All you ever wanted to know about orgasm.
By December 31, 1999 - last reviewed on June 9, 2016published
Steven and Beth are making love. They've been doing it two or three times a week for six months in much the same way: Beth lies on her back with her legs in the air. Steven kneels in front of her, inserts his penis and begins to thrust. Beth grinds her hips and moans slightly. Steven thrusts quickly for 30 seconds, moans, and having ejaculated, withdraws. They hug and lie together in the "spoon" position. Both feel mildly disappointed, but that's how they normally feel after sex. He rolls over and goes to sleep. She stays awake, feeling anxious and depressed.
Next door, Karen and Jason are making love for the first time. They spend lots of time on oral sex and both get very aroused. When Jason enters Karen, she is already so aroused that she has an orgasm immediately. Jason can feel the walls of her vagina pulsing around him. He slows down his thrusting. Now he can feel Karen's breathing change as she goes into a second orgasm, which causes her arms and legs to spasm and her heart to race. Now his breathing quickens and with an extremely loud moan he has an orgasm and ejaculation. His whole body spasms. Jason says, "Don't stop. If you keep moving, I can go again." And he does, having two more orgasms in five minutes. Afterward, Karen and Jason feel energized and give off a glow. They are no youngsters. They are in their late 30s.
These two anecdotes illustrate a number of things (other than the fact that I am unlikely to land a job writing erotica any time soon). First, sex is good for you. Because sexual arousal and orgasm involve an interplay of several body systems, it's well known that sex improves our breathing and circulation, resulting in bright eyes, a facial glow and shiny hair. Sex can also improve cardiovascular conditioning, strength, flexibility and muscle tone, and has been known to relieve the symptoms of specific medical conditions, such as menstrual problems, osteoporosis and arthritis.
Arousal and orgasm also benefit our mental health. Because they cause the release of pleasure-inducing endorphins in the brain, they can relieve anxiety and depression, increase vitality and boost the immune system. Sex also creates an emotional and physical bond that is essential for social support. With all the mental and physical benefits of sex, it's like we're walking around with a complete health care system inside our own body.
The second major point that the opening anecdotes illustrate is that orgasm is not the same for everyone. Men and women have different expectations about lovemaking and orgasms. Orgasms can vary greatly in their physical and psychological intensity, and both men and women may be capable of greater orgasmic responses than we previously thought possible.
If sex is good for your health, good sex is even better, and really great, mind-blowing multiorgasmic sex is even better than that! I believe that recent findings about male and female orgasm are changing our understanding of orgasm so radically that in the near future, we will find evidence that orgasm can have an even more profound effect on our physical and mental health. And the changing views will make it much easier for the average man and woman to reap these psychological and physical benefits.
Kinsey, Masters and Johnson, and other sex researchers defined orgasm as a reflex that occurs when muscle tension and blood flow to the pelvis reach a peak and are dispersed, and when the pubococcygeal (PC) muscle group that supports the pelvic floor spasms rhythmically at 0.8 second intervals and the heart rate accelerates rapidly (often as high as 180 beats a minute) and then slows down. For men, orgasm usually includes ejaculation.
Orgasm can involve changes in blood pressure, heavy breathing, muscle spasms in the buttocks, tension in the arms, legs and neck, facial grimacing, sweating, the sex flush (reddening of the skin on the chest and neck), tingling of the fingers and toes, yawning, moaning, screaming and uncontrollable emotional outbursts such as weeping and laughing (or bursting into songs like "Ah, sweet mystery of life, at last I've found you!"). Some people report a feeling of undefined sadness after orgasm, called post coital tristesse, which I always thought would make a great name for a rock group.
From a psychological standpoint, orgasm can provide a measure of relief or release, and encompass feelings of loss of control or even a sense of an altered state of consciousness, probably due to the release of endorphins.
I describe orgasms on a continuum from a localized genital sensation that is mildly pleasurable to a full-body orgasm with intense psychological sensations and all the fireworks--the kind of orgasm one of my clients calls "the psychedelic jackpot that lights up the universe." With this kind of variation, it's no wonder some women don't notice them.
The Female Orgasm
A brief history of orgasm reveals the radical changes in perspective over time.
In her excellent book, The Technology of Orgasm (Johns Hopkins, 1999), Rachel Maines describes the double standard of female orgasm in the Victorian era. Orgasm was considered both the cause and cure for hysteria, the latter assumption leading to the development of the vibrator. Also in the Victorian era, Sigmund Freud differentiated between what he called a clitoral orgasm and a vaginal orgasm. Female infants and children could masturbate by stimulating the clitoris and experience orgasmic sensations, he posited. By contrast, adult women could experience a vaginal orgasm (described as a deeper sensation) during intercourse. Failure to achieve vaginal orgasm in adulthood, he said, signaled psychological immaturity due to fixation at the phallic stage of psychosexual development.
