Orgasm

An orgasm (from Greek orgasmós, from orgán - "to swell", "be lustful"), also known as a sexual climax, is a pleasurable physical, psychological or emotional response to prolonged sexual stimulation It is often accompanied by a notable physiological reaction, such as ejaculation, blushing or spasm and may be followed by aftershocks.

Dictionaries still give the subsidiary meaning, "a similar point of intensity of emotional excitement," but as of the present day, this usage has become obscure. It can be startling to modern readers when encountered in older literature.

General
Both males and females can experience orgasms, but the exact response varies across gender. Generally speaking, orgasm is the third stage of four in the human sexual response cycle, which is the currently accepted model of the physiological process of sexual stimulation.

Shared physiology
Orgasm is the conclusion of the plateau phase of the sexual response cycle, shared by males and females alike. During orgasm, both males and females experience quick cycles of muscle contraction in the lower pelvic muscles, which surround both the anus and the primary sexual organs.

Orgasms in both men and women are often associated with other involuntary actions, including vocalizations and muscular spasms in other areas of the body. Also, a generally euphoric sensation is associated with orgasm.

Afterwards, orgasm generally causes perceived tiredness, and both males and females often feel a need to rest. This is recently attributed to the release of prolactin. Prolactin is a typical neuroendocrine response in depressed mood and irritation.

A recent study at the University of Groningen has indicated significant differences in brain activity during the female and male orgasm. PET scans showed that both the female and male orgasm 'shut down' areas in the brain associated with anxiety and fear (the Amygdala). It was found that the male orgasm focused the brain on sensory input from the genitals more than a female orgasm.

Human male orgasm
In a human male orgasm, there are rapid, rhythmic contractions of the prostate, urethra and the muscles at the base of the penis, which (in the adult) typically forces stored semen to be expelled through the penis' urethral opening, in a process known as peristalsis. This is referred to as ejaculation. The process usually takes from 3 to 10 seconds. The process is usually, but not always, extremely pleasurable. Orgasm is generally induced by direct stimulation of the penis. Some men experience heightened orgasm by direct stimulation of the prostate through the perineum.

Following ejaculation, a refractory period usually occurs during which a man cannot have another orgasm. This period can be anywhere from less than a minute to over half a day, depending on age and other individual factors. A few cases have been reported of men who appear to have no refractory period at all. Scientists theorize that a pituitary gland difference may cause this unique ability.

Male prostate orgasm
Some men are able to achieve ejaculation or orgasm through intra-anal stimulation of the prostate gland. Men reporting the sensation of prostate stimulation often give descriptions similar to women's accounts of g-spot stimulation. Other men report finding anal stimulation or penetration of any kind to be painful, or simply that they find no profound pleasure from it. With sufficient stimulation, the prostate can also be "milked". Providing that there is no simultaneous stimulation of the penis, prostate milking can cause ejaculation without orgasm. When combined with penile stimulation, some men report that prostate stimulation increases the volume of their ejaculation, and provides an enhanced and more pleasurable version of the standard male orgasm.

Male multiple orgasms
It is possible to have an orgasm without ejaculation, dry orgasm, or to ejaculate without reaching orgasm. Some men report that the ability to consciously separate orgasm and ejaculation has allowed them to achieve multiple orgasms. Men who have practised this technique extensively report that they can sometimes experience a continuous "wave" of orgasm. This can last, in theory, indefinitely, but in practice is limited by the man's ability to concentrate/meditate, or "surf" the "wave." In recent years a number of sex manuals for men have delved into this technique. Men who have become adept at this practice also report more powerful ejaculatory orgasms when they choose to have them. It is uncertain whether this is a result of more time between ejaculations, or a direct result of practice. Interestingly, the male multiple orgasm sometimes requires that the man "hold on", maintaining control to prevent ejaculation. In contrast, multi-orgasmic women sometimes report that they must relax and "let go" to experience multiple orgasms.

Internet rumors and a few scientific studies have pointed to the hormone prolactin as the likely cause of the male refractory period. Because of this, there is currently an experimental interest in drugs which inhibit prolactin, such as Dostinex (also known as Cabeser, or Cabergoline). Anecdotal reports on Dostinex suggest it may be capable of eliminating the refractory period altogether, allowing men to experience multiple ejaculatory orgasms in rapid succession. At least one scientific study supports these claims (J Endocrinol. 2003 Dec;179(3):357-65.) Dostinex is a hormone altering drug and has many potential side effects. It has not been approved for treating sexual dysfunction.

