Arrrrghghghghghghghghghghghghgh!!!!!!!

UBC student maps path of female arousal
Research may lead to Viagra-like drug for women
Gwendolyn Richards
Vancouver Sun
Tuesday, August 06, 2002

Shona Penhale has spent thousands of hours staring at slides covered in fuchsia stains and purple squiggles, trying to connect the dots.

These lines, thread-like even under a microscope, are the road map of female sexual arousal. Generally ignored by the medical community, they have never before been documented.

Until now.

And the work by the University of B.C. master's student to map the nerves in a mere eight centimetres of female genitalia is set to provide vital information to doctors and researchers that could lead to a viable Viagra-like drug for women and the advancement of studies on female sexual dysfunction.

At the very least, Penhale's ground-breaking research will be included in the next edition of Gray's Anatomy. It is expected to help doctors navigate more accurately during surgery and allow them to possibly spare the nerves that carry pleasurable sensations.

With the help of UBC undergraduate student Kim Frederiksen, Penhale has dissected the sexual arousal nerves that weave through the erectile tissue around the clitoris.

Although nerve pathways from the spinal cord to the pelvis have already been documented, this is the first time anyone has examined what happens to the bundle of nerves when it gets around the uterus and bladder and how it weaves through the pelvis to the external genitalia.

"It's completely uncharted," said Penhale. "All it says in any textbook that talks about these nerves is that they pass through the uro-genital diaphragm and out to the genitalia."

Through a tedious mapping process in her two-year project, Penhale has created a three-dimensional model of nerve pathways to demonstrate how the nerves lace through the connective tissue between the front wall of the vagina and the bladder.

For Penhale, the research has taken long hours, but the results will help even the score in the male-focused realm of sexual research.

While information on male sexual innervation has been proudly displayed in medical texts for years, little information has been available when it comes to the same nerves in women.

"Basically what has been said up until now is 'we know what it is in the male and we know the difference between the tissues as they develop, so we'll take the way it is in the male and just translate that to how it is in the female,' " explained Penhale.

Back in October at the annual Female Sexual Function Forum held in Boston, Mass., Penhale received a standing ovation for a 15-minute presentation on her research. Afterwards, a surgeon told Penhale the information is desperately needed. She found herself questioned by groups of doctors fascinated by her subject matter and findings. She eventually had to put a "Do Not Disturb" sign on her hotel door to get a quiet moment.

And it's no wonder the medical community is welcoming the research -- no one has done it before.

"I was stunned," she said. "I thought, 'How could, in the year 2000, we not know how the nerves run through a woman's pelvis and innervate her genitalia?' "

It was the same question asked by Dr. Rosemary Basson, an obstetrician-gynecologist for the B.C. Centre for Sexual Medicine, that lead to the study.

In a search for information for a patient, Basson turned to books, but found nothing. She then contacted Wayne Vogl, a UBC anatomy professor for his help. He searched, but found all the references were for men only.

"And he said, 'Guess what, I don't think anyone has ever traced this,' " said Basson.

So Basson and Vogl decided to find someone who would be willing to take on the project. UBC assistant professor Calvin Roskelley, who had worked with Penhale on an anatomy course, asked Penhale if she was interested in getting her master's degree by taking on the innervation research project.

Her work began in January 2000 and she is expected to publish her results this fall.

Those results, said Penhale, will provide important information for several aspects of sexual health.

Men undergoing prostate surgery have the distinct advantage of being operated on by surgeons who know the intricate paths of sexual nerves in the male genitalia. With that information, doctors use lasers and liposuction to avoid cutting any nerves that could prevent a man from getting an erection.

Without a map of genital innervation in women, surgeons performing hysterectomies, tumour or cyst removals or other surgeries in the genital area may cut through the nerves that transmit feelings of pleasure.

"Would you rather that doctors were able to cut around that tumour and try and avoid very special areas where a branch of these nerves go, or would you rather they just took it out without worrying about any of that and you not being able to have any sexual arousal after?" asked Penhale. "Your choice."

"We can't spare those nerves to spare women's sexual genital function if we don't know where they are," echoed Basson, adding the information can also be useful in surgeries on the vulva where some nerve damage is likely.

"Sometimes you can't avoid nerve damage, but then you can do nerve sparing, spare as much as you can," she said.

Basson said the research may also serve as a first step on the road towards creating a Viagra-like drug for women. Once doctors know where the nerves are, they can begin studying the neurotransmitters found in them.

"We know which ones are involved in men, but not women," she said. "That can help with developing a drug treatment for arousal and sexual enjoyment."

While Penhale's research provides much-needed information, Basson said there will still be obstacles in the effort to advance women's sexual health beyond reproduction.

Basson admits she was not surprised such a study had never been undertaken and said the discrepancy between the amount of research done on males compared to females comes down to the traditional view of what sex is about.

"The whole idea of vulval swelling, such that there can be enjoyment, pleasure, orgasm, hasn't been paramount to the thinking of what sex is about," she said. "Often women's sexuality in the medical world is equated with having a baby.

"One doesn't need to have an engorged and swollen clitoris for intercourse and conception, so that may be another reason it's not had the attention," she added.

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Heart. Gah.

I'm a radical feminist, not the fun kind. -- Andrea Dworkin