The Orgasmic Brain

Relevant links and references at the end of the transcript

Natasha Mitchell: Hello, I'm Natasha Mitchell, great to have your company on ABC Radio National, and on the net or your pod too. This is All in the Mind and cross your legs , in the name of neuroscience, we're getting orgasmic under a brain scanner.

Curiously I gather that having warm feet made a difference in all this too?

Gert Holstege: Yeah, that was very strange.

Natasha Mitchell: What was that about?

Gert Holstege: The point was that when the volunteer's in the scanner - she or he has to be comfortable, they have to feel OK. And one of the things that was clear, one of the things that they sometimes didn't like is that they were having cold feet. They were not completely naked but in the beginning they always had their shoes off and the socks off and then apparently it was one of the not nice things - they were getting cold feet.

Natasha Mitchell: They had to put their socks back on.

Gert Holstege: Yeah.

Natasha Mitchell: Orgasms have been in the news a lot of late and a few weeks ago you'll recall we covered the heated scientific debate over the question of whether the female orgasm has an evolutionary function. And boy, did we get a response. Many of you were emphatic about your position on the matter, and thanks for the entertaining correspondence.

Well, today we've got orgasms not in our genes so to speak, but on the brain! A Dutch team have done the unthinkable and scanned the brains of men and women while they have an orgasm. The results are intriguing - as you'll hear later in the show.

But physiologist Dr Gemma O'Brian from the School of Biological, Biomedical and Molecular Sciences at the University of New England also has a keen interest in the neurobiology of the orgasm...as fleeting an experience as it can be sometimes.

Gemma O'Brien: And this is one of the problems with trying to look inside the brain during something like orgasm. Orgasm's a fairly brief event. We enjoy the response for an extended period of time, the resolution phase, but the actual brain changes are fairly brief so finding a technique that can see what's happening in the brain ...

Natasha Mitchell: Snap shots it...

Gemma O'Brien: Indeed. They are usually either very good at brief timing, getting temporal resolution but not good at spatial resolution. Or you can get very accurate spatial information but it takes a very long time. So it's fine for looking at events that you can get a person to repeat over and over again for an extended period of time...and wouldn't it be nice if we could all do that for orgasm...but it's not so useful for studying orgasm.

Natasha Mitchell: And oddly enough you suggest that the orgasm and how it might work in the brain is a rarely probed question in science. Is that really the case - because science like the best of us is obsessed with sex?

Gemma O'Brien: Ah, but you don't go to close, Natasha, you keep everything very impersonal and third person in science and that's one reason I think orgasm has been left in the too hard basket. And of course we need to know what it is we want to measure, what it is we are investigating, we don't have a definition of orgasm.

Natasha Mitchell: Do we not?

Gemma O'Brien: We do not. Or, put the other way, how many million people there are in the world, that's how many million definitions we have of orgasm.

Natasha Mitchell: Well as a physiologist what would your definition of an orgasm be?

Gemma O'Brien: Well, I start with the Masters and Johnson summary of the overall human sexual response. So I divide the whole thing into a stage of arousal plateau, sexual climax and resolution. And it's the sexual climax part that many people use the word 'orgasm' for.

But I divide it up more analytically I suppose to try to sort out what's happening so during the climax I say there are three different groups of things happening. There are changes in the reproductive tract and the most obvious one is ejaculation, but there are a whole lot of contractions and things happening.

Natasha Mitchell: Which we should point out - girls and boys do.

Gemma O'Brien: Indeed. Some girls, not all, and most boys. But that's an interesting question too some boys can separate their ejaculation from the orgasm and that's another story. It is All in the Mind you know!

The second range of human responses are the ones that I call the 'viscerosomatic' changes. So this is things like the heart rate racing, blood pressure, sex flush of the skin and that catatonic spasm of all the muscles.

Then there's the third set of responses, those that happen in the brain and these are the ones that I refer to as 'orgasm'. These are a combination of emotion, joy, pleasure or reward, exhilaration - all of those sorts of things.

Natasha Mitchell: So your sense is that the orgasm is very much an experience of the brain?

Gemma O'Brien: That's right, and there are a number of reasons for being able to present it this way. One is, for example, in men who have a high spinal cord injury, a complete one. They may have ongoing capacity to use the reproductive tract so they can manually stimulate or tactilely stimulate to erection and all the way through to ejaculation but not detect anything by brain, not orgasm. They have to actually look or feel by hand to see whether anything happened.

Natasha Mitchell: But they don't actually have the sensations of euphoria that come with an organism?

Gemma O'Brien: That's right.

Natasha Mitchell: Yes, well you haven't embarked on any experimental research on this question yet but you've gone digging deep into the archives of research.