A scientific study to successfully document natural, fully ejaculatory, multiple orgasms in an adult male was conducted at Rutgers University in 1995. During the study, six fully ejaculatory orgasms were experienced in 36 minutes with no refractory period in evidence. The study was subsequently published in the "Journal of Sex Education and Therapy" (1998; Volume 23, No. 2; pp 157-162). It can also be said that in some cases, the refractory period can be reduced or even eliminated through the course of puberty and on into adulthood. Later, P. Haake P et al. observed a single male individual producing multiple orgasms without elevated prolactin response (Int J Impot Res. 2002 Apr;14(2):133-5).

Human female orgasm
In a human female orgasm, orgasm is preceded by moistening of the vaginal walls, and an enlargement of the clitoris due to increased blood flow trapped in the clitoris's spongy tissue. Some women exhibit a sex flush; a reddening of the skin over much of the body due to increased blood flow to the skin. As a woman comes closer to having orgasm, the clitoris moves inward under the clitoral hood, and the labia minora (minor lips) becomes darker. As orgasm becomes imminent, the vagina decreases in size by about 30% and also becomes congested from engorged soft tissue. The uterus then experiences muscular contractions. A woman experiences full orgasm when her uterus, vagina and pelvic muscles undergo a series of rhythmic contractions. The majority of women consider these contractions to be very pleasurable.

After the orgasm is over, the clitoris re-emerges from under the clitoral hood, and returns to its normal size in less than 10 minutes. Unlike men, women either do not have a refractory period or have a very short one and thus can experience a second orgasm soon after the first; some women can even follow this with additional consecutive orgasms, up to eight have been reported amongst some people; this is known as having multiple orgasms. After the initial orgasm, subsequent climaxes may be stronger or more pleasurable as the stimulation accumulates. Research shows that about 13% of women experience multiple orgasms; a larger number may be able to experience this with the proper stimulation (such as a vibrator) and frame of mind. However, some women's clitorises are very sensitive after orgasm, making additional stimulation initially painful. It is possible to engage in deep, rapid breaths while continuing stimulation and making a conscious intention to release the pain and tension. Doing this can allow for the intense stimulation to be interpreted not as painful but as intensely pleasurable. This technique is described by Betty Dodson in her book, "Sex For One".

Achieving multiple orgasm
Some women can achieve multiple orgasms: a series of orgasms, one after another with possibly increased intensity after the first. The great exertion involved can be blissfully debilitating for quite some time after.

This kind of orgasm would normally involve stimulation of the woman's clitoris rather than vagina. Some woman can do this manually using their fingers taking a pause of two or three seconds between each. A series of eight consecutive climaxes has been witnessed this way.

A vibrator applied directly to the clitoris can enable women who are not practised in using their fingertips. A vibrator used this way can be applied almost continuously to bring about orgasms that seem less separated. A battery powered tooth brush that vibrates with an oscillatory rotational motion is preferred by some for whom it is more effective than a vibrator.

The evolutionary purpose of orgasms
Some evolutionary biologists believe that female orgasms have a distinct purpose, such as increasing intimacy with a male partner in order to ensure the survival of the pair bond. They usually say this because, in the context of natural selection, the orgasm serves no purpose. It is postulated that it must be connected with the other unique part of human experience - love and the pair bond.

Others have theorized that they increase fertility by enhancing sperm retention. The 30% reduction in size of the vagina would help clench onto the penis (much like, or perhaps caused by the pubococcygeus muscles), which would not only make it more stimulating for the male (thus ensuring faster or more voluminous ejaculation). The British biologists Baker and Bellis have also suggested that the female orgasm may have an "upsuck" action, retaining favorable sperm and making conception more likely. This would be due to a tighter fit, with less space for sperm to escape during mating, as well as possibly more difficulty in pulling out while still erect for the male.

Other biologists, such as Stephen Jay Gould, suggest the female orgasm is analogous to the male nipple, an evolutionary holdover which, though associated with pleasure in the context of sexual behaviour, has no specific identified biological function.

Orgasm as vestigial
The clitoris is homologous to the penis, that is, the penis and clitoris develop from the same embryonic structure. It has been claimed by some researchers, such as Stephen Jay Gould that the clitoris is vestigial in the female, and that female orgasm serves no particular evolutionary function. Proponents of this theory, such as Dr. Elisabeth Lloyd, point to the relative difficulty of achieving female orgasm through vaginal sex, and limited evidence for increased fertility after orgasm. Feminists such as Natalie Angier have criticized that this theory understates the psychosocial value of female orgasm. Catherine Blackledge in The Story of V has criticized the theory from a more scientific standpoint, citing studies that indicate a possible connection between orgasm and successful conception.

Genetic basis of individual variation
A 2005 twin study found that one in three women reported never or seldom achieving orgasm during intercourse, and only one in ten always orgasmed. This variation in ability to orgasm, generally thought to be psychosocial, was found to be between 34-45% genetic. The study, examining 4000 women, was published in Biology Letters, a Royal Society journal.

