Advertisement
Original research| Volume 99, ISSUE 2, P299-305, February 2018

Randomized Trial of Clitoral Vacuum Suction Versus Vibratory Stimulation in Neurogenic Female Orgasmic Dysfunction

Published:September 09, 2017DOI:https://doi.org/10.1016/j.apmr.2017.09.001

      Highlights

      • Effective, safe therapies are shown to promote orgasm in women with spinal cord injury (SCI) or multiple sclerosis (MS).
      • Clitoral vacuum suction improved overall sexual function with sustained efficacy.
      • Vibratory stimulation improved orgasmic function during active treatment.
      • Clinicians should make these treatments available to women with MS or SCI.
      • Research should examine benefits of orgasm on spasticity and quality of life.

      Abstract

      Objective

      To examine the safety and efficacy of using a clitoral vacuum suction device (CVSD) versus vibratory stimulation (V) to treat orgasmic dysfunction in women with multiple sclerosis (MS) or spinal cord injury (SCI).

      Design

      Randomized clinical trial.

      Setting

      Two academic medical centers.

      Participants

      Women (N=31) including 20 with MS and 11 with SCI.

      Intervention

      A 12-week trial of the use of a CVSD versus V.

      Main Outcome Measures

      Female Sexual Function Inventory (FSFI) and Female Sexual Distress Scale (FSDS).

      Results

      Twenty-three women (18 MS, 5 SCI) completed the study including 13 of 16 randomized to CVSD and 10 of 15 randomized to V. There was a statistically significant increase in total FSFI score (P=.011), desire (P=.009), arousal (P=.009), lubrication (P=.008), orgasm (P=.012), and satisfaction (P=.049), and a significant decrease in distress as measured by FSDS (P=.020) in subjects using the CVSD. In subjects who used V, there was a statistically significant increase in the orgasm subscale of the FSFI (P=.028). Subjects using the CVSD maintained improvements 4 weeks after treatment.

      Conclusions

      CVSD is safe and overall efficacious to treat female neurogenic sexual dysfunction related to MS and SCI. V is also safe and efficacious for female neurogenic orgasmic dysfunction; however, results were limited to the active treatment period. Because of ease of access and cost, clinicians can consider use of V for women with MS or SCI with orgasmic dysfunction. CVSD is recommended for women with multiple sexual dysfunctions or for whom V is ineffective.

      Keywords

      List of abbreviations:

      CVSD (clitoral vacuum suction device), FOD (female orgasmic dysfunction), FSDS (Female Sexual Distress Scale), FSFI (Female Sexual Function Inventory), MS (multiple sclerosis), MSISQ-19 (Multiple Sclerosis Intimacy and Sexuality Questionnaire-19), SCI (spinal cord injury), SDS (sexual dysfunction score), V (vibratory stimulation)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Anderson K.D.
        • Borisoff J.F.
        • Johnson R.D.
        • et al.
        The impact of spinal cord injury on sexual function: concerns of the general population.
        Spinal Cord. 2007; 45: 328-337
        • Kessler T.M.
        • Fowler C.J.
        • Panicker J.N.
        Sexual dysfunction in multiple sclerosis.
        Expert Rev Neurother. 2009; 9: 341-350
        • Sipski M.L.
        • Alexander C.J.
        • Rosen R.C.
        Sexual arousal and orgasm in women: effects of spinal cord injury.
        Ann Neurol. 2001; 49: 35-44
        • Nortvedt M.W.
        • Riise T.
        • Frugaard J.
        • et al.
        Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis.
        Mult Scler. 2007; 13: 106-112
        • Secil Y.
        • Yetimalar Y.
        • Gedizlioglu M.
        • et al.
        Sexual dysfunction and sympathetic skin response recorded from the genital region in women with multiple sclerosis.
        Mult Scler. 2007; 13: 742-748
        • Gruenwald I.
        • Vardi Y.
        • Gartman I.
        • et al.
        Sexual dysfunction in females with multiple sclerosis: quantitative sensory testing.
        Mult Scler. 2007; 13: 95-105
        • Yang C.C.
        • Bowen J.R.
        • Kraft G.H.
        • et al.
        Cortical evoked potentials of the dorsal nerve of the clitoris and female sexual dysfunction in multiple sclerosis.
        J Urol. 2000; 164: 201-203
        • Rees P.M.
        • Folwer C.J.
        • Maas C.P.
        Sexual function in men and women with neurological disorders.
        Lancet. 2007; 369: 512-525
        • Laumann E.O.
        • Paik A.
        • Rosen R.C.
        Sexual dysfunction in the United States: prevalence and predictors.
        JAMA. 1999; 281: 537-544
        • Billups K.L.
        • Berman L.
        • Berman J.
        • et al.
        A new non-pharmacological vacuum therapy for female sexual dysfunction.
        J Sex Marital Ther. 2001; 27: 435-441
        • Schroder M.
        • Bieber E.J.
        • Mell L.K.
        • et al.
        Eros therapy: treatment of sexual dysfunction in postmenopausal women not on hormone replacement.
        Obstet Gynceol. 2003; 101 ([abstract]): 95S
        • Schroder M.
        • Mell L.
        • Hurteau J.
        Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients.
        Int J Radiat Oncol Biol Phys. 2005; 61: 1078-1086
      1. Billups KL, Bakdash D, Flaherty E, et al. Vacuum-induced clitoral engorgement for treatment of female sexual dysfunction in diabetic women. Presented at the Annual Meeting of the American Urological Association; 2002 May 25-30; Orlando, FL.