Gemma O'Brien: That's right, it's what I call theoretical research!

Natasha Mitchell: I guess the trouble here is though that it's an intensely subjective and private experience, how do you replicate it in the lab? You know how do you actually convince people that they should have an orgasm in a laboratory setting?

Gemma O'Brien: There are all sorts of people in the world, Natasha. Of course there are people prepared to do this sort of thing in the lab. But some examples of some early things that were done, there's a report from Heath from the 1970s.

Natasha Mitchell: And this is the classic Robert G Heath - he got away with a lot. He was working with epilepsy patients in particular - what did he get up to because this was destructive sort of research?

Gemma O'Brien: It was, it was definitely invasive at that stage, but it was for the individual patient's good. It was a situation where people who had really, really deleterious epileptic seizures where their life was disrupted by the number of seizures. And the approach, the surgical approach here is to go in and separate the part of the brain that's triggering the seizures and separate it from the rest of the brain.

Natasha Mitchell: Or remove it altogether in some cases.

Gemma O'Brien: That's right, yes. And obviously the surgeons, neurosurgeons do want to be very careful that they've got the right part of the brain and don't disconnect anything else.

So these people have surgery in a couple of stages, they go in early and electrodes are implanted into a number of deep sites in the brain and then they wake up from the surgery and move around undertaking normal activities for several weeks. During those weeks their brain function is recorded and the site of the seizures is recorded repeatedly so that the surgeons can identify exactly which part to resect or separate.

Natasha Mitchell: So what did he do with the electrodes and how did he pick up on people's orgasms while these were actually in place?

Gemma O'Brien: Well of course people walk around and do normal things during those weeks and that may or may not include orgasm for some people. In Heath's case, in the part of it that he published, he reported on some people that he actually had come into the laboratory to stimulate to orgasm so he could record their brain function. But the same could be done with people moving around in their normal private lives.

Natasha Mitchell: And what did he observe and of course we have to be aware that these experiments weren't necessarily well designed, so they might not be representative, they need to be replicated.

Gemma O'Brien: That's right. I think they really did grow out of some fascinating observations on people who were really primarily being examined for clinical reasons. I don't think it was very intensively designed research as you say.

But what he found was a change from very asynchronous activity in the brain and that's what any of us can be seen to be expressing during normal awake, aroused behaviour. Our nerves are all firing at different times, doing different things. But right at the time of orgasm they became very synchronised. He recorded very low frequency, large amplitude signals which meant all the nerves were doing the same thing at the same time. Something very intense was happening.

Because he had so many different electrodes in the brain he was able to map out a rough sequence of events. Importantly the sensory information seems to come up the spinal cord from the reproductive tract as you would expect, it starts at the thalamus which is our filtering station for all sensory information coming into the brain. And from there the important signals seemed to be moving along the mid-line of the brain toward the front of the brain. This is called the medial forebrain bundle. Now in the medial forebrain bundle there are nerves involved in many different pathways but there are very important ones going forward that pass through the pleasure centres.

And then the signals continued past there into the forebrain, the prefrontal cortex area, and that's where we process information associated with emotion.

Natasha Mitchell: Mmm, it's a sort of in our executive brain and brings it altogether in a sense.

Gemma O'Brien: That's right and decides whether this is a good thing or a bad thing, should I go with this and enjoy it or should I tuck away the knowledge of not doing this again. Those sorts of decisions are made there.

Natasha Mitchell: He famously got them to self stimulate, using these electrodes too.

Gemma O'Brien: Yes.

Natasha Mitchell: And they wouldn't stop, it was like a rat to a feeding lever and one of his patients described it as the 'goody place'.

Gemma O'Brien: If only we could all put our electrodes there, Natasha.

Natasha Mitchell: But seriously, this work did throw up some huge ethical questions about the rights and responsibilities of researchers with their patients.

Gemma O'Brien: Well yes, as I say this was very early, this was 30 years ago and many, many things have changed since then.

Natasha Mitchell: Physiologist Dr Gemma O'Brien from the University of New England. And on ABC Radio National, this is All in the Mind, I'm Natasha Mitchell - coming to you also on Radio Australia, the net and on your pod now too.

Well, from the past to the present and a recent breakthrough in understanding what's really going on in our heads when we have an orgasm. Leading neuroanatomist Professor Gert Holstege presented his latest results at the recent European Society for Human Reproduction and Development Conference, which was held in Copenhagen.

He heads up the Department of Anatomy and Embryology at the University of Groningen. And it's more than a salacious curiosity that prompted his recent brain scan study of 13 rather brave women and their male partners.

