Understanding orgasm begins with a butt plug.

November 25, 2016 3:16 PM

Nicole Prause (Wikipedia) studies the science of the connection between our brains and our genitals. This sometimes gets her into lots of trouble, but she couldn’t care less. Her study that indicated porn "addiction" was more like a high sex drive than true addiction (previously) generated calls for her to be fired. Her study of women's penis size preferences was the first to use 3-D printed phalluses.

Her current study asks the question "How do women really know if they are having an orgasm?"

Institutional attitudes towards sex research and ongoing safety threats from anti-porn organizations prompted her to found Liberos LLC in 2015.

More charming videos can be found at PBS's Secret Life of Scientists and Engineers.

posted by Johnny Wallflower (62 comments total)

A fine use of "more inside."
posted by Dip Flash at 3:34 PM on November 25, 2016 [64 favorites]

Nice framing and post, OP. Thanks!
posted by Bella Donna at 3:57 PM on November 25, 2016

What I got from the most recent Guardian profile is that no one really knows how to describe or characterize the female orgasm.
posted by My Dad at 4:00 PM on November 25, 2016

i find it a tad sketchy that her company teams with OneTaste, the bizarre commercial orgasm factory we discussed here. that said, more knowledge is better, assuming Ethics.
posted by j_curiouser at 4:01 PM on November 25, 2016 [6 favorites]

Sensations are created and experienced by the nervous system, not by mechanical states of the body, so defining an orgasm as muscle contractions is problematic. Your body doesn't "feel" like anything. It's all a subjective state inside your mind. Information from the peripheral nervous system is only one of the inputs used to decide what sensations you are going to experience. In the popular mind peripheral nervous system inputs ARE sensations. This is incorrect.

I studied pain science for a few years after I got into massage, and this problem shows up in medicine. You can have excruciating back pain, get a scan, and have the doctor tell you you aren't injured in any way. The conclusion then is you are making it up. But pain does not work this way - pain is an output of your brain presented to your consciousness as a way to tell you that you're under threat in this location. The brain can get this very wrong in a maladaptive way. It can also decide an area that is injured isn't a problem, so no pain will be felt.

And my goodness, male ejaculation doesn't require an orgasm, and vice versa.
posted by MillMan at 4:20 PM on November 25, 2016 [22 favorites]

What I got from the most recent Guardian profile is that no one really knows how to describe or characterize the female orgasm.

I'm not sure that's true. It's not very different from male orgasm, a set of muscle spasms interpreted as relatively localised pleasure at the point of sexual climax. Unless you've had an orgasm, you don't know what one feels like, and it would be easy for anyone to misidentify preclimactic pleasure as orgasm, if it weren't for the fact that male orgasm is associated with ejaculation.
posted by howfar at 4:22 PM on November 25, 2016 [8 favorites]

Orgasmic contractions are reflexive, with a characteristic 0.8 second period that seems to be the same for all humans both male and female. Male contractions are easily visible, female less so because the effects are mostly inside the body thus the butt plug sensors. If you aren't having those contractions, you aren't having an orgasm. But since those contractions aren't very outwardly noticeable unless they are very intense, it's possible to mistake other kinds of intense sensation for orgasm even in your own body if you don't have a prostate to spurt it out at you. And before you accuse me of mansplaining this, lots of women before the OP have described the same point of confusion.

I personally think it is kind of unforgivably stupid that we don't know where sexual arousal and orgasm come from in the nervous system. How is it that in 2016 with tools like fMRA we do not have the slightest clue where in those 0.8 second contractions originate, or how "sexual arousal" is encoded and built up and released. These are presumably very ancient mechanisms so probably implemented in spinal column ganglia. There should be no subjective assessment of whether someone is having an orgasm; it is a thing we should be able to ascertain directly, in real time, and with the same certainty we can tell someone has a fever or is having an epileptic seizure.

I would also bet a very large pile of money that when the nervous system mechanism is finally known we will find it is exactly the same in men and women, different only in the squishy parts that get squeezed by the contractions. And of course that bothersome refractory period we men have because of hydraulic limitations. Compared to something like blood glucose control you'd think sexual stimulation and release would be relatively simple and easy to study. That we have not done so is fucked up.
posted by Bringer Tom at 4:41 PM on November 25, 2016 [21 favorites]

male ejaculation doesn't require an orgasm, and vice versa.

