title: Costs of pleasure and the benefits of pain: self-perceived genital sensation, anatomy and sexual dysfunction.
abstract: Background Research has highlighted the complex association between female sexual dysfunction (FSD) and distress regarding sexual activity, with decreased physical pleasure being an important mediator. The current study aims to elucidate the association between pleasurable and painful genital sensitivity and FSD, and to further investigate whether FSD may be distressing because it prevents the experience of sexual pleasure, induces pain or both.
  
  
  
  Sexually active women (n=256; median, 22 years; range, 18-49 years) completed web-based questionnaires, including the Self-Assessment of Genital Anatomy and Sexual Function, the Female Sexual Function Index and the Female Sexual Distress Scale.
  
  
  
  Women reported their clitoris to be more sensitive than their vagina in terms of having more pleasurable responses (P<0.001), but not more painful responses (P=0.49). In women with FSD (n=36), impaired self-perceived genital sensation was found: they reported significantly less sexual pleasure and orgasm intensity, and more orgasm effort and discomfort within the clitoral and vaginal area than women without FSD (n=220) (P-value<0.05). The odds of having FSD were significantly greater in women with perceived increased discomfort in the vaginal area during stimulation (odds ratio=5.59, P=0.009, 95% confidence interval: 1.53-20.39), but not in the clitoral area.
  
  
  
  The data provide evidence of the relevance of self-perceived genital sensitivity to sexual pleasure and overall sexual experience. Enhancing the pleasurableness of genital sensations, especially during partnered sex, could decrease the likelihood of experiencing pain and concomitant FSD.
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Nina
authors.initials: N
authors.lastname: Callens
authors.affiliation: Department of Urology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Bronselaer
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Petra
authors.initials: P
authors.lastname: De Sutter
authors.affiliation: Department of Sexology and Gender Problems, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Griet
authors.initials: G
authors.lastname: De Cuypere
authors.affiliation: Department of Sexology and Gender Problems, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: T'Sjoen
authors.affiliation: Department of Urology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Piet
authors.initials: P
authors.lastname: Hoebeke
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology, University Hospital Ghent and Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
authors.forename: Martine
authors.initials: M
authors.lastname: Cools
mesh_terms: D000293:Adolescent; D000328:Adult; D002987:Clitoris / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009948:Orgasm; D010146:Pain; D057181:Pleasure; D012677:Sensation; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological; D020018:Sexual Dysfunctions, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult