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PubMed1982

The female orgasm: pelvic contractions.

Eleven nulliparous women manually self-stimulated to orgasm, each on three separate occasions. Pelvic contraction pressure was measured by an anal probe and a vaginal probe simultaneously. Near the perceived start of orgasm, a series of regular contractions began in nine of the women. Anal and vaginal contraction waveforms were synchronized with each other, and the same number of orgasmic contractions occurred in each lumen. Anal pressure had a higher resting baseline and greater amplitude contractions than vaginal pressure. The perceived start of orgasm did not correspond precisely with the onset of regular contractions. Mean intercontraction intervals increased linearly at an increment of about 0.1 second through the series of regular contractions. Amplitudes of contraction pressure waveforms, representing pelvic muscular force, were initially low, increased through the first half of the regular series, and then decreased. Area and net area of the pressure waveforms, reflecting pelvic muscular exertion (force x time), increased during the regular orgasmic contractions. Three of the women's orgasms consistently included only a series of regular contractions (orgasm type I). For six other women, orgasms consistently continued beyond the regular series with additional irregular contractions (orgasm type II). Types I and II had been identified previously in men. Two women had no regular contractions during reported orgasms. This pattern, type IV, had not been recorded in men. Women of different types showed marked differences in orgasm duration and number of contractions. Identification of these types in subjects is important for meaningful comparison of contraction parameters in different studies.

Adult↗

PubMed1989

Male multiple orgasms: a descriptive study.

Little is known about the phenomenon of multiple orgasms among men. The traditional view assumes there are two stages of orgasm in the healthy male: emission following orgasm almost instantly, followed by a refractory period. Contradictory experiences have been reported by men. Data from interviews with 21 multiply orgasmic men are presented. Men reported that detumescence does not always follow an orgasm, that a nonejaculatory orgasm can occur prior to as well as after an ejaculatory orgasm, and that it is possible to have a series of orgasms. Some of the men reported always having been multiply orgasmic, whereas others experienced it relatively late in life. Others have actively learned to become multiply orgasmic. It may be that our traditional expectations regarding the possible limited range of male orgasmic capacity have profoundly influenced men's behavior as well as research in this area.

Adult↗

PubMed1984

Female orgasmic experience: a subjective study.

Human female orgasm was studied by collecting and analyzing the subjective orgasmic histories of 30 women, ages 18 to 59 years. Virtually all of the 93% who reported they had experienced orgasm also reported some level of conscious control over whether or not they reached orgasm. Women differed widely as to preferred types of physical stimulation and/or mental activities to facilitate orgasm. Orgasms were experienced as centered in the clitoral and/or vaginal areas. Women over 40 were more likely to have experienced orgasm in more than one anatomic site than were women aged 18 to 29. Marital status, religion, occupation, educational level, experiences of pregnancy and childbirth, various reported characteristics of relationships with partners, and early sexual experience were not associated with where orgasm is experienced within the body or with other variables of adult orgasmic experience. The variation among women as to how orgasm is best reached, differences in where it is experienced within the body, and the reasons why an individual woman experiences orgasms differently over time remain poorly understood phenomena.

Adolescent↗

PubMed2002

The psychodynamics of orgasm.

Orgasm itself, along with its specific psychodynamic, has stimulated few reflections and little research in the psychoanalytical field to date. In this regard, perspectives relating to orgasm are generally placed within a wider context covering desire, arousal and, of course, satisfaction. Freud himself seemed to show no particular or systematic interest in an orgasmic psychodynamic per se. This article, the aim of which is to consider the specific nature of orgasm, proposes a two-stage reflection. First, it considers the specific aspects of orgasm in order to arrive at a phenomenology of the orgasm itself--within a clearly defined framework. Second, it explains this phenomenology from a psychoanalytical point of view. These reflections lead us to suggest that while the erogenous zones in men and women respectively are at the root of the sexual arousal that leads to orgasm, it is most probably in fantasy that the female orgasm finds its major trigger. This is all the more relevant given that the existence of a real qualitative difference between clitoral and vaginal orgasm is now being challenged. This would tend to confirm the idea of a predominance of fantasy over bodily location, given that, quite clearly, it is not possible to attribute the former role to a precise area of the body. In this respect, only the analytical process is able to lead us to the primary sources of orgasmic problems--both male and female--and, above all, to reconstruct the origin of a satisfactory or unsatisfactory orgasm.

