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Orgasm (from
Greek Greek may refer to: Greece Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group. *Greek language, a branch of the Indo-European language family. **Proto-Greek language, the assumed last common ancestor ...
, ; "excitement, swelling") or sexual climax is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic, involuntary muscular contractions in the
pelvic The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton). The ...
region characterized by sexual pleasure.Se
133–135
for orgasm information, an
page 76
for G-spot and vaginal nerve ending information.
Experienced by males and females, orgasms are controlled by the involuntary or
autonomic nervous system The autonomic nervous system (ANS), formerly referred to as the vegetative nervous system, is a division of the peripheral nervous system that supplies viscera, internal organs, smooth muscle and glands. The autonomic nervous system is a control ...
. They are usually associated with involuntary actions, including muscular
spasm A spasm is a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ such as the bladder. A spasmodic muscle contraction may be caused by many medical conditions, including dystonia. Most commonly, it is a muscle c ...
s in multiple areas of the body, a general
euphoric Euphoria ( ) is the experience (or affect) of pleasure or excitement and intense feelings of well-being and happiness. Certain natural rewards and social activities, such as aerobic exercise, laughter, listening to or making music and da ...
sensation and, frequently, body movements and vocalizations. The period after orgasm (known as the refractory period) is typically a relaxing experience, attributed to the release of the
neurohormone A neurohormone is any hormone produced and released by neuroendocrine cells (also called neurosecretory cells) into the blood. By definition of being hormones, they are secreted into the circulation for systemic effect, but they can also have a role ...
s
oxytocin Oxytocin (Oxt or OT) is a peptide hormone and neuropeptide normally produced in the hypothalamus and released by the posterior pituitary. It plays a role in social bonding, reproduction, childbirth, and the period after childbirth. Oxytocin ...
and
prolactin Prolactin (PRL), also known as lactotropin, is a protein best known for its role in enabling mammals to produce milk. It is influential in over 300 separate processes in various vertebrates, including humans. Prolactin is secreted from the pit ...
as well as endorphins (or "endogenous
morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a analgesic, pain medication, and is also commonly used recreational drug, recreationally, or to make ...
"). Human orgasms usually result from physical
sexual stimulation Sexual stimulation is any stimulus (including bodily contact) that leads to, enhances and maintains sexual arousal, and may lead to orgasm. Although sexual arousal may arise without physical stimulation, achieving orgasm usually requires physica ...
of the
penis A penis (plural ''penises'' or ''penes'' () is the primary sexual organ that male animals use to inseminate females (or hermaphrodites) during copulation. Such organs occur in many animals, both vertebrate and invertebrate, but males do n ...
in males (typically accompanying
ejaculation Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the male reproductory tract as a result of an orgasm. It is the final stage and natural objective of male sexual stimulation, and an essential componen ...
) and of the clitoris in females. * Sexual stimulation can be by self-practice (
masturbation Masturbation is the sexual stimulation of one's own genitals for sexual arousal or other sexual pleasure, usually to the point of orgasm. The stimulation may involve hands, fingers, everyday objects, sex toys such as vibrators, or combinatio ...
) or with a
sex partner Sexual partners are people who engage in sexual activity together. The sexual partners may be in a committed relationship, either on an exclusive basis or not, or engage in the sexual activity on a casual basis. They may be on intimate terms ...
( penetrative sex,
non-penetrative sex Non-penetrative sex or outercourse is sexual activity that usually does not include sexual penetration. It generally excludes the penetrative aspects of vaginal, anal, or oral sexual activity, but includes various forms of sexual and non-sex ...
, or other
sexual activity Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone (e.g., masturbation) ...
). The health effects surrounding the human orgasm are diverse. There are many physiological responses during sexual activity, including a relaxed state created by prolactin, as well as changes in the
central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all par ...
such as a temporary decrease in the metabolic activity of large parts of the
cerebral cortex The cerebral cortex, also known as the cerebral mantle, is the outer layer of neural tissue of the cerebrum of the brain in humans and other mammals. The cerebral cortex mostly consists of the six-layered neocortex, with just 10% consisting of ...
while there is no change or increased metabolic activity in the
limbic The limbic system, also known as the paleomammalian cortex, is a set of brain structures located on both sides of the thalamus, immediately beneath the medial temporal lobe of the cerebrum primarily in the forebrain.Schacter, Daniel L. 2012. ''Ps ...
(i.e., "bordering") areas of the brain. There is also a wide range of
sexual dysfunction Sexual dysfunction is difficulty experienced by an individual or partners during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. The World Health Organization defines sexual dysfunction a ...
s, such as anorgasmia. These effects affect cultural views of orgasm, such as the beliefs that orgasm and the frequency or consistency of it are either important or irrelevant for satisfaction in a sexual relationship, and theories about the biological and evolutionary functions of orgasm.


Definitions

In a clinical context, orgasm is usually defined strictly by the muscular contractions involved during sexual activity, along with the characteristic patterns of change in heart rate, blood pressure, and often respiration rate and depth. This is categorized as the sudden discharge of accumulated sexual tension during the sexual response cycle, resulting in rhythmic muscular contractions in the pelvic region. However, definitions of orgasm vary and there is sentiment that consensus on how to consistently classify it is absent. At least twenty-six definitions of orgasm were listed in the journal ''
Clinical Psychology Review Clinical Psychology Review' is a peer-reviewed academic journal that supports subscription based and open access publication of reviews on topics relevant to the field of clinical psychology. Gordon J. G. Asmundson ( University of Regina) serv ...
''. There is some debate whether certain types of sexual sensations should be accurately classified as orgasms, including female orgasms caused by
G-spot The G-spot, also called the Gräfenberg spot (for German gynecologist Ernst Gräfenberg), is characterized as an erogenous area of the vagina that, when stimulated, may lead to strong sexual arousal, powerful orgasms and potential female ejac ...
stimulation alone, and the demonstration of extended or continuous orgasms lasting several minutes or even an hour. The question centers around the clinical definition of orgasm, but this way of viewing orgasm is merely physiological, while there are also psychological, endocrinological, and neurological definitions of orgasm. 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 Vasocongestion, vascular congestion or vascular engorgement is the swelling of bodily tissues caused by increased vascular blood flow and a localized increase in blood pressure. Typical causes of vasocongestion in humans includes menstruation, sexu ...
and associated pleasure comparable to that of a full-contractionary orgasm. For example, modern findings support distinction between ejaculation and male orgasm. For this reason, there are views on both sides as to whether these can be accurately defined as orgasms.