Is this true? I have never experienced them separately. Retrograde ejaculation still counts as ejaculation, surely?
posted by howfar at 4:58 PM on November 25, 2016 [1 favorite]

And my goodness, male ejaculation doesn't require an orgasm, and vice versa.

This is exactly half true. Ejaculation most certainly does require orgasm; without those contractions, the prostate cannot pump ejaculate out to the urethra. This isn't subjective, it is hydraulic. You have to have an orgasm to ejaculate.

It is, however, possible for a man to have orgasm without ejaculation. However, the basis for this is a bit subtle and beyond the scope of the story so far. While there is a most likely an unmistakable (once you know where to look for it) spinal component responsible for the 0.8 second contractions, there is in humans also a limbic system (or at least that's where I assume it is, since nobody has fucking studied it) component responsible for the higher order components of the pleasure of orgasm.

Now while the brain and spinal components are usually synchronized, it's possible for them to desynchronize, either accidentally or deliberately. In one case this results in the spinal orgasm with ejaculation that "doesn't get you off." This is probably what is meant by "ejaculation without orgasm," although that's incorrect, because if there are contractions it's most definitely an orgasm, even if it doesn't subjectively feel all that good.

In the other direction it can result in the extended "30 minute orgasm" which obviously can't involve ejaculating for that period of time, but according to some with practice and technique can create a very extended bliss state.

I have experienced the bad orgasm that didn't get me off, but while I haven't experienced the protracted orgasm myself I have no reason to believe it isn't possible.

I tend to think that this desynchronization problem is particular to men because of our hydraulic mechanisms. But again, SCIENCE! would be our guide if it actually fucking looked at the question.
posted by Bringer Tom at 5:13 PM on November 25, 2016 [12 favorites]

Weirdly, it seems that, on MetaFilter, the best way to discuss an article about women's orgasms is... to talk about male orgasms. That's... illuminating.
posted by GenjiandProust at 5:25 PM on November 25, 2016 [135 favorites]

Male orgasms are easier to observe, and are probably very similar to female orgasms. Yeah, probably illuminating.
posted by Bringer Tom at 5:30 PM on November 25, 2016 [6 favorites]

Yeah, but maybe the actual research conducted by the subject of these articles is more illuminating than a half-assed analogy justified by an "it stands to reason that..." monologue.
posted by tobascodagama at 5:36 PM on November 25, 2016 [13 favorites]

I was confused that they detect orgasms in women with the use of a butt plug. Wouldn't a vaginal probe make more sense?
posted by epj at 5:36 PM on November 25, 2016 [2 favorites]

"Wouldn't a vaginal probe make more sense?"

Are you a conservative legislator?
posted by mystyk at 5:43 PM on November 25, 2016 [39 favorites]

In all seriousness though, epj, I presume there's some difficulty in measuring accurately in the very place that you're trying to stimulate, while many of the core muscles involved in the physical side of orgasm can be quite well measured from the other end, which is after all only a fraction of an inch away. If it helps, you could think of it as a sort of orgasmic corollary to the Heisenberg Uncertainty Principle...
posted by mystyk at 5:48 PM on November 25, 2016 [5 favorites]

Dr Prause's recent work is pretty clearly rooted in the fact that orgasm is a physiological phenomenon, and that the female orgasm is no more a mysterious and uncharacterisable ethereality than the male version. I do think that the Guardian piece is so all over the place, in tone, content and attitude, that maybe it's got us a bit confused.
posted by howfar at 5:48 PM on November 25, 2016 [4 favorites]

Ejaculation most certainly does require orgasm; without those contractions, the prostate cannot pump ejaculate out to the urethra. This isn't subjective, it is hydraulic.

It's not really subjective inasmuch inaccurate.
posted by FirstMateKate at 5:54 PM on November 25, 2016 [1 favorite]

You can have excruciating back pain, get a scan, and have the doctor tell you you aren't injured in any way.

I suspect that the explanation for this, more often than not, is one of the hundred errors that can be introduced between the visit and the diagnosis (e.g. patient communication error, bad hunch, bad machine, bad machine for that injury (or injury hidden behind bits), technician error, interpretive error). Maybe one day I'll throw out an Ask for the odds of errors compounding in the worst and average case for a given injury. I bet it's a lot in both.

