
Contents
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Introduction Introduction
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General principles of the organization of sexual function General principles of the organization of sexual function
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Sexual differences and similarities Sexual differences and similarities
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Hierarchy of control Hierarchy of control
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Innervation of the sexual organs Innervation of the sexual organs
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Parasympathetic Parasympathetic
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Sympathetic Sympathetic
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Somatic Somatic
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Sensory Sensory
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Penile and clitoral erectile mechanisms Penile and clitoral erectile mechanisms
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Architecture of the erectile tissue Architecture of the erectile tissue
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Dynamics of the erectile process Dynamics of the erectile process
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Biochemical mechanisms underlying erection Biochemical mechanisms underlying erection
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Vaginal lubrication Vaginal lubrication
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Anatomy of the vaginal epithelium Anatomy of the vaginal epithelium
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Vascular mechanisms Vascular mechanisms
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Sexual climax Sexual climax
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Nomenclature Nomenclature
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Phenomenology of sexual climax: females Phenomenology of sexual climax: females
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Phenomenology of sexual climax: males Phenomenology of sexual climax: males
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Spinal pathways Spinal pathways
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Reflexive clitoral and penile erections Reflexive clitoral and penile erections
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Vaginal vasodilation and lubrication Vaginal vasodilation and lubrication
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Somatic reflexes Somatic reflexes
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Spinal organization of sexual climax Spinal organization of sexual climax
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Supraspinal control of sexual functions Supraspinal control of sexual functions
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Brainstem nuclei and pathways Brainstem nuclei and pathways
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Diencephalic nuclei and pathways Diencephalic nuclei and pathways
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Forebrain mechanisms Forebrain mechanisms
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Imaging studies of sexual function in humans Imaging studies of sexual function in humans
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Conclusions Conclusions
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References References
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10 The autonomic neuroscience of sexual function
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Published:May 2013
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Introduction
In recent years, there has been tremendous progress in our understanding of the neural control of sexual function. It was little over 15 years ago that the neural messenger mediating penile erection, nitric oxide, was identified, following a search of over 100 years. This discovery helped the development and introduction of effective oral treatments for erectile dysfunction, which has been a goal from ancient times. Less than 5 years ago, the spinal neurons responsible for generating ejaculation were identified. Less spectacular, but just as important, has been an accelerating accumulation of knowledge about the pathways and neurochemistry underlying a variety of sexual responses in both sexes. Recently, functional imaging studies have extended this advancement into humans. This chapter will summarize many of these findings, but also make clear that many very important questions remain to be answered in this field.
General principles of the organization of sexual function
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