Achieving orgasm

Orgasms can be achieved during a variety of activities, including
vaginal In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hyme ...
,
anal Anal may refer to: Related to the anus *Related to the anus of animals: ** Anal fin, in fish anatomy ** Anal vein, in insect anatomy ** Anal scale, in reptile anatomy *Related to the human anus: ** Anal sex, a type of sexual activity involving s ...
or
oral sex Oral sex, sometimes referred to as oral intercourse, is sexual activity involving the stimulation of the genitalia of a person by another person using the mouth (including the lips, tongue, or teeth) and the throat. Cunnilingus is oral sex p ...
,
non-penetrative sex Non-penetrative sex or outercourse is sexual activity that usually does not include sexual penetration. It generally excludes the penetrative aspects of vaginal, anal, or oral sexual activity, but includes various forms of sexual and non-sex ...
or masturbation. They may also be achieved by the use of a
sex toy A sex toy is an object or device that is primarily used to facilitate human sexual pleasure, such as a dildo, artificial vagina or vibrator. Many popular sex toys are designed to resemble human genitals, and may be vibrating or non-vibratin ...
, such as a sensual vibrator or an
erotic electrostimulation Erotic electrostimulation (abbreviated erotic e-stim and also known as electrosex) is a sexual practice involving the application of electrical stimulation to the nerves of the body, with particular emphasis on the genitals, using a power sourc ...
. Achieving orgasm by stimulation of the
nipple The nipple is a raised region of tissue on the surface of the breast from which, in females, milk leaves the breast through the lactiferous ducts to feed an infant. The milk can flow through the nipple passively or it can be ejected by smooth mu ...
s or other
erogenous zone An erogenous zone (from Greek , ''érōs'' "love"; and English ''-genous'' "producing", from Greek , ''-genḗs'' "born") is an area of the human body that has heightened sensitivity, the stimulation of which may generate a sexual response, su ...
s is rarer. Multiple orgasms are also possible, especially in women, but they are also uncommon. Multiple orgasms are orgasms that occur within a short period of one another. In addition to physical stimulation, orgasm can be achieved from psychological arousal alone, such as during dreaming (
nocturnal emission A nocturnal emission, informally known as a wet dream, sex dream, nightfall or sleep orgasm, is a spontaneous orgasm during sleep that includes ejaculation for a male, or vaginal wetness or an orgasm (or both) for a female. Nocturnal emissions ...
for males or females) or by
forced orgasm A forced orgasm is consensual BDSM or kinky sexual play whereby a person consents to be forced to orgasm in a way that is beyond their control. The person being brought to involuntary orgasm would typically be put in physical restraints to ...
. Orgasm by psychological stimulation alone was first reported among people who had
spinal cord injury A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cor ...
. Although sexual function and sexuality after spinal cord injury is very often impacted, this injury does not deprive one of sexual feelings such as
sexual arousal Sexual arousal (also known as sexual excitement) describes the physiological and psychological responses in preparation for sexual intercourse or when exposed to sexual stimuli. A number of physiological responses occur in the body and mind as ...
and erotic desires. Scientific literature focuses on the psychology of female orgasm significantly more than it does on the psychology of male orgasm, which "appears to reflect the assumption that female orgasm is psychologically more complex than male orgasm," but "the limited empirical evidence available suggests that male and female orgasm may bear more similarities than differences. In one controlled study by Vance and Wagner (1976), independent raters could not differentiate written descriptions of male versus female orgasm experiences".


Females


Orgasmic factors and variabilities

In women, the most common way to achieve orgasm is by direct sexual stimulation of the clitoris (meaning consistent manual,
oral The word oral may refer to: Relating to the mouth * Relating to the mouth, the first portion of the alimentary canal that primarily receives food and liquid **Oral administration of medicines ** Oral examination (also known as an oral exam or or ...
, or other concentrated friction against the external parts of the clitoris). General statistics indicate that 70–80% of women require direct clitoral stimulation to achieve orgasm, although indirect clitoral stimulation (for example, via
vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...
l penetration) may also be sufficient. The
Mayo Clinic The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, ...
stated, "Orgasms vary in intensity, and women vary in the frequency of their orgasms and the amount of stimulation necessary to trigger an orgasm." Clitoral orgasms are easier to achieve because the glans of the clitoris, or clitoris as a whole, has more than 8,000 sensory
nerve endings A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...
, which is as many (or more in some cases) nerve endings as are present in the human penis or
glans penis In male human anatomy, the glans penis, commonly referred to as the glans, is the bulbous structure at the distal end of the human penis that is the human male's most sensitive erogenous zone and their primary anatomical source of sexual p ...
.Se
pages 270–271
for anal sex information, an
page 118
for information about the clitoris.
As the clitoris is homologous to the penis, it is the equivalent in its capacity to receive sexual stimulation. One misconception, particularly in older research publications, is that the vagina is completely insensitive. However, there are areas in the anterior vaginal wall and between the top junction of the
labia minora The labia minora (Latin for 'smaller lips', singular: ''labium minus'', 'smaller lip'), also known as the inner labia, inner lips, vaginal lips or nymphae are two flaps of skin on either side of the human vaginal opening in the vulva, situated b ...
and the
urethra The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra con ...
that are especially sensitive. With regard to specific density of nerve endings, while the area commonly described as the
G-spot The G-spot, also called the Gräfenberg spot (for German gynecologist Ernst Gräfenberg), is characterized as an erogenous area of the vagina that, when stimulated, may lead to strong sexual arousal, powerful orgasms and potential female ejac ...
may produce an orgasm, and the
urethral sponge The urethral sponge is a spongy cushion of tissue, found in the lower genital area of females, that sits against both the pubic bone and vaginal wall, and surrounds the urethra. Functions The urethral sponge is composed of erectile tissue; d ...
, an area in which the G-spot may be found, runs along the "roof" of the vagina and can create pleasurable sensations when stimulated, intense sexual pleasure (including orgasm) from vaginal stimulation is occasional or otherwise absent because the vagina has significantly fewer nerve endings than the clitoris. * The greatest concentration of vaginal nerve endings are at the lower third (near the entrance) of the vagina.
Sex educator Sex education, also known as sexual education, sexuality education or sex ed, is the instruction of issues relating to human sexuality, including emotional relations and responsibilities, human sexual anatomy, sexual activity, sexual reproduc ...
Rebecca Chalker states that only one part of the clitoris, the urethral sponge, is in contact with the penis, fingers, or a
dildo A dildo is a sex toy, often explicitly phallic in appearance, intended for sexual penetration or other sexual activity during masturbation or with sex partners. Dildos can be made from a number of materials and shaped like an erect human p ...
in the vagina. Hite and Chalker state that the tip of the clitoris and the inner lips, which are also very sensitive, are not receiving direct stimulation during penetrative intercourse. Because of this, some couples may engage in the woman on top position or the
coital alignment technique The coital alignment technique (CAT) sex position, known colloquially as grinding the corn, is used primarily as a variant of the missionary position and is designed to maximize clitoral stimulation during sexual intercourse. This is achieved by co ...
to maximize clitoral stimulation. For some women, the clitoris is very sensitive after climax, making additional stimulation initially painful. Masters and Johnson argued that all women are potentially multiply orgasmic, but that multiply orgasmic men are rare, and stated that "the female is capable of rapid return to orgasm immediately following an orgasmic experience, if re-stimulated before tensions have dropped below plateau phase response levels". Though generally reported that women do not experience a refractory period and thus can experience an additional orgasm, or multiple orgasms, soon after the first one, some sources state that both men and women experience a refractory period because women may also experience a period after orgasm in which further sexual stimulation does not produce excitement. After the initial orgasm, subsequent orgasms for women may be stronger or more pleasurable as the stimulation accumulates.


Clitoral and vaginal categories

Discussions of female orgasm are complicated by orgasms in women typically being divided into two categories: clitoral orgasm and vaginal (or G-spot) orgasm. In 1973,
Irving Singer Irving Singer (December 24, 1925 – February 1, 2015) was an American professor of philosophy who was on the faculty of the Massachusetts Institute of Technology for 55 years and wrote over 20 books. He was the author of books on various ...
theorized that there are three types of female orgasms; he categorized these as
vulva The vulva (plural: vulvas or vulvae; derived from Latin for wrapper or covering) consists of the external sex organ, female sex organs. The vulva includes the mons pubis (or mons veneris), labia majora, labia minora, clitoris, bulb of vestibu ...
l, uterine, and blended, but because he was a philosopher, "these categories were generated from descriptions of orgasm in literature rather than laboratory studies". In 1982, Ladas, Whipple and Perry also proposed three categories: the tenting type (derived from clitoral stimulation), the A-frame type (derived from G-spot stimulation), and the blended type (derived from clitoral and G-spot stimulation). In 1999, Whipple and Komisaruk proposed cervix stimulation as being able to cause a fourth type of female orgasm. Female orgasms by means other than clitoral or vaginal/G-spot stimulation are less prevalent in scientific literature and most scientists contend that no distinction should be made between "types" of female orgasm. This distinction began with
Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
, who postulated the concept of "vaginal orgasm" as separate from clitoral orgasm. In 1905, Freud stated that clitoral orgasms are purely an adolescent phenomenon and that upon reaching puberty, the proper response of mature women is a change-over to vaginal orgasms, meaning orgasms without any clitoral stimulation. While Freud provided no evidence for this basic assumption, the consequences of this theory were considerable. Many women felt inadequate when they could not achieve orgasm via vaginal intercourse alone, involving little or no clitoral stimulation, as Freud's theory made penile-vaginal intercourse the central component to women's sexual satisfaction. The first major national surveys of sexual behavior were the Kinsey Reports.
Alfred Kinsey Alfred Charles Kinsey (; June 23, 1894 – August 25, 1956) was an American sexologist, biologist, and professor of entomology and zoology who, in 1947, founded the Institute for Sex Research at Indiana University, now known as the Kinsey Insti ...
was the first researcher to harshly criticize Freud's ideas about female sexuality and orgasm when, through his interviews with thousands of women, Kinsey found that most of the women he surveyed could not have vaginal orgasms. He "criticized Freud and other theorists for projecting male constructs of sexuality onto women" and "viewed the clitoris as the main center of sexual response" and the vagina as "relatively unimportant" for sexual satisfaction, relaying that "few women inserted fingers or objects into their vaginas when they masturbated". He "concluded that satisfaction from penile penetration smainly psychological or perhaps the result of referred sensation". Masters and Johnson's research into the female sexual response cycle, as well as
Shere Hite Shere Hite (; November 2, 1942 – September 9, 2020) was an American-born German sex educator and feminist. Her sexological work focused primarily on female sexuality. Hite built upon biological studies of sex by Masters and Johnson and by Alfred ...
's, generally supported Kinsey's findings about female orgasm. Masters and Johnson's research on the topic came at the time of the second-wave feminist movement, and inspired feminists such as
Anne Koedt Anne Koedt (born 1941) is an American radical feminist activist and author of "The Myth of the Vaginal Orgasm", a 1970 classic feminist work on women's sexuality. She was connected to the group New York Radical Women and was a founding member ...
, author of '' The Myth of the Vaginal Orgasm'', to speak about the "false distinction" made between clitoral and vaginal orgasms and women's biology not being properly analyzed.


