tag:theconversation.com,2011:/nz/topics/vaginal-orgasm-13380/articlesVaginal orgasm – The Conversation2020-03-20T12:06:56Ztag:theconversation.com,2011:article/1316182020-03-20T12:06:56Z2020-03-20T12:06:56ZThe cervix is sensitive, and surgeons need to acknowledge the part it plays in some women’s pleasure<figure><img src="https://images.theconversation.com/files/318453/original/file-20200303-66089-ft9ekk.jpg?ixlib=rb-1.1.0&rect=35%2C53%2C5937%2C3925&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Women and their doctors need to communicate about potential sexual side effects from procedures that involve the cervix. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image/1497465971">RacheeLynn/Shutterstock.com</a></span></figcaption></figure><p>“Sexual Response in the Human Female,” popularly known as the “Kinsey Report,”
generated an <a href="https://www.latimes.com/archives/la-xpm-2004-nov-15-he-kinsey15-story.html">international sensation</a> in 1953, <a href="https://doi.org/10.1080/00224499809551925">revolutionizing</a>
the way society thinks of sex.</p>
<p>One particular statement <a href="http://www.iupress.indiana.edu/product_info.php?products_id=19796">in the book</a> regarding the cervix, however, has been misinterpreted leading to a misconception that persists today. On page 584, Kinsey states, “All of the clinical and experimental data show that the surface of the cervix is the most completely insensitive part of the female genital anatomy.” </p>
<p>Along with our colleague, physician <a href="https://sexualmed.org/team-members/irwin-goldstein/">Irwin Goldstein</a>, we are specialists in <a href="https://scholar.google.com/citations?user=M5zDkkAAAAAJ&hl=en&oi=ao">neuroscience</a> and sexual medicine. We believe Kinsey’s statement has led healthcare providers to conclude, erroneously, that the cervix is devoid of sensory nerves and can be cut or removed without consequence.</p>
<h2>A closer look at the data</h2>
<p>The Kinsey investigators reported when the cervix was “gently stroked” with a “glass, metal or cotton-tipped probe,” only <a href="http://www.iupress.indiana.edu/product_info.php?products_id=19796">5% of 878 women reported</a> they could feel it. This data was the basis of Kinsey’s claim of cervical insensitivity.</p>
<p>However, when the investigators stimulated the cervix of the same women with “distinct pressure” using “an object larger than a probe,” <a href="http://www.iupress.indiana.edu/product_info.php?products_id=19796">84% of the 878 women reported</a> they could feel it. Kinsey’s conclusion did not take into account his own significant finding.</p>
<h2>The sensate cervix</h2>
<p>There is extensive clear data from diverse sources that women can certainly feel stimulation of the cervix. Women commonly report they can <a href="https://www.healthline.com/health/womens-health/bleeding-after-pap-smear">feel the Pap smear</a>
procedure in which tissues are scraped from the cervix surface. </p>
<p>Many women undergoing cervical dilation for insertion of an intrauterine device (IUD) <a href="https://www.ncbi.nlm.nih.gov/pubmed/31882291">report pain</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/318450/original/file-20200303-66060-zuwgt3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/318450/original/file-20200303-66060-zuwgt3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/318450/original/file-20200303-66060-zuwgt3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318450/original/file-20200303-66060-zuwgt3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318450/original/file-20200303-66060-zuwgt3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318450/original/file-20200303-66060-zuwgt3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318450/original/file-20200303-66060-zuwgt3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318450/original/file-20200303-66060-zuwgt3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Cervical, clitoral and vaginal self-stimulation activate the same overlapping region of the sensory cortex, the paracentral lobule.</span>
<span class="attribution"><span class="source">Barry Komisaruk</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>In a <a href="https://doi.org/10.1111/j.1743-6109.2011.02388.x">functional MRI study</a>, when women stimulated their cervix, the same part of their brain responded as when they stimulated their clitoris or vagina. They also reported they could feel each region distinctly. The contribution of the cervix to orgasm is <a href="https://www.marieclaire.com/sex-love/a12826176/what-is-a-cervical-orgasm/">described in popular media</a> and <a href="https://jhupbooks.press.jhu.edu/title/science-orgasm">some women report</a> cervical-stimulated orgasms as having qualities different from clitoral or vaginal-stimulated orgasms. </p>
<h2>Surgery and the cervix</h2>
