May, 2000. The American College of Obstetricians and Gynecologists (ACOG) held its 48th Annual Clinical Meeting (ACM) in San Francisco, CA., at the Moscone Convention Center. The meeting began Monday, May 22 and ran through Wednesday, May 24. ACOG is a national medical organization which represents over 40,000 obstetricians and gynecologists throughout the United States. ACOG’s ACM is one of the largest gatherings of women’s health care practitioners, drawing thousands of physicians, experts, poster exhibitors, researchers, and guests.

Participants of the ACM were offered a large variety of continuing medical education courses with more than 35 post graduate courses, 42 clinical seminars, 24 paper sessions, 275 luncheon conferences, 8 scientific sessions, and current issue updates. ACM topics include obstetrics, oncology, primary/preventive care, endocrinology and infertility, and gynecology.

During the first day of the Poster Sessions, Monday, May 22, Winnifred Cutler, Ph.D. presented her scientific poster to the meeting participants. The Poster and Study titled, Sexual Response in Women, was co-authored by Dr. Cutler, Millicent Zacher, DO., Norma McCoy, Ph.D., Elizabeth Genovese, M.D., and Erika Friedmann, Ph.D. ACOG’s journal first announced the poster by publishing its abstract in the journal, Obstetrics and Gynecology, April 2000, Volume 95, Number 4, Page 19S-20S.

The authors’ objective was to investigate orgasmic experience in two groups of women. The first group:128 women with an intact uterus undergoing assessment in a women's wellness program. The second group: 39 patients with fibroid tumors.

The researchers demonstrated four conclusions, detailed in the poster, including their finding that women with fibroid tumors are more sexually responsive at both the vaginal site and at the cervical site, than intact well women. (See Table 5: Frequent Contribution to Orgasm by Site.)


ABSTRACT

Sexual Response in Women Sexual stimulation of the clitoris is well established as a trigger for orgasm for most women. Vaginal stimulation also has been reported to trigger orgasmic inevitability if the rhythm and pressure are individualized. Work in rats has established a significant role of cervical stimulation in triggering hypothalamic pituitary neural pathways that trigger GNRH release. Work in spinal-injured women with intact uteri has demonstrated that cervical and vaginal stimulation applied differentially trigger disparate orgasmic perceptions in these women. Objective: We investigated orgasmic experience in: a) 128 women with an intact uterus undergoing assessment in our women's wellness program; and b) 39 patients with uterine fibroid tumors. Methods: Consecutive patients undergoing comprehensive executive physical exams were offered perineometry tests of pubococcygeal muscle strength and endurance and asked to complete extensive questionnaires on genitourinary experience of incontinence and sexual responses including coital and orgasmic frequency for a research study. Informed consent was obtained to use their data. Once pilot data had been assessed, an unaffiliated gynecologist agreed to provide the same questionnaires to patients with fibroid tumors. Results: Confirming prior reports, clitoral and vaginal sites were commonly recognized. A third site--the cervix---was reported by a substantial minority of women. Both study groups showed similar responses. Cervical stimulation by penile tapping was recognized as making a contribution to orgasm by 35% of the wellness program women and 49% of the fibroid patients. Vaginal stimulation did in 63% and 71% respectively. Clitoral stimulation did in 94% and 92%. Although pelvic muscle strength and endurance had previously been shown to be inversely related to incontinence, neither was related to these sexual findings. Conclusion: These data suggest a hierarchy of sexual response. Most women recognize that clitoral stimulation evokes orgasm. Many of these recognize vaginal stimulation with a smaller proportion recognizing cervical stimulation.




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