Anaesthesia in women is, as a rule, due to inexcitability of the genital nerves and to lack of excitation at the centre of libido. Sometimes anatomical anomalies of the genitals may cause impotence of libido. The integrity and the free exercise of the generative organs are necessary for the integrity of the libidinous feeling, although sexual pleasure is experienced at the nervous centres, and the generative organs play only a secondary part. The vaginal bulbi and their muscle, the constrictor cunni, the intermediary net of veins between the bulbs and the clitoris, and the free part of the latter, the glans of the clitoris, must functionate normally in order to give full satisfaction in intercourse.
Hence diminution or extinction of the sense of libido will be caused by castration, degeneration of the ovarian glands, marasmus, sexual excesses and overindulgence in alcoholic beverages or cocaine.
In the following case the erotic feeling increased in such a degree after the castration, probably through the extinction of the libido, as to deceive the family physician and lead him to make the diagnosis nymphomania.
Miss X., a school teacher, over thirty years of age, was always chaste and indifferent not only to any carnal pleasure, but also to male company. On account of a uterine fibroid, a total extirpation of uterus and ovaries was performed. Since the operation the patient complains of great sexual excitability she had never experienced before the operation. She is so excited sexually that she is possessed of the almost imperative impulse to kiss every male person she meets on the street, and but for her position, she would have long ago yielded to this impulsive desire.
In another case of diminution of the potency of libido, only uterine inflammation and pregnancy could be discovered.
Mrs. M., thirty-five years of age, four months married, had always suffered pain in the back during menstruation. The patient complains that she only experienced libido twice since she has been married. Since the last experience in the first weeks of her married life, she has no pleasure at all. Coition, though not painful, causes her a disagreeable feeling. An examination revealed anteflexio uteri, enlargement and catarrh of the cervix, erosions and a three months’ pregnancy.
In the following case castration caused inability to experience libido.
Mrs. M., thirty-five years of age, for the last fifteen years married but sterile. When she was only two years married she began to suffer from attacks of headaches and vomiting, which repeated almost every other day. Her menstruation was regular. After having tried all the stomach specialists in the city without finding any relief from the vomiting spells, she consulted a gynaecologist, and he promptly found an ovary to be the cause of all her troubles. She had been previously operated upon for gall stones, which were not found and for appendicitis, when the presumably diseased appendix was removed. She now submitted to ovariectomy on the left side. Three months after the operation the vomiting spells returned, and she submitted again to a removal of the right ovary. But even this double castration did not relieve her. When she first consulted the author she was still suffering from these spells, especially before menstruation, which is still present although irregular. The patient declares that previous to the ovariotomies she experienced full libido and was able to induce orgasm. After the second ovariotomy this potency was lost. She gets excited during coition, but the orgasm cannot be produced. The following day she feels nervous and weak.
In another case of impotence of libido nothing else but anteflexio could be discovered.
Mrs. H., twenty-four years of age, four years married, was confined by the author a year ago of a healthy girl. The patient complains of never having experienced any libido. Before her confinement coition caused her great pain and misery. Since her confinement she suffers no more pain during the act, but libido is still absent. She complains of great dryness of the parts, so that vaseline has to be used to facilitate walking. At the examination there was found redness of the vulva, catarrh and erosion of the cervix and anteflexio.