Clitoral and vaginal relationships

Accounts that the vagina is capable of producing orgasms continue to be subject to debate because, in addition to the vagina's low concentration of nerve endings, reports of the G-spot's location are inconsistent—it appears to be nonexistent in some women and may be an extension of another structure, such as the
Skene's gland In female human anatomy, Skene's glands or the Skene glands ( , also known as the lesser vestibular glands, paraurethral glands) are glands located around the lower end of the urethra. The glands are surrounded by tissue that swells with blood ...
or the clitoris, which is a part of the Skene's gland. In a January 2012 ''
The Journal of Sexual Medicine ''The Journal of Sexual Medicine'' (''JSM'') is a peer-reviewed medical journal published on behalf of the International Society for Sexual Medicine. Besides the latter society, it is also an official journal for the International Society for the ...
'' review examining years of research into the existence of the G-spot, scholars stated that " ports in the public media would lead one to believe the G-spot is a well-characterized entity capable of providing extreme sexual stimulation, yet this is far from the truth". Possible explanations for the G-spot were examined by Masters and Johnson, who were the first researchers to determine that the clitoral structures surround and extend along and within the labia. In addition to observing that the majority of their female subjects could only have clitoral orgasms, they found that both clitoral and vaginal orgasms had the same stages of physical response. On this basis, they argued that clitoral stimulation is the source of both kinds of orgasms, reasoning that the clitoris is stimulated during penetration by friction against its hood; their notion that this provides the clitoris with sufficient sexual stimulation has been criticized by researchers such as
Elisabeth Lloyd Elisabeth Anne Lloyd (born September 3, 1956) is an American philosopher of science specialising in the philosophy of biology. She is currently Distinguished Professor of History and Philosophy of Science and Medicine - as well as Adjunct Professo ...
. Australian
urologist Urology (from Greek οὖρον ''ouron'' "urine" and '' -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of the urinary-tract system and the reproductive org ...
Helen O'Connell's 2005 research additionally indicates a connection between orgasms experienced vaginally and the clitoris, suggesting that clitoral tissue extends into the anterior wall of the vagina and that therefore clitoral and vaginal orgasms are of the same origin. Some studies, using
ultrasound Ultrasound is sound waves with frequency, frequencies higher than the upper audible limit of human hearing range, hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hea ...
, have found physiological evidence of the G-spot in women who report having orgasms during vaginal intercourse, but O'Connell suggests that the clitoris's interconnected relationship with the vagina is the physiological explanation for the conjectured G-spot. Having used
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
technology which enabled her to note a direct relationship between the legs or roots of the clitoris and the erectile tissue of the "clitoral bulbs" and corpora, and the distal urethra and vagina, she stated that the vaginal wall is the clitoris; that lifting the skin off the vagina on the side walls reveals the bulbs of the clitoris—triangular, crescental masses of erectile tissue. O'Connell et al., who performed dissections on the female genitals of
cadaver A cadaver or corpse is a dead human body that is used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Stud ...
s and used photography to map the structure of nerves in the clitoris, were already aware that the clitoris is more than just its glans and asserted in 1998 that there is more erectile tissue associated with the clitoris than is generally described in anatomical textbooks. They concluded that some females have more extensive clitoral tissues and nerves than others, especially having observed this in young cadavers as compared to elderly ones, and therefore whereas the majority of females can only achieve orgasm by direct stimulation of the external parts of the clitoris, the stimulation of the more generalized tissues of the clitoris via intercourse may be sufficient for others. French researchers Odile Buisson and Pierre Foldès reported similar findings to that of O'Connell's. In 2008, they published the first complete 3D
sonography Medical ultrasound includes diagnostic techniques (mainly imaging techniques) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, musc ...
of the stimulated clitoris, and republished it in 2009 with new research, demonstrating the ways in which erectile tissue of the clitoris engorges and surrounds the vagina, arguing that women may be able to achieve vaginal orgasm via stimulation of the G-spot because the highly innervated clitoris is pulled closely to the anterior wall of the vagina when the woman is sexually aroused and during vaginal penetration. They assert that since the front wall of the vagina is inextricably linked with the internal parts of the clitoris, stimulating the vagina without activating the clitoris may be next to impossible.See her

for the 2009 King's College London's findings on the G-spot an
page 145
for ultrasound/physiological material with regard to the G-spot.
In their 2009 published study, the "coronal planes during Perineum, perineal contraction and finger penetration demonstrated a close relationship between the root of the clitoris and the anterior vaginal wall". Buisson and Foldès suggested "that the special sensitivity of the lower anterior vaginal wall could be explained by pressure and movement of clitoris's root during a vaginal penetration and subsequent perineal contraction". Supporting a distinct G-spot is a study by
Rutgers University Rutgers University (; RU), officially Rutgers, The State University of New Jersey, is a Public university, public land-grant research university consisting of four campuses in New Jersey. Chartered in 1766, Rutgers was originally called Queen's ...
, published 2011, which was the first to map the female genitals onto the sensory portion of the brain; brain scans showed that the brain registered distinct feelings between stimulating the clitoris, the cervix and the vaginal wall – where the G-spot is reported to be – when several women stimulated themselves in a functional magnetic resonance (fMRI) machine. "I think that the bulk of the evidence shows that the G-spot is not a particular thing," stated Barry Komisaruk, head of the research findings. "It's not like saying, 'What is the thyroid gland?' The G-spot is more of a thing like New York City is a thing. It's a region, it's a convergence of many different structures." Commenting on Komisaruk's research and other findings,
Emmanuele Jannini Angelo Francesco Emmanuele Jannini (born 22 April 1960) is an Italian sex therapist , medical doctor, and academic. Biography He was professor of medical sexology at the University of L'Aquila and is full professor of endocrinology and medical ...
, a professor of endocrinology at the University of Aquila in Italy, acknowledged a series of essays published in March 2012 in ''
The Journal of Sexual Medicine ''The Journal of Sexual Medicine'' (''JSM'') is a peer-reviewed medical journal published on behalf of the International Society for Sexual Medicine. Besides the latter society, it is also an official journal for the International Society for the ...
'', which document evidence that vaginal and clitoral orgasms are separate phenomena that activate different areas of the brain and possibly suggest key psychological differences between women.


