female hyenas, exaptive use of an umbilicus as a brooding chamber by snails, the shoulder hump of the giant Irish deer, and several key features of human mentality-anchors the critique of overreliance upon adaptive scenarios in evolutionary explanation. Causes of historical origin must always be separated from current utilities; their conflation has seriously hampered the evolutionary analysis of form in the history of life.
Article
This review presents an atlas of the histology of the normal physiological states of the human breast including prenatal, prepubertal, and pubertal development, adult resting gland, pregnancy, lactation, and postinvolution. The aim is to produce a pictorial overview of the main stages in development and the common findings in the adult that are considered to be within the range of normality. Unlike inbred strains of animals, in humans it is clear that the chronology of ductal and lobular development is not predictable, either in the fetus, the infant, the peripubertal breast, or the adult. This is probably due to the individual variation in hormone levels both in utero and after birth. For many of the developmental time points there are very little data available. In this review we indicate the current state of knowledge of human breast development and some of the main similarities and differences with the rodent, the main animal model. The major phases of growth and development are described and accompanied by photographs that are representative of each stage. Stress is placed on terminology as there is confusion in the literature. This article is written as an accessory to the companion review on breast cancer.
Article
A total of 25 patients who underwent bilateral breast reduction were included in this study. Each patient's age, weight, height, and amount of breast tissue removed from each breast were recorded. The body mass index was calculated for each patient. On the day of the operation, tissue samples (two each) were taken from the central, lateral, and preaxillary areas of the breast. One of the samples was weighed, placed in a closed glass container, and heated for 10 minutes in a microwave oven at full power. The liquid fat was separated from the solid residue, and the percentage of fat was calculated. The other sample from each area was examined grossly, and representative sections, corresponding to the distribution of fat and connective tissue, were submitted for evaluation. In these samples, the percentage of fat, gland, and connective tissue was estimated using low-magnification light microscopy. In this group of patients (who had an average age of 34 years and who were significantly overweight as determined by a mean body mass index of 28), it was found (using the microwave method) that there was a mean fat percentage of 61 percent in the central breast area, 74 percent in the lateral breast area, and 73 percent in the preaxillary area. Upon microscopic examination, the pathologist reported that fat accounted for 64 percent of the central breast area, 92 percent of the lateral breast area, and 94 percent of the preaxillary area. On average, the central breast area in macromastia patients had only seven percent gland and 29 percent connective tissue. The lateral and preaxillary areas of the breast had one to three percent gland and five percent connective tissue. The two methods had a significant (p < 0.05) positive correlation in the central breast area, but in the lateral and preaxillary regions, the correlation was poor. In the microscopic examination, there was a tendency to overestimate the amount of fat. Both methods of evaluation used in the study concur that the enlarged breast of macromastia consists primarily of fat and that the glandular element is rather small.
Article
Whether the breast tissue undergoes morphologic changes in relation to the menstrual cycle had been a subject of debate. Elegant studies performed in the early 1980s provided conclusive evidence of cyclical changes in the normal breast lobules. These studies were almost entirely based on autopsy material and have not been validated in the clinical setting. In the present study, we examine breast tissues from surgical specimens from 73 premenopausal women and use morphological criteria to characterize the stage of the menstrual cycle. Patients taking oral contraceptives or hormonal therapy were excluded from this study. The following histological parameters were used to assess the menstrual stage: number of cell layers in the acini and presence and degree of vacuolation of the myoepithelial cells, stromal edema, infiltrate, mitosis, and apoptosis. The morphological stage was then correlated with the stage of the cycle, as determined by last menstrual period and the usual menstrual cycle length and in some patients with serum estrogen and progesterone levels. The morphologic stage was concordant with dates in 54 of the 73 patients (74%, P =.001). In 31 of these patients, serum levels of estradiol and progesterone at the time of surgery were available for correlation. Twenty-five (80%) of these were phase concordant by morphology and progesterone levels (P =.01), and 25 (80%), by dates and progesterone levels (P =.007). Women with a high morphologic score were seven times as likely to be in luteal phase as were women with a low score (odds ratio, 7.1; 95% confidence interval). Menstrual phase can be determined by the morphology of the normal lobules present within the surgically excised breast specimens. This will permit retrospective analysis of large archival databases to analyze the effect of timing of surgery in relation to menstrual cycle phase. It will also aid the design of epidemiological studies for breast cancer risk assessment.
Article
Body piercing is increasing in popularity around the world. In this review, I describe the history, origins, and peculiarities of various forms of body piercing, and procedures involved, variations in healing time, legal aspects and regulations, and complications and side-effects. I have also included a discussion of the motivation for and psychological background behind body piercing. In presenting research results, I aim to raise awareness of the many risks associated with body piercing. In presenting psychological data, I intend to create an understanding of the multifaceted and often intense motivations associated with body piercing, and, thus, to diminish any prejudices held by health professionals against people with piercings.
Article
During pregnancy there are regional increases in melanocyte activity, resulting in deposition of pigment along the linea alba, on the areolae, and elsewhere. This phenomenon is well known, but quantitative data on the extent of pigmentary change have not, to our knowledge, been reported. The subject holds further interest when it is recalled that these changes are an indication of pregnancy, and may possibly discriminate between pregnant and nonpregnant women. The present paper, then, deals with skin reflectance in young pregnant women, and, for comparison, skin reflectance in an equal number of women who were not pregnant at the time of examination.