The conclusion then is you are making it up. But pain does not work this way - pain is an output of your brain presented to your consciousness as a way to tell you that you're under threat in this location. The brain can get this very wrong in a maladaptive way. It can also decide an area that is injured isn't a problem, so no pain will be felt.

If brains sucking this much at working out the bits of reality we work within was as rampant as some would have you believe, I doubt we'd have made it this far as a species.
posted by cotton dress sock at 5:57 PM on November 25, 2016 [1 favorite]

This isn't subjective, it is hydraulic. You have to have an orgasm to ejaculate.

If that's the medical definition then I'm wrong. I was thinking of an orgasm in terms of peak pleasure. Either way, this article isn't up to date on its neuroscience. I'm going to assume Prause's neuroscience knowledge exceeds my armchair knowledge and guess that the article frames it this way for a pop audience and within the writer's own limitations, especially given the last section on Prause's focus on psychology.
posted by MillMan at 5:57 PM on November 25, 2016

Orgasm for men is binary: you have one, or you don't. It seems that for women, there is no consensus on the biomechanical process of orgasm.
posted by My Dad at 6:12 PM on November 25, 2016 [1 favorite]

If brains sucking this much at working out the bits of reality we work within was as rampant as some would have you believe, I doubt we'd have made it this far as a species.

As pain is not a property of tissue, determining what is or is not a threat and whether or not a pain state will increase odds of survival is a very difficult question. TED talk (I know, I know) from a pain researcher who tells a story of how he almost died after his brain got it wrong.
posted by MillMan at 6:15 PM on November 25, 2016 [5 favorites]

As pain is not a property of tissue, determining what is or is not a threat and whether or not a pain state will increase odds of survival is a very difficult question. TED talk (I know, I know) from a pain researcher who tells a story of how he almost died after his brain got it wrong.

I know it happens. I just wonder how often it would be suggested as the cause of various kinds of pain if there were a real effort to reduce the kind and incidence of some of those errors I mentioned.
posted by cotton dress sock at 6:18 PM on November 25, 2016 [1 favorite]

Anyhoo, back to orgasm science, I think I'm with My Dad, it's a bit circular - if an orgasm is defined as contractions, the answer to the question is presupposed.
posted by cotton dress sock at 6:36 PM on November 25, 2016 [2 favorites]

MetaFilter: men and women, different only in the squishy parts
posted by Johnny Wallflower at 7:51 PM on November 25, 2016 [5 favorites]

First, I agree that the Guardian article is a hot wet mess.

But second, within that limitation, I thought it was interesting that it appears that she is saying people's self-reporting is wrong, rather than that the current definition of what is an orgasm might be too limited:

When Prause began studying women in this way she noticed something surprising. “Many of the women who reported having an orgasm were not having any of the physical signs – the contractions – of an orgasm.”

In reality I am sure her research is more nuanced and more interesting; all I have to go on is what is in the article.

The blue phallus penis-preference study linked earlier is interesting -- it's funny that people have tried repeatedly to measure penis-size preferences without giving the subjects realistic sized models to choose between.
posted by Dip Flash at 7:53 PM on November 25, 2016 [5 favorites]

it's funny that people have tried repeatedly to measure penis-size preferences without giving the subjects realistic sized models to choose between.

I once spent a delightful evening browsing the red light district of Amsterdam with my friend Sara. In one adult toy shop, she hoisted a dildo and eyed it skeptically: "This is perfectly reasonable size for a penis, but if I'm paying €59 for this, I would expect something with a little more... presence."
posted by ricochet biscuit at 9:12 PM on November 25, 2016 [7 favorites]

I do recommend everyone read Come As You Are by Emily Nagoski. Very accessible information on the past and current scientific understanding of women's sexual pleasure and entertaining to boot!
posted by E. Whitehall at 9:36 PM on November 25, 2016 [8 favorites]

If it helps, you could think of it as a sort of orgasmic corollary to the Heisenberg Uncertainty Principle...

schroedinger's butt plug
posted by poffin boffin at 9:52 PM on November 25, 2016 [9 favorites]

Metafilter: wouldn't a vaginal probe make more sense?
posted by Segundus at 12:08 AM on November 26, 2016 [4 favorites]

