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Clinical and research concerns with vibratory stimulation: A review and pilot study of common stimulation devices

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  • Liberos LLC
  • Va Salt Lake City

Abstract and Figures

The parameters of vibrators used for sexual stimulation in laboratory settings and therapeutic contexts are usually unknown. The unidentified range of vibrator characteristics commonly used for sexual stimulation would help identify appropriate vibrator for different purposes and clients. Seven vibrators used for sexual stimulation were tested using a piezoelectric accelerometer mounted on their housing to quantify frequency, displacement, and acceleration of each. Vibratory frequency ranged from 43 to 148 Hz, displacement from 37 to 783 μm, and acceleration from 18 to 311 m/s. The range suggests vibrators used in laboratory studies could greatly increase their stimulation, while some devices actually may decrease sexual sensitivity temporarily. An in vivo study could characterize patterns of use that could maximize sexual arousal while mitigating potential loss of sensitivity.
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Clinical and research concerns with vibratory stimulation: a review
and pilot study of common stimulation devices
Nicole Prause
a
*, Verena Roberts
b
, Margaret Legarretta
b
and Liva M. Rigney Cox
b
a
Mind Research Network, Albuquerque, USA;
b
Department of Psychology,
Idaho State University, Pocatello, USA
(Received 26 October 2010; final version received 10 January 2012)
The parameters of vibrators used for sexual stimulation in laboratory settings and
therapeutic contexts are usually unknown. The unidentified range of vibrator
characteristics commonly used for sexual stimulation would help identify
appropriate vibrator for different purposes and clients. Seven vibrators used for
sexual stimulation were tested using a piezoelectric accelerometer mounted on
their housing to quantify frequency, displacement, and acceleration of each.
Vibratory frequency ranged from 43 to 148 Hz, displacement from 37 to 783 mm,
and acceleration from 18 to 311 m/s
2
. The range suggests vibrators used in
laboratory studies could greatly increase their stimulation, while some devices
actually may decrease sexual sensitivity temporarily. An in vivo study could
characterize patterns of use that could maximize sexual arousal while mitigating
potential loss of sensitivity.
Keywords: vibrator; sexual arousal; anorgasmia; delayed ejaculation
Introduction
In the book Becoming orgasmic: A sexual growth program for women (Heiman &
LoPiccolo, 1988), women with anorgasmia are encouraged to ‘‘feel comfortable
enough to explore vibrators as another means of learning about [themselves]’’
(p. 105). The progressive, directed masturbation exercises outlined in that book
appear to be a common aspect of anorgasmia treat ment (Heiman & Meston, 1997;
Leff & Israel, 1983; Morokoff & LoPiccolo, 1986). The possible efficacy of vibrators
in anorgasmia has even led to suggestions for using vibrators to induce sexual satiety
to supplant risky sexual fetishes (Martz, 2003), induce anti-nociceptive processes in
women with vulvodynia (Zolnoun, Lamvu, & Steege, 2008) and increase the breadth
of sexual repertoire to increa se sexual satisfaction even when a ‘‘problem’’ per se is
not present (Striar & Bartlik, 1999). Unfortunately, recommendations for selecting a
vibrator still largely conclude, ‘‘Do some shopping around’’ (Heiman & LoPiccolo,
1988, p. 107) or vary widely, with little empirical information about the vibratory
devices. Given the tremendous variability in genital physiology, stimulation
preference and orgasm consistency, this descriptive study described the range of
stimulation parameters of several common vibratory stimulation devices. These data
provide some empirical basis from which clinicians could work with clients to
*Corresponding author. Email: nprause@mrn.org
Sexual and Relationship Therapy
2012, iFirst article, 1–18
ISSN 1468-1994 print/ISSN 1468-1749 online
Ó 2012 College of Sexual and Relationship Therapists
http://dx.doi.org/10.1080/14681994.2012.660141
http://www.tandfonline.com
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identify vibrators of the desired intensity for the particular client preferences. Not
only can more or less intense devices be clearly communicated based on different
parameters, but it could raise other concerns (e.g., neuropathy) if client preferences
are strongly outside of the maximum or minimum in these ranges.
Laboratory use of vibrators with women
Laboratory studies still induce sexual arousal almost exclusively with visual sexual
stimuli, although a few have explored vibratory stimulation as a way to better
control the level of stimulus delivered. Film stimuli are vulnerable to individual
differences in attention to different components of the stimuli (Rupp & Wallen,
2007), preference for specific content (Janssen, Goodrich, Petrocelli, & Bancroft,
2009) or clinical histories making portions of the stimu li aversive (Wouda et al.,
1998). Sexual fantasy relies on the ability of the participant to fantasize effectively,
and fantasy often results in no, or lower, levels of sexual arousal (Laan, Everaerd,
Van Aanhold, & Rebel, 1993). The resulting uncontrolled levels of sexual arousal
always leave the possibility that the stimulus strength varied by individual rather
than the intentionally manipulated variable of interest. Vibratory stimulation may
offer a method to control at least the level of stimulation input more tightly.
In the few studies using vibrators for women to self-stimulate, most provide very
little information about the vibrator or women’s use of it (Basson & Brotto, 2003;
Levin & Wagner, 1985). One of the first reports using a vibrator to induce
sexual response in women appeared in 1976 (Van Dam, Honnebier, Van Zalinge, &
Barendregt), which asked women to self-stimulate for three minutes with a vibrator.
Another study described the stimulation as a ‘‘10 minute vibrator stimulus’’
(Bechara, Ber tolino, Casabe, & Fredotovich, 2004, p. 210) and another as to ‘‘allow
them to self-stimulate their clitoris’’ using ‘‘clitoral vibration’’ to orgasm (Levin &
Wylie, 2008).
Surprisingly, experimenters rarely attempt to control the vibratory stimulation
level for stimulation in women. Experimenters successfully conditioned sexual
response using two second stimulation periods from a 2cm butter fly-style (‘‘hands-
off’’) vibrator (Both et al., 2008). Laan and van Lunsen (2002) used vibratory
stimulation to successfully induce orgasm in all the female participants in a
laboratory study, which has been report ed only in poster format to date. These 10
women all were orgasmic prior to the study, although half denied having ever used a
vibrator before. Women adjusted the frequency to what they felt was ‘‘sexually
arousing’’, but the associated vibratory parameters are not reported. Only one
publication includes the exact settings of an experimenter-controlled vibrator. Gillan
and Brindley (1979) used an air sack pneumatically linked to a vibrator and attached
to the clitoris with eyelash glue. They describe frequencies between 30 and 130 Hz as
‘‘effective’’ and used 80 Hz for controlled stimulation. Their device extended 4 mm
over the clitoral hood and 6 mm along the labia minora, vibrating at an amplitude of
2 mm. They reported response latencies from two to four seconds. A difference from
the male literature, they noted no difference in response magnitude between
vibratory and fantasy stimulation.
A number of challenges exist to using vibrators to induce sexual arousal in the
laboratory. Sexual arousal reduces vibratory thresholds across high and low
frequencies (Chuanshu, Peter, Patricia, & Turman, 2007), so vibrators used for
sexual stimulation may also need to accommodate acute sensitization if used on
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individuals who already are sexually aroused. Longer time between intermittent
stimulation or lower speeds may accomplish this. Also, vibrat ors increase sexual
arousal only when presented in a sexual context, but not when presented in isolation.
Thus it still woul d be necessary to identify the minimal sexual context necessary
for the vibrat or to be processed as a sexual stimulus. Finally, the identification
of optimal vibrator characteristics and patterns of stimulation are needed.
The mechanical data sampled herein provide a range of common stimulation
intensity to assist in instrumentation and study design.
Rese archers primarily have used erotic films to induce sexual arousal. The films
initially excluded actual intercourse (Hoon, Wincze, & Hoon, 1976). Subsequently,
films were recommended to include ‘‘female-initiated, female-centered erotic
videotape[s]’’ (Laan, Everaerd, & Evers, 1995, p. 447) and better specify the
behav i ors portrayed (e.g., excluding violenc e, including foreplay: Hamilton, Fogle,
& Meston, 2008). Today, most film stimuli are edited to port ray equal lengths of
foreplay, then oral sex and then vaginal intercourse (Janssen, Car penter, &
Graham, 2003). This approach confounds time and stimulus intensity, making
differences in responses difficult to interpret. Furthermore, presenting films in this
way seems to rest on the assumption that foreplay and oral sex are nee ded to
‘‘warm up’’, whereas women actually report being more aroused by intercourse
(Woodard et al., 2008). Sexual arousal might be maximized in brief periods, and the
time confound remo ved, by presenting primarily intercourse. Still, in dividuals will
vary tremendously in the visual cues that signal sexual arousal to them (Graham,
Sande rs, Milhausen, & McBride, 2004 ). Aside from erotic films, researche rs
have also used imager y (e.g., Dekker & Everaerd, 1993), gui ded imagery (e.g.,
Harrell & Stolp, 19 85), photog raphs (e.g., Laan & Everaerd, 1995), fantasy (e.g.,
Smith & Over, 1987; Youn, 2006), manual self-stimulation (e.g., Sipski, Alexander,
& Rosen, 1995) and manual c litoral stimulation alone (e.g ., Sipski, Rosen, &
Alexander, 1996).
