Un-Selection Bias: A Lot of Sex Research Sounds Whacky Because We're Unwilling to Discuss (or Fund) it Seriously

Fri, 2010-08-13 08:11

Via Discover Magazine’s NCBI ROFL blog an Egyptian medical research team has a paper out called An electrophysiologic study of female ejaculation. Here’s the abstract ROFL cited

Opinions vary over whether female ejaculation exists or not. We investigated the hypothesis that female orgasm is not associated with ejaculation. Thirty-eight healthy women were studied. The study comprised of glans clitoris electrovibration with simultaneous recording of vaginal and uterine pressures as well as electromyography of corpus cavernous and ischio- and bulbo-cavernosus muscles. Glans clitoris electrovibration was continued until and throughout orgasm. Upon glans clitoris electrovibration, vaginal and uterine pressures as well as corpus cavernous electromyography diminished until a full erection occurred when the silent cavernosus muscles were activated. At orgasm, the electromyography of ischio-and bulbo-cavernosus muscles increased intermittently. The female orgasm was not associated with the appearance of fluid coming out of the vagina or urethra.

Read the abstract in context here.

Lest one imagine the researchers (led by the late Ali. A. Shafik of Cairo University) were singling out one sex for electromyographic scrutiny they’ve also published Electromyographic study of ejaculatory mechanism.

Cavernosus muscle (CM), seminal vesicle (SV) and vasal ampullary (VA) contractions at ejaculation are said to be reflex mechanisms (ejaculatory reflex), which have been scarcely dealt with in the literature. We investigated the hypothesis that contraction of the CMs, SVs and VA at ejaculation is a reflex action. The electromyographic (EMG) activity of CM, SV and VA during ejaculation was recorded in 28 healthy men. The test was repeated after separate anaesthetization of the glans penis (GP), CMs, SVs, and VA in the pre-ejaculatory period. Latent ejaculatory time (LET) was calculated. CMs showed no EMG activity until rigid erection phase was reached. SVs and VA exhibited resting EMG activity which increased gradually with different stages of erection. At ejaculation, CMs, SVs and VA showed two to four intermittent contractions. The mean LET was 1.3 +/- 0.2 sec. GP anaesthetization led to the disappearance of CM, SV and VA EMG activity at ejaculation, while bland gel did not affect EMG activity. CMs, SVs and VA when anaesthetized in the pre-ejaculatory period exhibited no EMG activity at ejaculation, while saline did not affect EMG activity. Increased EMG activity of CM, SV and VA apparently denotes increase in their contractile activity. CM, SV and VA contraction on GP stimulation and ejaculation are assumed to be reflex actions and are mediated through the ‘glans-cavernosovesicular reflex’ (GCVR) which presumably represents the ejaculatory reflex. Changes in LET or evoked response would indicate a defect in the reflex pathway. The GCVR might act as an investigative tool in diagnosing erectile dysfunction, provided further studies are performed in this respect.

Read the quote in context here.

And I might as well add that Shafik actually authored or co-authored an astonishing number of similar papers dealing with neuromuscular activity of the general pelvis, urogenital area, and lower intestinal tract.

Now when I saw the name it rang a bell and I realized Mary Roach had written about him in her (excellent) book about sex research, Bonk: The Curious Coupling of Science and Sex.

While Googling to confirm the connection (she did write about him) I ran across an interview of Roach by NPR’s Robert Siegel. Seigel approached the subject matter a little glibly, as mainstream types often feel obliged to do, and after a bit of mocking of Shafik’s self-funding, his seeming remoteness from western medicine (although he was often published in reputable peer-reviewed proctology, urology, andrology, and gynecology journals), and an admittedly goofy-sounding paper studying the effect of polyester on rat fertility, he asked Roach

SIEGEL: Well, after meeting people like Dr. Shafik in Cairo, and you and your husband taking part in a study with Dr. Dang in London and so many other interviews you report on on the book, then what do you come away, what’s the takeaway knowledge you have from having written “Bonk”?