I thought it was interesting that it appears that she is saying people's self-reporting is wrong, rather than that the current definition of what is an orgasm might be too limited:

I guess it's probably appropriate to be pretty restrictive about what orgasm means, at least as long as we're simultaneously very sceptical of it as the ne plus ultra of sexual pleasure? It seems like a restrictive definition of "appropriate pleasure" is maybe the main problem.
posted by howfar at 12:33 AM on November 26, 2016 [2 favorites]

My take: Among people who have butt-clenching pleasure spasms, there's a pretty strong consensus that those are orgasms. For reasons, there are a significant number of people (mostly women) who really enjoy the other aspects of sex without having orgasms. Of course, due to the focus on orgasms as the culmination of sex, lots of this group will report having an orgasm. However, some will later have butt-clenching pleasure spasms and recalibrate their understanding.

How do you get better data about sex in an environment where self-reporting is suspect? First, you develop a butt plug contract-o-meter. Second, listen hard to the people you are studying. That group of women who reported having orgasms before having (pubococcygeal muscle contraction plus pleasure) episodes should be your guide. If most of them support your definition, you're on the right track.
posted by Emmy Noether at 3:58 AM on November 26, 2016 [7 favorites]

So .8 seconds per orgasmic pulse? If those were triplets, that'd give exactly the ubiquitous 120 Beat Per Minute of dance music. Syncopate the threes with an accent in four maybe? Music producers of MeFi, please get on that.
posted by StickyCarpet at 4:31 AM on November 26, 2016 [5 favorites]

There's also a social element in play, in that women's orgasms have historically been seen as less important/non-procreative/non-essential/rude and shameful/only really good as a hysteria cure/whatever - that plus the lack of a visible outcome like you get with male orgasms means we don't have great frequent articulations of what women's orgasms feel like in mass culture. And it is a little bit mystical and arcane (not to mention rude mumble hangups about women's sexual pleasure) so we default to "it just feels really good" and "you'll know if when you have one", which aren't super helpful if you're someone like me who really needs a concrete idea of what they're aiming for before they can really do anything.

My earliest orgasms were like the base camp at the bottom of orgasm mountain; something was beginning to happen and it felt different but also intense and kind of scary, and for a long time (a few years at least) I hung out sexually at orgasm base camp just getting an idea of what was going on. And then a bunch of stuff (including better partners, a better understanding of my own arousal and desire, buying a Hitachi magic wand) started shifting and the orgasms started getting more and more intense and I stopped being so afraid of them and started learning to ride them.

And now I'm at the point where it basically feels like a third option for the kind of experience you can get from years of transcendental meditation or one massive dose of psychedelics - real explosive shooting through the stars meshing with the universe stuff happening mentally, sometimes even painful but such pleasure in the pain that it doesn't matter at all. I think my (male) partner gets slightly jealous sometimes - it seems to him like a totally different plane of experience to the peak of even his utmost best orgasm.

And I find myself wondering if this really is just the "women's sexuality gets better through their twenties towards their thirties" effect, or if that effect is actually just how long it takes many women to get to grips with their own sexual response in a society where women's role in sex is often geared towards pleasuring a male partner, putting their own pleasure second, understanding their desire in the context of the heteronormative stuff they're told they're meant to desire and it just takes ten years or more to unpack that and start getting to grips with something that was biologically feasible all along.

I don't know. But I'm enjoying finding out.
posted by terretu at 4:45 AM on November 26, 2016 [28 favorites]

This discussion got me curious how scientists measure orgasm. Which led me to this review article about measuring women's sexual response. Specifically mentions measuring blood flow and temperature variations as a way to measure female orgasm. For men, there's a Very Scientific Butt Plug that measures contractions of the anus.
posted by Nelson at 6:34 AM on November 26, 2016 [1 favorite]

terretu: There's also a social element in play, in that women's orgasms have historically been seen as less important/non-procreative/non-essential/rude and shameful/only really good as a hysteria cure/whatever

Not actually true: that's the 19th-20th century picture, but prior to the 19th century, received medical wisdom held that the female orgasm was an essential prerequisite for conception.