Non-genital vibratory stimulation
Vibration can be detected on most non-genital skin locations at 51 Hz, although
individual differences in physiology can alter thresholds, such as subcutaneous fat
increasing perceptual thresholds (Bikah, Hallbeck, & Flowers, 2008). Mechanor-
eceptor types and density vary considerably by skin type at different locations on the
body. These differences in mechanoreceptors produce reliable differences in the
ability to sense lower and high frequency vibrations. For exampl e, vibrations at low
frequencies (e.g., 25 Hz) are detected more easily over glabrous (hairless, e.g.,
fingertips) than sebaceous (hairy) skin, but higher frequency vibrations do not show
this difference by type of skin (e.g., 200 Hz: Mahns, Perkins, Sahai, Robinson, &
Rowe, 2006). This greater sensitivity (lower threshold) to higher frequencies tends to
persist even under intradermal lidocaine (Mahns et al., 2006). Interobserver
assessment of vibratory threshold in globulous skin after only a 15 minute lag
only ranges from low to moderate (ICC ¼ .32 to .88: Peters, Bienfait, de Visser, & de
Haan, 2003). Intraobserver reliability is much higher, so distinctions within an
individual probably can be made. However, low-interobserver reliability means that
different clinicians measuring patients probably cannot use this information to make
meaningful clinical distinctions. The clitoris is comprised largely of Merkel disk
receptors (Berman, Adhikari, & Goldstein, 2000), mechanoreceptors that are most
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sensitive to vibrations between 5 and 15 Hz. In contras t, penile dermis has scattered
Pacinian and Ruffini mechanoreceptors (Halata & Munger, 1986), which are
sensitive to high frequency (250 Hz) and stretch, respectively. While vibratory
threshold studies in non-genital regions suggest that men and women do not differ in
their general sensitivity to vibratory stimulation (Bikah et al., 2008), physiology
suggests that their genital vibratory thresholds should differ.
A vibrator, simp ly put, is a vibrating motor. Placed inside a housing, a vibrator
can provide stimulation that induces sexual arousal. The housing material varies
widely, but typically is some form of plastic in vibrators designed for sexual
stimulation.
The vibrating motor is made of an external ring or bearing fastened on a shaft,
which provides a rotational motion when provided with current (Ragulskis, Jon usas,
Kanapeckas, & Juzena, 2008). As the shaft spins, the weight generates centrifugal
force, causing it to vibrate around the shaft locat ion (see Figure 1). In addition to
weight and housing characteristics, the voltage supplied to the motor affects the
strength of the vibration that is transferred to the housing (Ragulskis, Jonusas,
Kanapeckas, & Juzena, 2008). Battery-powered vibrators typically have smaller,
lighter motors designed to operate on the relatively low current of batteries.
Vibrators that take power from a wall outlet receive 120V in the United States (220V
in Europe), so they may sustain less variable, higher rate and/or greater displacement
vibration. Vibrators can be characterized in terms of their frequency, displacement
and velocity. Frequency, the number of revolutions of the weight per unit time,
is usually quantified in hertz (Hz, cycles per second: Giancoli, 1 988). Displacement
refers to the change in position of a point in reference to a previous position. Thus,
Figure 1. Common vibratory motor showing counterweight that displaces housing when
shaft is rotated. Used with permission from Precision Microdrives.
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a vibrator with high displacement values is swinging farther through space with
each revolution. Acceleration, or the rate of change of position, is calculated using
displacement, speed and direction. Generally, vibrator motor specifications are
available from the motor manufacturer. However, motor specifications are
problematic to be used as a direct indicator of vibrator characteristics for sexual
stimulation for several reasons. First, the vibratory motor manufacturer was not
indicated on any of the devices examined for this study, suggesting it would be
difficult to find the specifications. Second, the motor specifications depend on the
power supplied, which may vary from the power actually available from batteries in
the particular device. Finally, the housing in which the motor is placed will alter
vibrator characteristics. For example, a heavy housing would not be displaced as far
as a lighter housing. This study specifically investigated the vibratory properties
within the particular housing powered by a controlled energy source to mimic the
source to be used by consumers if it could be consistently applied. An accelerometer
is a device to measure absolute motion, based on the force required to accelerate the
mass (Doeblin, 1966). An accelerometer indirectly measures parameters of vibration.
The accelerometer used in this study was a piezoelectric accelerometer, which records
the electricity generated by a latticed substance when it is put under the force of
vibration. The electric output produced is a marker of the amount of vibratory force.
Clinical and common use of vibrators
Clients may report concerns about vibrators becoming a sexual ‘‘crutch’’ or
decreasing their sensitivity (Heiman & LoPiccolo, 1988). Some of these fears appear
partially justified. Short-term adaptations do occur to vibratory stimulation, such
that stimulation 15 seconds after a constant vibratory stimulus cannot be
discriminated as well as prior to the vibratory stimulation (Tommerdahl et al.,
2005). However, vibrators may be no different than manual stimulation in decreasing
subsequent sensitivity. Manual massage of the anterior thigh in athletes exerts a
similar dampening of sensitivity by increasing presynaptic inhibition of spinal alpha
motoneurons (Povareshchenkova & Petrov, 2008). In other words, vibrators do
dampen sensitivity to subsequent stimulation at the same site, but manual
stimulation exerts a similar effect.
The greatest challenges to clinical use of vibrators may arise from client
expectations. New users can feel the vibrator is unnatural and may have to negotiate
its use with a sexual partner who is not supportive (Marcus, 2011b). Also, any
‘‘success’’ in self-stimulation to orgasm may not transfer to being able to orgasm in
the presence of a partner (Meston, Hull, Levin, & Sipski, 2004), although it is unclear
whether or not this problem is related to the use of a vibrator in self-stimulation.
By report, using a vibrator during masturbation did not impair sexual satisfaction
with a partner (Davis, Blank, Lin, & Bonillas, 1996). Vibrator use for genital
self-stimulation alone and with a partner is much more common in women than men
(Herbenick et al., 2009). Although 44.8% of men report having used a vibrator for
sexual stimulation in their lifetime, only 6.8% of that sample initially started using a
vibrator to facilitate their own orgasm (Reece et al., 2009). In contrast, 32.3% of
women started using a vibrator to facilitate their own orgasm (Herbenick et al.,
2010). Whether men are preferentially stimulating a female partner or identify it
only as co-occuring (not causing) orgasm (e.g., Merino-Salas, Arrabal-Polo, &
Arrabal-Martin, 2009) is unclear.
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Men
One of the first laboratory studies to use vibratory stimulation in men used a
‘‘commercially available’’ device oscillating at 120 Hz with an amplitude adjustable
between 5 and 50 mm covering a 1.5 by 2.0 cm area (Rowland & Slob, 1992). Erectile
responses were highest to a combination of vibration and visual stimulus. Later
studies used a Biothesiometer with a lower 60 Hz motor (Rowland, Cooper, & Slob,
1996). The ‘‘preferred’’ intensity/displacement did not differ by clinical groups (e.g.,
early ejaculation versus erectile dysfunction) on average. Subsequent studies found
similar effects wherein visual stimuli with vibration increased penile response and, to
a lesser extent, self-reported sexual response in men without sexual difficulties
(Rowland, Keeney, & Slob, 2004; Rowland & Slob, 1992).
A number of studies have used vibratory stimulation in an effort to better assess
and treat both erectile and ejaculation (premature/rapid or inhibited/delayed/retarded)
difficulties. Men with erectile difficulties specifically exhibited lower penile circumfer-
ence to vibration alone as compared to a non-patient group, although the groups of
men did not differ in their penile circumference to erotic film or film and vibration
together (e.g., Janssen, Everaerd, van Lunsen, & Oerlemans, 1994). Latency to
ejaculation or orgasm is almost always defined by the time elapsed until the participant
indicates with a button press (or similar) that they feel they have reached orgasm. It is
possible to record the contractions associated with orgasm electromyographically.
However, this often is measured from the anus to keep primary areas of stimulation
available (e.g., Carmichael, Warburton, Dixen, & Davidson, 1994), which may be less
acceptable to some volunteers or introduce confounds of additional anal stimulation or
discomfort. Generally, men with lifelong premature ejaculation exhibit higher vibratory
thresholds across genital and non-genital sites (Salonia et al., 2009; Xin et al., 1997).
However, vibratory thresholds determined in the laboratory appear unrelated to
ejaculatory latency in the laboratory or home (Brouke et al., 2007), which is usually the
variable of more clinical interest. Some have argued that sensory thresholds must be
lower in men with premature/rapid ejaculation because topical desensitizing agents tend
to increase latency to ejaculation (Wyllie & Hellstrom, 2011), but the sensory data do
not generally support this interpretation. More data support the possibility of using
vibrators to assess premature/rapid ejaculation as evidenced by a shorter latency to
ejaculation in those who report difficulty (Rowland, 2010). There is a patent on file (US
6814695: Wyllie & O’Leary, 2004) using a vibratory device to diagnose rapid
ejaculation. This bullet-type vibrator is strapped over the frenulum and, while the
stimulation level can be changed, 60 Hz was shown to reliably discriminate patients
from non-patients using latency to ejaculation (Dinsmore et al., 2006). The addition of
vibratory stimulation in a study including men with rapid or delayed ejaculation did
not help discriminate patient groups from non-patients (Rowland, Keeney, & Slob,
2004). In fact, in a review of clinical outcome measures for studies of premature
ejaculation treatments, vibrators were not mentioned (McMahon, 2008).