<p>Researchers also know the cervix is sensate based on the effects surgery can have on it. While well-intentioned medical procedures are designed to treat significant gynecological problems, in the process, they can cause damage to the nerve supply of the cervix.</p>
<p>According to one study, when the cervix is saved in a “sub-total” hysterectomy, women are significantly <a href="https://doi.org/10.3109/00016348309155779">more likely to continue experiencing orgasms</a> than when the cervix is removed in a “total” hysterectomy. </p>
<p>Another review of recent hysterectomy procedures, though, found <a href="https://doi.org/10.1002/14651858.CD004993.pub3">no significant difference in the effects on sexual response</a> between the two types of surgery. However, while the majority of the women reported an improvement in their sexual response, due to the resolution of the problem that necessitated their hysterectomy, in almost every one of the 22 reports reviewed, multiple women stated that their genital <a href="https://doi.org/10.1016/j.jmig.2011.01.012">sensations were diminished</a>. The discrepancies in the literature might well be due to different women’s preferred source of stimulation.</p>
<p>Some women undergoing an often-used loop electrosurgical excision procedure (LEEP) for the excision of lesions on the cervix <a href="https://doi.org/10.1111/j.1743-6109.2009.01633.x">report sexual side effects</a>. Some women describe a consequent distressing <a href="https://doi.org/10.1016/j.sxmr.2019.11.001">loss of orgasm and erotic feeling</a> in body regions including the clitoris and vagina. The procedure, in which a cone-shaped volume of cervix is burned away using a cauterizing wire loop, may be causing destruction of nerve pathways that normally convey genital sensation to the brain. </p>
<p>In another common surgical procedure for treatment of stress urinary incontinence, surgeons insert a mesh “mid-urethral sling” between the vagina and the urethra to produce a slight bend in the urethra, thereby adding resistance to the flow of urine. The sling may damage nerves that carry sensation from the vagina and cervix. Indeed, some women <a href="https://doi.org/10.1016/j.esxm.2016.12.001">report reduced</a> <a href="https://doi.org/10.1016/j.esxm.2016.12.001">orgasm satisfaction</a> after surgery. </p>
<h2>Talk to your doctor</h2>
<p>Doctors should be aware that three pairs of nerves – <a href="https://doi.org/10.1002/9781118896877.wbiehs314">pelvic, hypogastric and vagus</a> – convey sensation from the cervix to the brain. If any of these nerves are compromised, it can profoundly affect sexual pleasure. If surgical treatment is necessary, doctors should attempt to avoid the location of critical nerve pathways to minimize sensory damage. </p>
<p>Patients and their health care providers are often reluctant to discuss sensitive issues, such as possible side effects relating to sexual pleasure. At the very least, doctors should inform their patients of the possible detrimental consequences of their proposed treatment. </p>
<p>[<em>You’re smart and curious about the world. So are The Conversation’s authors and editors.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=youresmart">You can read us daily by subscribing to our newsletter</a>.]</p><img src="https://counter.theconversation.com/content/131618/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Sexual health experts say it’s a misconception that the cervix is insensitive, which can have implications for some medical procedures.Barry Komisaruk, Distinguished Professor of Psychology, Rutgers University - NewarkMaría Cruz Rodríguez del Cerro, Professor of Psychobiology, UNED - Universidad Nacional de Educación a DistanciaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/346512014-11-28T03:22:03Z2014-11-28T03:22:03ZFemale sexual dysfunction or not knowing how to ask for what feels good?<figure><img src="https://images.theconversation.com/files/65667/original/image-20141127-18564-lk48wz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Our culture tells women there's something wrong with them if they don't orgasm.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/gustavominas/5319063088">Gustavo Gomes/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>The recently published <a href="http://onlinelibrary.wiley.com/doi/10.1002/ca.22471/abstract">Italian study</a> suggesting women can only have clitoral, rather than vaginal, orgasms raises important questions about the medicalisation of female sexuality and sexual dysfunction. </p>
<p>Many women would be happy to have an orgasm any old way, as University of Western Sydney researcher <a href="https://theconversation.com/health-check-clash-of-the-orgasms-clitoral-vs-vaginal-32732?utm_medium=email&utm_campaign">Jane Ussher points out</a>, especially those who experience sexual difficulties.</p>
