The Atlantic
How Orgasm Could Dull Pain
A professor's lifelong research leads to a growing understanding of pleasure, pain, and the genital-brain relationship.
Merissa Nathan Gerson May 12 2014, 8:30 AM ET
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Above his desk at Rutgers University, psychology professor Barry Komisaruk has a framed image of what female brain activity looks like during orgasm. It looks like a sunset. Every major region of her brain ignites at the height of climax. He is the first to record such an image, and in recent years has used his research to improve women’s lives.
It started with hormones and doves. Back in the 1950s, Komisaruk, a behavioral neuroscientist and an author of The Science of Orgasmand The Orgasm Answer Guide, was looking at what he called “invisible forces that act at a distance” or, more specifically, at how neurons produced consciousness. He was anesthetizing doves, clamping them down, and drilling minuscule holes in their skulls to then implant hormone crystals into their brains. He was studying how hormone production stimulates behavior, and how behavior stimulates hormone production. This was his initial claim to fame, and the beginning of a long series of sexual behavioral studies that eventually revealed important facts about women, pleasure, and pain.
What followed were even more studies that included rats, dildos, MRIs and masturbation. It sounds a bit crazy, like a juicy episode of Masters of Sex, but what Komisaruk learned from subsequent experiments laid the foundation for what he is able to do to help people with sexual pathology today.
As a graduate student, Komisaruk, who was raised in the Bronx area of New York City, studied with Elizabeth Crosby, the famous neuro-anatomist who wrote the three-volume Comparative Anatomy of the Nervous System of Vertebrates.
“I took a chance writing to her for help with identifying the structures of the dove brain, and she answered me,” he told me. “She had been doing work on pigeon brains. She was five feet tall, and in her 90s, and sharp as a tack. I brought my brain slides and she went through and identified the structures of the dove brain for me.” This research led to his doctoral dissertation that showed where in the brain progesterone acts controlling aspects of reproductive behavior.
When Komisaruk pinched their feet, that crucial pain response did not occur.
According to Komisaruk, the next logical step was to examine how sex hormones affect neurons. In the 1970's, he studied with James Olds, a neuroscientist who discovered the “pleasure centers” in the brain. Olds had developed technology to record activity of single neurons in awake animals and invited Komisaruk to the University of Michigan to see if he could correlate the activity of single neurons in the brain to the rats’ behavior. In Olds’ lab, Komisaruk used different stimuli—brushing the face; giving the subjects chocolate, milk, and water; pinching a toe—and measured their neurological responses.
“Because in previous labs I saw that vaginal stimulation had such strong effects on the activity of neurons,” Komisaruk explains, “it was obvious to try the same stimulus in the awake rats in Olds’ lab.”
The test on the rats was simple. If you lightly pinch a rat’s foot, there is a pain reflex response as the leg withdraws from the pinch. When Komisaruk inserted a glass rod “dildo,” as he calls it, into the rat’s vagina, it became immobilized and went into the mating posture. Rats only mate every five days, on their cycle, but these female rats went into mating posture immediately upon vaginal stimulation at all stages of their cycle. When Komisaruk pinched their feet, that crucial pain response did not occur.
Was this a state of paralysis? Could they not feel the pain at all or was it the sexual state that overtook the pain altogether? Was the rat actually not feeling pain? He couldn’t ask the rats, but a similar experiment with human women would be able to provide him with the verbal feedback he needed.
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Back at Rutgers in the early 80's, Komisaruk ran a course on human sexuality. He had heard about the research that Beverly Whipple, a registered nurse on the faculty of Gloucester College, was conducting on what she termed the “G-spot” or “Grafenberg spot” and on female ejaculation.
She would go on to become Dr. Beverly Whipple, co-author of The G Spot and Other Recent Discoveries About Human Sexualityand would be named one of the 50 most influential scientists in the world by New Scientist Magazine in 2006.
Komisaruk brought her in to give a guest lecture in his course. Whipple mentioned that she wanted to earn a Ph.D., so Komisaruk invited her to enroll in the doctoral program at Rutgers, and to join his lab study to look at whether vaginal stimulation blocks pain in women.
“He invited me to come speak,” Whipple says. “He wanted someone with experience [and] from the human subject he wanted a verbal report he couldn’t get from the rats. I wondered why the G-spot was there, and Barry wanted to work with women."
Whipple had been doing her own research for years. She was a sex therapist, a nurse, and now a doctoral student as well. Prior to meeting Whipple, Komisaruk had never done any sex research on humans.
“It was the first time that any kind of sex research was going to be done on campus,” Komisaruk says, “and I wanted to be very careful about it. Nobody softened up the beaches for me to do the research. I had to fight to get it started.”