According to the researchers, heritability suggests that evolution has a role. They suggested this characteristic might have evolved because it helped females select males who were the most powerful and thoughtful, who would be the most likely to hang around as a long-term partner and be a better bet for bringing up offspring. In this theory, women who orgasm easily may have been satisfied with mates who were less skilled. While in certain cultures it has been posited that women who are more orgasmic may be more promiscuous, there has to date been no confirmation of this in a scientific study.

Vaginal versus clitoral orgasms
A distinction is sometimes made between clitoral and vaginal orgasms in women. An orgasm that results from combined clitoral and vaginal stimulation is called a blended orgasm. Many doctors and feminist advocates have claimed that vaginal orgasms do not exist, and that female orgasms are obtained only from clitoral arousal. Recent discoveries about the size of the clitoris &mdash; it extends inside the body, around the vagina &mdash; would seem to support this theory. On the other hand, other sources argue that vaginal orgasms are dominant or more "mature". However, these arguments are frequently criticized on the ground that they adhere to an androcentric view of sexuality which privileges the male sexual organ.

This latter viewpoint was first promulgated by Sigmund Freud. In 1905, Freud argued that clitoral orgasm was an adolescent phenomenon, and upon reaching puberty the proper response of mature women changes to vaginal orgasms. While Freud did not provide evidence supporting this basic assumption, the consequences of the theory were greatly elaborated thereafter.

In 1966, Masters and Johnson published pivotal research into the phases of sexual stimulation. Their work included women as well as men, and unlike Kinsey previously (in 1948 and 1953), set out to determine the physiological stages leading up to and following orgasm. One of the results was the promotion of the idea that vaginal and clitoral orgasms follow the same stages of physical response. Additionally, Masters and Johnson argued that clitoral stimulation is the primary source of orgasms.

This standpoint has been adopted by feminist advocates, to the extent that some hold that the vaginal orgasm was a mirage, created by men for their convenience. Certainly many women can only experience orgasm with clitoral stimulation, either alone or in addition to vaginal stimulation, while (less commonly) other women can only experience orgasm with vaginal stimulation. The clitoral-only orgasm school of thought became an article of faith in some feminist circles. Alternatively, some feminists feel the clitoral orgasm robs females of the source of their womanhood.

A new understanding of vaginal orgasm has been emerging since the 1980s. Many women report that some form of vaginal stimulation is essential to subjectively experience a complete orgasm, in addition to or instead of external (clitoral) stimulation. Recent anatomical research has pointed towards a connection between intravaginal tissues and the clitoris. It has been shown that these tissues have connecting nerves. This, combined with the anatomical evidence that the internal part of the clitoris is a much larger organ than previously thought could also explain credible reports of orgasms in women who have undergone clitoridectomy as part of so-called female circumcision.

In some cases it is possible for women to orgasm through stimulation of secondary sexual organs (e.g. breasts), and in very rare cases, without any direct stimulation to the genitalia or the other specific erogenous zones, but instead stimulation of the non-specific zones (e.g. neck).

Some women experience orgasm while giving birth. In addition, orgasm can be spontaneous, many people find this to be quite embarrassing but enjoyable, seeming to happen with no direct stimulation. Occasionally, orgasm can occur during sexual dreams.

Controversy: definition of orgasm
There is controversy surrounding male multiple orgasms, and female G-spot (vaginal, not blended) orgasms, because some feel that they do not fit within the clinical definition of orgasm. Male multiple orgasms, while pleasurable, often do not involve involuntary contractions. Similarly, there are not always contractions in female orgasms resulting from stimulation of the g-spot alone, without stimulation of the clitoris. However, both of these sensations in the two sexes are extremely pleasurable, and are often felt throughout the body, creating a mental state that is often described as transcendental. Because of this, some persons feel that these experiences can be accurately defined as orgasms. Others insist that orgasm is defined strictly by muscular contractions, and that these other sensations are too subjective to be quantified as orgasms.

Transwomen
Post-operative male-to-female transsexual women (having undergone vaginoplasty) generally experience full orgasm, involving any combination of the clitoris, vagina and labia.

Some transwomen experience female ejaculation, which can be from the prostate gland, seminal vesicles, and/or Cowper's glands, which are not removed during vaginoplasty.

Transmen
Post-operative female-to-male transsexual men (after having undergone metoidioplasty or phalloplasty) generally experience orgasm in the same way as other men, except that those who have had phalloplasty have a pump installed to create an erection, as the neopenis (with either surgical technique) has limited natural erection capability. Due to the lack of the necessary glands, they do not have the ability to ejaculate.