Other factors and research

Regular difficulty reaching orgasm after ample sexual stimulation, known as anorgasmia, is significantly more common in women than in men ( see below). In addition to sexual dysfunction being a cause for women's inability to reach orgasm, or the amount of time for sexual arousal needed to reach orgasm being variable and longer in women than in men, other factors include a lack of communication between sexual partners about what is needed for the woman to reach orgasm, feelings of sexual inadequacy in either partner, a focus on only penetration (vaginal or otherwise), and men generalizing women's trigger for orgasm based on their own sexual experiences with other women. Scholars state "many couples are locked into the idea that orgasms should be achieved only through intercourse aginal sex and that " en the word ''
foreplay Foreplay is a set of emotionally and physically intimate acts between one or more people meant to create sexual arousal and desire for sexual activity. Although foreplay is typically understood as physical sexual activity, nonphysical activiti ...
'' suggests that any other form of sexual stimulation is merely preparation for the 'main event.'... ...Because women reach orgasm through intercourse less consistently than men, they are more likely than men to have faked an orgasm". Sex counselor
Ian Kerner Ian Kerner is a sex counselor and practitioner of psychotherapy. He specializes in sex therapy, couples therapy and working with individuals on a range of relationship issues. Career Ian is a licensed psychotherapist and widely recognized sex ...
stated, "It's a myth that using the penis is the main way to pleasure a woman." He cites research concluding that women reach orgasm about 25% of the time with intercourse, compared with 81% of the time during oral sex (
cunnilingus Cunnilingus is an oral sex act performed by a person on the vulva or vagina of another person. The clitoris is the most sexually sensitive part of the human female genitalia, and its stimulation may result in a woman becoming sexually aroused ...
). In the first large-scale empirical study worldwide to link specific practices with orgasm, reported in the ''
Journal of Sex Research The ''Journal of Sex Research'' is a peer-reviewed academic journal covering the study of human sexuality and the field of sexology in general. It is published by Routledge on behalf of the Society for the Scientific Study of Sexuality. In 1963, th ...
'' in 2006, demographic and sexual history variables were comparatively weakly associated with orgasm. Data was analyzed from the Australian Study of Health and Relationships, a national telephone survey of sexual behavior and attitudes and sexual health knowledge carried out in 2001–2002, with a representative sample of 19,307 Australians aged 16 to 59. Practices included "vaginal intercourse alone (12%), vaginal + manual stimulation of the man's and/or woman's genitals (49%), and vaginal intercourse + manual + oral (32%)" and the " counters may also have included other practices. Men had an orgasm in 95% of encounters and women in 69%. Generally, the more practices engaged in, the higher a woman's chance of having an orgasm. Women were more likely to reach orgasm in encounters including cunnilingus". Other studies suggest that women exposed to lower levels of prenatal
androgen An androgen (from Greek ''andr-'', the stem of the word meaning "man") is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This inc ...
s are more likely to experience orgasm during vaginal intercourse than other women.


Exercise-induced

Kinsey, in his 1953 book ''Sexual Behavior in the Human Female'', stated that exercise could bring about sexual pleasure, including orgasm. A review in 1990 on the sexual response itself as exercise, reviewed the literature and stated that the field was poorly researched; it also said that studies had found that aerobic or isotonic exercise that resembles sexual activity or sexual positions can induce sexual pleasure, including orgasm. A 2007 review of the relationship between
pelvic floor The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the lev ...
dysfunction and sexual problems in men and women found that they are commonly linked and suggested that physical therapy strengthening the pelvic floor could help address the sexual problems but that it was not well studied enough to recommend. Starting in at least 2007, the term, "coregasm" was used in popular media to refer to exercise-induced orgasm or in academic parlance termed ''exercise-induced sexual pleasure'' or EISP,Volume 26, 2011, Debby Herbenick
Exercise-induced orgasm and pleasure among women
retrieved March 16, 2020, "...A secondary purpose was to understand and assess women's experiences of exercise-induced sexual pleasure (EISP)..."
and an extensive discussion of the "yogasm" occurred in a 2011 ''
Daily Beast ''The Daily Beast'' is an American news website focused on politics, media, and pop culture. It was founded in 2008. It has been characterized as a "high-end tabloid" by Noah Shachtman, the site's editor-in-chief from 2018 to 2021. In a 20 ...
'' posting. A paper published in 2012 presented results of an online survey of women who had experienced an orgasm or other sexual pleasure during exercise. The paper was widely discussed in popular media when it was published. The authors of the paper said that research on the relationship between exercise and sexual response was still lacking.


Males


Variabilities

In men, the most common way of achieving orgasm is by physical sexual stimulation of the
penis A penis (plural ''penises'' or ''penes'' () is the primary sexual organ that male animals use to inseminate females (or hermaphrodites) during copulation. Such organs occur in many animals, both vertebrate and invertebrate, but males do n ...
. This is usually accompanied by
ejaculation Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the male reproductory tract as a result of an orgasm. It is the final stage and natural objective of male sexual stimulation, and an essential componen ...
, but it is possible, though also rare, for men to orgasm without ejaculation (known as a "dry orgasm"). Prepubescent boys have dry orgasms. Dry orgasms can also occur as a result of
retrograde ejaculation Retrograde ejaculation occurs when semen which would be ejaculated via the urethra is redirected to the urinary bladder. Normally, the sphincter of the bladder contracts before ejaculation, sealing the bladder which besides inhibiting the releas ...
, or
hypogonadism Hypogonadism means diminished functional activity of the gonads—the testes or the ovaries—that may result in diminished production of sex hormones. Low androgen (e.g., testosterone) levels are referred to as hypoandrogenism and low estrogen ...
. Men may also ejaculate without reaching orgasm, which is known as anorgasmic ejaculation. They may also achieve orgasm by stimulation of the
prostate The prostate is both an Male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found only in some mammals. It differs between species anatomically, ...
( see below).


Two-stage model

The traditional view of male orgasm is that there are two stages: emission accompanying orgasm, almost instantly followed by a refractory period. The refractory period is the recovery phase after orgasm during which it is physiologically impossible for a man to have additional orgasms. In 1966,
Masters and Johnson The Masters and Johnson research team, composed of William H. Masters and Virginia E. Johnson, pioneered research into the nature of human sexual response and the diagnosis and treatment of sexual disorders and dysfunctions from 1957 until the 1 ...
published pivotal research about the phases of sexual stimulation. Their work included women and men, and, unlike
Alfred Kinsey Alfred Charles Kinsey (; June 23, 1894 – August 25, 1956) was an American sexologist, biologist, and professor of entomology and zoology who, in 1947, founded the Institute for Sex Research at Indiana University, now known as the Kinsey Insti ...
in 1948 and 1953, tried to determine the
physiological Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
stages before and after orgasm. Masters and Johnson argued that, in the first stage, "accessory organs contract and the male can feel the ejaculation coming; two to three seconds later the ejaculation occurs, which the man cannot constrain, delay, or in any way control" and that, in the second stage, "the male feels pleasurable contractions during ejaculation, reporting greater pleasure tied to a greater volume of ejaculate". They reported that, unlike females, "for the man the resolution phase includes a superimposed refractory period" and added that "many males below the age of 30, but relatively few thereafter, have the ability to ejaculate frequently and are subject to only very short refractory periods during the resolution phase". Masters and Johnson equated male orgasm and ejaculation and maintained the necessity for a refractory period between orgasms.


Subsequent and multiple orgasms

There has been little scientific study of multiple orgasm in men. Dunn and Trost defined male multiple orgasm as "two or more orgasms with or without ejaculation and without, or with only very limited, de-tumescence (loss of erection) during one and the same sexual encounter". Although, due to the refractory period, it is rare for men to achieve multiple orgasms, some men have reported having multiple, consecutive orgasms, particularly without ejaculation. There may not be an obvious refractory period, and the final orgasm may cause a refractory period. Multiple orgasms are more commonly reported in very young men than in older men. In younger men, the refractory period may only last a few minutes, but last more than an hour in older men. An increased infusion of the
hormone A hormone (from the Greek participle , "setting in motion") is a class of signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and behavior. Hormones are required ...
oxytocin Oxytocin (Oxt or OT) is a peptide hormone and neuropeptide normally produced in the hypothalamus and released by the posterior pituitary. It plays a role in social bonding, reproduction, childbirth, and the period after childbirth. Oxytocin ...
during ejaculation is believed to be chiefly responsible for the refractory period, and the amount by which oxytocin is increased may affect the length of each refractory period. A scientific study to successfully document natural, fully ejaculatory, multiple orgasms in an adult man was conducted at
Rutgers University Rutgers University (; RU), officially Rutgers, The State University of New Jersey, is a Public university, public land-grant research university consisting of four campuses in New Jersey. Chartered in 1766, Rutgers was originally called Queen's ...
in 1995. During the study, six fully ejaculatory orgasms were experienced in 36 minutes, with no apparent refractory period.


