Female orgasm

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Human sexuality

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A female orgasm (sexual climax) is the conclusion of the plateau phase of the sexual response cycle. Orgasm is characterized by intense physical pleasure, controlled by the involuntary, or autonomic, nervous system. It is accompanied by quick cycles of muscle contraction in the lower pelvic muscles, which surround the primary sexual organs and the anus. Orgasms are often associated with other involuntary actions, including muscular spasms in other areas of the body, a general euphoric sensation, and, frequently, vocalizations.

Vaginal orgasm

The female body can achieve orgasm from stimulation of the clitoris and from stimulation of the G-spot. The Gräfenberg spot, or G-spot, is a small area behind the female pubic bone surrounding the urethra and accessible through the anterior wall of the vagina. Many scientists believe that only certain women possess a G-spot. The G-spot orgasm is sometimes referred to as "vaginal," because it results from stimulation inside the vagina, including during sexual intercourse. However, only stimulation of the G-spot, and not other intravaginal stimulation, results in a "vaginal orgasm."^{[How to reference and link to summary or text]}

The "two-orgasm theory" (the belief that in women there is a vaginal orgasm and a clitoral orgasm), has been criticized by feminists such as Ellen Ross and Rayna Rapp as a "transparently male perception of the female body". The concept of purely vaginal orgasm was first postulated 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 provided no evidence for this basic assumption, the consequences of the theory were greatly elaborated, partly because many women felt inadequate when they could not achieve orgasm via vaginal intercourse that involved little or no clitoral stimulation.

In 1966, Masters and Johnson published pivotal research about the phases of sexual stimulation. Their work included women and men, and unlike Alfred Kinsey earlier (in 1948 and 1953), tried to determine the physiological stages before and after orgasm. One of the results was the promotion of the idea that vaginal and clitoral orgasms follow the same stages of physical response. Masters and Johnson also argued that clitoral stimulation is the primary source of orgasms.

Recent discoveries about the size of the clitoris - it extends inside the body, around the vagina - complicate or may invalidate attempts to distinguish clitoral vs. vaginal orgasms. Recent anatomical research shows that there are nerves connecting intravaginal tissues and the clitoris.^{[How to reference and link to summary or text]} This, with the anatomical evidence that the internal part of the clitoris is a much larger organ than previously thought, could explain credible reports of orgasms in women who have undergone clitorectomy as part of female circumcision. The link between the clitoris and the vagina is evidence that the clitoris is the 'seat' of the female orgasm and is far more wide-spread than the visible part most people associate with it. But it is possible that some women have more extensive clitoral tissues and nerves than others, and so that some women can achieve orgasm only by direct stimulation of the external part of the clitoris.

Breast and nipple stimulation

A breast orgasm is a female orgasm that is triggered from the stimulation of a woman's breast. Not all women experience this effect when the breasts are stimulated; however, some women claim that the stimulation of the breast area during sexual intercourse and foreplay, or just the simple act of having their breasts fondled, has created mild to intense orgasms. According to one study that questioned 213 women, 29% of them had experienced a breast orgasm at one time or another, This shows that it is not common, but it is possible. An orgasm is believed to occur in part because of the hormone oxytocin, which is produced in the body during sexual excitement and arousal. It has also been shown that oxytocin is produced when an individual's nipples are stimulated and become erect.

Spontaneous orgasms

Orgasms can be spontaneous, seeming to occur with no direct stimulation. Occasionally, orgasms can occur during sexual dreams.

The first orgasm of this type was reported among people who had spinal cord injury (SCI). Although SCI very often leads to loss of certain sensations and altered self-perception, a person with this disturbance is not deprived of sexual feelings such as sexual arousal and erotic desires. Thus some individuals are able to initiate orgasm by mere mental stimulation. Some non-sexual activity may result in a spontaneous orgasm. The best example of such activity is a release of tension that unintentionally involves slight genital stimulation, like rubbing of the seat of the bicycle against genitals during riding, exercising, when pelvic muscles are tightened or when yawning or sneezing.

It was also discovered that some anti-depressant drugs may provoke spontaneous climax as a side effect. There is no accurate data for how many patients who were on treatment with antidepressant drugs experienced spontaneous orgasm, as most were unwilling to acknowledge the fact.

