In all cases the CUMD measures in the Bonaparte were shorter than in the Landis sample, which likely reflects that Bonaparte used the clitoral frenulum as her measuring point for the clitoris, whereas the Landis group likely used the clitoral glans. This relationship between CUMD and orgasm was not evident for autosexual orgasms. The Bonaparte sample contained data for 33 of the 43 women on the occurrence of orgasm from masturbation autosexual orgasm. This finding is consistent with CUMD influencing orgasm in sexual intercourse and being unrelated to the occurrence of orgasm in general.
To determine whether CUMD reliably predicts orgasm in intercourse we calculated Receiver Operator Characteristic ROC curves, a technique developed for signal detection, but often used to assess the validity of medical diagnoses Hanley and McNeil, , ; Zweig and Campbell, In ROC curves, the area accounted for under the curve by the test variable is the principle measure of whether the test variable, CUMD in this case, distinguishes between two outcomes, orgasm in intercourse or not in this case.
Figure 5 illustrates that CUMD accounted for a significant proportion of area under the curve in both samples, supporting the claim that CUMD accurately distinguishes between regular and less regular orgasm in intercourse. In the Bonaparte sample Figure 5a 0. While both show significant predictive value the Bonaparte data show a greater predictive value than do the Landis data.
Although both ROCs accounted for significant area under the curve, the Bonaparte sample accounted for more area than did the Landis sample and showed greater sensitivity and specificity. The dashed diagonal like represents 0. This is reflected in the balance of true positives and false positives for the Landis data where the best balance between true and false positives occurs for a CUMD of 2.
Thus the Landis data distinguish between the two groups of women much less reliably than do the Bonaparte data. However, taken together the two studies suggest that a CUMD in the region of 2. Whether the difference in diagnostic power between the two samples reflects subject selection, in that the Bonaparte data were biased towards shorter CUMD size than the Landis sample, or whether this reflects differences in how genital measurements in the two studies were collected cannot be determined.
However, both samples suggest that CUMD provides substantial information for predicting whether or not a woman will experience orgasm in intercourse. We calculated an ROC curve on data from the Bonaparte sample for the relationship between CUMD and the likelihood of reaching orgasm from masturbation. The ROC curve accounted for 0. Data for autosexual orgasms are provided for comparison. Using a 2. The 2. These results support that knowing a woman's CUMD does not provide information allowing accurate prediction of whether or not she experiences autosexual orgasms, but can provide substantial information for predicting the occurrence of orgasms in intercourse.
Percentage of women experiencing orgasm in relation to whether their CUMD measurement is greater than or equal to 2. Lastly we asked whether CUMD could be used to accurately classify individuals into those who have orgasm in intercourse and those who do not. When the discriminant function was generated using data from the Bonaparte sample a significant Eigenvalue of 1.
Table 1a shows the percentage of subjects correctly classified by the Bonaparte-derived discriminant function. When the discriminant function was generated using data from the Landis sample a smaller, but still significant Eigenvalue of 0. These data show that CUMD can be used to accurately classify women according to the likelihood that they will have orgasms in intercourse.
However, CUMD's power as a diagnostic tool is limited in these data. Both discriminant functions very accurately classified women in the Bonaparte sample who reported experiencing orgasm in intercourse, but did poorly in making the same classification in the Landis data. However, even in this case only the Bonaparte-derived discriminant function classified these women better than chance.
Data from two independent samples, collected over 70 years ago and more than 15 years apart, support the notion that the distance between a woman's clitoris and her vagina influences the likelihood that she will regularly experience orgasm solely from intercourse. Women who reported more regularly experiencing orgasm had shorter CUMD measurements than did women who reported not experiencing or less regularly experiencing, orgasm in intercourse.