<p>It’s difficult to write about the topic of female sexuality without using negative language such as “female sexual dysfunction” or “failure” to orgasm. </p>
<p>Much of what has been written about the female orgasm is based on phallocentric assumptions, such as that women “should” have orgasms through penetrative sexual intercourse with men. And if they don’t achieve orgasm, there is something wrong with them.</p>
<p>Many women have absorbed these culturally acceptable views and the ongoing medicalisation of female sexuality continually reinforces them.</p>
<h2>Defining ‘female sexual dysfunction’</h2>
<p>According to the latest psychiatrists’ Diagnostic and Statistical Manual, the <a href="http://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596">DSM-V</a>, a woman suffers from “female orgasmic disorder” if she experiences a “marked delay in, marked infrequency of, or absence of orgasm or reduced intensity of orgasmic sensations” in 75-100% of situations of sexual intercourse. This must occur for at least six months and be accompanied by clinically significant distress. </p>
<p>Many women of my mother’s generation experienced such an absence of orgasms but without experiencing clinically significant distress because they had no real expectation of receiving sexual satisfaction from their partners. Their main concern was not to “fall” pregnant.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/65740/original/image-20141127-18173-1bqgfwe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/65740/original/image-20141127-18173-1bqgfwe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=435&fit=crop&dpr=1 600w, https://images.theconversation.com/files/65740/original/image-20141127-18173-1bqgfwe.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=435&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/65740/original/image-20141127-18173-1bqgfwe.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=435&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/65740/original/image-20141127-18173-1bqgfwe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=547&fit=crop&dpr=1 754w, https://images.theconversation.com/files/65740/original/image-20141127-18173-1bqgfwe.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=547&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/65740/original/image-20141127-18173-1bqgfwe.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=547&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Past generations had different sexual priorities.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-223625044/stock-photo-light-tone-bedroom-with-two-single-beds-in-cheerful-striped-bedding-with-yellow-pillows.html?src=Nfmj4i-U8hCiSxvCi1afnA-1-1">Iriana Shiyan/Shutterstock</a></span>
</figcaption>
</figure>
<p>The other most common female “dysfunction” is “female sexual interest/arousal dysfunction disorder”. Unlike “female orgasmic disorder”, this does at least have a male equivalent: “male hypo-active sexual desire disorder”. </p>
<p>Arousal difficulties are surprisingly common. A <a href="http://www.bmj.com/content/327/7412/426">large-scale UK study</a> found that 54% of women (compared with 35% of men) reported some form of sexual problem lasting for more than a month. The main problems these women experienced were a lack of interest in sex, an inability to orgasm, painful intercourse or trouble lubricating. </p>
<p>We know that sexual difficulties have a <a href="http://www.tandfonline.com/doi/full/10.1080/14681811.2013.771774#.VGw2tYf-PaR">negative impact</a> on women’s quality of life, their overall well-being and relationship satisfaction. </p>
<p>We also know that <a href="http://www.ncbi.nlm.nih.gov/pubmed/19361312">only one in three US women</a> who report a distressing sexual problem have ever spoken to their doctors about their difficulties. This is mainly because of their embarrassment about discussing sexual topics with a physician. As a result, many clinicians lack experience in the diagnosis and treatment of female sexual difficulties.</p>
<h2>The complexity of female sexuality</h2>
<p>There is a <a href="http://link.springer.com/article/10.1007%2Fs11195-009-9119-y#page-1">myth propagated in the media</a> of sexual spontaneity: satisfying sex happens spontaneously without the need for communication or negotiation and is mutually satisfying for both partners. </p>
<p>The reality is, of course, much more complicated. University of Pennsylvania researcher Maureen McHugh <a href="http://link.springer.com/article/10.1007%2Fs11199-006-9006-2#page-1">describes</a> what women really want as:</p>
<blockquote>
<p>better, more affectionate relationships, fulfilling consensual sexual relations, more time and energy for the expression of sexual desire, acceptance and acknowledgement of female sexual desire, and more sex education. </p>
</blockquote>