Adult↗

PubMed1976

Sleep orgasm in women.

Some of the recent most challenging contributions to our knowledge of female sexuality were provided by direct observations as early as during the second year of life concerning genital self-stimulation and masturbation in girls. Other investigators have advanced the proposition that girls are capable of vaginal masturbation and possibly of experiencing vaginal sensation and stimulation very early in life. Our own clinical study on sleep orgasm, based mainly on data obtained from the analysis of one woman, leads to formulating the hypothesis that in some instances the nursing situation may provide sensations in the genitals (vagina), not only for the mother, but also for the baby. We assume that such sensations in the genitals of the infant female are not the result of mechanical stimulation of the genital organs--as described during the second year and later--but are the result of a "resonance" phenomenon whereby the infant's genitals, including the vagina, are stimulated from within. The observations of orgasm made by others and by the author should be considered the first tentative steps toward an understanding of the complex nature of female orgasm. Eventually, further studies might lead to distinguishing more clearly a sexual orgasm in a narrower sense from a sucking orgasm, from an anger orgasm, and from a stress orgasm--i.e. an unspecific genital discharge. Sleep orgasm can represent gratification of unacceptable disguised sexual wishes and can therefore occur after intercourse and orgasm experienced when awake. The study of sleep orgasm might be of value in relation to the general problems of female orgasm. I would like to close with a reminder that some of the formulations presented in this paper are quite obviously largely speculative.

Adult↗

PubMed2002

THE PSYCHODYNAMICS OF ORGASM.

Orgasm itself, along with its specific psychodynamic, has stimulated few reflections and little research in the psychoanalytical field to date. In this regard, perspectives relating to orgasm are generally placed within a wider context covering desire, arousal and, of course, satisfaction. Freud himself seemed to show no particular or systematic interest in an orgasmic psychodynamic per se. This article, the aim of which is to consider the specific nature of orgasm, proposes a two-stage reflection. First, it considers the specific aspects of orgasm in order to arrive at a phenomenology of the orgasm itself-within a clearly defined framework. Second, it explains this phenomenology from a psychoanalytical point of view. These reflections lead us to suggest that while the erogenous zones in men and women respectively are at the root of the sexual arousal that leads to orgasm, it is most probably in fantasy that the female orgasm finds its major trigger. This is all the more relevant given that the existence of a real qualitative difference between clitoral and vaginal orgasm is now being challenged. This would tend to confirm the idea of a predominance of fantasy over bodily location, given that, quite clearly, it is not possible to attribute the former role to a precise area of the body. In this respect, only the analytical process is able to lead us to the primary sources of orgasmic problems-both male and female-and, above all, to reconstruct the origin of a satisfactory or unsatisfactory orgasm.

Journal Article↗

PubMed1992

Physiological correlates of imagery-induced orgasm in women.

Orgasm has been reported to occur in response to imagery in the absence of any physical stimulation. This study was undertaken to ascertain whether the subjective report of imagery-induced orgasm is accompanied by physiological and perceptual events that are characteristic of genitally stimulated orgasm. Subjects were women who claimed that they could experience orgasm from imagery alone. Orgasm from self-induced imagery or genital self-stimulation generated significant increases in systolic blood pressure, heart rate, pupil diameter, pain detection threshold, and pain tolerance threshold over resting control conditions. These findings provide evidence that orgasm from self-induced imagery and genital self-stimulation can each produce significant and substantial net sympathetic activation and concomitant significant increases in pain thresholds. The increases in the self-induced imagery orgasm condition were comparable in magnitude to those in the genital self-stimulation-produced orgasm condition. On this basis we state that physical genital stimulation is evidently not necessary to produce a state that is reported to be an orgasm and that a reassessment of the nature of orgasm is warranted.

Adult↗

PubMed1975

Secondary orgasmic dysfunction. I. Analysis and strategies for treatment.

Following treatment of six cases of primary orgasmic dysfunction and six cases of secondary orgasmic dysfunction, an analysis of assessment and outcome data indicated that (1)clients with secondary orgasmic dysfunction and those with primary orgasmic dysfunction did not differ significantly in most aspects of sexual behavior before treatment; (2) before treatment, secondary orgasmic dysfunction tended to be associated with a disturbed marital relationship, while primary orgasmic dysfunction did not; (3) following a behavioral treatment program focused on anxiety reduction and sexual skill training, organism in coitus was attained by clients with primary orgasmic dysfunction but not by clients with secondary orgasmic dysfunction. Based on these findings, suggestions for effective treatment of secondary orgasmic dysfunction are made.