When orgasms from masturbation were considered there was no meaningful relationship between CUMD and whether or not a woman experienced autosexual orgasms. Thus the influence of CUMD on women's orgasms is likely limited to orgasms solely from sexual intercourse. These results suggest that some of the variability in women experiencing orgasm from intercourse without concurrent clitoral stimulation reflects, as Bonaparte suggested in , the consequences of embryological processes that determine the position of the clitoris relative to the vagina.
Thus, some women may be anatomically predisposed to experience orgasm from intercourse, while the genital anatomy of other women makes such orgasms unlikely. While other factors, such as the sexual characteristics of a woman's partner, undoubtedly influence the likelihood of experiencing orgasm solely from intercourse, these data suggest that for some women their genital anatomy strongly influences the occurrence of orgasm in intercourse.
ROC and discriminant analysis revealed that CUMD can serve as a reliable and sensitive predictor of the likelihood that a woman will experience orgasm in intercourse. The two studies differed in the strength of this prediction with the Bonaparte sample providing better prediction and classification than does the Landis sample.
This difference between the two studies may reflect how the genital measurements were obtained. If as we suspect, Bonaparte used the frenulum of the clitoris as her clitoral marker while Landis and colleagues used the tip of the clitoral glans, one would expect much more variation in CUMD between subjects using the Landis method because the clitoral glans is larger and more variable than is the frenulum Verkauf, et al. The frenulum is essentially a single point at the base of the clitoral glans, and thus would vary much less between subjects than would the clitoral glans.
Thus the stronger relationship between CUMD and orgasm in intercourse in the Bonaparte study may simply reflect that she measured the same genital construct in all subjects, whereas the Landis technique may have had much greater inherent variance which reduced or obscured the magnitude of the relationship between CUMD and orgasm.
While the conclusion that a woman's genital configuration influences her likelihood of experiencing orgasm in intercourse has implications for women's sexual experience, caution in accepting this interpretation is warranted given possible bias in data collection. Although Bonaparte's data show a much stronger relationship between CUMD and orgasm than do the Landis data, Bonaparte apparently collected all of the data herself and she was certainly not blind to her hypothesis.
In addition, Bonaparte was personally invested in finding that orgasm in intercourse was affected by clitoral location as she was looking for an explanation for her own inability to experience orgasm in intercourse. By contrast, although Landis and his colleagues were aware of Bonaparte's hypothesis, they were also aware of Dickinson's refutation of that hypothesis, citing both works in their book.
It is thus unlikely that the Landis team had a particular bias in this aspect of their study. In addition, the Landis data were less easily biased since CUMD measures were collected by a doctor separate from the investigators collecting the interview data.
In addition, the genital examination data and the interview data were recorded in separate documents and collected at different times. It is thus possible that the Landis data are more objective and less biased than the Bonaparte data, and that is why they also show a weaker relationship between CUMD and orgasm in intercourse. They do, however, show a statistically significant and relatively large relationship in the same direction as that found by Bonaparte. Thus we think it likely that the differences between the two studies in the strength of the relationship between CUMD and orgasm likely reflect genital measurement differences instead of biased data collection.
Landis and colleagues replication of Bonaparte's finding 16 years later using a completely different research team in a completely different environment makes us more confident of the validity of the relationship between CUMD and orgasm despite the challenges these data present.
Unresolved, however, is the different distribution of CUMD measurements in the two studies. Bonaparte's women have CUMD measurements that average about 0. There is evidence that the Bonaparte and Landis CUMD measurements were likely collected using different methods and that the one that Landis likely used would produce both increased variability and a mean length difference of about 0.
However, given the limited information we have it is not possible to fully explain the differences between the two studies in the distributions of the CUMD measurements. Still, the consistent positive relationship between CUMD and orgasm in intercourse in both studies warrants further discussion, particularly what it implies about genital development how developmental differences might contribute to our understanding of variation in the ways in which women reach orgasm.