Orgasmic dysfunction
The inability to have orgasm is called anorgasmia, ejactulatory anhedonia, or inorgasmia. In situations where orgasm is desired, anorgasmia is mainly thought of as being caused by an inability to relax, or 'let go'. It seems to be closely associated with performance pressure and an unwillingness to pursue pleasure, as separate from the other person's satisfaction. It was the psychoanalyst Wilhelm Reich, in his 1927 book The Function of the Orgasm, who first made orgasm central to the concept of mental health and defined neurosis in terms of blocks to having full orgasm.

For a variety of reasons, some people choose to fake an orgasm.

If a male experiences erection, ejaculation, but no orgasm he said to have Sexual anhedonia

Drugs and orgasm
Certain drugs have been reported to have enhancing effects on orgasm. Alkyl nitrites are used by some men to enhance orgasm. Marijuana has widely been reported to enhance and prolong male orgasms, while at the same time delaying ejaculation. Stimulant, Psychedelic, and Ecstasy drug users of both sexes sometimes report heightened sexual pleasure. Some male cocaine users report rubbing the glans of their penis with cocaine in order to numb it and delay ejaculation. The use of recreational drugs to enhance orgasm may be unreliable or have hazardous side effects.

Studies have indicated that each of the three major erectile dysfunction drugs have different reported effects on orgasm. Anecdotal evidence suggests that women have enhanced orgasms with Sildenafil (commercially known as Viagra). In men, Sildenafil has varying effects on orgasm. Some men report enhancement, while others report that while they can achieve an erection with Sildenafil, their orgasms feel "hollow". Vardenafil behaves very similarly to Sildenafil. Tadalafil, a newer drug, in addition to treating erectile dysfunction over longer periods of time, is said to enhance orgasm and shorten the male refractory period. Some drugs, such as Cabergoline, are reported to shorten the refractory period without having any effect on erections or orgasms.

Studies have also proven that a common over-the-counter cough suppressant, Dextromethorphan, makes achieving orgasm extremely difficult.

Imipramine, a tri-cyclic anti-depressant (TCA), is known to cause spontaneous orgasms among patients who take it.

While prescribing drugs to solve problems, many sex therapists discourage the regular use of drugs to enhance sex, because of the elevated risk of dependency.

Inversely, a number of anti-depressant drugs, especially those in the class of selective serotonin reuptake inhibitors (SSRIs), have as a side effect a delay or even an inability to achieve orgasm. One potential basis of this side effect is penile anesthesia.

Orgasm in Tantric sex
In the Asian spiritual tradition of sexual practice known as Tantric sex, orgasm has a different value than in other cultural approaches to sexuality. Some practitioners of Tantric sex aim to eliminate orgasm from sexual intercourse by remaining for long periods of time at the pre-orgasmic state. According to some advocates of Tantric sex, such as Rajneesh, practising Tantric sex without orgasm will eventually lead to orgasmic feelings spreading out to all of conscious experience. Some current advocates of Tantric sex claim that in Western culture sexuality is put in the service of orgasm in a way that reduces the ability to have intense pleasure during each moment of sexual experience, and consequently that eliminating the striving toward orgasm enhances the pleasure to be derived from all aspects of sexual experience.

Orgasm in non-humans
The mechanics of the male orgasm are similar in most mammals, and females of some mammalian species have clitorises. There is evidence that some non-human animals, particularly primates, can experience orgasm in ways similar to humans.

Non-sexual meaning of the word "orgasm"
Dictionaries still indicate that the word "orgasm" can refer to any peak of emotional intensity&mdash;a "climax" in the non-sexual sense. As of 2006, the word would be likely to be misunderstood if used in that way; such usage is vanishingly rare. It does, however, occur in literature written prior to the sexual revolution:


 * Here in this cathedral at Burgos was the record of an incredible spiritual energy.... Those who had built and carved and painted here had been more than happy. They had left the record of their ecstasy in a divine orgasm of stone.&mdash;Hervey Allen, Anthony Adverse

In reference to a horse which is calming down after being "spooked:"


 * "it was a very weak and very sick mare he rode, stumbling and halting, afflicted with nervous jerks and recurring muscular spasms&mdash;the aftermath of the tremendous orgasm through which she had passed.&mdash;Jack London, Moon-Face and Other Stories, "Planchette."

In the following sentence, a newcomer to the Arctic is impressed with Malemute Kid's forceful personality. ("Breathing heavily" here means "asleep.")


 * "Malemute Kid was already breathing heavily; but the young mining engineer gazed straight up through the thick darkness, waiting for the strange orgasm which stirred his blood to die away."&mdash;Jack London, The Son of the Wolf, "An Odyssey of the North".