Multiple orgasms

In some cases, women either do not have a refractory period or have a very short one and thus can experience a second orgasm, and perhaps further ones, soon after the first. After the first, subsequent climaxes may be stronger or more pleasurable as the stimulation accumulates. For some women, their clitoris and nipples are very sensitive after climax, making additional stimulation initially painful. There are sensational reports of women having too many orgasms.

Definitions of "orgasm"

There is some debate whether certain types of sexual sensation should be accurately classified as 'orgasm', including female orgasms caused by G-spot stimulation alone, and the demonstration of extended or continuous orgasms lasting several minutes or even an hour. The question centers around clinical definition of orgasm.

Orgasm is usually defined in a clinical context strictly by the muscular contractions involved.

In these and similar cases, the sensations experienced are subjective and do not necessarily involve the involuntary contractions characteristic of orgasm. However, the sensations in both sexes are extremely pleasurable and are often felt throughout the body, causing a mental state that is often described as transcendental, and with vasocongestion and associated pleasure comparable to that of a full contractionary orgasm.

For this reason, there are views on both sides as to whether these can be accurately defined as orgasms.

Evolutionary function of orgasms

Most male orgasms expel sperm from the body during vaginal intercourse, which can result in conception. Evolutionary biologists have several hypotheses about the role, if any, of the female orgasm in the reproductive process. In 1967, Desmond Morris first suggested in his popular-science book The Naked Ape that female orgasm evolved to encourage physical intimacy with a male partner and help reinforce the pair bond. Morris suggested that the relative difficulty in achieving female orgasm, in comparison to the male's, might be favorable in Darwinian evolution by leading the female to select mates who bear qualities like patience, care, imagination, intelligence, as opposed to qualities like size and aggression, which pertain to mate selection in other primates. Such advantageous qualities thereby become accentuated within the species, driven by the differences between male and female orgasm. If males were motivated by, and taken to the point of, orgasm in the same way as females, those advantageous qualities would not be needed, since self-interest would be enough.

Morris also proposed that orgasm might facilitate conception by exhausting the female and keeping her horizontal, thus preventing the sperm from leaking out. This possibility, sometimes called the "Poleax Hypothesis" or the "Knockout Hypothesis," is now considered highly doubtful.

Other theories are based on the idea that the female orgasm might increase fertility. For example, the 30% reduction in size of the vagina could help clench onto the penis (much like, or perhaps caused by, the pubococcygeus muscles), which would make it more stimulating for the male (thus ensuring faster or more voluminous ejaculation). The British biologists Baker and Bellis have suggested that the female orgasm may have an "upsuck" action (similar to the esophagus' ability to swallow when upside down), resulting in the retaining of favorable sperm and making conception more likely. They posited a role of female orgasm in sperm competition.

A 1994 Learning Channel documentary on sex had fiber optic cameras inside the vagina of a woman while she had sexual intercourse. During her orgasm, her pelvic muscles contracted and her cervix repeatedly dipped into a pool of semen in the vaginal fornix, as if to ensure that sperm would proceed by the external orifice of the uterus, making conception more likely. Elisabeth Lloyd has criticized the accompanying narration of this film clip which describes it as an example of "Sperm Upsuck", saying that it depicted normal orgasmic uterine contractions, which have not been shown to have any effect on fertility.

The fact that women tend to reach orgasm more easily when they are ovulating suggests that it is tied to increasing fertility.

Other biologists surmise that the orgasm simply serves to motivate sex, thus increasing the rate of reproduction, which would be selected for during evolution. Since males typically reach orgasms faster than females, it potentially encourages a female's desire to engage in intercourse more frequently, increasing the likelihood of conception.

Purpose of female orgasm

The clitoris is homologous to the penis; that is, they both develop from the same embryonic structure. Stephen Jay Gould and other researchers have claimed that the clitoris is vestigial in females, and that female orgasm serves no particular evolutionary function. Proponents of this hypothesis, such as Dr. Elisabeth Lloyd, point to the relative difficulty of achieving female orgasm through vaginal sex, the limited evidence for increased fertility after orgasm and the lack of statistical correlation between the capacity of a woman to orgasm and the likelihood that she will engage in intercourse.

Science writer Natalie Angier has criticized this hypothesis as understating the psychosocial value of female orgasm. Catherine Blackledge in The Story of V, citing studies that indicate a possible connection between orgasm and successful conception, has criticized the hypothesis as ignoring the ongoing evolutionary advantages that result from successful conception. The anthropologist and primatologist Sarah Blaffer Hrdy has also criticized the argument that female orgasm as vestigial, writing that the idea smacked of sexism.