Similarly, these results do not resolve whether orgasm in intercourse for women with short CUMDs results from vaginal stimulation, from direct penile stimulation of the clitoral glans, from indirect clitoral stimulation though pelvic pressure, from stimulation of internal aspects of the clitoral complex, or from some combination of all of these. Any of these sources of stimulation could possibly produce the higher incidence of orgasm in intercourse found in women with shorter CUMD measurements.
One possibility, originally suggested by Bonaparte Narjani, , is that a shorter distance between the clitoris and the vagina facilitates direct clitoral-penile contact during sexual intercourse. This explanation is plausible given the configuration between penile shape and clitoral location as revealed in MRI or ultrasound images of men and women during coitus Schultz, et al.
However, without evidence of increased direct penile-clitoral contact during intercourse in women with shorter CUMD measurements it is not possible to conclude whether this is the mechanism through which CUMD affects orgasm in intercourse. Although the notion of pelvic or penile stimulation of the clitoral glans or shaft is intuitively appealing and is consistent with the data presented here, short CUMD, instead of being the actual mechanism increasing orgasm in intercourse, could be an external marker of other processes producing increased vaginal sensitivity that increases the likelihood of orgasm solely from sexual intercourse.
The clitoris consists of more than the shaft and clitoral glans. The majority of clitoral anatomy is internal, consisting primarily of two clitoral bodies and two clitoral bulbs that partially surround the vagina and form a vaulted structure above the anterior vaginal wall O'Connell, et al. Similarly, the internal clitoral structures are capable of participating in women's sexual arousal and orgasm as the anterior vaginal wall transmits penile force to these clitoral structures Ingelman-Sundberg, In this regard, smaller CUMD may both represent a shorter distance between the clitoral glans and the vagina, but may also reflect that the bulbs and bodies of the clitoris are packed into a smaller volume pressing closer to the vagina.
This compact spatial arrangement could result, for example, in more direct contact between the anterior vaginal wall and the erotically sensitive bulbs or bodies of the clitoris. This more direct contact between the vagina and portions of the clitoris distal to the shaft and glans produces increased vaginal sensitivity that is unlikely or impossible if these clitoral structures are distributed through out a larger volume.
Thus shorter CUMD would not directly affect external clitoral stimulation, but would be a proxy for increased vaginal sensitivity and an increased likelihood that vaginal stimulation can produce orgasm even if there is no increased penile stimulation of the clitoral glans or shaft during sexual intercourse.
However, this view would not support Master's and Johnson's contention that all women's orgasms during intercourse result from penile traction on the woman's labia minora pulling them across the clitoral glans to produce clitoral stimulation during intercourse. Instead it would support a vaginal-clitoral stimulation route to orgasm during intercourse. Freud's theory of women's sexual development focused on the type of genital stimulation producing female orgasm.
Freud contrasted orgasms from vaginal responsiveness with clitorally-induced orgasms, by which he meant orgasms resulting from stimulation of the external aspects of the clitoris. Ironically, Freud's distinction between vaginally- and clitorally-triggered orgasms may actually reflect a natural typology of women's orgasm induction. This typology has nothing to do with psychological maturity as Freud argued, but instead contrasts women who reach orgasm through vaginal stimulation of deep clitoral structures with women who reach orgasm through stimulation of external clitoral structures of the shaft or glans.
However, Freud, by valuing vaginal induction of orgasm over external clitoral induction has likely negatively affected many women and impeded investigation of the sources of this natural variation in women's sexual arousal and orgasm.
The results of the studies analyzed here suggest that these two different forms of orgasm induction might reflect which anatomical aspects of the clitoris have primary erotic sensitivity. Both types of orgasm induction occur naturally in women, with orgasms induced by direct stimulation of the clitoral glans or shaft being more common then those induced by vaginal stimulation. Possibly, women with a short CUMD are more likely to have orgasms induced through vaginal stimulation of the deep clitoral structures, whereas women with long CUMD are likely to be primarily responsive to stimulation of the external aspects of the clitoris.