Anal and prostate stimulation

In both sexes, pleasure can be derived from the nerve endings around the anus and the anus itself, such as during anal sex. It is possible for men to achieve orgasms through
prostate The prostate is both an Male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found only in some mammals. It differs between species anatomically, ...
stimulation alone. The prostate is the male homologue (variation) to the Skene's glands (which are believed to be connected to the female G-spot), and can be sexually stimulated through anal sex,
perineum The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), includi ...
massage or via a vibrator. Much of the available information about prostate-induced orgasms comes from anecdotal reports by individuals, and the exact mechanisms by which such orgasms are produced are unclear; some sources suggest this occurs via stimulation of nerves in the Prostatic plexus (nervous), prostatic plexus surrounding the organ, others suggest it is via nerves within the prostate itself, and others say changes in the brain (neuroplasticity) are required to derive pleasure from prostate stimulation. Regardless, prostate-induced orgasms are often reported to be intensely pleasurable. Prostate stimulation can produce a deeper orgasm, described by some men as more widespread and intense, longer-lasting, and allowing for greater feelings of ecstasy than orgasm elicited by penile stimulation only. The practice of pegging (sexual practice), pegging (consisting of a woman penetrating a man's anus with a strap-on dildo) stimulates the prostate. It is typical for a man to not reach orgasm as a receptive partner solely from anal sex. For women, penile-anal penetration may also indirectly stimulate the clitoris by the shared sensory nerves, especially the pudendal nerve, which gives off the inferior anal nerves and divides into the perineal nerve and the dorsal nerve of clitoris, dorsal nerve of the clitoris. The G-spot area, which is considered to be interconnected with the clitoris, may also be indirectly stimulated during anal sex.Se
page 3
for women preferring anal sex to vaginal sex, an
page 15
for reaching orgasm through indirect stimulation of the G-spot.
Although the anus has many nerve endings, their purpose is not specifically for inducing orgasm, and so a woman achieving orgasm solely by anal stimulation is rare. Direct stimulation of the clitoris, a G-spot area, or both, while engaging in anal sex can help some women enjoy the activity and reach orgasm during it. The aforementioned orgasms are sometimes referred to as ''anal orgasms,'' but sexologists and sex educators generally believe that orgasms derived from anal penetration are the result of the relationship between the nerves of the anus, rectum, clitoris or G-spot area in women, and the anus's proximity to the prostate and relationship between the anal and rectal nerves in men, rather than orgasms originating from the anus itself.


Nipple stimulation

For women, stimulation of the breast area during sexual intercourse or
foreplay Foreplay is a set of emotionally and physically intimate acts between one or more people meant to create sexual arousal and desire for sexual activity. Although foreplay is typically understood as physical sexual activity, nonphysical activiti ...
, or solely having the breasts fondled, can create mild to intense orgasms, sometimes referred to as a ''breast orgasm'' or ''nipple orgasm''. Few women report experiencing orgasm from nipple stimulation. Before Komisaruk et al.'s functional magnetic resonance (fMRI) research on nipple stimulation in 2011, reports of women achieving orgasm from nipple stimulation relied solely on anecdotal evidence. Komisaruk's study was the first to map the female genitals onto the sensory portion of the brain; it indicates that sensation from the nipples travels to the same part of the brain as sensations from the vagina, clitoris and cervix, and that these reported orgasms are genital orgasms caused by nipple stimulation, and may be directly linked to the genital sensory cortex ("the genital area of the brain"). * An orgasm is believed to occur in part because of the hormone
oxytocin Oxytocin (Oxt or OT) is a peptide hormone and neuropeptide normally produced in the hypothalamus and released by the posterior pituitary. It plays a role in social bonding, reproduction, childbirth, and the period after childbirth. Oxytocin ...
, which is produced in the body during sexual excitement and arousal and labor. It has also been shown that oxytocin is produced when a man or woman's nipples are stimulated and become erect. Komisaruk also relayed, however, that preliminary data suggests that nipple nerves may directly link up with the relevant parts of the brain without uterine mediation, acknowledging the men in his study who showed the same pattern of nipple stimulation activating genital brain regions.


Medical aspects


Physiological responses

Masters and Johnson were some of the first researchers to study the sexual response cycle in the early 1960s, based on the observation of 382 women and 312 men. They described a cycle that begins with excitement as blood rushes into the genitals, then reaches a plateau during which they are fully aroused, which leads to orgasm, and finally resolution, in which the blood leaves the genitals. In the 1970s, Helen Singer Kaplan added the category of desire to the cycle, which she argued precedes sexual excitation. She stated that emotions of anxiety, defensiveness and the failure of communication can interfere with desire and orgasm. In the late 1980s and after, Rosemary Basson proposed a more cyclical alternative to what had largely been viewed as linear progression. In her model, desire feeds arousal and orgasm, and is in turn fueled by the rest of the orgasmic cycle. Rather than orgasm being the peak of the sexual experience, she suggested that it is just one point in the circle and that people could feel sexually satisfied at any stage, reducing the focus on climax as an end-goal of all sexual activity.


Males

As a man nears orgasm during stimulation of the penis, he feels an intense and highly pleasurable pulsating sensation of Neuromuscular junction, neuromuscular euphoria. These pulsating sensations originates from the contractions of
pelvic floor The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the lev ...
muscles that begin in the anal sphincter and travels to the glans penis, tip of the penis, commonly described as a "throbbing" or "tingling" sensation. They eventually increase in speed and intensity as the orgasm approaches, until a final "plateau" (the orgasmic) pleasure sustained for several seconds. During orgasm, a human male experiences rapid, rhythmic contractions of the anus, anal sphincter, the prostate, and the bulbospongiosus muscles of the penis. The sperm are transmitted up the vas deferens from the testicles, into the prostate gland as well as through the seminal vesicles to produce what is known as semen. The prostate produces a secretion that forms one of the components of ejaculate. Except for in cases of a dry orgasm, contraction of the sphincter and prostate force stored semen to be expelled through External urethral orifice (male), the penis's urethral opening. The process takes from three to ten seconds, and produces a pleasurable feeling. Ejaculation may continue for a few seconds after the euphoric sensation gradually tapers off. It is believed that the exact feeling of "orgasm" varies from one man to another. After ejaculation, a refractory period usually occurs, during which a man cannot achieve another orgasm. This can last anywhere from less than a minute to several hours or days, depending on age and other individual factors.


