MRI can be used to find the G spot

Researchers are in pursuit of the elusive G spot, or Grafenberg's zone – again – this time with the aid of a magnetic resonance imaging (MRI) scanning machine and inert ultrasound gel. In a case series 21 women were scanned, using gel to open up the vaginal cavity, making anatomical identification clearer. The aim was to locate in vivo, the macroscopic and histological correlates of what have been recently identified in dissections of cadavers as the ‘G spot complex’ (GSC) or female erectile body. A GSC was identified in 13 of the 21 women; its visibility much enhanced with vaginal opacification, by ultrasound gel. Venus is tempted to touch on another point, namely just how much does the spot's anatomical position matter to real women's sexual feelings?

BJOG 2016;123:1542–1549. doi:10.1111/1471-0528.13864

Male testosterone levels correlate poorly with individual symptoms

Meanwhile in men, a systematic review of testosterone levels in older individuals has concluded, unsurprisingly, that there's a weak correlation between signs, symptoms of reduced libido and erectile dysfunction, and testosterone levels. There's also uncertainty about what threshold testosterone levels should be considered low for men as they age. Big pharma won't like it – they revel in pointing the finger at testosterone ‘deficiency’. Clinicians, on the other hand, will be familiar with the tendency for poor correlation between hormones and individual experience – take the example of follicle-stimulating hormone levels and menopausal symptoms in women.

Can Med Assoc J 2016. pii: cmaj.150262

Canadian research explores barriers associated with PrEP use

Pre-exposure prophylaxis (PrEP), subject of a controversial recent decision by NHS England, which has chosen not to commission it, reduces the risk of HIV transmission. It can, however, also cause harm if not used properly. Canadian pharmacists with experience in working with HIV were recruited to explore their support for PrEP and to establish what barriers exist to promoting its use. Some 69% of survey respondents said they would provide education positively supporting PrEP use and 54% believed Health Canada should approve PrEP. Familiarity with the concept of PrEP didn't appear to be significantly associated with support for PrEP. Lower costs and greater dissemination of information are needed to make it more widely promoted.

Int J STD AIDS 2016;27:608–616. doi:10.1177/0956462415589896

Vaccine has no effect on pre-existing HPV infection

Does human papillomavirus (HPV) vaccination influence the outcome of cervical lesions already present at the time of vaccination? Nearly 2000 young women who had the carcinogenic form of HPV infection – serotypes 16 and 18 – and 311 young women who underwent excisional treatment for cervical pre-cancer were randomised as part of a community-based trial to receive either the HPV vaccine or hepatitis A vaccine; three doses over 6 months. Researchers found no vaccine effect on the fate of detectable HPV infections, nor any impact on those who were infected but treated, after 4 years.

Am J Obstet Gynecol 2016;215:212.e1–212.e15. doi.org/10.1016/j.ajog.2016.02.021

Discontinuation rates are lower with IUS than subdermal implant

It can seem a shame when a woman discontinues use of long-acting reversible contraception (LARC), but we need to understand why women choose to stop. A new large, multicentre, European, randomised, open-label, Phase 3 trial comparing the levonorgestrel-releasing intrauterine system (LNG-IUS) with the etonogestrel subdermal implant (ENG) in 766 young women found a significantly lower discontinuation rate after 12 months with the LNG-IUS (19.6% compared to 26.8% with the ENG). Reasons for discontinuation were chiefly increased bleeding, but also side effects such as changes in libido and mood.

Fertil Steril 2016;106:151–157. doi: 10.1016/j.fertnstert.2016.02.036

Early experience of same-sex attraction influences identity labels

“I liked girls and thought they were pretty” is the title of a qualitative study of early memories of young lesbians and bisexual women into same-sex attraction. What appears central to initial experiences of attraction are embodied feelings, relationships with other young women, and social environments – including media images. But early experiences of same-sex attraction produced different types of interpretations within individuals, and these in turn influenced whether the study participants did or did not take up same-sex identity labels. Without these, women will be routinely missed in outreach efforts, say the authors.

Arch Sex Behav 2016;45:1375–1389. doi: 10.1007/s10508-015-0507-3

British maternity clinic offers specialist support to rape survivors

And finally, Venus would like to invite a big round of applause for the first British maternity clinic offering specialist support to rape survivors that has opened at the Royal London Hospital. The service is backed by the ‘My Body Back’ project (http://www.mybodybackproject.com) and provides clinical and psychological support, as well as mental health advice. It has been developed in direct response to feedback from women who report that they experience flashbacks of the attack when years later undergoing routine antenatal checks and tests, and from the loss of control during labour. For confidential advice and information e-mail maternity@mybodybackproject.com