        • Sipski M.
        • Alexander C.
        • Gomez-Marin O.
        • et al.
        Effects of vibratory stimulation on sexual response in women with SCI.
        J Rehabil Res Dev. 2005; 42: 609-616
        • Courtois F.
        • Charvier K.
        • Leriche A.
        • et al.
        Perceived physiological and orgasmic sensations at ejaculation in spinal cord injured men.
        J Sex Med. 2008; 5: 2419-2430
        • Sanders A.S.
        • Foley F.W.
        • LaRocca N.G.
        • et al.
        The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19).
        Sex Disabil. 2000; 18: 3-26
        • Rosen R.
        • Brown C.
        • Heiman J.
        • et al.
        The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.
        J Sex Marital Ther. 2000; 26: 191-208
        • Derogatis L.R.
        • Rosen R.
        • Leiblum S.
        • Burnett A.
        • Heiman J.
        The Female Sexual Distress Scale (FSDS): initial validation of a standardized scale for assessment of sexually-related personal distress in women.
        J Sex Marital Ther. 2002; 28: 317-330
        • Mah K.
        • Binik Y.M.
        Do all orgasms feel alike? Evaluating a two-dimensional model of the orgasm experience across gender and sexual context.
        J Sex Res. 2002; 39: 104-113
        • Othmer E.
        • Penick E.
        • Powell B.
        • et al.
        PDI-R.
        Western Psychological Services, Torrance1989
        • Guess M.K.
        • Connell K.A.
        • Chudnoff S.
        • et al.
        The effects of a genital vibratory stimulation device on sexual function and genital stimulation.
        Female Pelvic Med Reconstr Surg. 2017; 23: 256-262
        • Alexander M.
        • Kozyrev N.
        • Bosma R.
        • et al.
        fMRI localization of spinal cord processing underlying female sexual arousal.
        J Sex Marital Ther. 2016; 42: 36-47
        • Alexander M.
        • Kozyrev N.
        • Figley C.R.
        • et al.
        Altered spinal cord activity during sexual stimulation in women with SCI: a pilot fMRI study.
        Spinal Cord Ser Cases. 2017; 3: 16041
        • Alexander M.S.
        • Marson L.
        The neurologic control of arousal and orgasm with specific attention to spinal cord lesions: integrating basic and clinical sciences.
        Auton Neurosci. 2017 Jan 25; ([Epub ahead of print])
        • Scheepe J.R.
        • Alamyar M.
        • Pastoor H.
        • Hintzen R.Q.
        • Blok B.F.
        Female sexual dysfunction in multiple sclerosis: results of a survey among Dutch urologists and patients.
        Neurourol Urodyn. 2017; 36: 116-120
        • Schairer L.C.
        • Foley F.W.
        • Zemon V.
        • et al.
        The impact of sexual dysfunction on health-related quality of life in people with multiple sclerosis.
        Mult Scler. 2014; 20: 610-616
        • Forbes A.
        • While A.
        • Mathes L.
        • et al.
        Health problems and health-related quality of life in people with multiple sclerosis.
        Clin Rehabil. 2006; 20: 67-78
        • Tepavcevic D.K.
        • Kostic J.
        • Basuroski I.D.
        • Stojsavljevic N.
        • Pekmezovic T.
        • Drulovic J.
        The impact of sexual dysfunction on quality of life measured by MSQoL-54 in patients with multiple sclerosis.
        Mult Scler. 2008; 14: 1131-1136
        • Zorzon M.
        • Zivadinov R.
        • Rosco A.
        • et al.
        Sexual dysfunction in multiple sclerosis: a case-control study. I. Frequency and comparison of groups.
        Mult Scler. 1999; 5: 418-427
        • Tepper M.S.
        Sexual education in spinal cord injury rehabilitation: current trends and recommendations.
        Sex Disabil. 1992; 10: 15-31
        • Alexander M.S.
        • Courtois F.
        • Elliott S.
        • Tepper M.
        Improving the ability of persons with spinal cord injury to achieve orgasm: collective wisdom.
        Top Spinal Cord Inj Rehabil. 2017; 23: 57-70
        • Hess M.
        • Hough S.
        Impact of spinal cord injury on sexuality: broad-based clinical practice intervention and practical application.
        J Spinal Cord Med. 2012; 35: 212-219
        • Laessoe L.
        • Nielsen J.B.
        • Biering-Sorensen F.
        • Sonksen J.
        Antispastic effect of penile vibration in men with spinal cord lesion.
        Arch Phys Med Rehabil. 2004; 85: 919-924