Pfaus James G
Center for Sexual Health and Interventions, Czech National Institute of Mental Health, Klecany 25067, Czech Republic.
Faculty of Humanities, Department of Psychology and Life Sciences, Charles University, Prague 18200, Czech Republic.
Sex Med Rev. 2025 Jul 3;13(3):381-393. doi: 10.1093/sxmrev/qeaf023.
Sexual activity produces pleasure related to sexual arousal, desire, and genitosensory and erogenous stimulation. Orgasms produce a whole brain and body rush of ecstatic pleasure followed by relaxation and refractoriness. This pleasure results from the activation of neurochemical reward pathways in the brain. This is differentiated by spinal pathways that control climax, the particular motor movements of the pelvic floor and the experience of tension release.
To relate the activation of key neurochemical reward and bonding systems, notably dopamine, oxytocin, and opioids, to the pleasure of sexual activity in general and orgasms in particular.
A narrative review of the neurochemical and neuroanatomical mechanisms activated during sexual stimulation and orgasm in rats and humans, and how they are related overall to the generation of sexual pleasure and reward.
Appetitive sexual pleasure involves the activation of dopamine and oxytocin release in hypothalamic and mesolimbic regions that regulate sexual arousal and desire, and are reinforced by localized opioid activity. Orgasms are thought to result in part from a massive release of opioids into these regions that inhibits dopamine and oxytocin transmission, but that initiates molecular changes to sensitize both systems and induce sexually conditioned place and partner preferences. Serotonin is also activated at orgasm and contributes to feelings of satiety and refractoriness. Orgasm disorders are distressing, cause resentment and conflict in a relationship, and diminish overall sexual health and well-being.
Orgasms are an important component of sexual pleasure for humans and perhaps all vertebrates. Endogenous opioids like β-endorphin that bind to mu opioid receptors are likely responsible for sexual pleasure and reward.
性活动会产生与性唤起、欲望以及生殖感觉和性感刺激相关的愉悦感。性高潮会引发全脑和全身的狂喜愉悦感，随后是放松和不应期。这种愉悦感源于大脑中神经化学奖赏通路的激活。这与控制高潮的脊髓通路、盆底的特定运动以及紧张释放的体验有所不同。
将关键神经化学奖赏和联结系统（尤其是多巴胺、催产素和阿片类物质）的激活与一般性活动的愉悦感，特别是性高潮的愉悦感联系起来。
对大鼠和人类在性刺激和性高潮期间激活的神经化学和神经解剖学机制进行叙述性综述，以及它们总体上如何与性愉悦和奖赏的产生相关。
性欲求性愉悦涉及下丘脑和中脑边缘区域多巴胺和催产素释放的激活，这些区域调节性唤起和欲望，并通过局部阿片类物质的活动得到增强。性高潮被认为部分是由于阿片类物质大量释放到这些区域，抑制了多巴胺和催产素的传递，但启动了分子变化，使这两个系统敏感化，并诱导性条件性位置和伴侣偏好。血清素在性高潮时也被激活，并有助于产生饱腹感和不应期的感觉。性高潮障碍令人苦恼，会在关系中引发怨恨和冲突，并损害整体性健康和幸福感。
性高潮是人类乃至所有脊椎动物性愉悦的重要组成部分。与μ阿片受体结合的内源性阿片类物质如β-内啡肽可能是性愉悦和奖赏的原因。