Vibratory stimulation has been tested for its therapeutic efficacy, or to test the
therapeutic efficacy of related methods, in men. Vibratory stimulation does enhance
erections in men with premature ejaculation and erectile dysfunction (Rowland, den
Ouden, & Slob, 1994). Using the FertiCare vibrator (Multicept A/S, Denmark)
applied to the frenulum (frequency ¼ 100 Hz; amplitude ¼ 2.5 mm) vardenafil
was tested as a treatment for premature ejaculation (Go
¨
kC¸ e, Demirtas, Halis, &
Ekmekcioglu, 2010). Varden afil significantly delayed ejaculation latency over
placebo during laboratory vibratory stimulation. Vib ratory stimulation helped
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distinguish between topical treatment s for premature ejaculation (Xin, Choi, &
Lee, 2000). Vibrators also may be helpful in facilitating orgasm in men with
inhibited/delayed ejaculation. Thirty-four men reporting ejaculation difficulty used a
commercially avail able vibrator (Pin Point Massager, Brookstone, Merrimack, NH)
applied in one minute on/one minute off pattern three times in each session to the
frenulum (Nelson, Ahmed, Valenzuela, Parker, & Mulhall, 2007). The study was not
controlled or blinded, but men reported improved orgasm and satisfaction at three
and six months of regular use. However, in a summary document on the treatment of
inhibited/delayed ejaculation, Richardson and Goldmeier (2006) found the evidence
for the efficacy of vibrators in this clinical group weak. Vibrators may still be most
helpful in resear ch to better characterize the mechanism of efficacy in treatments for
orgasm difficulties. For example, vibrators helped demonstrate that alpha-stimulat-
ing midodrine may be effective treating inhibited/delayed ejacul ation because it
lowers sensitivity thresholds, which, in turn, lower ejaculatory thresholds (Courtois
et al., 2008). While relatively less common for men to use vibrators for their own
pleasure, possibly due to stigma attached to using a ‘‘woman’s’’ stimulation device,
new studies are emerging that investigate men’s use of vibrators for their own
pleasure (Reece, Herbenick et al., 2010; Reece, Rosenberger et al., 2010).
Women
Most studies of women that use vibrators are testing sensitivity, but some researchers
have asked participants to self-stimulate with the vibrator and, far less frequently,
controlled the vibrator automatically. The vibrators used for these different purposes
also varies systematically, as sensitivity testing requires greater precision over
location and vibratory parameters. The first vibratory threshold study in women
identified the threshold of a 100 Hz device placed on the clitoris in women without
known pathology to be .27 mm (amplitude) on average with a range of .09 to .48 and
standard deviation of .10 (Helstro
¨
m & Lundberg, 1992). The threshold was slightly
higher in the hands of the same women and in women who had a hysterectomy. A
subsequent study tested intravaginal and clitoral stimulation at 100 Hz with a range
of 0–130 mm (Vardi, Gruenwald, Sprecher, Gertman, & Yartnitsky, 2000). On an
ascending test of limits, clitoral thresholds averaged 1.75 mm and vaginal thresholds
averaged 7.38 mm, consistent with the dense innervations of the clitoris (Martin-
Alguacil, Pfaff, Shelley, & Schober, 2008) and self-reported areas of sensitivity
(Schober, Meyer-Bahlburg, & Ransley, 2004). Thresholds may be lowered by
vasoactive agents (Berman et al., 2001) and sexual arousal and orgasm (Gruenwald,
Lowenstein, Gartman, & Vardi, 2007). Thresholds are higher in regular bike riders
as compared to runners (Guess et al., 2006) and in women with sexual dysfunction
(Esposito et al., 2007). Multiple studies support that women’s vibratory thresholds to
increase as they get older (Connell et al., 2005; Guess et al., 2006; Vardi et al., 2000).
Methods
The decision to test vibrators mechanically, rather than in-vivo, was primarily made
for the greater level of control available in the mechanical environment. Of course,
users may hold the devices at different locations, press with different force, different
grip force, have more or less pubic hair or fat, use some of the devices internally
preferentially or have clitoral glans less sensitive to particular testing ranges. Rather
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than attempt to control dozens of unknown material and physical variables, this
pilot study represents a first attempt to work from stimulus preference ‘‘backwards’’
to allow the development of likely more appropriate stimulation devices for research
and some guidance for clinicians in the future.
Vibrator models were selected using three methods: (1) searches conducted in
spring of 2009 for highly-rated vibrators across multiple Internet sites selling sexual
aids, (2) recommendations of colleagues in clinical practice performing sex therapy
and (3) two additional vibrators with atypical housing. Since most clinical and
research applications to date with women have not used devices that insert into
the vagina, and to maximize potential comparability with male stimulation, only
vibrators designed to be used externally were considered. To meet criterion (1) the
popularity/sales of stimulation devices on Internet sites selling vibrators character-
ized as ‘‘for sexual stimulation’’ (e.g., Amazon.com) were used to rank order the
devices. The top five selling vibrators from each website in Spring 2009 were cross-
examined and the three vibrators that occurred most frequently on these top-seller
lists were included. Two additional models were selected based on input from
colleagues in clinical practice from professional listservs (e.g., SexLab). One vibrator
was added at the author’s discretion due to its atypical thin ‘‘pet al’’ stimulation area
that might have vibratory characteristics distinct from the other vibrators.
Accelerometer
A quartz piezoelectric accelerometer (PCB Piezotronics) with 10.46 mV/g sensitivity
at 100Hz was used. It weighed .05 oz, which should minimize reactive vibrations of
the accelerometer back against the vibrating motor. Its sampling range from 1 to
1000 þ Hz very adequately covers the likely range of vibrator parameters based on
published studies. The output of the piezoelectric transducer is a continuous, time-
varying voltage that is measured as a discrete voltage at the sampling rate and then
converted to acceleration (m/s
2
) by a proportionality factor specified with the
sensor’s manufacture calibration.
Procedure
Flat, even surfaces are ideal for mounting the accelerometer, but none of the
vibrators tested had a flat surface. Iden tical washers were affixed to each vibrator
with ceramic epoxy. The width of each washer was just sufficient to accommodate
the accelerometer width to minimize additional weight. The washer was mounted as
close to the area used for sexual stimulation as possible, on the plane at which
vibration would be applied to the genitalia. The exact mount position of the washer
on each vibrator is described in Table 1. The accelerometer then was mounted on
the washer using wax to improve vibration transmission and reduce elect rical
interference per the manufacturer’s recommendations. Each vibrator was mounted
in rigid, rounded clamp held aloft by a metal stand. The stand was cushioned and
held firmly against a table by c-clamps identically for all vibrators to damp resonance
from the mount. The accelerometer cord also was held by a cushioned arm to reduce
reverberation from the accelerometer cord. Any vibratory testing (e.g., of dental
instruments) will be somewhat contaminated by the testing situation (e.g.,
attachment of instrument) and these are standard procedures to reduce such
contamination in engineering applications.
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Table 1. Tested vibrators with specifications (links to specific device photographs).