Their first tests were on how pain thresholds were altered by vaginal self-stimulation in women. “I wanted to know whether it would work and if so, which nerves were involved,” he explains. They used a machine that measured pain thresholds by gradually compressing the fingers, while asking women to masturbate manually. Whipple was in the room with the women, Komisaruk was in a separate room evaluating the data collection on a computer. They found that vaginal self-stimulation more than doubled the women’s pain thresholds.
Without the pain-reducing effect of vaginal stimulation, childbirth might be even more painful.
In a subsequent study, they measured pain thresholds during childbirth. They found a significant reduction in pain sensitivity as the baby started to emerge through the birth canal, a correlation with G-spot stimulus. They speculate that without the pain-reducing effect of vaginal stimulation, childbirth might be even more painful, and that the pain-reducing effect could lessen the stress of childbirth and thereby promote bonding between mother and newborn.
Later, through testing women with spinal cord injuries, much like Komisaruk's tests with rats (only now with consent, ethics, doctors, and nurses), Komisaruk and Whipple found that earlier medical understanding stating that women with spinal cord injuries would be unable to feel sexual pleasure from vaginal stimulation was incorrect. In testing for pain and for pleasure after paralysis, Komisaruk and Whipple began to map the body from genital to brain.
While doctors had told many of the women with spinal cord injuries that they would be unable to feel anything ever again from the waist down, Komisaruk and Whipple revealed that, in fact, the vagina and cervix retained sensation in all levels of spinal cord injury. This followed an early anecdotal paper by Whipple on women with spinal cord injury who claimed they could feel pleasure below the belt, which was both confirmed and validated by discovery of the neurological basis for their ability.
Women with spinal cord injuries consented to testing and the protocol followed the Institutional Review Board for the Protection of Human Subjects in Research standards. In order to identify which vaginal sensory nerves transmitted the pain-blocking signal, Komisaruk designed a vaginal and cervical stimulator and had it engineered. The stimulator involved attaching a tampon with a Velcro tip to an acrylic self-stimulator with a handle.
On the handle was a force monitor so that the women with spinal cord injury could be told if they were using excessive force. Prior to the testing, a gynecologist fitted a diaphragm inside the research participant that also had Velcro attached. The Velcro on the tampon, once inserted at a right angle, attached to the Velcro on the diaphragm to ensure the cervical self-stimulation would be precisely located.
The women's nerves transmitted sensory activity from the clitoris, vagina, and cervix, even though the spinal cord was severed.
Their testing, the first of its kind at Rutgers University, involved self-stimulation, a head-stabilizer much like the clamps Komisaruk used while studying bird brains, and a massive MRI machine. The women were told to masturbate while their heads, held still, were being documented for brain activity.
Komisaruk and Whipple showed that women with paralysis from upper thoracic spinal cord injury could feel their vagina and cervix, and could experience orgasm via vaginal or cervical self-stimulation. The women's nerves transmitted sensory activity from the clitoris, vagina, and cervix, even though the spinal cord was severed. By using a functional MRI, Komisaruk and Whipple found that the vagus nerve, which bypasses the spinal cord and forms a direct pathway from the vagina and cervix to the brain, was still functioning.
This research directly refuted medical claims by Alfred Kinsey and his colleagues in the groundbreaking 1953 book, Sexual Behavior In The Human Female, which says, “The cervix is the most completely insensitive part of the female genital anatomy,” and that “[in] view of evidence that the walls of the vagina are ordinarily insensitive, it is obvious that the satisfactions obtained from vaginal penetration must depend on some mechanism that lies outside the vaginal walls themselves.”
And further, the research by Komisaruk and Whipple showed that women with certain spinal cord injuries who doctors had told were insensate below the waist in fact could experience pleasure and possibly even orgasm not only through vaginal-cervical stimulation, but also through stimulation of non-genital regions such as the breasts, neck, ears, and other sensitive points of the body.
From decades of this type of research, according to Komisaruk, “We have worked out the basic relationship of the genital system to the brain, where the genital system is represented in the brain in women and men. Today we are focusing on genital pain and a number of very distressing genital pathologies. As we begin to better understand the basics, we are beginning to understand the pathologies and how they can be treated.”
The results of these tests inform what he does today, addressing sexual pathologies in both men and women. “There are problems of orgasm,” Komisaruk explains. “There are syndromes of genital pathology–pain, anorgasmia, persistent genital arousal disorder, sexual repression coming off of anti-depressants, feeling sick for days coming off of orgasm—and nobody has the foggiest notion of what causes them and we are getting at that.”
Today Komisaruk’s lab runs multiple sexual research studies on both women and men. He continues, with his team at Rutgers, to study cerebral responses to sexual stimulus and works with a range of specific sexual conditions to better understand their causes.
“If you understand the way that the genital system gets to the brain,” he says, “we can understand pathologies, where there is a blockage—say, in people who don’t have orgasms—where is their system blocked, and why. That’s where we are going now. Once we can understand the natural process, we can understand the pathology and how to attack.”