Alfred Kinsey, in his monumental work Sexual Behavior in the Human Female, also held that as a girl grew up, her clitoral orgasms somehow evolved into vaginal orgasms. "The vagina itself should be the center of sensory stimulation and this, as we have seen," he said, "is a physical and physiologic impossibility for nearly all females."
Taking cues from Kinsey, Masters and Johnson concluded that, regardless of the source of the stimulation, all orgasms happened because they somehow activated the clitoris, either directly or indirectly, and caused PC muscle spasms. The clitoris then became the gold standard of female orgasm. I remember countless magazine advice columns from this era urging men to find "the man in the boat."
A problem with Masters and Johnson is that their studies focused on such minute physical details of arousal and orgasm that a lot of people started missing the big picture. For example, they said the clitoris retracts before orgasm. I knew several women who thought they had a problem because they approached orgasm with their clitoris waving in the breeze. Just because most people in a sex laboratory experience phases of excitement, plateau, orgasm and resolution doesn't mean that's the best or only way to make love.
With the publication of The G Spot (Reinhart and Winston, 1982), Alice Ladas, John Perry and Beverly Whipple demonstrated that the vagina contains at least one area that is sensitive and can trigger orgasm in some women. They also demonstrated the existence of female ejaculation. (This phenomenon was already known to individual women, many of whom thought they had lost control during sex and peed on their partner.) Research continues on the exact nature of the fluid contained in these ejaculations, but, in a radical change from only 15 years ago, sex researchers now assume that all women ejaculate, but often in amounts too small to be noticed.
In my book Discover Your Sensual Potential (HarperCollins, 1999), I explained how to stimulate an area in the upper rear of the vagina known as the culde-sac, also called the fornix. I relied on Masters and Johnson for a phenomenon called "tenting," in which, when a woman becomes really aroused, the muscles and ligaments surrounding the uterus lift it up and allow penetration into this extra inch or so of space behind the cervix, resulting in some incredible orgasmic sensations.
I also relied on a little-known article from the Journal of Sex Research published in 1972. In "Types of Female Orgasm," researchers Singer and Singer described vulval, uterine and blended orgasms. A vulval orgasm resembles what we consider a clitoral orgasm, with spasms of the PC muscle. The uterine orgasm results from stimulation deep inside the vagina. A blended orgasm (although it sounds like a designer coffee drink) combines the two.
The publication of The G Spot led the way for a continued alphabet soup approach to female orgasm: The U spot is the sensitive opening to the urethra; Debbie Tideman, in The X Spot Orgasm, describes stimulation of the cervix; I find that stimulation of the PC muscle that surrounds the opening of the vagina is very successful in enhancing orgasm. And in Are We Having Fun Yet? (Hyperion, 1997), Marcia and Lisa Douglas claim that the female genitals form an "orgasmic crescent" composed of erectile tissue--including the clitoris, the part of the clitoris that extends into the body, the G spot and the area surrounding the urethra--which swells with arousal in a sort of female erection.
Today, female orgasm still suffers from a kind of double standard: On one hand, we have new and expanded information about orgasm triggers. On the other hand, many women are still 'not regularly orgasmic and feel cheated, left out, inferior or resigned, because their expectation of having an orgasm is so low.
Feminist thought suggests that this history amounts to a conspiracy to prevent women from experiencing sexual pleasure, or at the least, a series of value judgments about the female body. But the picture reveals no conspiracy. What we have here is researchers starting out literally "in the dark." Rather than rendering this history obsolete, I see us building on it to discover stronger and more frequent female orgasms.
The Male Orgasm
Male orgasm is not without controversy. The prevailing view only several years ago was that orgasm and ejaculation were one and the same, and that men were not capable of multiple orgasm except in rare cases.
Several years ago, when I trained to be a sexual surrogate partner, what struck me most was that the male surrogate partners I met had that ability. And as a surrogate partner, I found that men I treated for premature ejaculation would, as an unexpected "side effect" of learning ejaculation control, experience spontaneous multiple orgasms.
At the time, there wasn't much reading available on the topic. In the Journal of Sex Research in 1978, Mina Robbins and Gordon Jensen reported interviewing 13 multiorgasmic men, concluding that it is possible for men to have multiple orgasms by separating orgasm from ejaculation. Sex therapists and researchers William Hartman and Marilyn Fithian wrote Any Man Can (St. Martin's Press, 1984), that described some rudimentary techniques that men could use to become multiply orgasmic. In 1989, Marian Dunn and Jan Trost, writing in the Archives of Sexual Behavior, expanded the thinking following interviews with 21 multiorgasmic men. They found that there are different patterns of male orgasmic ability, that men don't always lose their erection after an orgasm or ejaculation, multiple orgasms could be learned, and that expectations can limit men's orgasmic response. Recently, Beverly Whipple and colleagues, reporting in the Journal of Sex Education and Therapy, studied a man who experienced six orgasms in 36 minutes with no erection loss and no attempt to control ejaculation.