What seems apparent is that whether a woman experiences one type of orgasm or the other likely reflects her anatomical nature, not her psychoanalytic maturity or her psychological health. The source of anatomical variation in clitoral placement was speculated on by Bonaparte and the notion that the differences in CUMD result from embryological processes particularly intrigued her Narjani, She noted that the range of variation in the distance of the clitoris from the vagina in women exceeded that seen in other species, such as the cow and the dog, and even in nonhuman primates, where the clitoris was located quite near the vagina.
Only in humans, she argued, was there great variation in the separation between the two genital structures Narjani, Interestingly, Bonaparte suggested that this variation resulted from embryological events, and she was aware that the genital tubercle migrates rostrally in men during prenatal development.
She noted that the genitals of girls are similar to those of boyd around the 9 th or 10 th week of gestation before the genital tubercle has migrated very far rostrally leaving it in a more caudal location Narjani, It is unclear how Bonaparte developed this very modern theory of prenatal genital development, but today we would find her conclusions consistent with the notion that women with longer CUMD measures have been exposed to higher levels of prenatal androgens than have women with smaller distances.
Bonaparte suggested that variation in CUMD likely reflects the timing of the cessation of rostral migration of the woman's genital tubercle during prenatal life. This migration is necessary in males to produce the much more rostral location of the penis necessary for successful sexual intercourse. Genital tubercle migration occurs in mammalian males and studies in animals show that prenatal androgens control this migration.
Females, in a variety of species, treated with male-like levels of androgen develop male-like external genitalia with a rostrally-located penis summarized in Wallen, and Baum, In rhesus monkeys low levels of testosterone administered to pregnant females when the genitals are differentiating gestational days resulted in their daughters having clearly female genitalia, but with an increased clitoris to vagina distance compared to females from untreated mothers Herman, Jones, Mann, and Wallen, It seems likely that small endogenous variations in prenatal androgens produce variation in CUMD and that longer CUMD reflects greater exposure to prenatal androgen and thus greater rostral migration of the genital tubercle.
While there is no direct evidence for the relationship between CUMD and natural variation in prenatal androgens in women there is such evidence in rats. Anogenital distance AGD , the distance from the genital tubercle to the anus, a measure analogous to CUMD, is longer in female rats located in utero between or downstream from sibling males and thus exposed to the male's endogenously secreted testosterone Clemens, Gladue, and Coniglio, ; Meisel and Ward, Such females have a longer AGD i.
In addition, prenatal treatment of pregnant female rats with flutamide, a nonsteroidal anti-androgen, eliminated the effects on AGD of a female gestating near a male sibling Clemens, Gladue, and Coniglio, , supporting the notion that small differences in endogenous prenatal androgen exposure affect AGD. Interestingly, natural variation in female rat AGD predicts better adult reproductive function and earlier e. Thus data from rats support the notion that AGD serves as a proxy for the degree of prenatal exposure to androgens.
If CUMD is similarly affected by endogenous prenatal androgen variation, it may be an external indicator of a woman's exposure to prenatal androgens. If true, this suggests that women exposed to lower levels of prenatal androgens are more likely to achieve orgasm solely through intercourse than are women exposed to higher levels of prenatal androgens. Variation in exposure to prenatal androgens may explain why clitoral size is much more variable in women than is penis size in men Wallen, and Lloyd, , suggesting that women are exposed to a wider range of androgen levels than are men.
Particularly intriguing is the notion that orgasm solely from sexual intercourse seems most likely to occur in women who may have been exposed to the lowest levels of prenatal androgens. Exposure to higher levels of androgens does not preclude orgasm, but may result in easier orgasm from direct stimulation of the clitoral shaft or glans, than from stimulation of the vagina or internal clitoral structures in close proximity to the vaginal walls. Thus the clitoral and vaginal eroticism that Freud invested with substantial psychoanalytic importance, may exist, but simply reflect the extent to which a woman was prenatally exposed to androgens.
