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International Urogynecology Journal
Erschienen in: International Urogynecology Journal 5/2018

28.12.2017 | Review Article

Differential diagnostics of female “sexual” fluids: a narrative review

verfasst von: Zlatko Pastor, Roman Chmel

Erschienen in: International Urogynecology Journal | Ausgabe 5/2018

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Abstract

Introduction and hypothesis

Women expel various kinds of fluids during sexual activities. These are manifestations of sexual arousal and orgasm or coital incontinence. This study is aimed at suggesting a diagnostic scheme to differentiate among these phenomena.

Methods

Web of Science and Ovid (MEDLINE) databases were systematically searched from 1950 to 2017 for articles on various fluid expulsion phenomena in women during sexual activities, which contain relevant information on sources and composition of the expelled fluids.

Results

An ultra-filtrate of blood plasma of variable quantity, which is composed of transvaginal transudate at sexual stimulation, enables vaginal lubrication. Female ejaculation (FE) is the secretion of a few milliliters of thick, milky fluid by the female prostate (Skene’s glands) during orgasm, which contains prostate-specific antigen. Squirting (SQ) is defined as the orgasmic transurethral expulsion of tenths of milliliters of a form of urine containing various concentrations of urea, creatinine, and uric acid. FE and SQ are two phenomena with different mechanisms. Coital incontinence (CI) could be classified into penetration and orgasm forms, which could be associated with stress urinary incontinence or detrusor hyperactivity.