(This belief had some unpleasant side-effects, and still lingers in some areas -- c.f. the belief by some right-wing politicians that rape can't result in pregnancy.)
posted by cstross at 7:08 AM on November 26, 2016 [7 favorites]

Wouldn't MRIs be able to show the mechanical aspects or is that not the mystery here? And of course the hee-hee and thou-shalt-hate-thy-urges schools don't help.
posted by lon_star at 7:48 AM on November 26, 2016

Well as of 2011 finally have a fMRI of the brain during orgasm. tl;dr it looks a lot like an epileptic seizure.

And in 2009 it was discovered that the engorged clitoris is a lot bigger than we ever thought, although we've known the penis has an extensive internal root for hmmmm years so maybe it should have occurred to someone to image that a little earlier.
posted by Bringer Tom at 8:06 AM on November 26, 2016 [5 favorites]

Dip Flash: "The blue phallus penis-preference study linked earlier is interesting -- it's funny that people have tried repeatedly to measure penis-size preferences without giving the subjects realistic sized models to choose between."

I was disappointed that the study didn't actually have anyone giving the models a test drive. It seems to assume experience with a wide range of encountered sizes previously. Considering the study average was 6 partners (lifetime) (15 of 75 subjects had never had intercourse) and statistically most of those partners would have been within a standard deviation of the average this seems to be a serious limitation. And maybe an influence on the barely above average preference result of the study.

Also it's is good they acknowledge the unrealistic cross section of their models and that it merits further study. Shape of objects has a large effect on our perception of object size. I wonder how well people can equate the circumferences of round triangles and circles.

Both shape and experience being factors are acknowledged by the researchers; I hope they manage to study this further.
posted by Mitheral at 8:13 AM on November 26, 2016 [2 favorites]

I think the problem with talking about orgasm is that it means two different things, in this context. A sudden sensation of pleasure, OR a physiological set of happenings. The experiment with the butt-plugs is definitely looking at the latter of these.

The reason that this is a problem is that we tend to speak about female orgasm as the former, and male as the latter (and we assume the former comes alongside it), but that the former is purely a sensation. All mentioned by others above.

However, sensations, whether it be pain or pleasure, are entirely the product of the brain. They are contextual! You can get the response of pleasure (or pain) from any nerve signal. Pressure, heat, cold, soft touch, even pressure in the digestive tract can all present as either positive or negative, or even neutral, depending on the situation.

So then, coming back to orgasm-as-pleasurable-sensation, it can pretty much be brought on by any other stimulus given the right context (which can be social, emotional, chemical or whatever). And here things really lead to confusion, because one possible stimulus is orgasm-as-physiological-process. And of course, the process could also end up giving the sensation of pain as well!
posted by fizban at 8:15 AM on November 26, 2016 [3 favorites]

(I spend a lot of time dealing with the pain side of this, and we really aren't broken (sorry to pick on you, cotton dress sock) but sometimes our brains can do with a bit of help re-contextualising things!)
posted by fizban at 8:17 AM on November 26, 2016

If brains sucking this much at working out the bits of reality we work within was as rampant as some would have you believe, I doubt we'd have made it this far as a species.

I want to agree, but then I remember how many people have allergies, which is basically your body being very wrong about it being under attack, and I go back to thinking it's a miracle our species has survived as long as it has.

(I know very little about allergies or brains, so apologies for the over-simplification.)
posted by greermahoney at 8:55 AM on November 26, 2016 [3 favorites]

Of course pain (like all experience) is neurally mediated, and can be shaped by interpretation and framing, I don't think I said otherwise?

My issue is with the authority so often lended to e.g. a single scan to determine pain's relationship to physical damage, in the context of real-world medical care.

It is at least possible that the cause of "excruciating" back pain might have been missed, for instance. And I don't think the case of someone walking around with physically (locally) causeless, "excruciating" pain can be said to be typical.

And truly, if the reliability of our signalling system is as bad (and ubiquitously bad) as a lot of "it's all & only neurally caused" people say, that seems like an important and unlikely species-level vulnerability. (Although of course you can't really use evo arguments in that way, I'm just talking on the level of face value)
posted by cotton dress sock at 9:24 AM on November 26, 2016 [1 favorite]

Yeah I do think all too often "there is nothing wrong in an area of pain because these scans show nothing" is a failure of science to understand the issue rather than the brains.