Females

A woman's orgasm may, in some cases, last a little longer than a man's. Women's orgasms have been estimated to last, on average, approximately 20 seconds, and to consist of a series of muscular contractions in the pelvic area that includes the vagina, the uterus, and the anus. For some women, on some occasions, these contractions begin soon after the woman reports that the orgasm has started and continue at intervals of about one second with initially increasing, and then reducing, intensity. In some instances, the series of regular contractions is followed by a few additional contractions or shudders at irregular intervals. In other cases, the woman reports having an orgasm, but no pelvic contractions are measured at all. Women's orgasms are 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 retracts under the clitoral hood, and the
labia minora The labia minora (Latin for 'smaller lips', singular: ''labium minus'', 'smaller lip'), also known as the inner labia, inner lips, vaginal lips or nymphae are two flaps of skin on either side of the human vaginal opening in the vulva, situated b ...
(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. Elsewhere in the body, myofibroblasts of the nipple-Areolar connective tissue, areolar complex contract, causing erection of the nipples and contraction of the areolar diameter, reaching their maximum at the start of orgasm. A woman experiences full orgasm when her uterus, vagina, anus, and
pelvic The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton). The ...
muscles undergo a series of rhythmic contractions. Most women find these contractions very pleasurable. Researchers from the University of Groningen, University Medical Center of Groningen in the Netherlands correlated the sensation of orgasm with muscular contractions occurring at a frequency of 8–13 Hz centered in the pelvis and measured in the anus. They argue that the presence of this particular frequency of contractions can distinguish between voluntary contraction of these muscles and spontaneous involuntary contractions, and appears to more accurately correlate with orgasm as opposed to other metrics like heart rate that only measure excitation. They assert that they have identified "[t]he first objective and quantitative measure that has a strong correspondence with the subjective experience that orgasm ultimately is" and state that the measure of contractions that occur at a frequency of 8–13 Hz is specific to orgasm. They found that using this metric they could distinguish from rest, voluntary muscular contractions, and even unsuccessful orgasm attempts. Since ancient times in Western Europe, women could be Medical diagnosis, medically diagnosed with a disorder called female hysteria, the symptoms of which included faintness, nervousness, insomnia, fluid retention, heaviness in abdomen, muscle spasm, shortness of breath, irritability, loss of appetite for food or sex, and "a tendency to cause trouble". Women considered suffering from the condition would sometimes undergo "pelvic massage" — Fingering (sexual act), stimulation of the genitals by the doctor until the woman experienced "hysterical paroxysm" (i.e., orgasm). Paroxysm was regarded as a medical treatment, and not a sexual release. The disorder has ceased to be recognized as a medical condition since the 1920s.


Brain

There have been very few studies correlating orgasm and brain activity in real time. One study examined 12 healthy women using a positron emission tomography (PET) scanner while they were being stimulated by their partners. Brain changes were observed and compared between states of rest, sexual stimulation, faked orgasm, and actual orgasm. Differences were reported in the brains of men and women during stimulation. However, changes in brain activity were observed in both sexes in which the brain regions associated with behavioral control, fear and anxiety shut down. Regarding these changes, Gert Holstege said in an interview with ''The Times'', "What this means is that deactivation, letting go of all fear and anxiety, might be the most important thing, even necessary, to have an orgasm." While stroking the clitoris, the parts of the female brain responsible for processing fear, anxiety and behavioral control start to diminish in activity. This reaches a peak at orgasm when the female brain's emotion centers are effectively closed down to produce an almost trance-like state. Holstege is quoted as saying, at the 2005 meeting of the European Society for Human Reproduction and Development: "At the moment of orgasm, women do not have any emotional feelings." However, a subsequent report by Rudie Kortekaas, et al. stated, "Gender commonalities were most evident during orgasm... From these results, we conclude that during the sexual act, differential brain responses across genders are principally related to the stimulatory (plateau) phase and not to the orgasmic phase itself." Research has shown that as in women, the emotional centers of a man's brain also become deactivated during orgasm but to a lesser extent than in women. Brain scans of both sexes have shown that the pleasure centers of a man's brain show more intense activity than in women during orgasm. Male and female brains demonstrate similar changes during orgasm, with brain activity scans showing a temporary decrease in the metabolism, metabolic activity of large parts of the
cerebral cortex The cerebral cortex, also known as the cerebral mantle, is the outer layer of neural tissue of the cerebrum of the brain in humans and other mammals. The cerebral cortex mostly consists of the six-layered neocortex, with just 10% consisting of ...
with normal or increased metabolic activity in the limbic areas of the brain. EEG tracings from volunteers during orgasm were first obtained by Mosovich and Tallaferro in 1954. These research workers recorded EEG changes resembling petit mal or the clonic phase of a grand mal seizure. Further studies in this direction were carried out by Sem-Jacobsen (1968), Heath (1972), Cohen et al. (1976), and others. Sarrel et al. reported a similar observation in 1977. These reports continue to be cited. Unlike them, Craber et al. (1985) failed to find any distinctive EEG changes in four men during masturbation and ejaculation; the authors concluded that the case for the existence of EEG changes specifically related to sexual arousal and orgasm remained unproven. So disagreement arises as to whether the experiment conducted by Mosovich & Tallaferro casts a new light on the nature of orgasm. In some recent studies, authors tend to adopt the opposite point of view that there are no remarkable EEG changes during ejaculation in humans.


Health


General

Orgasm, and sexual activity as a whole, are physical activities that can require exertion of many major bodily systems. A 1997 study in the ''BMJ'' based upon 918 men age 45–59 found that after a ten-year follow-up, men who had fewer orgasms were twice as likely to die of any cause as those having two or more orgasms a week. A follow-up in 2001 which focused more specifically on cardiovascular health found that having sex three or more times a week was associated with a 50% reduction in the risk of heart attack or stroke. There is some research suggesting that greater resting heart rate variability is associated with orgasms through penile-vaginal intercourse without additional simultaneous clitoral stimulation. A small percentage of men have a disease called postorgasmic illness syndrome (POIS), which causes severe muscle pain throughout the body and other symptoms immediately following
ejaculation Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the male reproductory tract as a result of an orgasm. It is the final stage and natural objective of male sexual stimulation, and an essential componen ...
. The symptoms last for up to a week. Some doctors speculate that the frequency of POIS "in the population may be greater than has been reported in the academic literature", and that many POIS sufferers are undiagnosed.


Dysfunction and satisfaction

The inability to have orgasm, or regular difficulty reaching orgasm after ample sexual stimulation, is called anorgasmia or inorgasmia. If a male experiences erection and ejaculation but no orgasm, he is said to have sexual anhedonia (a condition in which an individual cannot feel pleasure from an orgasm) or ejaculatory anhedonia. Anorgasmia is significantly more common in women than in men, which has been attributed to the lack of sex education with regard to women's bodies, especially in Antisexualism, sex-negative cultures, such as clitoral stimulation usually being key for women to orgasm. Approximately 25% of women report difficulties with orgasm, 10% of women have never had an orgasm, and 40% or 40–50% have either complained about sexual dissatisfaction or experienced difficulty becoming sexually aroused at some point in their lives. A 1994 study by Laumann et al. found that 75.0% of men and 28.6% of women always had orgasms with their spouse, while 40.2% of men and 79.7% of women thought their spouse always orgasmed during sex. These rates were different in non-marital straight relationships (cohabitational, long-term and short-term heterosexual relationships), with rates increasing to 80.5% for men and 43.0% for women orgasming during sex with their short-term partners, and 69.3% for men and 82.6% for women thinking their short-term partners always orgasmed. Women are much more likely to be nearly always or always orgasmic when alone than with a partner. However, in a 1996 study by Davis et al., 62% of women in a partnered relationship said they were satisfied with the frequency/consistency of their orgasms. Additionally, some women express that their most satisfying sexual experiences entail being connected to someone, rather than solely basing satisfaction on orgasm. Kinsey's 1953 ''Kinsey Reports, Sexual Behavior in the Human Female'' showed that, over the previous five years of sexual activity, 78% of women had orgasms in 60% to 100% of Women who have sex with women, sexual encounters with other women, compared with 55% for heterosexual sex. Kinsey attributed this difference to female partners knowing more about women's sexuality and how to optimize women's sexual satisfaction than male partners do. Like Kinsey, scholars such as Peplau, Fingerhut and Beals (2004) and Diamond (2006) found that lesbians have orgasms more often and more easily in sexual interactions than heterosexual women do, and that female partners are more likely to emphasize the emotional aspects of lovemaking. In contrast, research by Diane Holmberg and Karen L. Blair (2009), published in the ''Journal of Sex Research'', found that women in same-sex relationships enjoyed identical sexual desire, sexual communication, sexual satisfaction, and satisfaction with orgasm as their heterosexual counterparts. Specifically in relation to simultaneous orgasm and similar practices, many sexologists claim that the problem of premature ejaculation is closely related to the idea encouraged by a scientific approach in the early 20th century when mutual orgasm was overly emphasized as an objective and a sign of true sexual satisfaction in intimate relationships. If orgasm is desired, anorgasmia may be attributed to an inability to relax. It may be 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. Psychoanalyst Wilhelm Reich, in his 1927 book ''Die Funktion des Orgasmus'' (published in English in 1980 as ''Genitality in the Theory and Therapy of Neurosis'') was the first to make orgasm central to the concept of mental health, and defined neurosis in terms of blocks to having orgastic potency. 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. Menopause may involve loss of hormones supporting sexuality and genital functionality. Vaginal and clitoral atrophy and dryness affects up to 50%–60% of postmenopausal women. Testosterone levels in men fall as they age. Sexual dysfunction overall becomes more likely with poor physical and emotional health. "Negative experiences in sexual relationships and overall well-being" are associated with sexual dysfunction.