<p>It is disconcerting to consider that <a href="https://theconversation.com/australians-are-having-sex-less-often-than-a-decade-ago-33935">more than one in five women</a> have experienced sexual coercion at some point in their lives. Hardly surprisingly, then, that some of these women experience some form of “sexual dysfunction” or difficulty later in life. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/65666/original/image-20141127-15350-13x9srx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/65666/original/image-20141127-15350-13x9srx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/65666/original/image-20141127-15350-13x9srx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/65666/original/image-20141127-15350-13x9srx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/65666/original/image-20141127-15350-13x9srx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/65666/original/image-20141127-15350-13x9srx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/65666/original/image-20141127-15350-13x9srx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sexual problems often have relational, cultural and power dimensions.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/spencer_davis/6021509588">Spencer Davis/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The medical model tends to pathologise the complex sexual difficulties women experience, which often have relational, cultural and power dimensions. According to the DSM-V:</p>
<blockquote>
<p>women differ in how important orgasm is to their sexual satisfaction. There may be marked sociocultural and generational differences in women’s “orgasmic ability”. (my emphasis)</p>
</blockquote>
<p>This leads to the question: does women’s ability to orgasm vary greatly, or does women’s ability to ask for their sexual needs to be satisfied vary from culture to culture and from generation to generation?</p>
<h2>Empowerment of women</h2>
<p>A <a href="http://www.medscape.com/viewarticle/498001_2">multinational study</a> demonstrated that the reported prevalence of sexual problems does vary by region. For women, a lack of interest in sex and inability to reach orgasm were the most common sexual problems across the world regions, ranging from 26% to 43% and 18% to 41%, respectively. </p>
<p>Participants described issues such as age, physical health, mental health and relationship satisfaction as influencing sexual functioning, as well as cultural differences. </p>
<p>We like to think women are empowered in Australia and yet we are under-represented in boardrooms and in parliament. Women in positions of power still suffer from sexism and misogyny, as then prime minister Julia Gillard so powerfully <a href="https://www.youtube.com/watch?v=SOPsxpMzYw4">described</a> in her misogyny speech. This resonated with women around the globe who, unfortunately, could relate to her experiences. </p>
<p>Is it any wonder, then, that women find it hard to negotiate their own sexual satisfaction?</p>
<p>Stanford University clinician and researcher Leah Millheiser has done much to promote female sexual health, particularly for women with cancer. Her Youtube video, <a href="https://www.youtube.com/watch?v=nlP5rY2pfG0">What our mothers never taught us: changes in female sexual function throughout the lifespan</a>, outlines a wide range of treatments available to women to improve their sexual functioning. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/nlP5rY2pfG0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
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<p>These treatments vary from drug therapy to sex therapy, with a great range in between including the use of vibrators, vaginal lubrication, pelvic floor exercises and so on. Despite using medical language, it is empowering for women to have easy access to the knowledge that they are not alone in experiencing sexual difficulties and that treatments are available.</p>
<h2>The future is brighter</h2>
<p>It’s still easy to gain the impression from popular culture that women should prioritise the sexual satisfaction of their male partner, over and above their own. I sincerely hope this generation of young women know more about how their bodies work and are willing to prioritise their own desire for sexual satisfaction along with their partner’s desires.</p><img src="https://counter.theconversation.com/content/34651/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sally Hunter is affiliated with the Psychotherapy and Counselling Federation of Australia.</span></em></p>The recently published Italian study suggesting women can only have clitoral, rather than vaginal, orgasms raises important questions about the medicalisation of female sexuality and sexual dysfunction…Sally Hunter, Lecturer, School of Rural Medicine, University of New EnglandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/327322014-11-10T03:29:50Z2014-11-10T03:29:50ZHealth Check: clash of the orgasms, clitoral vs vaginal<figure><img src="https://images.theconversation.com/files/63801/original/fh96gn5q-1415234225.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Most women are just happy to have an orgasm, any old way. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/ares_tavolazzi/6076535631">Ares Tavolazzi/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span></figcaption></figure><p>Controversy over vaginal versus clitoral orgasm is nothing new; it’s a debate that has consumed sexologists and psychoanalysts for the last 100 years. Now, new research has added fresh fuel to the controversy.</p>