Possibly variation in prenatal androgens produces other genital changes, in addition to rostral migration of the genital tubercle, that influence the type of stimulation a women requires for reaching orgasm. In males the genital tubercle differentiates into the penis under the influence of prenatal androgens. In this process the primary erogenous areas of the penis become the underside of the glans penis, where the frenulum connects the foreskin to the glans penis and, to a much lesser extent, the penile shaft.
Thus, although the penis enlarges substantially under the influence of androgens the parts which contribute to sexual sensations remain, or become, quite small. In females the genital tubercle, without the strong influence of androgens, migrates much less than in males and differentiates into the clitoris possibly with a more diffuse distribution of erotic sensitivity such that the clitoral bulbs and bodies as well as the shaft and glans are erotically responsive.
Women who are exposed to higher levels of prenatal androgens may not only have a more male-like rostral clitoral location, but also their clitoral eroticism may become more similar to that of the penis. Thus, increased prenatal androgen exposure may focus erotic sensitivity to the clitoral shaft and glans reducing or eliminating erotic sensitivity in the bulbs and bodies of the clitoris. In this view, all women possess erotic sensitivity in the clitoral shaft and glans, but only women exposed to lower levels of prenatal androgens retain significant erotic sensitivity in the internal clitoral structures.
CUMD size, which likely reflects the extent of prenatal androgen exposure, might also be a proxy for the erotic sensitivity of internal clitoral structures, and thus the likelihood that women will experience orgasm solely from intercourse. These findings support CUMD as a potential proxy for prenatal androgen exposure in women and suggest a number of studies.
The first is that CUMD should be positively correlated with clitoral size, since in males the rostral migration of the genital tubercle is combined with an increase in genital tubercle size. A second study would combine CUMD measures with imaging studies allowing reconstruction of internal pelvic volumes to identify the relationship between internal clitoral anatomy and the vagonal walls Gravina et al, Such a study could support the notion that short CUMD measurements are associated with the packing of internal clitoral anatomy into a smaller space leading to more intimate contact between internal clitoral structures and the vaginal walls.
Hypotheses offered here could be directly tested by investigating women with atypical prenatal androgen exposure. For example, women with complete androgen insensitivity CAIS resulting from not having functional androgen receptors, would be expected to have very short CUMD, with their internal clitoral structures packed into a much smaller volume than would women with typical androgen exposure.
Women with CAIS would also be expected to more reliably experience orgasm in intercourse than women exposed to androgens. We do not know how this might affect the relationship between the vaginal walls and the internal aspects of the clitoris.
Women with congenital adrenal hyperplasia CAH could contribute significantly to our understanding of genital anatomical development and orgasm. Studies of same and mixed sex twins could directly test the hypothesis that small differences in prenatal androgen exposure affect CUMD, with women with female co-twins having smaller CUMD measurements than would women with male co-twins.
Lastly, the findings of Bonaparte and Landis need to be replicated using an assessment of orgasm that clearly distinguishes orgasms during intercourse without concurrent clitoral stimulation from those with concurrent clitoral stimulation.
A standardized method of measuring CUMD needs to be developed, possibly one which measures actual clitoral-vaginal distances, though the size and flexibility of the vaginal opening make this challenging. Such studies might explain the great variation among women in the sexually arousing stimulation necessary for orgasm and why some women more easily experience orgasm in intercourse than do others.
Ultimately such studies could establish the factors that cause the natural variation in women's orgasms and possibly why men and women differ so markedly in the likelihood that they will experience orgasm solely from sexual intercourse. Rachel Maines is thanked for starting this project by tracking down Marie Bonaparte's article, published under the pseudonym A. Liana Zhou and Shawn C. Wilson of the Kinsey Institute for Research in Sex, Gender and Reproduction library are thanked for discovering the original Landis data sheets.