Theoretical biological and evolutionary functions of female orgasm


Shifts in research

The function or functions of the human female orgasm have been debated among researchers. Researchers have several hypotheses about the role, if any, of the female orgasm in the reproductive and therefore evolutionary process. The literature started with the argument that female orgasm is a byproduct of shared early male ontogeny, where male orgasm is an adaptation. Research has shifted to investigate and also support the sire-choice hypothesis, which proposes that female orgasm has been shaped by natural selection to function in the selection of high quality sires (male parents) for offspring. Therefore, orgasm increases the chances of conceiving with males of a high genetic quality. Research by Randy Thornhill et al. (1995) suggested that female orgasm is more frequent during intercourse with a male partner with low fluctuating asymmetry.


Selective pressure and mating

Wallen K and Lloyd EA stated, "In men, orgasms are under strong selective pressure as orgasms are coupled with ejaculation and thus contribute to male reproductive success. By contrast, women's orgasms in intercourse are highly variable and are under little selective pressure as they are not a reproductive necessity." Desmond Morris suggested in his 1967 popular-science book ''The Naked Ape'' that the 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 Darwinism, Darwinian evolution by leading the female to select Mating, mates who bear qualities like patience, care, imagination, and 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.


Fertility

There are theories that the female orgasm might increase fertility. For example, it has been suggested that 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 a peristalsis or "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. The observation that women tend to reach orgasm more easily when they are ovulating also has led to the suggestion that it is tied to increasing fertility. Evolutionary biologist Robin Baker argues in ''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 evolutionary fit men. This theory suggests that an orgasm during intercourse functions as a bypass button to a woman's natural cervical filter against sperm and pathogens, and that an orgasm before functions to strengthen the filter. Desmond Morris 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 "Poleaxe Hypothesis" or the "Knockout Hypothesis", is now considered unlikely. A 1994 TLC (TV channel), 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 floor, pelvic muscles contracted and her Vaginal portion of cervix, cervix repeatedly dipped into a pool of semen in the vaginal fornix, which might ensure that sperm would proceed by the external orifice of the uterus, making conception more likely. Evolutionary psychologists Christopher Ryan and Cacilda Jethá, in their discussion of the female orgasm, address how long it takes for females to achieve orgasm compared to males, and females' ability to have multiple orgasms, hypothesizing how especially well suited to multiple partners and insemination this is. They quote primate sexuality specialist Alan Dixson in saying that the monogamy-maintenance explanation for female orgasm "seems far-fetched" because "females of other primate species, and particularly those with multimale-multifemale [promiscuous] mating systems such as macaques and chimpanzees, exhibit orgasmic responses in the absence of such bonding or the formation of stable family units." On the other hand, Dixson states that "Gibbons, which are primarily monogamous, do not exhibit obvious signs of female orgasm." The female promiscuity explanation of female sexuality was echoed at least 12 years earlier by other evolutionary biologists, and there is increasing scientific awareness of the female proceptive phase. Though Dixson classifies humans as mildly polygynous in his survey of primate sexuality, he appears to have doubts, when he writes, "One might argue that ... the female's orgasm is rewarding, increases her willingness to copulate with a variety of males rather than one partner, and thus promotes sperm competition." Ryan and Jethá use this as evidence for their theory that partible paternity and promiscuity were common for early modern humans.


Adaptive or vestigial

The clitoris is homology (biology), homologous to the penis; that is, they both develop from the same embryonic structure. While researchers such as Geoffrey Miller (psychologist), Geoffrey Miller, Helen Fisher (anthropologist), Helen Fisher, Meredith Small and Sarah Blaffer Hrdy "have viewed the clitoral orgasm as a legitimate adaptation in its own right, with major implications for female sexual behavior and sexual evolution," others, such as Donald Symons and Stephen Jay Gould, have asserted that the clitoris is vestigiality, vestigial or nonadaptive, and that the female orgasm serves no particular evolutionary function. However, Gould acknowledged that "most female orgasms emanate from a clitoral, rather than vaginal (or some other), site" and stated that his nonadaptive belief "has been widely misunderstood as a denial of either the adaptive value of female orgasm in general, or even as a claim that female orgasms lack significance in some broader sense". He explained that although he accepts that "clitoral orgasm plays a pleasurable and central role in female sexuality and its joys," "[a]ll these favorable attributes, however, emerge just as clearly and just as easily, whether the clitoral site of orgasm arose as a Spandrel (biology), spandrel or an adaptation". He said that the "male biologists who fretted over [the adaptionist questions] simply assumed that a deeply vaginal site, nearer the region of fertilization, would offer greater selective benefit" due to their Darwinian, ''summum bonum'' beliefs about enhanced reproductive success. Proponents of the nonadaptive hypothesis, such as Elisabeth Lloyd, refer 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. "Lloyd is by no means against evolutionary psychology. Quite the opposite; in her methods and in her writing, she advocates and demonstrates a commitment to the careful application of evolutionary theory to the study of human behavior," stated Meredith Chivers, Meredith L. Chivers. She added that Lloyd "meticulously considers the theoretical and empirical bases for each account and ultimately concludes that there is little evidence to support an adaptionist account of female orgasm" and that Lloyd instead "views female orgasm as an ontogenetic leftover; women have orgasms because the urogenital neurophysiology for orgasm is so strongly selected for in males that this developmental blueprint gets expressed in females without affecting fitness, just as males have nipples that serve no fitness-related function". A 2005 twin study found that one in three women reported never or seldom achieving orgasm during sexual 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. Elisabeth Lloyd has cited this as evidence for the notion that female orgasm is not adaptive. Miller, Hrdy, Helen O'Connell and Natalie Angier have criticized the "female orgasm is vestigial" hypothesis as understating and devaluing the psychosocial value of the female orgasm. Hrdy stated that the hypothesis smacks of sexism. O'Connell said, "It boils down to rivalry between the sexes: the idea that one sex is sexual and the other reproductive. The truth is that both are sexual and both are reproductive." O'Connell used
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
technology to define the true size and shape of the clitoris, suggesting that it extends into the anterior wall of the vagina (#Females, see above). O'Connell describes typical textbook descriptions of the clitoris as lacking detail and including inaccuracies, saying that the work of Georg Ludwig Kobelt in the early 19th century provides a most comprehensive and accurate description of clitoral anatomy. She argues that the bulbs appear to be part of the clitoris and that the distal urethra and vagina are intimately related structures, although they are not erectile in character, forming a tissue cluster with the clitoris that appears to be the center of female sexual function and orgasm. By contrast, Nancy Tuana, at the 2002 conference for ''Canadian Society of Women in Philosophy'', argues that the clitoris is unnecessary in reproduction, but that this is why it has been "historically ignored", mainly because of "a fear of pleasure. It is pleasure separated from reproduction. That's the fear". She reasoned that this fear is the cause of the ignorance that veils female sexuality.