Always assuming the problem is in the brain is a thing docs who don't know what's wrong have been doing to ill people they don't understand for centuries to the harm of many. It's scary and hard to face how fallible and incomplete doctors knowledge can really be and far easier to blame patients (or their supposed misfiring confused brains).
posted by xarnop at 9:31 AM on November 26, 2016 [3 favorites]

Exactly, and I think it ends up taking things in a weirdly idealist or at least Cartesian direction again.
posted by cotton dress sock at 9:37 AM on November 26, 2016

I feel that there's a danger in dismissing the subjective from the physiological. It's the sort of analysis that leads Michael Fucking Bailey to conclude that bi men(*) don't really exist because we don't get equally erect looking at porn, then walk that back to say that bi men might be gay men who don't fear the vulva. On the other side, there's the physiological work that says most women are bisexual on some more honest plane of physiology.

Then there's the old anti-kink/anti-sodomy arguments that those forms of sexuality cannot be intrinsically satisfying as "nature intended," we're really just processing a form of trauma as pleasurable. Using the word "orgasm" to talk about, for example, the extreme bliss from anal sex whether or not it involves contractions with a period of 0.8 seconds at the end is, in part, due to the poverty of English in describing those experience. It is also, in part, a choice to claim marginalized sex acts as pleasurable and normal.

(*) using Bailey's definition
posted by CBrachyrhynchos at 9:48 AM on November 26, 2016 [4 favorites]

I once tried to achieve an orgasm during an acid trip, out of experimental curiosity. Well, it was a quiet Saturday.

I obviously can't guarantee that what I experienced was an accurate reflection of physiological events, but my god it was weird and deeply uncomfortable. The timing of events was completely out, things fired out of sequence and seemingly independent of each other - ejaculation didn't properly occur, with the peristalsis very uneven and not synchronised with sensation.

I would think twice before signing up for a repeat ride.
posted by Devonian at 10:01 AM on November 26, 2016 [2 favorites]

Oddly, I didn't question the butt-plug-o-meter at all. Seems legit to me because everybody has a butt. If you're measuring butt spasms, everyone has a butt AND the butt is located adjacent to the actual parts being studied for both male and female genitalia. It'd make for results that you can compare to each other. Butts clench fairly reliably on men and at least somewhat reliably on women during orgasm. As long as they use the research for good and not, for example, to tell women that they're orgasming all wrong and need to add .8 second intervals of butt clenching to their faking-an-orgasm routine, I'm fine with butt-plug-o-meters.

Also, but on a related note, I feel pretty damn strongly that the bits involved in orgasm for women are not limited to the clitoris and adjacent erectile tissue. I'm basing my opinion on the fact that I've had a hysterectomy in which the uterus and cervix were removed. This operation didn't touch the external bits, though.

Prior to hysterectomy, orgasm was the whole wham-bam, .8 second clenchy thing as described in the article. And seriously, it was body-shuddering good, boneless relaxation afterwards, body breaks out in cold sweat, etc. Post-hysterectomy orgasm was immediately... less. I still do the clenchy thing, but it's significantly less, like way less, and I assume that this is because half of the stuff that used to do the clenchy thing is, well, missing. My ob/gyn did not mention this as a possible side effect of hysterectomy and I feel like that was a serious oversight on his part. Did he think I wouldn't notice? That I wouldn't care? I mean, I'm happy enough to not be bleeding to my knees for two weeks out of every four, but I still would have like to have been briefed on the full range of things-to-expect-post-op.
posted by which_chick at 10:21 AM on November 26, 2016 [16 favorites]

And truly, if the reliability of our signalling system is as bad (and ubiquitously bad) as a lot of "it's all & only neurally caused" people say, that seems like an important and unlikely species-level vulnerability.

It's interesting that you used the term Cartesian in your next comment because I think that is part of the problem you are running into here. I get the feeling you assume peripheral nerve input (nociception in this case) maps to pain or injury. There is in fact no correlation. I wish I could find the link to the paper but I read a good one a while back talking about how noisy nociception is - if it were all mapped directly to pain we would be in constant agony (and some pain dysfunctions relate to that, actually). This is part (but only part) of why pain is such a difficult problem. Even if nociception mapped really well to crushing pressure, burns, and punctures, the brain would still have to use many other contextual clues to make an adaptive choice because we're constantly facing survival problems that require more attention than a hangnail. Many body injuries don't require pain - spinal degeneration is a part of aging, as an example, and many people have disc issues before they're even adults. The brain can make this choice - if we can move through the years just fine with this herniated disc, why create a pain state? Studying this has forced me to rethink what being healthy means. Does it mean having the body of an 18 year old? To me the answer is relative - can my body do what I want it to on a daily basis?