Adult↗

PubMed1983

Dimensions of subjective female orgasmic responsiveness.

Results of recent psychological research have been at odds with the major physiological evidence on the nature of female orgasmic responsiveness. Although female orgasm appears to be a single process physiologically, subjective reports by women indicate that individual differences in their experience is multidimensional. The basis for the discrepant findings is analyzed via two studies of reported orgasmic experiences in women. One sample of 115 sexually experienced women yielded data that replicated the finding that coital and masturbatory orgasmic responsiveness can be statistically distinguished and independently assessed, thus indicating that sample selection associated with prior research could not explain the result. A separate sample of 101 sexually experienced women were given an instrument that assessed coital responsiveness but differentiated masturbatory responsiveness into dimensions associated with masturbation when alone and with a partner without intercourse. A confirmatory factor analysis substantiated the existence of the three dimensions of female orgasm. However, female orgasmic responsiveness was highly correlated across the three dimensions so that it was possible to isolate a large second-order factor of general orgasmic responsiveness that is consistent with most of the physiological evidence on the unitary nature of orgasm. Correlates of the orgasm scales with background data revealed some discriminant validity for the three dimensions of responsiveness.

Adolescent↗

PubMed1996

Orgasm after radical prostatectomy.

OBJECTIVE: To evaluate the ability to obtain and the quality of orgasm after radical prostatectomy. PATIENTS AND METHODS: The orgasms experienced after undergoing radical prostatectomy were evaluated in 20 men (median age 65 years, range 56-76) using a semi-structured interview and a self-administered questionnaire. In addition, the patients were asked to write a brief statement about their experiences and sensations during orgasm before and after the operation. RESULTS: Eighteen patients returned the questionnaire and 17 completed a statement indicating what their orgasm was like before and after radical prostatectomy. After the operation, no patient was able to maintain a completely rigid erection, but for five patients the erection was sufficient for sexual intercourse. Nine patients used a vacuum device or intracavernosal self-injection. Half the patients reported diminished sexual desire (libido) and arousal after the operation and reported the same to occur in their partners. During their "dry' orgasm post-operatively, none of the patients experienced the exquisite sensation of inevitability, the so-called "point of no return'. Seven of the 14 patients experiencing orgasm complained that their orgasmic sensation was weakened. Four patients reported normal pleasure and sensation compared to that experienced pre-operatively. Surprisingly, nine of the 14 patients had involuntary loss of urine at orgasm; for five of them this was sufficient reason to avoid any sexual contact with their partner. CONCLUSION: Radical prostatectomy may have serious consequences on libido and erectile function but sometimes other important factors, such as the absence of prostate and seminal vesicle contractions, the loss of ejaculation and involuntary loss of urine, may also compromise the orgasm.

Aged↗

PubMed1986

Enhancing relationships: understanding the feminine mystique of pretending orgasm.

As individuals become increasingly aware of their sexuality and orgasmic responsiveness, concomitantly, the phenomenon of pretending orgasm is becoming a greater part of the sexual relationship for many couples. However, few studies exist concerning this phenomenon despite the fact that nearly two-thirds of all females have reported pretending orgasm. Therefore, the purpose of this study was to profile those females who have pretended orgasm by examining the dimensions of their sexual and orgasmic behaviors, the factors that inhibit their orgasm, the dynamics of partner interaction, and any desired changes in their sexual lives. A survey research design was employed utilizing the responses of 805 professional nurses who participated in a study concerning self-perceptions of the female sexual response. The findings indicate that those females who have ever pretended orgasm became sexually active at a younger age and have been more sexually explorative than those females who have not pretended orgasm. Furthermore, the role of their sex partners was a significant dimension in their orgasmic pretense. The resultant impact on coupled relationships has many critical implications for therapists.

Adult↗

PubMed2006

Regional cerebral blood flow changes associated with clitorally induced orgasm in healthy women.

