LOS ANGELES -- Like so many explorers before him, Dr. Adam Ostrzenski has long dreamed of finding a piece of elusive territory with a reputation for near-mythic powers.
Ostrzenski's quarry is the G spot, the long-conjectured trigger for enhancing female orgasm. And in an article published Wednesday by the Journal of Sexual Medicine, the semi-retired Florida gynecologist declared that he had found it.
To do so, Ostrzenski conducted a postmortem examination of an 83-year-old woman in Warsaw Medical University's Department of Forensic Medicine. Unlike the United States, which strictly regulates the research use of cadavers, Poland allows the dissection of human remains soon after death, when fine distinctions in tissue remain easy to see.
Inspecting the six distinct layers of tissue that make up a woman's vaginal wall, Ostrzenski said, he uncovered small, grape-like clusters of erectile tissue housed in a sac less than 1 centimeter across -- "a deep, deep structure" nestled between the vaginal wall's fifth layer, the endopelvic fascia, and its sixth, the dorsal perineal membrane. The dissection took seven hours for the Poland-trained physician and anatomist, who said the first principles of medicine -- "first you have to establish the anatomy" -- prompted him to undertake the study. If confirmed by further investigation, he said, he hopes his finding will help rewrite female anatomy books.
But his study quickly touched off a scientific and political tempest among the small camp of experts in female sexual health.
In some corners, Ostrzenski's study is cause for celebration. To have isolated a unique structure capable of boosting women's orgasmic powers should lay to rest the doubts of those who question its existence, said sexual medicine specialist Dr. Andrew Goldstein, director of the Centers for Vulvovaginal Disorders in Annapolis, Md.
Others, however, are crying foul. Ostrzenski's report not only fails to support his grand claim of a "new discovery" but falls prey to the all-too-common urge to simplify women's sexuality, said Beverly Whipple, the Rutgers University sexologist who popularized the name "G spot" as coauthor of a 1982 book on the subject.
Laying out a bundle of poorly defined tissues and calling them the G spot likens women's powers of sexual pleasure to the "on-off switch" that better describes men's sexuality, Whipple said. In suggesting he has found and characterized the exact structure that boosts the intensity of orgasm in women, Ostrzenski ignores research that suggests there is no single magical "spot" that does all that, she added. "No, there is not an 'it'!" she said. "It is not one entity."
Whipple and two of her colleagues have already drafted a critique of the study, which she hopes to publish in a future issue of the Journal of Sexual Medicine. In the critique, the three fault Ostrzenski for failing to show that the "G spot" he discovered has nerve endings; that it is, as he claims, erectile tissue; or that it has any role to play in female sexual arousal.
Ostrzenski acknowledged that he had not detailed exactly what type of tissue makes up the G spot or how it works its magic, in part because the Polish regulations that govern dissection of fresh cadavers prevented him from taking samples for histological testing, he said. And he said he makes no claim that the G spot he has found will be in the same place, nor that it will have the same powers, for every woman.
"Absolutely, there will be variation," he said.
Dr. Irwin Goldstein, editor of the Journal of Sexual Medicine, said he's not sure what the fuss is about. Despite its name, the G spot "certainly doesn't have a flag on it, like X-marks-the-spot," he said. The fact that Ostrzenski may have found one of many potential organs of female pleasure does not diminish the discovery, he added.
Some of the backlash may come from Ostrzenski's other professional pursuits, which include performing plastic surgery on women's genitalia -- a growing practice that was condemned by the American College of Obstetricians and Gynecologists in 2007. Among the services advertised on Ostrzenski's website are "G spotplasty," typically offered as a means to enhance sexual pleasure despite a lack of evidence that it works.
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The G spot was first identified in 1950 by the German gynecologist Ernst Grafenberg and was long thought to belong to the female urological anatomy. But its powers of pleasure have been attested to as far back as the third century, when an early medical text reported the swelling of the anterior vaginal wall during sexual arousal.
Off and on since then, the precise organ of female orgasm has been hotly debated. Many, including the father of modern psychiatry, Sigmund Freud, asserted that the vaginal walls were strongly implicated. Others, noting the paucity of nerve endings on the surface of the vaginal walls and the comparative density of nerve endings in the female clitoris, countered that the organ of female pleasure was plain for all to see. The fact that women commonly report orgasms with clitoral stimulation -- and not so commonly with sexual intercourse -- appeared to bolster their case that the clitoris is the G spot.
Still, the existence of at least one distinct G spot inside the vagina has gained growing scientific credence in recent years. In 2004, a team of researchers demonstrated that electrostimulation to the front vaginal wall near the bladder caused swelling that enhanced sexual arousal. Studies of female sexual anatomy and function have shown that stimulating the area raises a woman's pain threshold -- an evident benefit for childbirth -- and prompts the release of oxytocin, a hormone associated with enhanced bonding and trust.
Other studies have suggested that there may be many G spots. Brain scans of women in various states of sexual arousal have underscored the fluid nature of female sexuality and the key role of psychological factors in women's sexual pleasure, said Dr. Michael Krychman, director of the Southern California Center for Sexual Health in Newport Beach.
Researchers have documented cases of women achieving orgasm with cervical stimulation even after spinal cord injuries that should have left them numb below the waist, and others doing so in the absence of any direct physical stimulation.
Still, Krychman said, Ostrzenski's report offers an important caveat for those who think women's sexual arousal is entirely a mental matter. While the psychological dimensions of women's sexuality dominate the field, the new study recognizes that "women have anatomy issues that contribute to their sexual problems," he said. "There are remedies -- physical remedies -- that can be brought to bear on those."
Ostrzenski said he planned to head back to Warsaw in May to conduct additional postmortem anatomical studies. This time, he said, he hopes to gain permission to remove and conduct lab studies of tissues he finds in the vaginal wall.
"I have just put my toes into the water," he said.