And I think she just knocked the answer right out of the park (emphasis mine.)

MS. ROACH: Well, I think that one of the things that I’m left with is a lingering sense of surprise that there are still a good number of mysteries in the realm of sexual physiology.

You kind of have the sense – as a person who has sex, you figure, well, you know, it seems to work, what else do we need to know, which is kind of a ridiculous attitude. That would be like somebody saying to a person who’s studying, say, the esophageal sphincter, well, we all know how to eat, why do we need to study that?

SIEGEL: Mm-hmm.

MS. ROACH: So, I come against that all the time. People are saying, well, what’s the point of this research, you know? Tell me something I don’t know about sex. We don’t know, for example, the mechanisms of ejaculation, what the trigger is for that. And there’ve been all kinds of elaborate and quite frightening little studies that have been done in that realm, just any number of things that we really should still be looking into, and yet it’s very difficult for sex researchers to get funding for purely anatomical and physiological research these days.

She said it here.

The mild rebuke is well taken. The researchers Roach documented often are a little goofy, they usually are self-funded, they often are from seemingly-obscure parts of the world, and even when much of their work is actually credible when they’re cited in the mainstream press (whether by NPR or Discover Magazine) it’s their whackiest work that gets singled out rather than their more useful work.

I like her useful comparison of attitudes towards sex and food since I’m often taken by the analogies. If our social attitudes were reversed you really might be as difficult to get funding for credible research in the U.S. and western Europe. We might instead be subjected to knee-squeezingly embarrassed radio discussions of the swallowing reflex and other bodily functions above the belt.

Do we really need to know more about the electromyography of ischio-and bulbo-cavernosus muscles in women or the the ‘glans-cavernosovesicular reflex’ in men as it pertains to sexual arousal, orgasm, and/or ejaculation (male or female?) Why as a matter of fact we do.

Because, not to put too fine a point on it, laughing is not the only thing we enjoy doing while rolling on the floor.

The first abstract is missing

Submitted by Sungold (not verified) on Fri, 2010-08-13 09:50.

The first abstract is missing some important info – it looks like you accidentally pasted a link over it. The scrambled sentence should read: “The study comprised of glans clitoris electrovibration with simultaneous recording of vaginal and uterine pressures as well as electromyography of corpus cavernous and ischio- and bulbo-cavernosus muscles.”

Important, I say, because it makes clear that electromyography was performed on some really sensitive areas in both studies. I’ve undergone electromyography. It involves inserting thin needles deep into muscles and then moving them slightly. Descriptions of EMG as “uncomfortable” were obviously written by people who’ve never experienced it. It hurts enough that my neurologist said a lot of people opt out before the testing is completed. And she wasn’t inserting needles into anyone’s genitals.

I can’t imagine anyone being able to orgasm during EMG unless they have a strong fetish for a very particular type of pain. So while I agree with your point that the science of sex should be treated like a legitimate enterprise, I wonder what those studies actually measured!

Yup. And from his list of

Submitted by figleaf on Fri, 2010-08-13 13:14.

Yup. And from his list of projects it looked like he used electromyography to measure all manner of voluntary and involuntary pelvic and G-I tract activities from erections to defecation to digestion. Either the doc was very persuasive, very good at painlessly inserting the instruments, had very dedicated volunteers, or, possibly used very unethical methods to gain compliance with his subjects. (Important question: does Cairo University enforce standard human-subjects research protocols?)

No matter how you look at it, though, the concerns you raise just emphasize the importance of fostering legitimate research.

Thanks, Sungold,

fl

Dunno about Cairo’s IRB

Submitted by Sungold (not verified) on Fri, 2010-08-13 20:37.

Dunno about Cairo’s IRB protocols (or eve whether they have some equivalent to the IRB) – but I am here to say that there’s no doctor on earth who can painlessly insert those needles. And what’s bad in one’s calf is gonna be excruciating between one’s legs. Add a hearty vibration, and all of a sudden you’ve got a nice experiment in the body’s own capacity to produce endorphins.

Still shuddering. Yikes.

User login