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A machine that delivers an orgasm at the push of a button has been patented in the US. The implant could help women whose lives have been blighted by an inability to achieve orgasms naturally. Orgasmic dysfunction is not uncommon among women, says Julia Cole, a psychosexual therapist and consultant with Relate, the relationship counselling service. And a number of issues can cause it, says Jim Pfaus, who studies the neurobiology of sexual behaviour at Concordia University in Montreal. "Some women confuse what's called sympathetic arousal, like increased heart rate, clammy hands, nerves and so on, with fear," he explains. "That makes them want to get out of the situation." Psychotherapy is a common treatment for the condition, although if anxiety is a factor, patients may also be prescribed valium. "But valium can actually delay orgasm," says Pfaus. The patient remains conscious during the operation to help the surgeon find the best position for the electrodes. Stuart Meloy, a surgeon at Piedmont Anesthesia and Pain Consultants in Winston-Salem, North Carolina, made the breakthrough came one day when he failed to hit the right spot. "I was placing the electrodes and suddenly the woman started exclaiming emphatically," he says. "I asked her what was up and she said, 'You're going to have to teach my husband to do that'." Meloy expects clinical trials to begin later this year with Medtronic, a company based in Minneapolis. He says the stimulating wires could connect to a signal generator smaller than a packet of cigarettes implanted under the skin of one of the patient's buttocks. "Then you'd have a hand-held remote control to trigger it," he says. "But it's as invasive as a pacemaker, so this is only for extreme cases." Meloy believes the device could help couples overcome problems caused by orgasmic dysfunction. "If you've got a couple who've been together for a while and it's just not happening any more, maybe they'll get through it a bit easier with this," he says. He's quick to add that the device will be programmed to limit its use. "But whether it's once a day, four times a week - who am I to say?" But would women subject themselves to such invasive surgery? "If young women of 15 or so are having painful operations to enlarge their breasts when they don't have to, are you kidding? Of course it'll be used," says Pfaus. Cole agrees that some women would try it if they felt the problem was severe enough. "I feel about this the way I feel about Viagra," says Cole. "It may help some people, but they should also address the underlying reasons for the problem." Meloy has yet to test the device on men, but says there's no reason it shouldn't work in the same way.