<p>Completed by a team of Italian sexologists and <a href="http://onlinelibrary.wiley.com/doi/10.1002/ca.22471/abstract">published in the journal Clinical Anatomy</a>, the review concludes vaginal orgasms don’t exist. Female orgasm is only possible if the clitoris is stimulated during masturbation, cunnilingus, partner masturbation or with a finger during intercourse, the researchers say. Penetration alone is not enough.</p>
<p>This latest swing of the pendulum – from the view that vaginal orgasm is the ideal that women should aspire to and anything else is second rate – is unlikely to actually affect women. Indeed, one of the more interesting threads in this whole debate is the predominance of men’s voices. Perhaps what we should be talking about is why male experts dictate the parameters of women’s pleasure.</p>
<h2>Frigidity and failure</h2>
<p>Sigmund Freud was one of the first to investigate the “dark continent” of female sexuality. He declared the clitoral orgasm “<a href="http://www.sciencedirect.com/science/article/pii/S115813600900173X">infantile and immature</a>”. A woman could claim sexual maturity only when she experienced a vaginal orgasm, he said, ignoring her “<a href="http://www.jstor.org/discover/10.2307/3178545?uid=3737536&uid=2&uid=4&sid=21104884418903">amputated penis</a>”, the clitoris. </p>
<p>Inability to achieve vaginal orgasm meant a woman was “frigid” or “not a real woman”, claimed Freud and many of his followers. This failure was attributed to deep-rooted <a href="http://www.tandfonline.com/doi/abs/10.1080/00224497009550680?journalCode=hjsr20#.VDg_4fnqojI">neurotic problems</a>.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/63803/original/fygfbggz-1415234628.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/63803/original/fygfbggz-1415234628.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=844&fit=crop&dpr=1 600w, https://images.theconversation.com/files/63803/original/fygfbggz-1415234628.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=844&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/63803/original/fygfbggz-1415234628.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=844&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/63803/original/fygfbggz-1415234628.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1061&fit=crop&dpr=1 754w, https://images.theconversation.com/files/63803/original/fygfbggz-1415234628.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1061&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/63803/original/fygfbggz-1415234628.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1061&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Sigmund Freud declared the clitoral orgasm ‘infantile and immature’.</span>
<span class="attribution"><a class="source" href="http://commons.wikimedia.org/wiki/File:Sigmund_Freud_LIFE.jpg">Max Halberstadt/Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>The pressure was on. To be “normal” and “mature”, women had to orgasm during sexual intercourse. And successive generations were diagnosed with sexual dysfunction when they failed to achieve this holy grail of sexual response. Many felt like failures; their bodies had let them down. </p>
<p>Unsurprisingly, <a href="http://www.ncbi.nlm.nih.gov/pubmed/24939172">faking orgasms</a> during intercourse became the norm. No one wants her partner to think she is failing to be a “real woman”. </p>
<h2>Celebrating the clitoral orgasm</h2>
<p>Then US sexologists <a href="http://www.amazon.com/Human-Sexual-Response-William-Masters/dp/0923891218">William Masters and Virginia Johnson</a> came along. Observing couples having sex in the laboratory in the 1960s, they concluded women’s orgasms started in the clitoris and then extended to the vagina. </p>
<p>Any pleasure women experienced through penetration was due to the connection between clitoris and vagina. They reported “frigidity” as resulting from poor sexual technique, not women’s ambivalence about their social role. And that women were capable of multiple orgasm, while men were not. </p>
<p>Feminists in the 1960s took up this research with glee, declaring the clitoral orgasm the mark of a <a href="http://ws301spring2008.wikispaces.com/file/view/Myth+of+the+Vaginal+Orgasm.pdf">liberated woman</a>. Some went further, arguing women should eschew <a href="http://www.jstor.org/discover/10.2307/3178545?uid=3737536&uid=2&uid=4&sid=21104884418903">penile penetration</a> altogether. Now a symbol of women’s oppression, it was unnecessary for sexual pleasure. </p>