Fringe theories

Brody Costa et al. suggest that women's vaginal orgasm consistency is associated with being told in childhood or adolescence that the vagina is the important zone for inducing female orgasm. Other proposed factors include how well women focus mentally on vaginal sensations during penile-vaginal intercourse, the greater duration of intercourse, and preference for above-average penis length. Costa theorizes that vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip. His research indicates that "[a] prominent and sharply raised lip tubercle has been associated with greater odds (odds ratio = 12.3) of ever having a vaginal orgasm, and also with greater past month vaginal orgasm consistency (an effect driven by the women who never had a vaginal orgasm), than less prominent lip tubercle categories." However, lip tubercle was not associated with social desirability responding, or with orgasm triggered by masturbation during penile-vaginal sex, solitary or partner clitoral or vaginal masturbation, vibrator, or cunnilingus. An empirical study carried out in 2008 provides evidence for Freud's implied link between inability to have a vaginal orgasm and psychosexual Defence mechanisms, immaturity. In the study, women reported their past month frequency of different sexual behaviors and corresponding orgasm rates and completed the Defense Style Questionnaire (DSQ-40), which is associated with various Psychopathology, psychopathologies. The study concluded that a "vaginal orgasm was associated with less somatization, dissociation, displacement, autistic fantasy, devaluation, and isolation of affect." Moreover, "vaginally anorgasmic women had immature defenses scores comparable to those of established (depression, social anxiety disorder, panic disorder, and obsessive–compulsive disorder) outpatient psychiatric groups." In the study, a vaginal orgasm (as opposed to a clitoral orgasm) was defined as being triggered solely by penile–vaginal intercourse. According to Wilhelm Reich, the lack of women's capacity to have a vaginal orgasm is due to a lack of orgastic potency, which he believed to be the result of culture's suppression of genital sexuality.


Involuntary orgasm

Medical research shows that the genital reflex is also regulated by the spinal cord, and not necessarily under conscious control. An involuntary orgasm may occur as the result of sexual assault or rape, which may result in feelings of shame caused by internalization of Victim blaming, victim-blaming attitudes. The incidence of those who experience unsolicited sexual contact and experience orgasm is very low, though possibly under-reported due to shame or embarrassment of the victim. Such orgasms may happen to either gender. An unwanted orgasm may arise from a persistent genital arousal disorder. In consensual BDSM play,
forced orgasm A forced orgasm is consensual BDSM or kinky sexual play whereby a person consents to be forced to orgasm in a way that is beyond their control. The person being brought to involuntary orgasm would typically be put in physical restraints to ...
may be practised to exercise orgasm control.


Tantric sex

Tantric sex, which is not the same as Vajrayana, Buddhist tantra (Vajrayana), is the ancient Indian spiritual tradition of sexual practices. It attributes a different value to orgasm than traditional cultural approaches to sexuality. Some practitioners of Tantra, tantric sex aim to eliminate orgasm from sexual intercourse by remaining for a long time in the pre-orgasmic and non-emission state. Advocates of this, such as Rajneesh, claim that it eventually causes orgasmic feelings to spread out to all of one's conscious experience. Advocates of tantric and neotantric sex who claim that Western culture focuses too much on the goal of climactic orgasm, which reduces the ability to have intense pleasure during other moments of the sexual experience, suggest that eliminating this enables a richer, fuller and more intense connection.


Literature

Orgasm has been widely described in literature over the centuries. In antiquity, Latin literature addressed the subject as much as Greek literature: Book III of Ovid's ''Metamorphoses'' retells a discussion between Jove and Juno (mythology), Juno, in which the former states: "The sense of pleasure in the male is far / More dull and dead, than what you females share." Juno rejects this thought; they agree to ask the opinion of Tiresias ("who had known Venus (mythology), Venus/Love in both ways," having lived seven years as a female). Tiresias offends Juno by agreeing with Jove, and she strikes him blind on the spot (Jove lessens the blow by giving Tiresias the gift of foresight, and a long life). Earlier, in the ''Ars Amatoria'', Ovid states that he abhors sexual intercourse that fails to complete both partners. The theme of orgasm survived during Romanticism and is incorporated in many Homoeroticism, homoerotic works. In ''FRAGMENT: Supposed to be an Epithalamium of Francis Ravaillac and Charlotte Cordé'', Percy Bysshe Shelley (1792–1822), "a translator of extraordinary range and versatility", wrote the phrase "No life can equal such a death." That phrase has been seen as a metaphor for orgasm,Hellenism and Homoeroticism in Shelley and his Circle
", by John Lauritsen (2008). Consulted on 10 December 2009.
and it was preceded by the rhythmic urgency of the previous lines "Suck on, suck on, I glow, I glow!", which has been seen as alluding to fellatio. For Shelley, orgasm was "the almost involuntary consequences of a state of abandonment in the society of a person of surpassing attractions". Edward Ellerker Williams, the last love of Shelley's life, was remembered by the poet in "The Boat on the Serchio", which has been considered as possibly "the grandest portrayal of orgasm in literature": Shelley, in this poem, associates orgasm with death when he writes "the death which lovers love". In French literature, the term ''la petite mort'' (the little death) is a famous euphemism for orgasm; it is the representation of man who forgets himself and the world during orgasm. Jorge Luis Borges, in the same vision, wrote in one of the several footnotes of "Tlön, Uqbar, Orbis Tertius" that one of the churches of Tlön claims Platonism, Platonically that "All men, in the vertiginous moment of coitus, are the same man. All men who repeat a line from Shakespeare ''are'' William Shakespeare." Shakespeare himself was knowledgeable of this idea: lines "I will live in thy heart, die in thy lap, and be buried in thy eyes" and "I will die bravely, like a smug bridegroom", said respectively by Benedick in ''Much Ado About Nothing'' and by King Lear in King Lear, the play of that ilk, are interpreted as "to die in a woman's lap" = "to experience a sexual orgasm".
Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
with his psychoanalytic projects, in ''The Ego and the Id'' (1923), speculates that sexual satisfaction by orgasm make Eros ("life instinct") exhausted and leaves the field open to Thanatos ("death instinct"), in other words, with orgasm Eros fulfills its mission and gives way to Thanatos. Other modern authors have chosen to represent the orgasm without metaphors. In the novel ''Lady Chatterley's Lover'' (1928), by D. H. Lawrence, we can find an explicit narrative of a sexual act between a couple: "As he began to move, in the sudden helpless orgasm there awoke in her strange thrills rippling inside her..."


Other animals

The mechanics of male orgasm are similar in most male mammals. Females of some mammal and some non-mammal species, such as alligators, have clitorises. There has been ongoing research about the sexuality of dolphins, one of many species which engage in sexual intercourse for Non-reproductive sexual behavior in animals, reasons other than reproduction.National Geographic's ''Dolphins: The wild side'' documentary (1999). "Sex is as frequent as it is casual, a social tool used to strengthen and maintain bonds. But beneath the harmony lies a darker side of dolphins. Gangs of strong males pick on younger or smaller dolphins.", quote fro
National Geographic website
/ref> The duration of orgasm varies considerably among different mammal species.


See also

* Birthgasm * Child sexuality * Coitus reservatus * Eroto-comatose lucidity * Female ejaculation (''squirt'') * Female sexual arousal disorder * Forced orgasm (a BDSM term) * ''Kama Sutra'' — an ancient text on human sexual behavior * Orgasm gap * Persistent sexual arousal syndrome * Sex position * Sexual function * ''La petite mort''— "the little death" in French (a euphemism for orgasm) * Venus Butterfly


References


Further reading

* Banker-Riskin, Anita; Grandinetti, Deborah (1997). ''Simultaneous Orgasm: And Other Joys of Sexual Intimacy''. Hunter House Publishers, Hunter House. , . * Gabriele Froböse, Rolf Froböse, Michael Gross (Translator): ''Lust and Love: Is it More than Chemistry?'' Publisher: Royal Society of Chemistry, , (2006). * * PARTRIDGE, Eric (2001). ''Shakespeare's bawdy: Classics Series Routledge classics''. 2nd ed., Routledge. , . *Plato (2001). ''The Banquet''. (P.B. Shelley, Trans., J. Lauritsen, Ed., Foreword). Provincetown, MA: Pagan Press. * WEBB, Timothy (1976). ''The violet in the crucible: Shelley and translation'', 1976. Oxford: Clarendon Press.


External links


Men's Health: Male Orgasm



TED Talk
by Mary Roach on 10 things you didn't know about orgasm {{Authority control Orgasm, Human sexuality Sexual acts Euphoriants