Vibrator Description
a
Specifications
A ‘‘Magic Wand’’ by
Hitachi
Batteries: NONE
Settings: OFF/ON(low, high)
Operating V: 110V
Sample point: Mounted on side of device ‘‘head’’
measured normal to axis of symmetry of device
Morphology: 4 in by 1 in; tip is flattened with a number
of small firm projections
B Hard plastic, straight
insertable
Batteries: 2x1.5V ‘‘C’’
Settings: OFF/ON(variable)
Operating V: Low V ¼ 1.0V, High V ¼ 3.0V
Sample point: Mounted on side of device normal to
axis of rotation of DC-motor
Morphology: Tip is formed into a concave depression
with rounded, ridged edges
C Hard plastic, wavy
with clitoral ‘‘cup’’
on side of terminal
Batteries: 2x1.5V ‘‘AA’’
Settings: OFF/ON(variable)
Operating V: Low V ¼ 0.8V, High V ¼ 3.0V
Sample point: Mounted on side of device normal to axis
of rotation of DC-motor
Morphology: Inch-long flexible tapered tip with
flagellar-type movement, which could not be mounted
by the accelerometer
D Soft plastic egg Batteries: 2x1.5V ‘‘AA’’
Settings: OFF/ON(variable)
Operating V: V ¼ 2.8V [other settings just OFF/ON
variations]
Sample point: Mounted on side of device normal to axis
of rotation of DC-motor
Morphology: 4 in by 1 in; tip is flattened with a number
of small firm projections
E ‘‘Pocket Rocket’’ Batteries: 1x1.5V ‘‘AA’’
Settings: OFF/ON
Operating V: V ¼ 1.5V
Sample point: Mounted on side of device normal to axis
of rotation of DC-motor
Morphology: 3 in by 1 in at the widest point
F Soft plastic, flower
appearance with
long pistol as
stimulation point
Batteries: 4x1.5V ‘‘button cell’’
Settings: OFF/ON(variable)
Operating V: Low V ¼ 1.65V, High V ¼ 2.6V
Sample point: (1) tip of device; (2) periphery of
device (petal)
Morphology: Central body houses the vibrating motor;
‘‘nose’’ at clitoris used for accelerometer mount
G Butterfly with thigh
straps
Batteries: 3x1.5V ‘‘AA’’
Settings: OFF/ON(variable)
Operating V: Low V ¼ 1.44V, High V ¼ 4.1V
Sample point: Mounted on (1) main device housing
normal to axis of rotation of DC-motor; (2) periphery
of device covering (nose)
Morphology: Vibrating motor is housed within the head
Note:
a
Online links to specific device photographs: A http://tinyurl.com/yz39bzd; B http://tinyurl.com/
2egeg9z; C http://tinyurl.com/2fw84ua; D http://tinyurl.com/277n3fw; E http://tinyurl.com/25lzvnl;
F http://tinyurl.com/2arqveb; G http://tinyurl.com/25lzvnl
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Six of the devices were battery (DC) powered and one was mains (AC) powered
(Vibrator A). To determine the operating voltages of the DC-powered test devices,
new batteries were installed and the potentials between the DC-motor terminals were
measured. The devices were operated within the range of their design and intended
use. If the devices had more than one speed setting, the operating voltages were
taken to be those that generated the mini mum and maxi mum speed of the DC-motor
based on the applied battery voltage allowed by the device settings. The operating
voltages for each device were then recorded.
Then, the batteries were removed. Small holes were drilled into the device
housings and 28 AWG lead wires were soldered to the motor terminals. The lead
wires were then affixed to the device housings with electrical tape. The batteries were
insulated at the terminals and placed back into the devices to provide the same
weight loading present during normal device operation. To standardize and maintain
consistent control of the operating voltage applied to the devices, a DC power supply
was used for each trial. In other words, vibrators typic ally use speed-varying
potentiometers that could contribute to signal variability over time, so a consistent
power supply was used to reduce such variability.
Vibrators were run for 30 seconds, then the signal of the next 30 seconds was
recorded. If a high and low setting was provided, the vibrator was tested at the
lowest and highest available setting in separate trials. LabVIEW (National
Instruments, 2009) was used to record the signal, which was sampl ed at 2000 Hz.
Motors powered in this way are extremely regular (cp. Figure 2) and reliable.
Data analysis
Data were processed using Matlab R2009A (The Mathworks Inc., 2009). The
piezoelectric voltage recorded between 15 and 16 seconds (of the 30 second sample)
were used for calculations as motor rotation would be stable across this interval.
Vibratory motors, unless at fault, are highly regular (see Figure 2) and do not require
Figure 2. Signal from vibrator A from second 15 to 15.1 (high setting).
10 N. Prause et al.
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additional samples beyond one second (see Figure 3). Calculations were made for
period (Hz), displacement (mm) and acceleration (m/s
2
) from this sample.
To calculate these values, an FFT was performed on the acceleration-
transformed data. This frequency was then input as the cutoff-frequency of a first-
order, low-pass Butterworth filter. Having remove d the frequency components of
the signal greater than the operati ng frequency, the amplitude of the filtered signal
was scaled to the amplitude of the original signal using a peak-picking method.
A two-term Fourier fit [A*sin() þ B*cos()] was then performed to produce a
functional representation of the waveform.
The maximum acceleration of the device at the point measured by the
accelerometer was taken as a local maxima (also e qual to the global maximum)
of the resulting function. After integrating the function twice, the maximum
displacement of the device was measured as the maximum value of the signal.
Results
Results from the sample and transformations and calculations are shown in Table 2.
Vibratory frequency ranged from 43 to 148 Hz, displacement from 37 to 783 mm and
acceleration from 18 to 311 m/s
2
. As expected, lower settings decreased the oscillation
frequency and acceleration. However, the displacement at higher and lower setting
was dependent on the device housing. For instance, the lower speed setting resulted
in g reater displacement for vibrator B, but higher displ acement for vibrator C.
Discussion
The purpose of this study was to evaluate the mechanical properties of common
sexual stimulation devices. Results indicated that the frequency of vibration ranged
from 43 to 148 Hz, displacement from 37 to 783 mm and acceleration from 18 to
Figure 3. Discrete Fourier transform from vibrator A (high setting) showing clear frequency
peak.
Sexual and Relationship Therapy 11
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311 m/s
2
. With the exceptio n of acceleration, which is not reported in the
psychological studies using vibratory stimulation, frequency and displacement
vary from the stimulation parame ters used in previous laboratory investigations for
men and women. While the frequency generally was consistent with frequencies used
in laboratory studies, the tested displacement was much higher (cp. 37 to 783) than
the women’s (2 mm) or men’s (5 to 50 mm) studies to date. This may simply reflect
that vibratory parameters are provided for studies of sensitivity and rarely in studies
of stimulation. If displacement is similar for stimulation devices, this suggests that
preferred vibratory stimuli displace at a much larger distance than laboratory
instruments and could justify research devices with higher maximum displacement.
This information could aid clinicians in three ways. First, the vibratory
acceleration of all vibrators tested exceeded the minimum detection threshold for
both the vaginal and clitoral area in a sample of women averaging 40 years of age
(Helpman, Greenstein, Hartoov, & Abramov, 2009). Thus, clients can likely be
assured they are very unlikely to select a vibrator that is completely ineffective or
undetectable. Similarly, clini cians could response to client concerns that their own
genitals are not sufficiently sensitive. Specifically, clinicians could either help identify
highly stimulating vibrator types based on these data or they could select weaker
vibrators with less concern that the client actually would experience disappointment
being unable to feel the device. To use the first strategy, hard clitoral cu p on vibrator
C on the high setting exhibi ted the highest displacement, but the ‘‘Magic Wand’’
vibrator A exhibits both high displacement and frequency. Second, clients with
strong concerns about becoming ‘‘desensitized’’ by vibrators now have additional
information. They can receive education that desensitization can occur from vibrator
use, but desensitization is likely to be transitory. Als o, the clinician can identify a low
displacement device, such as the ‘‘Pocket Rocket’’ vibrator E, with evidence that it
actually is a lower intensity device. Finally, these data may increase client acceptance
of vibrator use by allowing more specific fit to client preferences. For example, if a
client has become frustrated by the use of less intense vibrators in the past, but is
reluctant to accept a vibrator that plugs in to the wall, a battery-powered variant
that is more intense than his/her current vibrator can be identified. For example, a
‘‘butterfly’’ vibrator G has greater displacement than a ‘‘Pocket Rocket’’ vibrator E
that the client already may have tried. Any clinical recommendations are still limited.
Table 2. Frequency, displacement, and acceleration of vibrators.
Vibrator Setting
Highest-amplitude frequency
(Hz)
Displacement
(mm)
Acceleration
(mg)
A High 101 452.9 185.7
Low 89 452.4 143.8
B High 115 256.9 165.6
Low 43 330.8 26.8
C High 69 719.7 137.8
Low 30 783.2 29.2
D 98 280.1 114.2
E High 148 82.1 73.1
Low 108 92.3 43.1
F High 128 164.4 109.2
Low 63 161.7 25.7
G 115 223.1 123.5
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Most of the vibrators published with sufficient mechanical information to compare
with these new data represented sensory testing and were not used for stimulation.
Also, the properties of the vibrators will be modified by actual use.
The displacement of these devices was much greater than the displacement of
devices used in laboratories to date. It appears that researchers interested in using
vibrators to maximize the sexual response in the laboratory may safely and
effectively increase the displacement of their stimulation devices. As vibrators move
into fMRI (functional magnetic resonance imaging) environments (Montant,
Romaiguere, & Roll, 2009), the need to quickly induce high levels of sexual arousal
for some designs may drive the use of higher displacement vibrators. A pneumatic
vibrator design was extended from the Montant, Romaiguere and Roll (2009)
design and currently is being used as the first genital vibratory stimulator in the
MRI environment (see Figure 4). The appropriate pattern of stimulation to avoid
desensitization also needs to be established.
There are several limitations to this study. First, the vibrators were not tested
with a human population. For example, it is possible that the devices with lower
displacement actually are experienced as more pleasurable or more pleasurable only
early during use. Testing of these parameters in an experimental setting is an
essential next-step to further develop appropriate devices for laboratory use.
Second, it is unclear how actual use may affect these machine characteristics. Use
involves applying some force to hold or press the device against the desired area,
which would change the vibratory characteristics of the devices. Thicker lubricants
also could alter the intensity of the stimulation. Since actual use is likely to vary
widely between individuals, the current approach represents an early study of device
efficacy. Simple hand grip measures could assess typical force applied during vibrator
use and perhaps help distinguish more and less effective levels of pressure.
Effectiveness studies examining how actual vibrator use impacts their stimulation
qualities should follow.