Cecile J. Click is thanked for transcribing the Landis raw data from the original records. Daniella Sanchez is thanked for blind coding of the Landis data. Nancy Bliwise is thanked for introducing Receiver Operating Characteristic curves as an analytical tool. Harold Gouzoules is thanked for advice on the use of discriminant analysis. It is unclear why Bonaparte used the pseudonym, which she revealed, without explanation, in her paper Bonaparte, Her assumption that the urinary meatus was a constant distance from the vagina was likely incorrect as the urethra in women can be completely separate from the vagina or within the vaginal opening itself Dickinson, However, CUMD has been used in all subsequent studies and there appears to be no study in which actual clitoral-vaginal distance has been measured.
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Elisabeth A. National Center for Biotechnology Information , U. Horm Behav. Author manuscript; available in PMC Jan Kim Wallen , Ph. Lloyd , Ph. Author information Copyright and License information Disclaimer. Corresponding Author: Kim Wallen, ude. Copyright notice. The publisher's final edited version of this article is available at Horm Behav.
See other articles in PMC that cite the published article. Abstract In men and women sexual arousal culminates in orgasm, with female orgasm solely from sexual intercourse often regarded as a unique feature of human sexuality. Keywords: orgasm in intercourse, genital anatomy, sex differences, clitoral position, prenatal androgens.
Open in a separate window. Figure 1. Table 2 Classification of subjects from the Bonaparte and Landis samples when using discriminant functions generated from either the Bonaparte or the Landis samples. Classification using discriminant function A. Bonaparte sample genital measurement A detailed description of how the genital measurements were obtained was included in the article. Figure 2. Landis sample genital measurement All subjects in the Landis sample received a gynecological examination which included measuring the clitoris to urinary meatus distance.
Landis sample measurement of orgasm Orgasm occurrence during intercourse was assessed during a lengthy face to face interview, done by one of the study's authors with Bowles doing the majority of the interviews according to the published text. Figure 3. Relationship between orgasm and CUMD The relationship between the reported occurrence of orgasm during intercourse and CUMD was investigated by determining whether women in each sample who reported orgasm in intercourse had shorter CUMD measurements than did women who never reported orgasm in intercourse.
Figure 4. Receiver Operator Characteristic curves To determine whether CUMD reliably predicts orgasm in intercourse we calculated Receiver Operator Characteristic ROC curves, a technique developed for signal detection, but often used to assess the validity of medical diagnoses Hanley and McNeil, , ; Zweig and Campbell, Figure 5. Table 1 Percentage of women experiencing orgasm in relation to whether their CUMD measurement is greater than or equal to 2.
Discriminant analysis Lastly we asked whether CUMD could be used to accurately classify individuals into those who have orgasm in intercourse and those who do not. Discussion Data from two independent samples, collected over 70 years ago and more than 15 years apart, support the notion that the distance between a woman's clitoris and her vagina influences the likelihood that she will regularly experience orgasm solely from intercourse.
Acknowledgments Dr. Footnotes 1 Narjani is a pseudonym for the psychoanalyst Marie Bonaparte whose idea it was that the distance between the clitoris and vagina affects the likelihood of woman experiencing orgasm in intercourse. References Alzate H. Vaginal eroticism: a replication study. Arch Sex Behav. Vaginal orgasm is associated with less use of immature psychological defense mechanisms. J Sex Med. Sonography of the clitoris.
Biostatistics Discriminant analysis. Singapore Med J. Prenatal endogenous androgenic influences on masculine sexual behavior and genital morphology in male and female rats. A power primer. Psychological Bulletin.
Atlas of Human Sexual Anatomy. Williams and Wilkins; Baltimore, MD: Basic Books; New York: The clitoral complex: a dynamic sonographic study. Behavioral and physiological evidence of sexual climax in the female stump-tailed macaque Macaca arctoides Science. Measurement of the thickness of the urethrovaginal space in women with or without vaginal orgasm. Selection and interpretation of diagnostic tests and procedures.
