Abstract
The effect of glans clitoris (GC) stimulation on the vagina, uterus and pelvic floor muscles (levator ani (LA) or pubococcygeus, puborectalis (PR)) was studied in 16 healthy volunteers (mean age 34.9 years). The GC was stimulated mechanically and electrically while recording the vaginal and uterine pressures and the electromyographic activity of PR and LA. Stimulation caused a drop in the uterine (P<0.001) and upper vaginal (P<0.05) pressures (1.6 and 2.9 cmH2O, respectively) and an increase in the middle (P<0.001) and lower (P<0.001) vaginal pressures (58.6 and 89.2 cmH2O, respectively). It also effected an increase of EMG activity in the PR (P<0.01) and LA (P<0.01). Response was greater with electrical than with mechanical stimulation (P<0.05). No response occurred upon stimulation of the anesthetized GC or the anesthetized PR or LA. The reproducibility of the PR and LA contraction on GC stimulation postulates a reflex relationship which we call the ‘clitoromotor reflex’. This induces uterovaginal changes that enhance the sexual response of both partners, and also prepares the uterus and vagina for the reproductive process. LA contraction pulls open and reduces the pressure in the upper vagina as well as elevating the cervix uteri. PR contraction constricts the middle and lower vagina and increases their pressure.
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Editorial Comment: This article describes a reflex which is operative during coitus. It results in ballooning of the upper vagina (assuming lateral sidewall attachments are intact) and contraction of the paravaginal muscles. The study is nicely done and objectively establishes the existence of this physiological reflex.
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Shafik, A. The ‘clitoromotor’ reflex. Int Urogynecol J 6, 329–336 (1995). https://doi.org/10.1007/BF01892737
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DOI: https://doi.org/10.1007/BF01892737