Conclusion

Squirting, FE, and CI are different phenomena with various mechanisms and could be differentiated according to source, quantity, expulsion mechanism, and subjective feelings during sexual activities.
Literatur
1.
Kratochvíl S. Orgasmic expulsions in women. Cesk Psychiatr. 1994;90:71–7.PubMed
2.
Perry JD, Whipple B. Pelvic muscle strength of female ejaculators: evidence in support of a new theory of orgasm. J Sex Res. 1981;17:22–39.CrossRef
3.
Zaviačič M. The human female prostate. Bratislava: Slovak Academic Press; 1999.
4.
Darling CA, Davidson JK, Conwaywelch C. Female ejaculation: perceived origins, the Grafenberg spot area, and sexual responsiveness. Arch Sex Behav. 1990;19:29–47.CrossRefPubMed
5.
Bullough B, David M, Whipple B, Dixon J, Allgeier ER, Drury KC. Subjective reports of female orgasmic expulsion of fluid. Nurse Pract. 1984;9:55–9.CrossRefPubMed
6.
Goldberg DC, Whipple B, Fishkin RE, Waxman H, Fink PJ, Weisberg M. The Grafenberg spot and female ejaculation: a review of initial hypotheses. J Sex Marital Ther. 1983;9:27–37.CrossRefPubMed
7.
8.
Zaviačič M, Zaviačičová A, Holomán IK, Molčan J. Female urethral expulsions evoked by local digital stimulation of the G-spot: differences in the response pattern. J Sex Res. 1988;24:311–8.CrossRefPubMed
9.
Wimpissinger F, Springer C, Stackl W. International online survey: female ejaculation has a positive impact on women’s and their partners’ sexual lives. BJU Int. 2013;112:177–85.CrossRef
10.
Rubio-Casillas A, Jannini EA. New insights from one case of female ejaculation. J Sex Med. 2011;8:3500–4.CrossRefPubMed
11.
Korda JB, Goldstein SW, Sommer F. The history of female ejaculation. J Sex Med. 2010;7:1965–75.CrossRefPubMed
12.
Sevely JL, Bennett JW. Concerning female ejaculation and the female prostate. J Sex Res. 1978;14:1–20.CrossRef
13.
Addiego F, Belzer EG, Commoli J, Moger W, Perry JD, Whipple B. Female ejaculation. A case study. J Sex Res. 1981;17:13–21.CrossRef
14.
Salama S, Boitrelle F, Gauquelin A, Malagrida L, Thiounn N, Desvaux P. Nature and origin of “squirting” in female sexuality. J Sex Med. 2015;12:661–6.CrossRefPubMed
15.
Pastor Z. Female ejaculation orgasm vs. coital incontinence: a systematic review. J Sex Med. 2013;10:1682–91.CrossRefPubMed
16.
Grafenberg E. The role of the urethra in female orgasm. Int J Sex. 1950;3:145–8.
17.
Heath D. Female ejaculation: its relationship to disturbances of erotic function. Med Hypotheses. 1987;24:103–6.CrossRefPubMed
18.
Heath D. An investigation into the origins of a copious vaginal discharge during intercourse: “enough to wet the bed”—that “is not urine”. J Sex Res. 1984;20:194–215.CrossRef
19.
Wimpissinger F, Stifter K, Grin W, Stackl W. The female prostate revisited: perineal ultrasound and biochemical studies of female ejaculate. J Sex Med. 2007;4:1388–93.CrossRefPubMed
20.
Belzer EG. Orgasmic expulsions of women: a review and heuristic inquiry. J Sex Res. 1981;17:1–12.CrossRef
21.
Zaviačič M, Doležalová S, Holomán IK, Zaviačičová A, Mikulecký M. Concentrations of fructose in female ejaculate and urine: a comparative biochemical study. J Sex Res. 1988;24:319–25.CrossRefPubMed
22.
Kinsey AC, Pomeroy WB, Martin CE. Sexual behaviour in the human female. Oxford: Saunders; 1953.
23.
Belzer EG Jr. A review of female ejaculation and the Grafenberg spot. Women Health. 1984;9:5–16.CrossRefPubMed
24.
Levin RJ, Wagner G. Human vaginal fluid-ionic composition and modification by sexual arousal. J Physiol. 1977;266:62P–3P.PubMed
25.
Levin RJ, Both S, Georgiadis J, Kukkonen T, Park K, Yang CC. The physiology of female sexual function and the pathophysiology of female sexual dysfunction (committee 13A). J Sex Med. 2016;13:733–59.CrossRefPubMed
26.
Preti G, Huggins GR, Silverberg GD. Alterations in the organic compounds of vaginal secretions caused by sexual arousal. Fertil Steril. 1979;32:47–54.CrossRefPubMed
27.
Moller BR, Kaspersen P. The acidity of the vagina. In: Horowitz BJ, Mardh PA, editors. Vaginitis and vaginosis. New York: Wiley-Liss; 1991. p. 63–7.
28.
Wagner G, Levin RJ. Vaginal fluid. In: Hafez ESE, Evans TN, editors. The human vagina. Amsterdam: North Holland Publishing Co; 1978. p. 121–38.
29.
Wagner G, Levin RJ. Electrolytes in vaginal fluid during the menstrual cycle of coitally active and inactive women. J Reprod Fertil. 1980;60:17–27.CrossRefPubMed
30.
Godley MJ. Quantitation of vaginal discharge in healthy volunteers. BJOG. 1985;92:739–42.CrossRef
31.
Dawson SJ, Sawatsky ML, Lalumiere ML. Assessment of introital lubrication. Arch Sex Behav. 2015;44:1527–35.CrossRefPubMed
32.
33.
Zaviačič M, Zajičková M, Blažeková J, et al. Weight, size, macroanatomy, and histology of the normal prostate in the adult human female: a minireview. J Histotechnol. 2000;23:61–9.CrossRef