Like any evolved mechanism it doesn't make sense to talk about it being maladaptive because it's imperfect - it's as nonsensical as asking why our vision isn't a perfect representation of our environment, or at least one that never fails us in a survival sense. From a competition perspective we could ask if other species' pain systems are better adapted than ours. This is entirely possible but the nervous system of any species faces the same challenge as ours.

And yes, scans can and do miss physical problems.

Going back to the article - some of the later comments here are finally noting the glaringly obvious gender framing problem: start with a specific interpretation of the male experience (which I was questioning in my first comment), and work on the female experience from there.
posted by MillMan at 10:46 AM on November 26, 2016 [3 favorites]

I actually don't assume there's a perfect or direct map between tissue damage and pain, no. I'm well (all too ) aware of how nocioception can go wonky in chronic pain. However I feel that

There is in fact no correlation.

is a bit strong, especially for acute pain

how noisy nociception is - if it were all mapped directly to pain

Can you clarify this a bit? For me nocioception = pain. Do you mean if insult to tissue were mapped directly to pain?

Many body injuries don't require pain - spinal degeneration is a part of aging, as an example, and many people have disc issues before they're even adults. The brain can make this choice - if we can move through the years just fine with this herniated disc, why create a pain state?

It may well make that choice! (I think it often doesn't for many, though, including young people with disc issues)
posted by cotton dress sock at 11:00 AM on November 26, 2016

If brains sucking this much at working out the bits of reality we work within was as rampant as some would have you believe, I doubt we'd have made it this far as a species.

There are two obvious objections to this. First of all evolution does not optimize for perfection, it optimizes for "good enough to reproduce."

The second issue is that the bugs in human cognition and perception are so many and so well documented as to falsify both intelligent design and the naive view of evolution moving toward teleological perfection. We're just not that good at reality unless we use pretty advanced math to check our perceptions.
posted by CBrachyrhynchos at 11:09 AM on November 26, 2016 [2 favorites]

Let me be clearer, I don't believe in naive realism; I don't believe we perceive the world (or our bodies) directly or perfectly. I also acknowledge the weaknesses of the evo argument, just looking at it for a sense of perspective - I do think it would be extremely maladaptive to have people walking around (hunting or whatever) on e.g. broken femurs; people and animals in pain respond to that set of signals by retreating and resting (and things heal as well as they can in that time). I also think it'd be unhelpful for early people to have found themselves functionally incapacitated by minor, less harmful injuries. I am saying it would make the most sense for there to be some middle ground between damage (& intensity of damage) and pain perception, and for misperception as extreme as totally functionally incapacitating damageless pain to be possible but less common than many are currently suggesting.

And with that I will let orgasm convos resume (or will at least bow out of the derail)
posted by cotton dress sock at 11:21 AM on November 26, 2016

The PBS video glosses over what exactly "this sometimes gets her into a lot of trouble" actually means. So I went Googling for more information, and found this 2015 interivew at lehmiller.com:

Prause: I think there are many reasons why my research in this area [sex addiction] has generated resistance. The most obvious are financial incentives, where some of the resistance comes from therapists who provide services to "sex addict" patients, and bloggers who are selling books or trying to establish their therapy practices. Another is religious fanaticism, where several Latter Day Saint organizations have specifically targeted my research. Another major group is the (overwhelmingly) very young men who have been misled that our research claims they do not have a problem. Of course, we have never made that claim (in fact, our last study suggests the opposite), but they do not have the science background to be able to investigate the claims themselves.

posted by davidwitteveen at 12:46 PM on November 26, 2016 [3 favorites]

Regarding uterine involvement in orgasm, Pubmed has some good information.

Female sexuality: a land of contrasts.
posted by Emmy Noether at 1:05 PM on November 26, 2016 [1 favorite]

And now I'm at the point where it basically feels like a third option for the kind of experience you can get from years of transcendental meditation or one massive dose of psychedelics - real explosive shooting through the stars meshing with the universe stuff happening mentally, sometimes even painful but such pleasure in the pain that it doesn't matter at all. I think my (male) partner gets slightly jealous sometimes - it seems to him like a totally different plane of experience to the peak of even his utmost best orgasm.