Evolutionary biologist Robin Baker argues in his Sperm Wars that occurrence and timing of orgasms are all a part of the female body's unconscious strategy to collect and retain sperm from more evolutionarily fit men. An orgasm during intercourse functions as a bypass button to a woman's natural cervical filter against sperm and pathogens. An orgasm before functions to strengthen the filter.

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 34% to 45% genetic. The study, examining 4000 women, was published in Biology letters, a Royal Society journal. Dr. Elisabeth Lloyd has cited this as evidence for her Fantastic Bonus Theory.

Medical aspects of orgasm

Physiological responses

A typical woman's orgasm lasts much longer than that of a man. It is preceded by erection of the clitoris and moistening of the opening of the vagina. 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 nears orgasm, the clitoral glans moves inward under the clitoral hood, and the labia minora (inner lips) become darker. As orgasm becomes imminent, the outer third of the vagina tightens and narrows, while overall the vagina lengthens and dilates and also becomes congested from engorged soft tissue. The uterus then experiences muscular contractions. A woman experiences full orgasm when her uterus, vagina, anus, and pelvic muscles undergo a series of rhythmic contractions. Most women find these contractions very pleasurable. Recently, researchers from the University Medical Center of Groningen, the Netherlands, showed that it is possible to objectively recognize orgasms just by the specific frequencies of these contractions (abstract). After orgasm, the clitoris re-emerges from under the clitoral hood, and returns to its normal size, typically within ten minutes.

Orgasmic dysfunction

The inability to have orgasm in the female is called anorgasmia. If orgasm is desired, anorgasmia is mainly attributed to 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. Often, women worry so much about the pleasure of their partner that they become anxious, which manifests as impatience with the delay of orgasm for them. This delay can lead to frustration of not reaching orgasmic sexual satisfaction.

However, anorgasmia can also be caused by medical problems such as diabetic neuropathy, multiple sclerosis, genital mutilation or complications from genital surgery, pelvic trauma (such as from a blunt straddle injury caused by falling on the bars of a climbing frame, bicycle or gymnastics beam), hormonal imbalances, total hysterectomy, spinal cord injury, cauda equina syndrome, vulvodynia and cardiovascular disease (Berman et al. 2005).

Women suffering from anorgasmia with no obvious psychological cause would need to be examined by their GP to check for absence of disease. Blood tests would also need to be done (full blood count, liver function, estradiol, total testosterone, SHBG, FSH/LH, prolactin, thyroid function, lipids and fasting blood sugar) to check for other conditions such as diabetes, lack of ovulation, low thyroid function or hormone imbalances (Berman et al. 2005). They would then need to be referred (with their blood test results) to a uro-neurologist or specialist in sexual medicine (Berman et al. 2005). The specialist would then check the blood results and carry out nerve conduction tests to test for nerve damage. These tests are conducted using the Genito-Sensory Analyzer (TSA; Medoc Ltd., Israel). The GenitoSensory Analyzer (GSA) is a quantitative sensory testing tool designed to quantify vibratory and thermal sensation in the vagina and clitoris in a reproducible manner, and may therefore contribute to the diagnosis and management of female sexual dysfunction. Normal thresholds for warm, cold, and vibratory sensation at predetermined points in the vaginal wall and clitoris have been established (Helpman L.,Greenstein A.,Hartoov J.,Abramov L. 2009) and a patients scores can be established against such thresholds.

Just as with erectile dysfunction in men, lack of sexual function in women may be treated with hormones to correct imbalances, clitoral vacuum pump devices or medication to improve blood flow and sexual sensation (Berman et al. 2005).

Orgasm and mental health

Psychoanalyst Wilhelm Reich, in his 1927 book The Function of the Orgasm was the first to make orgasm central to the concept of mental health, and defined neurosis in terms of blocks to having full orgasm. Although orgasm dysfunction can have psychological components, physiological factors often play a role. For instance, delayed orgasm or the inability to achieve orgasm is a common side effect of many medications.

See also

• Female ejaculation
• Female sexual dysfunction
• Frigidity
• Masturbation
• Sexual intercourse (human)
• Foreplay Techniques