Gert Holstege: Because there are a lot of problems for a lot of people having sex or having an orgasm. This is enormous, I think 10% to 15% of all people, I'm not talking about a few people, many, many, millions and millions of people have problems with that.

The problem is that no one knows exactly what's going on, the main thing of all these problems is in the brain and are not because there is something wrong on the genitals or so. So not understanding totally what's going on in the brain means that you cannot really do something for these people. And now we've started to have an idea of what's really going on in the brain.

Natasha Mitchell: Yes, it's extraordinary that we don't know what's going in the brain. But look before we get to the brain, one person has described the experience of an orgasm in the body as a sort of 'psychosomatic circle'. What do you think they mean by that?

Gert Holstege: Of course the whole thing of orgasm is a brain activation. The brain activates the genitals, controls everything.

And, you know, the basic idea of the brain is the brain is built according to only two laws. Now, law No.1 is "survival of the individual". And law No.2 is "survival of the species". And sex and everything that has to do with sex of course is for law No.2. There are no other laws. That is also the reason if you do something OK you get a reward. And so if you have sex and the sex is going alright then you have a reward which is called orgasm. So the brain always rewards those activities that are good for law No.1 or law No.2.

Natasha Mitchell: It's interesting you say that because so often we focus on the genitals in the experience of orgasm.

Gert Holstege: Yah, but they are just tools.

Natasha Mitchell: But you're arguing that it all comes back to the brain, they are just tools.

Gert Holstege: Yes, they are just tools, it's all in the brain.

Natasha Mitchell: You've co-opted the most contemporary brain scan technology so PET and FMRI in your own work, these are technologies that measure cerebral blood flow or activity in the brain. What have these technologies allowed you to do that you couldn't do in the past when it comes to probing the orgasm?

Gert Holstege: Right, you have to remember again that until ten years ago we could not see activations in the brain at least not easily and not of the complete brain. The technology enables us to do these studies, before that it was almost impossible.

Now for an example you can lie in a PET scanner and you can have sex in this PET scanner, at least you can be sexually stimulated in the scanner and it was not possible before. So now we can take a look at the brain, the brain activation or even more important, the deactivation doing certain tasks. You couldn't do it before and now we can do it, now we are doing this kind of experiments.

Natasha Mitchell: And you certainly are, you've put both men and women into scanners and encouraged them to have orgasms and measured what's going on in their brain. A couple of years ago you published a study in which you measured what was going on in the brain of men who have orgasm. I'm curious to know what your ethics committee and university thought of your proposal to do this work?

Gert Holstege: Oh, that's an interesting story because in this case I first went to a good neuroscience friends of mine in America, especially at Harvard in Boston. And I was asking, "suppose I do this kind of study, would it mean that you would not take me seriously anymore". "No, no, no. It is very important and you should really do that and it's not possible in the United States". So that was very encouraging. And so then I went to the President of the University Groningen and I asked him the same question, and they all were in favour. Because it was very high risk, not only high risk technically but also high risk that it could be seen as sleaze or something, and this is the last thing we wanted.

Natasha Mitchell: Why did your participants want to volunteer to do the study because I'm not sure, as curious as I am that I'd put my hand up for this one?

Gert Holstege: Actually it became easier and easier because the volunteers had a good time and they told all kinds of other people "Ah yes, you should do this". And so they came from all over the country.

Natasha Mitchell: Well, this first study was with men, what did you get your subjects to do?

Gert Holstege: The stimulator was the partner, the normal partner they had.

Natasha Mitchell: Because you didn't want them to move in the scanner did you?

Gert Holstege: Right, they should not masturbate and no one did masturbate because if you are masturbating you're using your hands or arms of whatsoever. And then you see arm and hand movement in the scanner, in the brain. And that's what we are not interested in.

And they were always right handed people and heterosexuals because they had to be some kind of similar group of people of course. And in the beginning it was very hard to get an orgasm, but we also got more and more relaxed, and the more relaxed you were the easier it was to get an orgasm.

Natasha Mitchell: Well only 8 people in your first sample of 11 men managed to have an orgasm whilst they were having their brain scanned. You made some interesting observations about what was going on in their brains leading up to and at the point of ejaculation.

Gert Holstege: The point is the stimulation took two minutes which is necessary for PET scanning. You have to do a task for two minutes, whatever the task is.

And during stimulation we saw comparing women and men, men paid more attention to when the female partner was touching the penis, they found it very important. You could see that in terms of which kind of brain parts were activated. When the women were in the scanner and the men were stimulating, when they were stimulating the clitoris, the women did not pay so much importance to this.

Natasha Mitchell: So the actual sort of touching didn't register in the brain as much.