Principles and applications. Ann Intern Med. The meaning and use of the area under a receiver operating characteristic ROC curve. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Timing of prenatal androgen exposure: anatomical and endocrine effects on juvenile male and female rhesus monkeys. The Hite Report. Macmillan; New York: The anterior vaginal wall as an organ for the transmission of active forces to the urethra and the clitoris.
Sexual Behavior in the Human Male. WB Saunders; Philadelphia: Sexual Behavior in the Human Female. Woman's Orgasm. Bobs-Merrill Company, Inc. The Science of Orgasm. Sex in Development. Hoeber Inc. Some considerations concerning orgasm in the female. Psychosom Med. Human Sexual Response. Little Brown; Boston: Fetal female rats are masculinized by male littermates located caudally in the uterus. A microdialysis study of ventral striatal dopamine during sexual behavior in female Syrian hamsters.
Altogether, what these results reveal is that when women are asked about their experiences with orgasm during vaginal intercourse in general , different women seem to be interpreting it in different ways. Some are thinking about intercourse alone no clitoral stimulation , some are thinking about intercourse with added clitoral stimulation, and some appear to be thinking about both of these things at the same time and averaging them together.
These numbers suggest that while men do seem to recognize the important role clitoral stimulation plays with respect to the female orgasm, they tend to overestimate how often women are actually reaching orgasm. Why is that? Together, what all of these findings demonstrate is the importance of asking women and men alike clear and detailed questions about orgasms in survey research.
This will not only help give us a better idea of how often women tend to reach orgasm when having sex, but it will also help to highlight the specific forms of stimulation that women find most pleasurable. Shirazi, T. Archives of Sexual Behavior.
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This is problematic because it means that different women may be interpreting the question in different ways. In this study, researchers surveyed more than 1, women about their experiences with orgasm using three different questions. Specifically, all participants answered the following:. Altogether, what these results reveal is that when women are asked about their experiences with orgasm during vaginal intercourse in general , different women seem to be interpreting it in different ways.
Some are thinking about intercourse alone no clitoral stimulation , some are thinking about intercourse with added clitoral stimulation, and some appear to be thinking about both of these things at the same time and averaging them together. These numbers suggest that while men do seem to recognize the important role clitoral stimulation plays with respect to the female orgasm, they tend to overestimate how often women are actually reaching orgasm. Why is that? Together, what all of these findings demonstrate is the importance of asking women and men alike clear and detailed questions about orgasms in survey research.
This will not only help give us a better idea of how often women tend to reach orgasm when having sex, but it will also help to highlight the specific forms of stimulation that women find most pleasurable. These fluids nourish and support the sperm so they can live after ejaculation for a limited time. This mixture of fluid and sperm, known as semen, is what is moved through the urethra and out the penis during orgasm.
The testosterone flowing through a man's body, along with psychological factors, determines the strength of his desire for sex. Testosterone is the primary factor which drives sexual desire, says Michael Ingber, MD , a physician in urology and female pelvic medicine and reconstructive surgery at the Atlantic Health System in Morristown, New Jersey, and a fellow of the International Society for the Study of Women's Sexual Health.
This sexual desire, or libido, is key in kicking off the process that will lead to orgasm. If a man has no sex drive — for example, if he has clinically low testosterone or is suffering from depression — his body may not respond to sexual stimuli and he may not be able to experience orgasm.
Some men can have problems reaching orgasm. These most often stem from psychological factors; for example, they are still affected by a traumatic event or a restrictive upbringing, or they have fallen into masturbation patterns that could have conditioned the body to take longer to orgasm. A short-term way to address problems with orgasm involves stimulation of the penis with a vibrator or some other type of sex toy.
However, to really make meaningful changes, a man may need to go through some form of sex therapy. Therapy usually involves "homework" in which a couple engages in sexual activities that reduce performance pressure and focus on pleasure.
If you are consistently experiencing problems with orgasm and ejaculation, contact your doctor. A thorough medical exam and history may reveal the reason why.
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