Article
The nipple is covered by an epidermis with a characteristically intricate understructure of ridges. There are numerous, large sebaceous glands in the nipple, some opening inside the milk ducts. The terminal segments of the milk ducts are surrounded by bundles of smooth muscle arranged in sphincter-like patterns. There are relatively few nerve endings in the epidermis of the nipple and areola; these are Krause-like endings, and a number of non-descript nerve endings are found around the epidermal ridges. All of these nerves, and those around the apocrine and eccrine sweat glands in the areola, contain acetylcholinesterase. The tubercles of Montgomery are accessory mammary glands. Though mammary glands are said to be modified apocrine sweat glands, the two have neither gross, nor histological and histochemical resemblances.
Article
Patients with macromastia often comment on a lack of sensation in their nipple-areola complex. A study was designed to investigate the cause of this decreased sensation. Two hypotheses were proposed. First, the decreased sensation could result from neuropraxia of the sensory nerve fibers secondary to traction caused by the heavy breast parenchyma. The second hypothesis proposed that tissue expansion of the nipple and areola by the voluminous breast parenchyma caused a decrease in nerve fibers per surface area and hence decreased sensory perception. Sixty-one patients were assessed in the study. All patients underwent surgery in which histological biopsy of either the areola alone (31 reduction mammaplasty patients) or the nipple and areola (30 mastectomy patients) was possible. Before surgery, each nipple-areola complex was tested with Weinstein Enhanced Sensory Test monofilaments as a quantitative test of tactile sensation. Breast cup size, ptosis, and weight of tissue excised were recorded to allow general assessment of the breast size. The nipple and areola biopsy specimens were assessed using immunohistochemistry (S-100 polyclonal antibody, Dako Z311) to measure nerve fiber count per unit area. Statistical analysis was undertaken to find any association among sensitivity, breast cup size, ptosis, weight of tissue resected, and nerve fiber density in the nipple and areola biopsy specimens. Sensitivity at the areola decreased with increasing breast cup size (r = 0.47, p < 0.001) and ptosis (r = 0.42, p = 0.002 for increasing distance between inframammary crease and nipple; r = 0.49, p < 0.001 for increasing manubrium to nipple distance). There was a weak correlation between nerve fiber density at the areola and breast cup size (r = -0.22, p = 0.1). Sensitivity at the nipple was higher than at the areola. Nerve fiber density count at the nipple was higher than at the areola, but there was no statistically significant correlation between nipple sensitivity and breast cup size, ptosis, or weight of tissue resected. The results suggest that the areola and nipple are different in their neuroanatomy. The areola is a thin, pliable structure that is predisposed to stretch as the breast enlarges and therefore experience a decrease in nerve fiber density. The nipple is a compact structure that is less likely to stretch with breast enlargement. In the nipple, neither sensory perception nor nerve fiber density varied with size or breast ptosis. The perceived lack of sensation in the nipple-areola complex is multifactorial. This study shows that neither traction injury to the sensory nerves nor decreased nerve density alone can explain the subjective numbness reported by patients with macromastia. Psychological factors, such as dissatisfaction with body form or interpretation of lack of sensation in the areola as also affecting the nipple, may influence the patient's assessment of the nipple-areola sensitivity.
Article
This study was undertaken to prospectively evaluate breast sensibility before and after reduction mammaplasty with a new, objective, and quantitative neurophysiologic method based on the anatomic knowledge of breast innervation and the congruent areas of dermatomal maps. An innovative application of dermatomal somatosensory evoked potentials was used to study the breast regions of 42 healthy women, bilaterally. The areas stimulated in each breast were the superior quadrant, the nipple-areola complex and the medial and lateral quadrants, and the inferior quadrant; these areas correspond to T3, T4, and T5 dermatomes, respectively, following the accepted concepts of segmentary innervation of the skin. The two groups of 21 patients each were formed according to breast size: group I comprised small-breasted, unoperated controls (brassiere cup size A or B); group II comprised macromastia patients (brassiere cup size C or greater) who presented to a general plastic surgery department for breast reduction surgery. First the authors established the normal range of latency and amplitude in the dermatomal somatosensory evoked potentials for the five areas stimulated in patients with small breasts and compared these parameters with those obtained from patients with macromastia. Then, after the macromastia patients underwent reduction mammaplasty using the McKissock technique, the authors compared the postoperative sensory values with their own preoperative values and with those from the small-breasted group. Using dermatomal somatosensory evoked potentials, they found that small breasts were statistically more sensitive than large breasts, which concurs with studies in the literature that use other methods to evaluate breast sensibility. They also found that after breast reduction, the macromastia patients presented statistically significant improvement in breast sensibility in relation to their own preoperative latency and amplitude values, with no statistical difference in amplitude with respect to the small-breasted group; this finding suggests that after breast reduction, sensibility similar to that of the small-breasted group can be considered a possibility. Furthermore, in comparisons of each of the five areas stimulated, there was no significant difference in values within the small-breasted group or within the macromastia group before or after surgery; this supports a possible overlap between adjacent dermatomes. This innovative application of dermatomal somatosensory evoked potentials is an objective, quantitative, and noninvasive method that has allowed the authors to evaluate breast sensibility and to compare postsurgical sensory outcomes.