Whether cause or result, vibrator use is relat ed to better self-perceptions of
genitalia (Herbenick & Reece, 2010), greater relationship satisfaction amongst
female vibrator users whose male partners like their vibrator use (Her benick et al.,
Figure 4. First MRI-safe genital vibrator. Fins are spun by compressed air to displace the
counter weight and produce vibration.
Sexual and Relationship Therapy 13
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2010) and increases the sexual arousal response in the laboratory over film alone
(e.g., Janssen, Everaerd, van Lunsen, & Oerlemans, 1994). The range of
specifications of common stimulation devices provided could aid in the appropriate
selection of vibrators for improving sexual functioning and enhance researchers’
ability to study high arousal states in the laboratory while minimizing risk of injury.
The next step could entail human application to identify not only intensity, but also
patterns of stimulation that results in orgasm. This may suggest how those who
consistently experience orgasm pace their use and provide a window into the
physiology involved in generating orgasm.
Acknowledgments
The authors wish to thank Anish Sebastian and Marco Schoen, PhD for their assistance with
data collection and analyses.
Notes on contributors
Nicole Prause, PhD, is a research scientist at Mind Research Network and research assistant
professor at the University of New Mexico. She was trained as a clinical scientist with research
emphasis in statistics and neuroscience from Indiana University, Bloomington and The Kinsey
Institute for Research in Sex, Gender, and Reproduction. Her research focuses on HIV risk
behaviors, substance use and sexual functioning, approach motivation, and reward processing
using a variety of psycophysiological methods.
Verena Roberts received her PhD in Clinical Psychology from Idaho State University in 2010.
She then completed a postdoctoral fellowship in Integrated Primary Care Psychology through
the Colorado Health Foundation in Denver, Colorado where she worked at Swedish Family
Medicine and an outpatient family medicine clinic through Denver Health. Dr Roberts joined
the internal medicine faculty at Denver Health in 2011 and provides clinical services at
Eastside Family Health Center as an integrated primary care psychologist. She has been
actively involved in establishing integrated care services at Denver Health, including
developing a hypertension clinic. Dr Roberts’ research has focused on sexual functioning,
women’s health, and integration of behavioral health into primary care services.
Margaret Legarreta, MS, is a graduate student at Idaho State University and is currently on
internship at the Central Texas Veteran’s Health Care System. Margaret’s past research has
focused on behavior change and health promotion regarding HIV risk behaviors in regards to
sexual activity and drug use. Currently she is training in behavioral medicine and primary care
approaches to clinical work.
Liva M. Rigney Cox received her PhD in clinical psychology from Idaho State University in
2011. She was trained as a scientist-practitioner with a research emphasis in hebephilia and
ephebophilia. She is currently completing her post-doctoral training at Pocatello Women’s
Correctional Center and Seasons of Hope Developmental Disability and Mental Health Clinic
in Pocatello, Idaho.
References
Basson, R., & Brotto, L.A. (2003). Sexual psychophysiology and effects of sildenafil citrate
in oestrogenised women with acquired genital arousal disorder and impaired orgasm: A
randomised controlled trial. BJOG: an International Journal of Obstetrics & Gynaecology,
110(11), 1014–1024.
Bechara, A., Bertolino, M.V., Casabe, A., & Fredotovich, N. (2004). A double-blind
randomized placebo control study comparing the objective and subjective changes in
female sexual response using sublingual apomorphine. Journal of Sexual Medicine, 1(2),
209–214.
Berman, J.R., Adhikari, S.P., & Goldstein, I. (2000). Anatomy and physiology of female
sexual function and dysfunction: Classification, evaluation and treatment options.
European Urology , 38(1), 20–29.
14 N. Prause et al.
Downloaded by [University of New Mexico], [Nicole Prause] at 20:46 01 March 2012
Berman, J.R., Berman, L.A., Lin, H., Flaherty, E., Lahey, N., Goldstein, I., & Cantey-Kiser,
J. (2001). Effect of sildenafil on subjective and physiologic parameters of the female sexual
response in women with sexual arousal disorder. Journal of Sex & Marital Therapy, 27(5),
411–420.
Bikah, M., Hallbeck, M.S., & Flowers, J.H. (2008). Supracutaneous vibrotactile perception
threshold at various non-glabrous body loci. Ergonomics, 51(6), 920–934.
Both, S., Laan, E., Spiering, M., Nilsson, T., Oomens, S., & Everaerd, W. (2008). Appetitive
and aversive classical conditioning of female sexual response. Journal of Sexual Medicine,
5(6), 1386–1401.
Carmichael, M.S., Warburton, V.L., Dixen, J., & Davidson, J.M. (1994). Relationships
among cardiovascular, muscular, and oxytocin responses during human sexual activity.
Archives of Sexual Behavior, 2(1), 59–79.
Chuanshu, J., Peter, K.K., Patricia, W., & Turman, A.B. (2007). Effects of visual erotic stimulation
on vibrotactile detection thresholds in men. Archives of Sexual Behavior, 36(6), 787.
Connell, K., Guess, M.K., Bleustein, C.B., Powers, K., Lazarou, G., Mikhail, M., & Melman,
A. (2005). Effects of age, menopause, and comorbidities on neurological function of the
female genitalia. International Journal of Impotence Research, 17(1), 63–70.
Courtois, F., Charvier, K., Leriche, A., Vezina, J.-G., Cote, I., Raymond, D., . . . Belanger, M.
(2008). Perceived physiological and orgasmic sensations at ejaculation in spinal cord
injured men. Journal of Sexual Medicine, 5(10), 2419–2430.
Davis, C.M., Blank, J., Lin, H.-Y., & Bonillas, C. (1996). Characteristics of vibrator use
among women. Journal of Sex Research, 33(4), 313–320.
Dekker, J., & Everaerd, W. (1993). Imagery and sexual arousal. Sexual & Marital Therapy,
8(3), 283–285.
Dinsmore, W.W., Ralph, D.J., Kell, P., Wylie, K.R., Dean, J.P., Novak, C., . . . Wyllie, M.G.
(2006). Evaluation of the Sexual Assessment Monitor, a diagnostic device used to
electronically quantify ejaculatory latency time: findings from three studies. BJU
International, 98(3), 613–618. doi: 10.1111/j.1464-410X.2006.06286.x
Doeblin, E.O. (1966). Measurement systems: Application and design. New York: McGraw Hill.
Esposito, K., Ciotola, M., Giugliano, F., Carleo, D., Schisano, B., Maglione, E., . . .
Guigliano, D. (2007). Quantitative sensory and autonomic testing in nondiabetic women
with sexual dysfunction. Journal of Sexual Medicine, 4(5), 1367–1372.
Giancoli, D.C. (1988). Physics for scientists and engineers (2nd ed.). New York: Prentice Hall.
Gillan, P., & Brindley, G.S. (1979). Vaginal and pelvic floor responses to sexual stimulation.
Psychophysiology, 16(5), 471–481.
Go
¨
kc¸ e, A., Demirtas, A., Halis, F., & Ekmekcioglu, O. (2010). In vitro measurement of
ejaculation latency time (ELT) and the effects of vardenafil on ELT on lifelong premature
ejaculators: Placebo-controlled, double-blind, cross-over laboratory setting. International
Urology and Nephrology, 42(4), 881–887. doi: 10.1007/s11255-010-9710-2
Graham, C., Sanders, S., Milhausen, R., & McBride, K. (2004). Turning on and turning off:
A focus group study of the factors that affect women’s sexual arousal. Archives of Sexual
Behavior, 33(6), 527–538.
Gruenwald, I., Lowenstein, L., Gartman, I., & Vardi, Y. (2007). Physiological changes in female
genital sensation during sexual stimulation. Journal of Sexual Medicine
, 4(2), 390–394.
Guess, M.K., Connell, K., Schrader, S., Reutman, S., Wang, A., LaCombe, J., . . . Mikhail, M.
(2006). Genital sensation and sexual function in women bicyclists and runners: Are your
feet safer than your seat? Journal of Sexual Medicine, 3(6), 1018–1027.
Halata, Z., & Munger, B. (1986). The neuroanatomical basis for the protopathic sensibility of
the human glans penis. Brain Research, 371(2), 205–230.
Hamilton, L.D., Fogle, E.A., & Meston, C.M. (2008). The roles of testosterone and alpha-
amylase in exercise-induced sexual arousal in women. Journal of Sexual Medicine, 5(4),
845–853.
Harrell, T.H., & Stolp, R.D. (1985). Effects of erotic guided imagery on female sexual arousal
and emotional response. Journal of Sex Research, 21(3), 292–304.
Heiman, J., & LoPiccolo, J. (1988). Becoming orgasmic: A sexual and personal growth program
for women. New York: Prentice Hall.
Heiman, J.R., & Meston, C.M. (1997). Empirically validated treatment for sexual dysfunction.
Annual Review of Sex Research, 3, 148–194.
Sexual and Relationship Therapy 15
Downloaded by [University of New Mexico], [Nicole Prause] at 20:46 01 March 2012
Helpman, L., Greenstein, A., Hartoov, J., & Abramov, L. (2009). Genito-sensory analysis in
women with arousal and orgasmic dysfunction. Journal of Sexual Medicine, 6(4), 1039–1044.