Yes, this is a really interesting difference. It's seems like the female experience is something completely different, and on another level. I wouldn't say that I'm jealous, exactly, but, rather I am in awe.
posted by My Dad at 1:38 PM on November 26, 2016

There certainly seems to be a much wider range of female orgasmic experience than with men, at least as far as my observations go. With my more obviously and repeatedly orgasmic partners, the description of what the sensation is actually like is far more vivid and complex than those who tend towards the male one-shot model. Then there have been those who just get to an (often prolonged) state of very high arousal, but claim to rarely if ever actually climax - though I'd be hard put to observe much difference. The descriptions of what it's like, though, can be wonderfully psychedelic and mind-altering - and yes, I am very envious. It seems something of a compensation for the downsides of female reproductive physiology.

Still, being with someone you love as their brains get blown through cosmic pleasure is in itself pretty life-affirming. The hows may be murky, but I have no problem with the why.
posted by Devonian at 5:23 PM on November 26, 2016 [1 favorite]

The size-preferences research is fascinating, mostly because it seems so easy to do, and yet (it seems) nobody bothered to do it before. It doesn't take a lot of imagination to wonder what else is out there in the accepted body of knowledge that's based solely or largely on self-reported answers to abstract questions, which are basically a few hours time on a 3D printer away from uncovering different results.
posted by Kadin2048 at 8:58 PM on November 26, 2016 [1 favorite]

Anyhoo, back to orgasm science, I think I'm with My Dad,

Out of all of the contexts and places that this phrase could have shown up, I am really glad that it was here, in this one.
posted by Dormant Gorilla at 10:16 PM on November 26, 2016 [11 favorites]

And of course that bothersome refractory period we men have because of hydraulic limitations.

Hydraulic limitations? Maybe I'm not getting what you mean but as far as know the male refractory period seems to be related to changes in hormone levels - particularly elevated prolactin and oxytocin. There may be other factors but there are reports that drugs that block prolactin may significantly decrease or eliminate said refractory period. And it doesn't seem uncommon for women to encounter a similar sorts of unpleasant hypersensitivity at some point - it's just maybe less universal or not the same pattern.
posted by atoxyl at 12:04 AM on November 27, 2016 [2 favorites]

Hydraulic limitations?

The refractory period is usually described as a period of about 20 minutes during which erection is inhibited. While there is also a period of uncomfortable hypersensitivity after orgasm in my experience that is much briefer. And the de-erectile refractory period isn't absolute; PDE5 inhibitors blow through it, as does the Coolidge Effect.

I have always assumed that if there is a reason for the refractory period (other than "well that's how it works for no particular reason," which is quite possible) it would probably be that sex is more effective for procreation if some time is taken for prostate fluid volume to rebuild. Granted this is just an assumption on my part, because this is yet another area where our ignorance is impressive in its depth and vastness.
posted by Bringer Tom at 6:55 AM on November 27, 2016

I'd never heard of the Coolidge Effect before and the origin story of the name on Wikipedia is just too terrific not to share

… an old joke about Calvin Coolidge when he was President … The President and Mrs. Coolidge were being shown [separately] around an experimental government farm. When [Mrs. Coolidge] came to the chicken yard she noticed that a rooster was mating very frequently. She asked the attendant how often that happened and was told, "Dozens of times each day." Mrs. Coolidge said, "Tell that to the President when he comes by." Upon being told, the President asked, "Same hen every time?" The reply was, "Oh, no, Mr. President, a different hen every time." President: "Tell that to Mrs. Coolidge."

posted by Nelson at 7:15 AM on November 27, 2016 [1 favorite]

The descriptions of what it's like, though, can be wonderfully psychedelic and mind-altering

One of those basically unknowable things, but I've sometimes wondered how much of that is differences in the actual experience versus differences in how men and women tend to describe internal states in general.
posted by ROU_Xenophobe at 7:54 AM on November 27, 2016 [1 favorite]

I had read somewhere once that you can have an erection, ejaculation or orgasm independent of the other two.
posted by 922257033c4a0f3cecdbd819a46d626999d1af4a at 5:34 PM on November 27, 2016 [1 favorite]