Piezo2 and perineal mechanosensation are essential for sexual function

Despite the potential importance of genital mechanosensation for sexual reproduction little is known about how perineal touch influences mating. Here we explored how mechanosensation affords exquisite awareness of the genitals and controls reproduction in mice and humans. Using genetic strategies and in vivo functional imaging, we demonstrated that the mechanosensitive ion channel Piezo2 is necessary for behavioral sensitivity to perineal touch. Notably, Piezo2-function is needed for triggering a touch-evoked erection reflex and successful mating in both male and female mice. Humans with complete loss of PIEZO2 function have genital hyposensitivity and experience no direct pleasure from gentle touch or vibration. Together, our results explain how perineal mechanoreceptors detect the gentlest of stimuli and trigger physiologically important sexual responses, providing a platform for exploring the sensory basis of sexual pleasure and its relationship to affective touch.