Brain processing of visual stimuli representing sexual penetration versus core and animal-reminder disgust in women with lifelong vaginismus

• Published in: PloS one 2014-01, Vol.9 (1), p.e84882-e84882
• Main Authors: Borg, Charmaine, Georgiadis, Janniko R, Renken, Remco J, Spoelstra, Symen K, Weijmar Schultz, Willibrord, de Jong, Peter J
• Format: Article
• Language: English
• Subjects: Adult; Animals; Arousal; Biology; Brain; Brain - diagnostic imaging; Brain - physiopathology; Brain Mapping; Coitus - physiology; Coitus - psychology; Contaminants; Dyspareunia - physiopathology; Dyspareunia - psychology; Emotions; Emotions - physiology; Fear & phobias; Female; Food contamination; Functional magnetic resonance imaging; Humans; Imagination - physiology; Information processing; Magnetic induction; Magnetic resonance; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medicine; Muscle contraction; Muscles; Neuroimaging; Neurosciences; Pain; Pathogens; Penetration; Photic Stimulation - methods; Pictures; Psychopathology; Psychosexual disorders; Radiography; Reminder; Sexual behavior; Sexual intercourse; Smooth muscle; Social and Behavioral Sciences; Time Factors; Vagina; Vaginismus - physiopathology; Vaginismus - psychology; Visual stimuli; Women; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0084882

It has been proposed that disgust evolved to protect humans from contamination. Through eliciting the overwhelming urge to withdraw from the disgusting stimuli, it would facilitate avoidance of contact with pathogens. The physical proximity implied in sexual intercourse provides ample opportunity for contamination and may thus set the stage for eliciting pathogen disgust. Building on this, it has been argued that the involuntary muscle contraction characteristic of vaginismus (i.e., inability to have vaginal penetration) may be elicited by the prospect of penetration by potential contaminants. To further investigate this disgust-based interpretation of vaginismus (in DSM-5 classified as a Genito-Pelvic Pain/Penetration Disorder, GPPPD) we used functional magnetic resonance imaging (fMRI) to examine if women with vaginismus (n = 21) show relatively strong convergence in their brain responses towards sexual penetration- and disgust-related pictures compared to sexually asymptomatic women (n = 21) and women suffering from vulvar pain (dyspareunia/also classified as GPPPD in the DSM-5, n = 21). At the subjective level, both clinical groups rated penetration stimuli as more disgusting than asymptomatic women. However, the brain responses to penetration stimuli did not differ between groups. In addition, there was considerable conjoint brain activity in response to penetration and disgust pictures, which yield for both animal-reminder (e.g., mutilation) and core (e.g., rotten food) disgust domains. However, this overlap in brain activation was similar for all groups. A possible explanation for the lack of vaginismus-specific brain responses lies in the alleged female ambiguity (procreation/pleasure vs. contamination/disgust) toward penetration: generally in women a (default) disgust response tendency may prevail in the absence of sexual readiness. Accordingly, a critical next step would be to examine the processing of penetration stimuli following the induction of sexual arousal.