There is a severe lack of knowledge regarding the brain regions involved in human sexual performance in general, and female orgasm in particular. We used [15O]-H2O positron emission tomography to measure regional cerebral blood flow (rCBF) in 12 healthy women during a nonsexual resting state, clitorally induced orgasm, sexual clitoral stimulation (sexual arousal control) and imitation of orgasm (motor output control). Extracerebral markers of sexual performance and orgasm were rectal pressure variability (RPstd) and perceived level of sexual arousal (PSA). Sexual stimulation of the clitoris (compared to rest) significantly increased rCBF in the left secondary and right dorsal primary somatosensory cortex, providing the first account of neocortical processing of sexual clitoral information. In contrast, orgasm was mainly associated with profound rCBF decreases in the neocortex when compared with the control conditions (clitoral stimulation and imitation of orgasm), particularly in the left lateral orbitofrontal cortex, inferior temporal gyrus and anterior temporal pole. Significant positive correlations were found between RPstd and rCBF in the left deep cerebellar nuclei, and between PSA and rCBF in the ventral midbrain and right caudate nucleus. We propose that decreased blood flow in the left lateral orbitofrontal cortex signifies behavioural disinhibition during orgasm in women, and that deactivation of the temporal lobe is directly related to high sexual arousal. In addition, the deep cerebellar nuclei may be involved in orgasm-specific muscle contractions while the involvement of the ventral midbrain and right caudate nucleus suggests a role for dopamine in female sexual arousal and orgasm.

Adult↗

PubMed2004

Disorders of orgasm in women.

INTRODUCTION: Orgasm is a sensation of intense pleasure creating an altered consciousness state accompanied by pelvic striated circumvaginal musculature and uterine/anal contractions and myotonia that resolves sexually-induced vasocongestion and induces well-being/contentment. In 1,749 randomly-sampled U.S. women, 24% reported an orgasmic dysfunction. AIM: To provide recommendations/guidelines concerning state-of-the-art knowledge for management of orgasmic disorders in women. METHODS: An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a process over a 2-year period. Concerning the Disorders of Orgasm in Women Committee, there were four experts from two countries. MAIN OUTCOME MEASURE: Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation and debate. RESULTS: Female Orgasmic Disorder, the second most frequently reported women's sexual problem is considered to be the persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase that causes marked distress or interpersonal difficulty (DSM-IV). Empirical treatment outcome research is available for cognitive behavioral and pharmacological approaches. Cognitive-behavioral therapy for anorgasmia promotes attitude and sexually-relevant thought changes and anxiety reduction using behavioral exercises such as directed masturbation, sensate focus, and systematic desensitization treatments as well as sex education, communication skills training, and Kegel exercises. To date there are no pharmacological agents trials (i.e., bupropion, granisetron, and sildenafil) proven to be beneficial beyond placebo in enhancing orgasmic function in women diagnosed with Female Orgasmic Disorder. CONCLUSIONS: More research is needed in understanding management of women with orgasmic dysfunction.

Behavior Therapy↗

PubMed2004

Women's orgasm.

An orgasm in the human female is a variable, transient peak sensation of intense pleasure, creating an altered state of consciousness, usually with an initiation accompanied by involuntary, rhythmic contractions of the pelvic striated circumvaginal musculature, often with concomitant uterine and anal contractions, and myotonia that resolves the sexually induced vasocongestion and myotonia, generally with an induction of well-being and contentment. Women's orgasms can be induced by erotic stimulation of a variety of genital and nongenital sites. As of yet, no definitive explanations for what triggers orgasm have emerged. Studies of brain imaging indicate increased activation at orgasm, compared to pre-orgasm, in the paraventricular nucleus of the hypothalamus, periaqueductal gray of the midbrain, hippocampus, and the cerebellum. Psychosocial factors commonly discussed in relation to female orgasmic ability include age, education, social class, religion, personality, and relationship issues. Findings from surveys and clinical reports suggest that orgasm problems are the second most frequently reported sexual problems in women. Cognitive-behavioral therapy for anorgasmia focuses on promoting changes in attitudes and sexually relevant thoughts, decreasing anxiety, and increasing orgasmic ability and satisfaction. To date there are no pharmacological agents proven to be beneficial beyond placebo in enhancing orgasmic function in women.

Arousal↗

PubMed1993

[The duration of female orgasm].

Short orgasm lasting from 3 to 15 second was for a long time viewed as the only regularly occurring type of female orgastic experience. Bohlen et al. (1992) and other authors demonstrated in physiological experiments the occurrence of a longer female orgasm of the duration between 20 seconds and 2 minutes. Hubalek and Raboch (1984) found in structured interviews with marital couples that such long female orgasms were not exceptional. About 40% of 121 women estimated the duration of their orgasm to be 30 to 60 seconds or even longer, mostly in agreement with independent estimates of their husbands. Our own findings are based on our sexuological inventory SGZ, which contains one open question concerning the duration of respondent's orgasm. In a sample of 200 women treated for neurosis 37% reported long orgasm, 37% short orgasm and 26% did not answer the question. In a sample of 100 female health professionals and counselors, 48% experienced predominantly long orgasm and 44% short ones (8% did not answer). Our data confirm relatively frequent occurrence of long orgasm in females.