Gert Holstege: Apparently it was more important for men than for women. On the other hand what was the same between men and women was that during sexual stimulation was that there was a decrease of those parts that usually are involved in fear or anxiety.

Natasha Mitchell: And that part of the brain is called the amygdala, very important in processing fear.

Gert Holstege: Exactly yes. Both in men and in women they were deactivated.

Natasha Mitchell: What happened during orgasm?

Gert Holstege: In women we saw an enormous deactivation and that was the major thing we found. Deactivation - so a lower level of functioning in the region of the temporal lobe and the amygdala.

We found an activation in the cerebellum. Don't ask me what it means because no one knows this.

Natasha Mitchell: Now just to clarify, you saw an activation of the cerebellum and that's the structure at the base of our brain and that's sometimes called our "little brain", or our "reptilian brain". It's associated with things like movement coordination.

Gert Holstege: Yes, yes. Very big in men.

Natasha Mitchell: There was an increase in activity there?

Gert Holstege: Yes, yes.

Natasha Mitchell: And you don't know why?

Gert Holstege: No, we were thinking we should see more activations which I think is a little strange. But on the other hand another problem with this technique is that you have to keep the head still, but during orgasm to keep your head completely still is not any easy task. And it is possible that, for example, small parts of activation you cannot see because of movement of the head.

Natasha Mitchell: Back to the amygdala. I was interested to also read that neurobiologists have seen a similar deactivation in the amygdala in brains when people who are deeply in love see a photo of their loved ones. So in a sense is this sort of 'euphoric' marker if you like?

Gert Holstege: Yes, yes. That's very interesting - our finding of the deactivation of the fear centres.

For example in the concentration camp when you have to fight for your life and then you have to survive which is not easy. You see, for example, in women they don't have their monthly periods anymore because sex and offspring should not be produced during...

Natasha Mitchell: ...a fearful situation.

Gert Holstege: Exactly because that is bad for the offspring. Too dangerous, yes.

Natasha Mitchell: It's an interesting evolutionary argument that one.

I want to go to the rest of the brain, what you've pointed to there is the amygdala, the cerebellum, these are all structures that are lower in the brain. What about the cortex which is so part of our conscious awareness as humans, did it light up during orgasm?

Gert Holstege: Now what we saw those parts of the cortex, for example, the prefrontal or orbito-frontal cortex - so the cortex that is just behind of above your eyes, this part of the brain are also deactivated. And these parts of the brain are involved in control of basic emotions.

Natasha Mitchell: So in a sense we abandon our emotions during orgasm?

Gert Holstege: Absolutely.

Natasha Mitchell: What's similar in the brain...when you talk about the orgasm being something like a heroin rush in the brain do you see similar pathways, say, the so-called reward pathways in the brain lighting up as you would when someone has a heroin fix?

Gert Holstege: Yes, so in the men we have to verify this. But we don't see this activation of this reward region in women, which is really peculiar. On the other hand we are not so sure that it's not there because of the movement of the heads. If you have a big region that's activated or deactivated you still see it, but small regions may escape detections because of the movement. This is a technical problem that never occurs in any other PET scan study because everybody keeps their head still.

Natasha Mitchell: So while we've managed to fly to the moon it seems it's still hard work designing an experiment to study what comes natural - having sex.

Excerpt from the movie "When Harry Met Sally"

Sally: How do you know that they're really?

Harry: What are you saying, that they fake orgasm?

Sally:It's possible.

Harry:Get out of here.

Sally:Why, most women at one time or another have faked it.

Harry:Well they haven't faked it with me.

Sally:How do you know?

Harry:You don't think that I can tell the difference?

Sally:No.

Harry:Get out of here

Sally: Ohhhh.

Harry:Are you OK?

Sally:Oh, oh, on God, ooh, oh God, oh God, oh right there, oh, oh, oh God, oh, yes! yes! yes!

Natasha Mitchell: Sally there demonstrating the art of faking it in the classic flick When Harry met Sally.

Professor Gert Holstege and his Dutch team have just revealed that Harry might not know the difference but Sally's brain certainly does. Observing the embarrassment of his male volunteers if they couldn't have an orgasm in the lab, he took some heed of Sally's point about his women subjects.

Female in Café (from Harry Met Sally): I'll have what she's having....

Gert Holstege: I wanted to be sure that they were not going to fake orgasm during real orgasm. We were asking in the beginning of the experiment "could you fake orgasm?". "So do everything that you think, the kind of movements and everything that you're doing when you are faking an orgasm". And so the reason behind this was then they wouldn't do that when there was a real orgasm.