<p>The feminist argument went mainstream when Shere Hite appeared on the cover of Time magazine in 1987. She had <a href="http://books.google.com.au/books/about/The_Hite_Report.html?id=s3OZaVn2wfkC">interviewed 1,844 American women</a> and declared the “true” female orgasm was clitoral. The female sexual revolution seemed to have been won with women speaking for their own sexual pleasure. </p>
<h2>Phallocentric backlash</h2>
<p>Then came the inevitable backlash. In recent years, there has been a proliferation of sex research attempting to establish the superiority of the vaginal orgasm, and the role of the penis in producing it. </p>
<p>In echoes of Freud, we are told the vaginal orgasm is the only way for women to achieve sexual, life and <a href="http://www.ncbi.nlm.nih.gov/pubmed/19453891">relationship satisfaction</a>, as well as good <a href="http://www.tandfonline.com/doi/abs/10.1080/14681990601059669?journalCode=csmt20#.VDhAVPnqojI">psychological health</a>. </p>
<p>Women who don’t have vaginal orgasms are described as <a href="http://www.ncbi.nlm.nih.gov/pubmed/18331253">emotionally unstable</a>, with <a href="http://www.ncbi.nlm.nih.gov/pubmed/18331263">immature defence mechanisms</a> and low <a href="http://www.ncbi.nlm.nih.gov/pubmed/19453897">emotional intelligence</a>. Apparently, you can even identify a woman who has a history of vaginal orgasm <a href="http://www.ncbi.nlm.nih.gov/pubmed/18637995">by her walk</a> – it is that central to her very being.</p>
<p>So what causes a vaginal orgasm, according to these researchers? Not stimulation of the clitoris during intercourse. Rather, a <a href="http://www.ncbi.nlm.nih.gov/pubmed/23006745">long penis</a>, which allegedly gives an evolutionary advantage to well-endowed men. Or <a href="http://www.ncbi.nlm.nih.gov/pubmed/19170844">long-lasting intercourse</a>, which we are told is much better than “foreplay”, with <a href="http://www.ncbi.nlm.nih.gov/pubmed/21143422">simultaneous orgasm</a> during intercourse being the best of all.</p>
<p>Would it surprise you if I told you this phallocentric research is all conducted by men? Would their interest in the vaginal orgasm possibly have something to do with maintaining the primacy of the penis? </p>
<p>After all, the implications of the clitoral orgasm are grave for heterosexual men. Women can pleasure themselves (or be pleasured by each other) as effectively as they can be pleasured by a man if the penis is superfluous to their ability to orgasm. A man’s <a href="http://onlinelibrary.wiley.com/doi/10.1002/ca.22471/abstract">fingers become more important</a>, or <a href="http://www.psychologytoday.com/blog/hive-mind/201312/the-myth-the-myth-the-vaginal-orgasm">his smell</a>, which some heterosexual women rate more highly than penis size. </p>
<h2>A woman’s perspective</h2>
<p>From a woman’s perspective, this whole debate is a little irrelevant. </p>
<p>Some women enjoy vaginal <a href="https://www.researchgate.net/publication/26831991_The_downside_of_Viagra_women%27s_experiences_and_concerns">penetration</a> – with penis or fingers – and gain considerable sexual pleasure as a result. Other women prefer to be <a href="http://gero.usc.edu/AgeWorks/fall_session2012/tdl/gero500/readings/Week7.pdf">touched</a>, use a vibrator, or receive oral sex. A lucky few have orgasms <a href="http://www.ncbi.nlm.nih.gov/pubmed/803147">in their sleep</a>, in the absence of any physical stimulation. And some prefer to have a <a href="http://eprints.uwe.ac.uk/16536/1/Hayfield%20%2B%20Clarke%20Cup%20of%20Tea%20UWE%20research%20repository.pdf">cup of tea</a>.</p>
<p>To imply that all women are the same, that we <em>should</em> have any sort of orgasm and are dysfunctional if we don’t, is the most damaging part of this controversy. </p>
<p>Regardless of how orgasm is achieved, it is, by definition, an extremely pleasurable experience. And no woman I know would rate one form of orgasm as more “mature” than another. Most would just be happy to have one, any old way.</p><img src="https://counter.theconversation.com/content/32732/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jane Ussher receives funding from the Australian Research Council, Cancer Council NSW, Family Planning NSW, Prostate Cancer Foundation of Australia, and the Community Migrant Resource Centre, for research on sexuality.</span></em></p>Controversy over vaginal versus clitoral orgasm is nothing new; it’s a debate that has consumed sexologists and psychoanalysts for the last 100 years. Now, new research has added fresh fuel to the controversy…Jane Ussher, Professor of Women's Health Psychology, Translational Health Research Institute (THRI), Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.