Helstro
¨
m, L., & Lundberg, P. (1992). Vibratory perception thresholds in the female genital
region. Acta Neurologica Scandinavica, 86, 635–637.
Herbenick, D., & Reece, M. (2010). Development and validation of the Female Genital
Self-Image Scale. Journal of Sexual Medicine, 7(5), 1822–1830.
Herbenick, D., Reece, M., Sanders, S., Dodge, B., Ghassemi, A., & Fortenberry, J.D. (2009).
Prevalence and characteristics of vibrator use by women in the United States: Results from
a nationally representative study. Journal of Sexual Medicine, 6(7), 1857–1866.
Herbenick, D., Reece, M., Sanders, S.A., Dodge, B., Ghassemi, A., & Fortenberry, J.D.
(2010). Women’s vibrator use in sexual partnerships: Results from a nationally
representative survey in the United States. Journal of Sex & Marital Therapy, 36(1), 49–65.
Hoon, P.W., Wincze, J.P., & Hoon, E.F. (1976). Physiological assessment of sexual arousal in
women. Psychophysiology, 13(3), 196–204.
Janssen, E., Carpenter, D., & Graham, C. (2003). Selecting films for sex research: gentder
differences in erotic film preference. Archives of Sexual Behavior, 32(3), 243–251.
Janssen, E., Everaerd, W., Van Lunsen, R.H., & Oerlemans, S. (1994). Validation of a
psychophysiological waking erectile assessment (WEA) for the diagnosis of male erectile
disorder. Urology, 43(5), 686–696.
Janssen, E., Goodrich, D., Petrocelli, J., & Bancroft, J. (2009). Psychophysiological response
patterns and risky sexual behavior in heterosexual and homosexual men. Archives of
Sexual Behavior, 38(4), 538–550.
Laan, E., & Everaerd, W. (1995). Habituation of female sexual arousal to slides and film.
Archives of Sexual Behavior, 24(5), 517–541.
Laan, E., Everaerd, W., & Evers, A. (1995). Assessment of female sexual arousal: Response
specificity and construct validity. Psychophysiology, 32(5), 476–485.
Laan, E., Everaerd, W., Van Aanhold, M.-T., & Rebel, M. (1993). Performance demand and
sexual arousal in women. Behaviour Research & Therapy, 31(1), 25–35.
Laan, E., & van Lunsen, R.H.W. (2002, July). Orgasm latency, duration and quality in women:
Validation of a laboratory sexual stimulation technique. Paper presented at the Annual
Meeting of the International Academy of Sex Research, Hamburg, Germany.
Leff, J.J., & Israel, M. (1983). The relationship between mode of female masturbation and
achievement of orgasm in coitus. Archives of Sexual Behavior, 12(3), 227–236.
Levin, R.J., & Wagner, G. (1985). Orgasm in women in the laboratory: Quantitative studies
on duration, intensity, latency and vaginal blood flow. Archives of Sexual Behavior, 14(5),
439–449.
Levin, R.J., & Wylie, K. (2008). Vaginal vasomotion its appearance, measurement, and
usefulness in assessing the mechanisms of vasodilatation. Journal of Sexual Medicine, 5,
377–386.
Mahns, D.A., Perkins, N.M., Sahai, V., Robinson, L., & Rowe, M.J. (2006). Vibrotactile
frequency discrimination in human hairy skin.
Journal of Neurophysiology, 95(3),
1442–1450.
Martin-Alguacil, N., Pfaff, D.W., Shelley, D.N., & Schober, J.M. (2008). Clitoral sexual
arousal: An immunocytochemical and innervation study of the clitoris. British Journal of
Urology, 101, 1407–1413.
Martz, D. (2003). Behavioral treatment for a female engaging in autoerotic asphyxiation.
Clinical Case Studies, 2(3), 236–242.
McMahon, C.G. (2008). Clinical trial methodology in premature ejaculation observational,
interventional, and treatment preference studies Part II study design, outcome
measures, data analysis, and reporting. Journal of Sexual Medicine, 5(8), 1817–1833. doi:
10.1111/j.1743-6109.2008.00837.x
Merino-Salas, S., Arrabal-Polo, M.A., & Arrabal-Martin, M. (2009). Vaginal vibrator in the
rectum of a young man. Archives of Sexual Behavior, 38(4), 457. doi: 10.1007/s10508-008-
9459-1
Meston, C.M., Hull, E., Levin, R.J., & Sipski, M. (2004). Disorders of orgasm in women.
Journal of Sexual Medicine, 1(1), 66–68.
Montant, M., Romaiguere, P., & Roll, J.-P. (2009). A new vibrator to stimulate muscle
proprioceptors in fMRI. Human Brain Mapping, 30(3), 990–997.
16 N. Prause et al.
Downloaded by [University of New Mexico], [Nicole Prause] at 20:46 01 March 2012
Morokoff, P.J., & LoPiccolo, J. (1986). A comparative evaluation of minimal therapist contact
and 15-session treatment for female orgasmic dysfunction. Journal of Consulting and
Clinical Psychology, 54(3), 294–300.
National Instruments (2009). LabVIEW (Version 2009). Austin, TX: National instruments.
Nelson, C., Ahmed, A., Valenzuela, R., Parker, M., & Mulhall, J. (2007). Assessment of penile
vibratory stimulation as a management strategy in men with secondary retarded orgasm.
Urology, 69(3), 555–556.
Peters, E.W., Bienfait, H.M.E., de Visser, M., & de Haan, R.J. (2003). The reliability of
assessment of vibration sense. Acta Neurologica Scandinavica, 107(4), 293–298.
Povareshchenkova, Y.A., & Petrov, D.A. (2008). Modulation of the presynaptic inhibition
of spinal alpha-motoneurons during mechanical stimulation of different types. Human
Physiology, 34(1), 97–102.
Ragulskis, K., Jonusas, R., Kanapeckas, K., & Juzena, K. (2008). Research of dynamics of
rotary vibration actuators based on magnetic coupling. Journal of Vibroengineering, 10,
325–328.
Reece, M., Herbenick, D., Sanders, S.A., Dodge, B., Ghassemi, A., & Fortenberry, J.D.
(2009). Prevalence and characteristics of vibrator use by men in the United States. Journal
of Sexual Medicine, 6(7), 1867–1874.
Reece, M., Herbenick, D., Dodge, B., Sanders, S.A., Ghassemi, A., & Fortenberry, J.D.
(2010). Vibrator use among heterosexual men varies by partnership status: Results from
a nationally representative study in the United States. Journal of Sex & Marital Therapy,
36(5), 389–407.
Reece, M., Rosenberger, J.G., Schick, V., Herbenick, D., Dodge, B., & Novak, D.S. (2010).
Characteristics of vibrator use by gay and bisexually identified men in the United States.
Journal of Sexual Medicine, 7(10), 3467–3476.
Richardson, D., Goldmeier, D., & BASHH Special Interest Group for Sexual Dysfunction.
(2006). Recommendations for the management of retarded ejaculation: BASHH Special
Interest Group for Sexual Dysfunction. International Journal of STD & AIDS, 17(1), 7–13.
doi: 10.1258/095646206775220450
Rowland, D.L., den Ouden, A.H., & Slob, A.K. (1994). The use of vibrotactile stimulation for
determining sexual potency in the laboratory in men with erectile problems: Methodo-
logical considerations. International Journal of Impotence Research, 6(3), 153–161.
Rowland, D., Keeney, C., & Slob, A.K. (2004). Sexual response in men with inhibited or
retarded ejaculation. International Journal of Impotence Research, 16(3), 270–274.
Rowland, D.L. (2010). Genital and heart rate response to erotic stimulation in men with and
without premature ejaculation. International Journal of Impotence Research, 22(5), 318–
324.
Rowland, D.L., Cooper, S.E., & Slob, A.K. (1996). Genital and psychoaffective response to
erotic stimulation in sexually functional and dysfunctional men. Journal of Abnormal
Psychology, 105(2), 194–203.
Rowland, D.L., & Slob, A.K. (1992). Vibrotactile stimulation enhances sexual response in
sexually functional men: A study using concomitant measures of erection. Archives of
Sexual Behavior, 21(4), 387–400.
Rupp, H.A., & Wallen, K. (2007). Sex differences in viewing sexual stimuli: An eye-tracking
study in men and women. Hormones and Behavior
, 51(4), 524–533.
Salonia, A., Sacca, A., Briganti, A., Del Carro, U., Deho, F., Zanni, G., et al. (2009).
Quantitative sensory testing of peripheral thresholds in patients with lifelong premature
ejaculation: A case-controlled study. Journal of Sexual Medicine, 6(6), 1755–1762.
Schober, J.M., Meyer-Bahlburg, H.F., & Ransley, P.G. (2004). Self-assessment of genital
anatomy, sexual sensitivity and function in women: Implications for genitoplasty. British
Journal of Urology International, 94(4), 589–594.
