Women's Orgasm

Headnote

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.

Key Words: physiology of orgasm, treatment of anorgasmia, women's orgasm.

Definition of Women's Orgasm

More than one author has commented on the extensive literature that exists about the human female orgasm. It has been discussed from clinical, ethological, philosophical, physiological, psychological, sociological, and typological perspectives (Levin, 1992). Symons (1979, p. 86) observed that although "the human female orgasm definitely exists [it] inspires interest, debate, polemics, ideology, technical manuals and scientific and popular literature solely because it is so often absent!" It is clear that natural selection has not favored females who could orgasm easily, hence it is not likely an essential feature of the reproductive process. Even its definition is hard to pin down because enigmatically it has both nomothetic (the study or discovery of general laws) and idiographic (individual's performance) aspects. Because the exact neural activity of the cerebral neuronal discharge is so poorly understood, most of those defining orgasm use reported or observed physical changes (usually muscular and cardiovascular), with an emphasis that this is the culmination or most intense moment of sexual arousal....