34.
Cartwright R, Elvy S, Cardozo L. Do women with female ejaculation have detrusor overactivity? J Sex Med. 2007;4:1655–8.CrossRefPubMed
35.
Levin RJ, Wylie K. Vaginal vasomotion: its appearance, measurement, and usefulness in assessing the mechanisms of vasodilatation. J Sex Med. 2008;5:377–86.CrossRefPubMed
36.
Levin RJ. Actions of spermicidal and virucidal agents on electrogenic ion transfer across human vaginal epithelium in vitro. Pharmacol Toxicol. 1997;81:219–25.CrossRefPubMed
37.
Belzer EG Jr, Whipple B, Moger W. On female ejaculation. J Sex Res. 1984;20(4):403–6.CrossRef
38.
Skene AJC. The anatomy and pathology of two important glands of the female urethra. Am J Obstet Dis Women Child. 1880;13:265–70.
39.
Huffman JW. The detailed anatomy of paraurethral ducts in the adult human female. Am J Obstet Gynecol. 1948;55:86–101.CrossRefPubMed
40.
Dwyer PL. Skene’s gland revisited: function, dysfunction and the G spot. Int Urogynecol J. 2012;23:135–7.CrossRefPubMed
41.
Dietrich W, Susani M, Stifter L, Haitel A. The human female prostate-immunohistochemical study with prostate-specific antigen, prostate-specific alkaline phosphatase, and androgen receptor and 3-D remodeling. J Sex Med. 2011;8:2816–21.CrossRefPubMed
42.
Wimpissinger F, Tscherney R, Stackl W. Magnetic resonance imaging of female prostate pathology. J Sex Med. 2009;6:1704–11.CrossRefPubMed
43.
44.
Owen DH, Katz DF. A review of the physical and chemical properties of human semen and the formulation of a semen simulant. J Androl. 2005;26:459–69.CrossRefPubMed
45.
Cooper TG, Noonan E, von Eckardstein, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010;16:231–45.CrossRefPubMed
46.
Coffey D. What is the prostate and what is its function? In: Robaire B, Pryor JL, Trasler JM, editors. Handbook of andrology. Lawrence: Allen Press Inc.; 1995.
47.
Biancardi MF, dos Santos FCA, de Carvalho HF, Sanches BDA, Taboga SR. Female prostate: historical, developmental, and morphological perspectives. Cell Biol Int. 2017;41:1174–83.CrossRefPubMed
48.
Lilja H. A kallikrein-like serine protease in prostatic fluid cleaves the predominant seminal vesicle protein. J Clin Invest. 1985;76:1899–903.CrossRefPubMedPubMedCentral
49.
Moalem S, Reidenberg JS. Does female ejaculation serve an antimicrobial purpose? Med Hypotheses. 2009;73:1069–71.CrossRefPubMed
50.
Haylen B, De Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol. 2010;21:5–26.CrossRef
51.
Serati M, Salvatore S, Uccella S, et al. Urinary incontinence at orgasm: relation to detrusor overactivity and treatment efficacy. Eur Urol. 2008;54:911–7.CrossRefPubMed
52.
Serati M, Salvatore S, Uccella S, Nappi RE, Bolis P. Female urinary incontinence during intercourse: a review on an understudied problem for women’s sexuality. J Sex Med. 2009;6:40–8.CrossRefPubMed
53.
Lau H-H, Huang W-C, Su T-H. Urinary leakage during sexual intercourse among women with incontinence: incidence and risk factors. PLoS One. 2017;12:e0177075.CrossRefPubMedPubMedCentral
54.
Jha S, Strelley K, Radley S. Incontinence during intercourse: myths unravelled. Int Urogynecol J. 2012;23:633–7.CrossRefPubMed
55.
El-Azab AS, Yousef HA, Seifeldein GS. Coital incontinence: relation to detrusor over-activity and stress incontinence. Neurourol Urodyn. 2011;30:520–4.CrossRefPubMed
56.
Hilton P. Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom. Br J Obstet Gynaecol. 1988;95:377–81.CrossRefPubMed
57.
58.
Vierhout ME, Gianotten WL. Mechanisms of urine loss during sexual activity. Eur J Obstet Gynecol Reprod Biol. 1993;52:45–7.CrossRefPubMed
59.
Moran PA, Dwyer PL, Ziccone SP. Urinary leakage during coitus in women. J Obstet Gynecol. 1999;19:286–8.CrossRef
60.
Nilsson M, Lalos O, Lindkvist H, Lalos A. How do urinary incontinence and urgency affect women’s sexual life? Acta Obstet Gynecol Scand. 2011;90:621–8.CrossRefPubMed
61.
Madhu C, Hashim H, Enki D, Yaasin M, Drake M. Coital incontinence: what can we learn from urodynamic assessment? Urology. 2015;85:1034–8.CrossRefPubMed
62.
Gilliland AL. Women’s experiences of female ejaculation. Sex Cult. 2009;13(3):121–34.CrossRef
63.
Leiblum SR, Hayes RD, Wanser RA, Nelson JS. Vaginal dryness: a comparison of prevalence and interventions in 11 countries. J Sex Med. 2009;6:2425–33.CrossRefPubMed
Metadaten
Titel
Differential diagnostics of female “sexual” fluids: a narrative review
verfasst von
Zlatko Pastor
Roman Chmel
Publikationsdatum
28.12.2017
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 5/2018
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3527-9

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