Sipski, M., Alexander, C., & Rosen, R. (1995). Physiological parameters associated with
psychogenic sexual arousal in women with complete spinal cord injuries. Archives of
Physical Medicine and Rehabilitation, 76(9), 811–818.
Sipski, M., Rosen, R., & Alexander, C. (1996). Physiological parameters associated with
the performance of a distracting task and genital self-stimulation in women with
complete spinal cord injuries. Archives of Physical Medicine and Rehabilitation, 77(5),
419–424.
Sexual and Relationship Therapy 17
Downloaded by [University of New Mexico], [Nicole Prause] at 20:46 01 March 2012
Smith, D., & Over, R. (1987). Correlates of fantasy-induced and film-induced male sexual
arousal. Archives of Sexual Behavior, 16(5), 395–409.
Striar, S., & Bartlik, B. (1999). Stimulation of the libido: The use of erotica in sex therapy.
Psychiatric Annals, 29(1), 60–62.
The Mathworks Inc. (2009). MatLab (Version 7). Natick, MA.
Tommerdahl, M., Hester, K.D., Felix, E.R., Hollins, M., Favorov, O.V., Quibrera, P.M., &
Whitsel, B.L. (2005). Human vibrotactile frequency discriminative capacity after
adaptation to 25 Hz or 200 Hz stimulation. Brain Research, 1057(1–2), 1–9.
Van Dam, F.S., Honnebier, W.J., Van Zalinge, E.A., & Barendregt, J.T. (1976). Sexual
arousal measured by photoplethysmography. Behavioral Engineering, 3(4), 97–101.
Vardi, Y., Gruenwald, I., Sprecher, E., Gertman, I., & Yartnitsky, D. (2000). Normative
values for female genital sensation. Urology, 56(6), 1035–1040.
Woodard, T.L., Collins, K., Perez, M., Balon, R., Tancer, M.E., Kruger, M., . . . Diamond,
M.P. (2008). What kind of erotic film clips should we use in female sex research? An
exploratory study. Journal of Sexual Medicine, 5(1), 146–154.
Wouda, J.C., Hartmen, P.M., Bakker, R.M., Bakker, J.O., van de Weil, H.B.M., Schultz, W.,
& Weijmar, C.M. (1998). Vaginal plethysmography in women with dyspareunia. Journal
of Sex Research, 35(2), 141–147.
Wyllie, M.G., & Hellstrom, W.J. (2011). The link between penile hypersensitivity and
premature ejaculation. BJU International, 107(3), 452–457.
Wyllie, M., & O’Leary, M. (2004). U.S. Patent No. 6814695. Washington, DC: U.S. Patent
and Trademark Office.
Xin, Z., Choi, Y.J., & Lee, W. (2000). Penile vibratory threshold changes with various doses of
SS-cream in patients with primary premature ejaculation. Yonsei Medical Journal, 41(1),
29–33.
Xin, Z.C., Chung, W.S., Choi, Y.D., Seong, D.H., Choi, Y.J., & Choi, H.K. (1997).
Penile sensitivity in patients with primary premature ejaculation. Journal of Urology, 158,
187–188.
Youn, G. (2006). Subjective sexual arousal in response to erotica: Effects of gender, guided
fantasy, erotic stimulus, and duration of exposure. Archives of Sexual Behavior, 35(1), 87.
Zolnoun, D., Lamvu, G., & Steege, J. (2008). Patient perceptions of vulvar vibration therapy
for refractory vulvar pain. Sexual and Relationship Therapy, 23(4), 345–353.
18 N. Prause et al.
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... Vibrators also vary in the intensity of vibration, and for some women, specifically those whose sexual function may have been impacted by aging or health conditions, a more intense vibration may be necessary for arousal and orgasm (Connell et al., 2005;Guess et al., 2006;Vardi, Gruenwald, Sprecher, Gertman, & Yartnitsky, 2000). The Hitachi Magic Wand was identified in one study as having a high vibratory acceleration (Prause, Roberts, Legarretta, & Rigney Cox, 2012). However, this same study assessed the vibratory acceleration of a sampling of commercially available vibrators and demonstrated that every vibrator tested had adequate intensity to reach the minimum genital vibratory detection threshold in women averaging 40 years of age (Prause et al., 2012). ...
... The Hitachi Magic Wand was identified in one study as having a high vibratory acceleration (Prause, Roberts, Legarretta, & Rigney Cox, 2012). However, this same study assessed the vibratory acceleration of a sampling of commercially available vibrators and demonstrated that every vibrator tested had adequate intensity to reach the minimum genital vibratory detection threshold in women averaging 40 years of age (Prause et al., 2012). Thus, although vibrators vary in intensity, it is likely that most commercially available vibrators will be intense enough to meet the needs of premenopausal users. ...
... In other words, while psychologic dependence on the ease and intensity of stimulation with a vibrator is possible, physiologic dependence is unlikely. Similarly, it is unlikely that, given the continuous restructuring of female genital nerve beds, vibrator use could result in long-term genital desensitization (Prause et al., 2012). ...
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Vibrators are an evidence-based treatment for a variety of sexual dysfunctions and sexual enhancement; however, the use of a genital vibrator lacks best practice recommendations. This aim of this article is to provide current, best practice recommendations regarding the use of vibratory stimulation for the treatment of sexual dysfunction and/or sexual or relationship enhancement. A multidisciplinary team of sexual health specialists collaborated to develop best practice recommendations based on a narrative literature review. Recommendations for the use of vibratory stimulation for the treatment of sexual dysfunction are provided, with special attention to counseling patients on choosing and safely using a vibrator. Further study is needed to determine the most effective methods to counsel patients on vibrator use and to provide evidence-based cleaning recommendations.
... Vibrators as a sexual stimulus in research are not often used for women despite their relative widespread use as a tool to enhance sexual arousal in personal settings [53]. Vibrators consist of a vibrating motor that is encased in a housing and applied to the genital area as a means of sexual stimulation (for detailed description of vibrator properties, see [54]). Research using vibrators has demonstrated that vibrotactile stimulation can produce significantly greater genital responses, as measured through VPP, when paired with film clips than film clips alone [52]. ...
... Research using vibrators has demonstrated that vibrotactile stimulation can produce significantly greater genital responses, as measured through VPP, when paired with film clips than film clips alone [52]. A recent study examining the technical properties of various vibrators suggests that vibrator use can provide a more controlled stimulus intensity than other modalities, although the authors do point out that most studies using vibrotactile stimulation to date have provided very little technical information or standardization of vibrator use between participants [54]. The few recent studies that have used vibrotactile stimulation have demonstrated increases in genital response with vibrator use [55][56][57][58][59]; however, the use of a vibrator may interfere with concurrent genital arousal recording for devices that require physical contact with participants, such as VPP, as the vibrator might produce movement artifacts in the data recording. ...
... Although vibrators are not often used in studies of female sexual response, the few published studies that have this type of stimuli have either allowed participants to bring their own (e.g., [23]) or have provided a standardized unit for all participants (e.g., [55]). Prause and colleagues suggest that experimenters consider various parameters in choosing a vibrotactile stimulus, such as instrument displacement, acceleration, and frequency [54]. Additionally, the variability between devices can result in significant differences in the level of sexual response and must be accounted for within study designs, for example by ensuring that all participants use the same kind of instrument or using the instrument type as a covariate in the final data analysis. ...
Article
IntroductionMultiple methods and devices are available for the assessment of female sexual response, each with strengths and limitations that can impact interpretation of research results. As such, it is important to have an understanding of available methodologies and instruments.AimTo review recent literature on the measurement of female sexual response, and to describe the methods and devices, and their strengths and limitations.MethodsA literature review was performed regarding methodology and instruments used to quantify female sexual response.Main Outcome MeasuresThe description of currently available instruments and methods to quantify sexual response in women.ResultsMethodologies used to examine female sexual arousal employ a variety of stimuli and instruments to elicit and record sexual response. The variation in research designs across studies highlights the importance of understanding (i) how sexual response is elicited in studies; (ii) what kinds of experimental designs are available for assessing sexual psychophysiology; and (iii) the various types of instrumentation used to collect data.Conclusions The physiological and self-reported measurement of female sexual response is crucial to our understanding of the mechanisms and factors involved with healthy sexual functioning. As such, it is important to understand the strengths and limitations associated with different stimuli, research designs, and instruments. Kukkonen TM. Devices and methods to measure female sexual arousal. Sex Med Rev **;**:**–**.
... Haptic, or tactile, feedback is an increasingly common modality for interacting with computer systems given its potential to increase learning [1,2], particularly in virtual reality clinical contexts [3], to provide analogs of real-world experiences [4], and to provide physiologically reactive stimulation [5]. For all of these reasons, haptic feedback systems have been implemented for mechanistic studies using neuroimaging [6][7][8][9], particularly including devices that include vibrotactile stimulation [9][10][11][12][13]. Neurofeedback, in which individuals learn to manipulate brain function, has specifically been shown to benefit from such vibrotactile haptic feedback [14][15][16][17]; biofeedback studies more generally have also shown the benefits of this vibratory modality [18]. ...
