The Nitty Gritty on Orgasms

Orgasms and Quality Sex 

In orgasm, we feel pleasure sensations in body and brain like few other human actions can give us. 

Orgasm in both sexes results in an oxytocin (bonding chemical) release as muscles contract and dopamine (a pleasure chemical) floods the reward centers of the brain.

Orgasming in Women vs Men

Research shows that over 90% of Western women have experienced an orgasm sometime in their lives and 88% have had an orgasm during intercourse.

Research also confirms that the quality of sex a woman experiences dramatically impacts her chances of orgasming. In fact, 70% of the variation in women’s frequency of orgasm during sex is due to external environmental factors, including positive (or negative) aspects of her partner.

For men, the situation is a bit (no, make that, VERY) different. Between 91% (younger) and 75% (older) of heterosexual men regularly orgasm during partnered sex.

For women this number drops down to 39% (younger) and 29% (older) for partnered sex with men. In contrast, 83% of women who have partnered sex with other women regularly orgasm.

To a great extent, this is related to an understanding among women as to how to touch and stimulate the female clitoris (not too soft, not too hard, “just right!”).

Indeed, much of the time, a woman’s inability to orgasm in partnered sex is due to “operator error.” Women who have to masturbate after intercourse to find release already know this.

Understanding the Female "Orgasm Organ"

Few of us in our society are taught the actual physiology and anatomy of this female “orgasm organ” and most of us need a better knowledge of its breadth and depth.

Perhaps the most prevalent myth in human society about the clitoris regards its location: the external glans (‘nub”, “head”) is just the tip of a much larger iceberg of an organ that lies under and around our entire vulva and urethra. Anatomically, most of the clitoris lies deep beneath the fat and muscle fascia (covering) the vulva with the clitoris attached to the front of our pubic area and on both sides of the vulvar labia.

Pretty much every place we or a partner put(s) pressure on in this crotch area can feel good because the clitoris is so large underneath.

Evolutionary biology suggests that somewhere in the last 300,000 years, natural selection experimented with developing this large organ underneath our female skin as primates moved from mammalian sex during “heat” to being sexually receptive all month long.

Purpose of the Clitoris

For reasons mainly of pleasure assurance, the clitoris developed with a boomerang shape that measures about five inches long from front to back along both sides of the genital opening, protruding about two to three inches deep under our skin, and lying, at least that wide from side to side across the woman’s pelvis on both sides of our vulva.

The woman’s clitoris is essentially the same size as a man’s penis, but with 90% of the arousal tissue under the skin around our vulva.

This clitoris is made out of erectile cells that enlarge when aroused (like the penis…again the penis is actually a male external version of the female clitoris). It also developed sensitivity to estrogen and testosterone sex steroids in order to help maintain function.

One way we know that the clitoris came into being at least in some part to make sure people had a good deal of sex is that women who go through menopause (and have, thus, concluded their reproductive function) without hormone replacement (HRT) will discover that their clitoral cells begin dying back (atrophy of the clitoris cells). When these same women take HRT (which tricks our bodies into thinking we are still reproductively active) this atrophy does not occur.

Women's Sexual "Cluster"

Overall, female sexual response involves the clitoris and the distal (outer most) urethra and vagina—all three form a unified “cluster” that becomes engorged with blood during sexual arousal.

The infamous G spot on MRI studies is not a separate part of female biology from the clitoris—it is part of the clitoral aspect of the cluster of organs that respond with increased blood flow (the arousal tissue) during sexual stimulation. It is unclear to researchers in our field just how many people know at a conscious level that the clitoris is as large as it is, but we estimate that the numbers are low.

At the same time, even if, in reading this, you are first learning how big the clitoris actually is, your body (if you are a woman) most likely already knew. It knew every time you ground into your lover during sex. Your body was not just trying to get the external head of the clit to be stimulated but, rather, you were seeking friction on the whole clitoris wrapping around your partner’s penis.

Missing Information

One would think that this anatomy would be well taught, but in reality the clitoris keeps getting lost in medical textbooks. In contrast to the many pages devoted to penile anatomy, showing the nerves, blood supply and muscles that are important for doing surgery on or treating disease of the penis, detailed information for the clitoris has been lacking, even in classics like Gray’s Anatomy (which most doctors still use in their training).

Thankfully, the feminists of the ‘70s forced textbooks to be corrected and somewhat more accurate information was added back in, although detail is still lacking in most medical texts, and, occasionally, even modern versions misplace aspects of this organ, making it difficult for healthcare providers to understand its true physiology and size.

Perhaps one of the reasons (along with sexism) that the clitoris has received short shrift may be that scientists were not sure how it (and the orgasms it gives us) were “needed” in sexual biology.

Making Sense of the Clitoris

Given the fact that many women do not experience “vaginal orgasms” ( defined as “being able to orgasm with a man during penile-vaginal intercourse”) without significant direct stimulation of the clitoris, it makes some sense that both scientists and lovers have had difficulty understanding this organ.

In trying to make sense of it all, some scientists and sexual therapists spend a lot of time debating (with hundreds of published articles on hours of research studies) the pros and cons of different types of female orgasm.

However, many progressive scientists like me have come to realize that these discussions are somewhat ridiculous. As my sister said recently, “Similar to the medieval arguments on how many angels could dance on the head of a pin.”

The fact is: all women, with any contact of their genital area, are having clitorally-triggered orgasms to some degree because it is not possible to penetrate, touch or lick this pubic region of women without contacting the clitoris.

Discussions of what feels best and is most fulfilling for individual women is a matter of preference regarding the type of stimulation that most easily triggers her to climax. Although a recent study confirmed that, for many women, “being on top” allows us to control the stretching and pressing of the male pelvis on our whole clitoris and increases our orgasm response.

- Dr. E

Science can help us nurture and enjoy our sexual selves.


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