Natasha Mitchell: And what was the difference between when they were really having an orgasm and when they were faking an orgasm?

Gert Holstege: Yes, now because there was a big deactivation during real orgasm, as I told you, of the amygdala. And there was no deactivation whatsoever during faking orgasm.

Natasha Mitchell: Now I understand that also when women were faking an orgasm - parts of what are called their motor cortex - which control movements in our body lit up and that's the part of the brain that consciously controls movement.

Gert Holstege: Yes, didn't see it in a real orgasm although they made the same movements and we saw it in faking orgasms, yes.

Natasha Mitchell: So does that say that the movements when we're actually having a orgasm are unconscious?

Gert Holstege: At least it's not coming from the motor cortex. Yeah, it's true that you are not consciously making movements during organism, that's true.

Natasha Mitchell: Well this is perhaps not a complete picture yet of how organism works in the brain. What do you conclude from this study overall?

Gert Holstege: The conclusion is that this deactivation is really unbelievable.

For example, you take alcohol, one of the things with alcohol is that you get a decrease of fearful feelings. Cocaine is the same thing.

Natasha Mitchell: I mean surely that could indicate that if our reward pathways are in a sense satiated during orgasm, that we could potentially all be addicted to sex?

Gert Holstege: Actually real people that are addicted to heroin are not interested anymore in sex - it's a very well known fact. Because they say "when I take the needle and I inject myself with heroin I get a much better orgasm than during sex".

So it is really something...and we are addicted to sex as you know, as everybody is. The point this prefrontal cortex this orbital frontal cortex that is controlling whether we can do it or not. And for example people that don't have this part of the brain and these people exist, these people really go for it all the time.

Natasha Mitchell: Right.

Gert Holstege: Yeah, absolutely. But we don't do it because...

Natasha Mitchell: So our rational mind sort of takes over.

Gert Holstege: Yes, yes. But an interesting thing is that our rational mind is also deactivated during orgasm.

What I think is the result of our study is how important it is that your level of anxiety of fear has to be in control. If you're not in control of that and you have a too high level of fear then you can expect that you will have problems with orgasm.

Natasha Mitchell: Well it's certainly very interesting work that's attracted considerable attention for you this week and...

Gert Holstege: Yes, absolutely. yes.

Natasha Mitchell: And thank you very much for joining me on the program this week.

Gert Holstege: Thank you, thank you so much.

Natasha Mitchell: Neuroscientist Professor Gert Holstege from the University of Groningen. And by the way catch The Health Report this week on air or on-line for more extraordinary insights into how the brain processes fear, scary faces this time.

Now Dr Gemma O'Brien at the University of New England is hoping to launch her own research into how orgasm works in the brain. Her hypothesis is that the experience of orgasm and the manic phase of bipolar depression may have interesting parallels, and she'd like to take brain wave measurements of people to test this.

She things unearthing the sex life of the brain is crucially important. For example, you may have had the debilitating experience of taking a medication that suppresses your libido.

Gemma O'Brien: It's not only libido that at least is tested by some pharmaceutical companies. When I've mentioned the pleasure centres in the brain we're particularly talking about the dopamine pathways. There's another hormone and transmitter very similar to it called serotonin and noradrenaline is part of the same family of chemicals. Now a lot of people using anti-depressant drugs are using drugs that influence the way dopamine works and the way serotonin works. Many of your listeners will be familiar with the term SSRI, which stands for Selective Serotonin Reuptake Inhibitors. They're altering their serotonin status in the brain. A side effect for some people - wait for it, is - spontaneous orgasm. A side effect for some other people is anorgasmia. So a chemical that's being marketed as an anti-depressant is in my view a depressant.

Now if I can understand better how these chemicals are working in a normal orgasmic function, in a normal brain, we should be able to help pharmaceutical companies to design better drugs, drugs with fewer side effects. So, if the pharmaceutical industry would like to beat a path to my door I'm easy to find at the University of New England!

Natasha Mitchell: Who's paying you?

Gemma O'Brien: No one yet obviously!

Natasha Mitchell: Dr Gemma O'Brien, look it really is a very interesting area to be delving into and I wish you luck in trying to get some of these studies up and running.

Gemma O'Brien: Thank you Natasha.

Natasha Mitchell: Physiologist, Dr Gemma O'Brien from the University of New England.

And you can hear this program again on the web as MP3 download or on your pod with Radio National's all new podcast service. More gumph about that on our website as well as the transcript and references, links etc and our email address, don't hold back, we love your feedback. That's at abc.net.au/rn and head to All in the Mind under programs. My thanks today to sound engineer Jen Parsonage.

I'm Natasha Mitchell... Catch you next for more explorations of our mental universe.