... Design alternatives: We have explored many design alternatives to the current system. Prause et al. (2012) [13] used a system with an air compressor, tubing and an air-powered imbalanced turbine in lieu of the vibrating motor and PVC [12]. This system worked well for us, but was much louder and had less power. ...
Article
Full-text available
The most common feedback displays in the fMRI environment are visual, e.g., in which participants try to increase or decrease the level of a thermometer. However, haptic feedback is increasingly valued in computer interaction tasks, particularly for real-time fMRI feedback. fMRI-neurofeedback is a clinical intervention that has not yet taken advantage of this trend. Here we describe a low-cost, user-friendly, MR-compatible system that can provide graded haptic vibrotactile stimulation in an initial application to fMRI neurofeedback. We also present a feasibility demonstration showing that we could successfully set up the system and obtain data in the context of a neurofeedback paradigm. We conclude that vibrotactile stimulation using this low-cost system is a viable method of feedback presentation, and encourage neurofeedback researchers to incorporate this type of feedback into their studies.
... While vibrator use is relatively common in women (Herbenick et al. , 2010, men rarely report using them for their own sexual pleasure ). Methods for equating vibratory parameters (Prause et al. 2011) for reinforcement similar to monetary parameters also is unclear. Seconds of visual sexual stimuli offered a few advantages, in addition to being legal to provide as reinforcement. ...
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Risky decision-making has been studied using multitrial behavioral tasks. Concordance of such tasks to risky behaviors could be improved by: (1) mathematically modeling the components of decision change and (2) providing reinforcement specific to the risk behavior studied. Men completed two Balloon Analog Risk Tasks (BART). One provided financial reinforcement (money) and the other provided sexual reinforcement (seconds of erotic film viewing). Parameters of a mathematical model of BART performance were fit to each individual. Correlations between the model parameters and four risk categories (financial, sexual, antisociality, and substance use) demonstrated predictive utility for the same behaviors regardless of task reinforcement, providing little evidence of reinforcement specificity. A reward sensitivity parameter was uniquely related to sexual risk behavior. Additional analyses explored parameter stability fit to fewer trials.
... Also, films may cause women to focus more or less on physical aspects of intercourse that could contradict the instruction set (e.g., heavy breathing may direct women's attention back to nongenital cues). Using stronger sexual stimuli, such as clitoral vibration [41], could produce a ceiling effect [5]. Finally, some cognitive manipulations, such as the effects of performance demands [5], are only apparent during sexual fantasy and not erotic films. ...
Article
Women are often reported to have a low coherence (often referred to as "discordance" in sexuality literature) between their genital response and self-reported sexual arousal. The purpose of this study was to determine whether differing instructions for rating sexual arousal would increase the coherence between genital response and self-reported arousal in women. Genital responses were recorded, using vaginal photoplethysmography, from 32 young women while they fantasized in three different conditions. Conditions instructed women to rate their overall sexual arousal, any physical cues, and genital blood flow. The primary outcome measure was the coherence of vaginal pulse amplitude (VPA) and reported sexual response in the three conditions. Unexpectedly, both VPA response and self-reported sexual arousal were higher when women were asked to rate their genital blood flow. Examining only participants who reported at least some sexual arousal in all conditions (n = 17), coherence was highest when women were instructed to rate overall sexual arousal. Results suggest that focusing on genital blood flow during sexual fantasy may increase women's (self-reported and genital) sexual response. Focusing on any physical arousal cues during sexual fantasy was associated with lower coherence of women's genital response and self-reported arousal compared with when they were instructed to rate their overall sexual arousal. Prause N, Barela J, Roberts V, and Graham C. Instructions to rate genital vasocongestion increases genital and self-reported sexual arousal but not coherence between genital and self-reported sexual arousal. J Sex Med **;**:**-**.
Chapter
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Orgasm is assumed to be the height of sexual pleasure, reinforcing the recurrence of sexual behaviors. Surprisingly, data supporting the role of orgasm as a reward in women appear lacking. The most likely psychological function of orgasm in women, consistent with the very limited empirical information, is as a secondary reinforcer. In other words, sexual arousal is the primary reward for sexual behavior in women and orgasm associates sexual arousal with the partner. Data from a small (n = 38 women) pilot are presented to highlight the challenges of studying female orgasm. Challenges include differentiating vaginally- or clitorally-generated orgasms by self-report and the large proportion of women who are unsure if they experience orgasms. Finally, the recent spate of publications purporting to show differences in penile-vaginal intercourse induced orgasms is critiqued in light of the information reviewed.
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We investigated by means of vaginal plethysmography the extent to which the genital reactions of women with dyspareunia (N = 18) differed from those of women without dyspareunia (N = 16) during sexual arousal. In addition, we used questionnaires to investigate whether the genital reaction was correlated with the women's subjective experience of sexual arousal. In both groups, there was a clear increase in vaginal vasocongestion while they watched various erotic scenes compared with the situation at rest. While participants watched video fragments showing oral sex (cunnilingus and fellatio), the reactions were the same across the two groups. While participants watched video fragments showing coitus, there was a further increase in vaginal vasocongestion in the women without dyspareunia, but a decrease in vasocongestion in women with dyspareunia. The results of questionnaires assessing their perceived levels of sexual arousal while watching the video fragments showed that this reduction in genital response in the women with dyspareunia went unnoticed.
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The article analyses a new type of a mechanical rotary oscillator - vibrator, the base of which is made of steady magnets. The scheme of a vibrator's regulated power is submitted to excite the rotary oscillations of a turning frame. Some of the dynamical characteristics of a vibrator have been researched.
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In this exploratory study, we investigated several demographic and sexual history correlates of vibrator usage among a diverse sample of 202 women. They completed a 35‐item questionnaire that included the predictor variables and items allowing them to describe their experiences using vibrators. Vibrators were used primarily to enhance sexual responsiveness and sexual pleasure, most commonly in autoerotic activity, but, for more than two thirds of the sample, also in partnered activity. A majority indicated orgasms triggered by vibrator stimulation were more intense than others. Nearly half experienced multiple orgasms when using a vibrator. Most were very satisfied with their orgasmic experience in autoerotic activity and were either moderately or very satisfied with their orgasmic experience in partnered activity. The clitoris is the preferred site of vibrator stimulation for most, but there was great diversity in both preferred location and technique. These results were interpreted as indicating the value of being self‐reliant in enhancing sexual responsiveness and satisfaction. Because of sampling limitations, additional research is needed to replicate and to extend these findings.
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Background SS-cream (severance secret cream) is a topical agent made from extracts of nine natural products for the treatment of primary premature ejaculation (PE). In order to investigate the clinical efficacy of SS-cream, we assessed the ejaculatory latency and penile vibratory threshold of patients with primary premature ejaculation in a double-blind placebo-controlled study. Method Thirty-two patients with a mean age of 37.7 ± 6.6 years were randomized into treatment and control groups. Ejaculatory latency and vibration threshold were assessed twice (in both the penile shaft and glans penis) in the screening period, and three times after application of SS-cream or placebo, depending on whether they were in the treatment or control group. The end points for clinical efficacy were defined as a prolonged ejaculatory latency of more than 2 min, and an increased vibration threshold of more than 0.04 microns (μ) after treatment. Results In the screening period for the total group the mean ejaculatory latency was assessed at 1.45 ± 0.57 min, while the mean vibratory thresholds of the glans penis and penile shaft were 0.73 ± 0.034 μ and 0.065 ± 0.034 μ, respectively. After treatment the mean ejaculatory latency was prolonged to 2.27 ± 2.24 in the placebo group, and 11.06 ± 8.26 min in the SS-cream group. The mean vibratory thresholds were increased to 0.067 ± 0.028 μ, and 0.100 ± 0.050 μ at the penile shaft, and 0.080 ± 0.035, and 0.170 ± 0.090 at the glans penis for each group, respectively. In the treatment group the mean ejaculatory latency and mean vibratory thresholds at the glans penis and the penile shaft were significantly improved with the application of SS-cream (P P With these results we conclude that SS-cream increased the penile sensory threshold, and is therefore clinically effective in treating the heightened sensory response in patients with PE.
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The discrepancy between survey findings that women require a romantic context for arousal to erotica and the results of laboratory research which have failed to confirm this effect has led to continued controversy over the role of context in female sexual arousal. Methodological criticisms of laboratory research have focused on the passive nature of cue manipulations utilized to create casual versus committed contexts and failure to validate the effectiveness of context manipulations. The present study investigated the effects of erotic guided imagery on female sexual arousal in committed and casual contexts. Sixty‐five women listened to tapes of erotic guided imagery. Participants imagined either themselves or another woman engaging in a committed or casual sexual relationship. Dependent variables consisted of three measures of subjective sexual arousal and the Differential Emotions Scale. A self‐report measure revealed that subjects clearly differentiated the two contexts. Examination of mean scores on the dependent variables indicated that all subjects were sexually aroused by the guided imagery, experienced moderate interest and enjoyment, and experienced minimal negative emotional responses. Multivariate analysis of variance revealed no significant differences for the main effects of context, person, or the interaction between person and context. The findings reaffirm previous laboratory research indicating that women do not require a committed context as a prerequisite for sexual arousal and positive emotional response to imagined erotic stimuli