Anorgasmia can be depressing, despite the antidepressants.

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Neither Here Nor There: Anorgasmia and Non-genital Orgasms

I­n some cases, we know what causes anorgasmia (the inability to reach orgasm). Drugs like Celexa, Zoloft and Paxil -- known as SSRIs, or selective seratonin reuptake inhibitors -- are often used to treat depression, anxiety and other mental illnesses. Like most drugs, however, they can have side effects. For some people, this includes sexual ones, including anorgasmia. But why? SSRIs can decrease the brain's production of dopamine, the neurotransmitter that provides pleasurable feelings and reinforces a person's desire to once again perform the action that brought him or her pleasure. Sometimes the problem goes away on its own, or it can be resolved by switching to a different antidepressant or taking another drug in addition to the SSRI. However, a small number of people experience post-SSRI sexual dysfunction (PSSD) that lasts for days, weeks, months or even years after discontinuing use of an SSRI. The cause of this dysfunction isn't understood, as stopping the SSRI allows dopamine production to return to normal.

The Dutch studies about orgasms (mentioned earlier), along with others, have also been the basis for continuing research in helping women who are anorgasmic. Dr. Barry Komisaruk at Rutgers University is currently studying women who are anorgasmic and women who are constantly aroused sexually but are unable to reach orgasm. The latter group of women were each put in an MRI scanner where they could see their brain activity on a monitor. Their brain scans showed that the brain thought they were in fact constantly being sexually stimulated. The women then used imagery and other neurofeedback exercises to calm their brains. Dr. Komisaruk believes that anorgasmic women could also learn to read and react to their brain activity to try to reach orgasm.

Perhaps more unusual-sounding than orgasmia is the concept of orgasms that have nothing to do with the genitalia at all. Some people can orgasm from being touched in other places on the body, such as the nipples. In this case, researchers believe that the sensations in the nipples are transmitted to the same areas of the brain that receive information from the genitals. However, people have also reported actually feeling orgasms in other parts of their bodies, including their hands and feet. Several people have even described having orgasms in limbs that were no longer there. One reason may be the layout of the cortical homunculus, a map that shows how different places of the brain's sensory and motor cortices correspond to the organs and limbs of the body. A person who feels an orgasm in a phantom foot, for example, may have experienced a remapping of the senses because the foot is located next to the genitals in the homunculus. The foot is no longer there to provide sensation, so the area for genital sensation took over the space.

Although we now know more about how orgasms impact the brain than ever before, there's still a lot that we don't know. For example, scientists are still debating the evolutionary reason behind the female orgasm. But it's probably safe to say that most people aren't too concerned about the "why" -- they'd prefer to focus on the whos, whats and whens of sex.

For more articles you might like on sex, the brain and sex on the brain, try the links on the next page.