In a book I wrote called How To Make Love All Night (HarperCollins, 1994), I identified three patterns of male multiple orgasm: one is a non-ejaculatory orgasm (NEO) in which a man has an orgasm but inhibits ejaculation using the PC muscle. After several orgasms he then "releases the hounds." In multi-ejaculation, a man has several orgasms in a row, all accompanied by full or partial ejaculation. In a third pattern, a man has an intense orgasm and ejaculation, followed by less intense orgasms, or "aftershocks." All of these patterns can occur without erection loss.
Men who experience multiple orgasms report feeling energized after orgasm rather than depleted; are able to understand and enjoy their partner's arousal better; feel closer to their partners; have more options during a sexual encounter with the same partner—which promotes monogamy; and find that their partners had positive reactions. The men find that their orgasms were actually stronger and more intense because they were full-body orgasms rather than localized genital sensations.
The Implications Of These Findings?
We need to study the impact of psychological variables such as thoughts, fantasies and dreams on orgasm and then on physical health. If enhancing orgasm does prove to promote physical health and help relieve pain—and promote mental health by relieving anxiety and depression and protecting against stress—this is clearly an alternative to drugs. As part of this approach, we need to study the quality rather than the quantity or frequency of sexual encounters. Let's get over "Am I normal?" and move toward "Why not be fabulous?"
I would like to propose a new "sexual hygiene" movement in which the emphasis is on the relationship of sex to physical health, vitality, wellness, wellbeing and even creativity.
I think a useful framework from which to view sex education is one that uses expectations—a central concept in many areas of psychology. Expectations can either limit or enhance our sexual experience. In a sense, the current expectation of what many women experience during orgasm is too high—it's unrealistic to expect fireworks when you have no knowledge of your own response and no orgasm history. On the other hand, our current expectations are too low in that we expect preference, not passion, and performance, not pleasure. Sex education should promote aspiration, not limitations, stressing that when you're in a long-term relationship there's always more to learn about your own response and your partner's response.
Exploring Orgasmic Potential
The future of sex is not cybersex or the Orgasmatron, Woody Allen's futuristic orgasm-producing home appliance in his 1973 movie Sleeper. It's still arousal and orgasm with a living, breathing partner. Expanding our orgasmic potential may help end some of the gender divisiveness that many of us have experienced, and allow us to use our bodies to create shared emotional peak experiences that I believe form the basis of adult relationships. It's good to be sexually fit and orgasmic, but the meaning is more important than the techniques used to get there.
We haven't even come close to exploring our orgasmic potential. I'm not naive enough to believe that orgasmic energy powers the universe, cures cancer, or prevents mass killings (though it does a pretty good job of keeping me off the streets). In addition to all of the physical and mental benefits we can get from sex, we can also experience more and greater benefits if we individually and mutually unleash our orgasmic potential.
Here's a question we should all look forward to pondering: If both partners are multiorgasmic, how do you know when you're through making love?
A Bigger Better Orgasm
Both men and woman can use the following techniques to make orgasms longer, stronger, more intense and, ultimately, more healthful.
1. GAIN PELVIC MUSCLE CONTROL. The pubococcygeal (PC) muscle group, which supports the pelvic floor, is the one that spasms when you have an orgasm. If it's in good shape, more blood will flow to the pelvic area during arousal and the PC will contract more strongly, making orgasms last longer and feel more intense. To paraphrase a statement about scientific discovery, "Orgasm favors the prepared body." Kegel exercises are a simple way to strengthen PC muscles. To do them, squeeze the muscle you use to voluntarily hold back your urine. Hold for two seconds and then release. Repeat 20 times, three times a day.
2. CONTROL VOLUNTARY MOVEMENTS IN SEX. You may already realize that some of the phenomena happening to your body during sex are under your control. While you cannot voluntarily increase and decrease your heart rate, you can take charge of various voluntary activities and thereby improve your sexual sensations.
As you approach orgasm, try speeding up your breathing and alternately tensing and relaxing your arm or leg muscles. During another session of lovemaking, practice squeezing or fluttering your PC muscle. The main behavioral principle is to choose one physical aspect of orgasm that you can control and overpractice it. Soon you will have trained your body so that all of these responses will work together effortlessly and occur spontaneously during future orgasms.
3. MONITOR YOUR AROUSAL LEVELS. As you make love, note your arousal levels on a scale from 1 to 10, with 10 being orgasm. As you reach each level, briefly stop and allow your arousal to subside so that rather than shooting straight for the moon, your arousal rises in a wave-like pattern. This technique, known as peaking, results in intense orgasms, possibly because it optimizes endorphin release.
In a related exercise, plateauing, squeeze your PC muscle, change your breathing, change your focus or change your speed in order to stay at high arousal levels for a long time prior to orgasm. Learning peaking and plateauing with a partner helps you develop a shared language of arousal and orgasm.
Barbara Keesling, Ph.D., is a lecturer on human sexuality at the California State University at Fullerton, and has written nine books, including Getting Close: A Lover's Guide to Embracing Fantasy and Heightening Sexual Connection (HarperCollins, 1999).