Adult↗

PubMed1991

Female sexual response and the timing of partner orgasm.

Although orgasm can be experienced in many ways with or without a partner, partner involvement continues to be a noted preference for many women. In order to examine the timing of partner orgasm in relationship to female sexual response, women who usually experience orgasm before, simultaneously, or after their male partner's first orgasm were examined in the context of their orgasmic behaviors, role of their partners in sexual interaction, and their level of sexual satisfaction. A survey research design, which utilized the responses of 709 adult women, indicated that those women who usually experienced orgasm after their male partners perceived less physiological and psychological sexual satisfaction. Furthermore, several other significant results were found regarding timing of partner orgasm. With the failure to reach orgasm through sexual intercourse being reported by women as a common sexual complaint, sex educators and therapists can use these findings to facilitate an increased awareness of timing factors influencing satisfying sexual relationships.

Adult↗

PubMed2003

Specificity of the neuroendocrine response to orgasm during sexual arousal in men.

We have demonstrated that sexual activity produces transient sympathoadrenal activation and a pronounced, long-lasting increase in prolactin in men and women. However, by analyzing endocrine alterations at 10-min intervals, a precise assignment of these changes to the pre-, peri- and postorgasmic periods was not possible. Thus, the current study aimed to accurately differentiate the endocrine response to sexual arousal and orgasm in men using an automatic blood collection technique with 2-min sampling intervals. Blood was drawn continuously before, during and after orgasm over a total period of 40 min in 10 healthy subjects and were compared with samples obtained under a control condition. Sexual activity induced transient increases of plasma epinephrine and norepinephrine levels during orgasm with a rapid decline thereafter. In contrast, prolactin levels increased immediately after orgasm and remained elevated throughout the experiment. Although oxytocin was acutely increased after orgasm, these changes were not consistent and did not reach statistical significance. Vasopressin, LH, FSH and testosterone plasma concentrations remained unaltered during sexual arousal and orgasm. These data confirm that prolactin is secreted after orgasm and, compared with oxytocin, seems to represent a more reliable and sustained marker for orgasm in man. The results further reinforce a role for prolactin either as a neuroendocrine reproductive reflex or as a feedback mechanism modulating dopaminergic systems in the central nervous system that are responsible for appetitive behavior.

Adolescent↗

PubMed2004

The utility of tamsulosin in the management of orgasm-associated pain: a pilot analysis.

INTRODUCTION: Orgasmic pain is an infrequently reported but distressing problem for the patients who experience it. No consensus exists as to its etiology however bladder neck/pelvic floor spasm may play a role. This analysis was conducted to assess the effect of the alpha-blocking medication, tamsulosin on post-orgasmic pain. METHODS: In a prospective, non-placebo controlled study, patients with orgasmic pain were interviewed and administered tamsulosin 0.4 mg po qhs for at least 4 weeks. Outcome measures included libido, pain and continence and these were evaluated using the International Index of Erectile Function (IIEF), a visual analog scale (VAS) for pain and an incontinence scale respectively pre and post treatment. Patients were separated into groups based on etiology of the problem (radical prostatectomy, radiation therapy, and other) for statistical analysis. RESULTS: 98 patients were enrolled. Pain was located predominantly in the penis (72%), with other sites including testis, rectum and abdomen. Most patients (52%) experienced pain for less than 5 minutes post-orgasm. 76/98 (77%) patients reported significant improvement in pain (>/=2 points on pain VAS) and 12/98 (12%) noted complete resolution of their pain. The VAS for pain reflected a statistically significant decrease in pain for all groups in response to tamsulosin treatment. The entire group had a decrease of 2.7 points between pre and post-treatment phases. The IIEF libido domain increased significantly (mean of 2.4 points) for all treatment groups. CONCLUSION: Tamsulosin decreases orgasmic pain intensity in patients with orgasmic pain. These data support the hypothesis that orgasmic pain is related to bladder neck and/or pelvic floor muscle spasm.

Abdomen↗