So what exactly is going on when you have an orgasm? And why do we have them anyway?
Male and female orgasms are actually quite similar in many ways though female orgasms generally last much longer. But both involve a rapid series of muscular contractions in the genital and anal areas, every 0.8 seconds, in fact. Women may experience more intense contractions than men because the uterus can contract along with the vagina and the pelvic muscles. As both men and women experience orgasm, other muscles may shake or go into spasm. In some people, hands tighten, toes clench, and backs arch. Meanwhile, pleasure centers in the brain are highly activated, while activity in the cerebral cortex, where conscious thought takes place, momentarily recedes. It’s no wonder the French call orgasm la petite mort, “the little death.” The combination, of course, for most of us feels very, very good.
As to why we have orgasms, well, there’s never been much disagreement over the evolutionary motivation for the physiology behind the delivery of genetic material from males: sperm pass up through the vas deferens into the ejaculatory ducts and then are combined with fluid from the seminal vesicles and the prostate itself to make semen. Contractions in the prostate and the penis force the semen into the urethra and out through the head of the penis. That is ejaculation. And that explosive generation of semen from the penis during vaginal intercourse is what launches sperm on their oneway journey to fertilize an egg. This has been the only way to achieve reproduction for all but the last thirty or so years of human existence.
From nature’s point of view, the best strategy for male reproductive success is not too different from what some twentieth-century Chicago politicians supposedly advised their supporters when it came to voting: early and often. So in addition to the physiological evolution of the orgasm reflex as a means to release sperm, it’s more than likely that the pleasurable nature of it created an impetus for men to seek out sex—and finish the job every time.
But what about women? Women can clearly conceive without orgasm. So what’s the evolutionary point behind female orgasm? That’s a mystery about which the scientific community has still not come to agreement, although it’s getting closer. The search began with the notion that just because female orgasm isn’t required, that doesn’t mean it doesn’t help. As sex researcher Dr. Beverly Whipple, and her coauthors point out, in The Science of Orgasm: “An intricately coordinated physiological process between male and female sexual systems enables fertilization. In women, orgasm is evidently not one of the components that is essential to fertilization…. However, several studies…suggest that orgasm may assist the process.”
Many theories have been advanced along those lines, some of which make sense, others that would be fine if they weren’t so contradicted by the basic facts of typical human sexual interaction. For example, one outlandish theory argued that female orgasm served to tire women out so they would remain flat on their backs, giving sperm a chance to make their way past the cervix and into the uterus without leaking out. But as Dr. Elisabeth Lloyd pointed out in her 2005 book, The Case of the Female Orgasm, women are less likely than men to be tired or sedentary after orgasm, and they’re actually much more likely to have an orgasm while on top. Which means if female orgasm is an adaptation to keep women lying still on their backs after sex, it’s a pretty poor adaptation.
Another theory, advanced by Robin Baker, the author of Sperm Wars, and his colleague Mark Bellis, suggests that the contractions of the uterus during orgasm act to suck sperm into it through the cervix, aiding fertility. Baker and Bellis actually attached a fiber-optic camera to the base of a man’s penis so they could film the intravaginal activity during female orgasm. And their footage certainly shows the woman’s cervix repeatedly dipping into a pool of semen as her uterus contracts during orgasm, a phenomenon Baker calls “up-suck.” Baker said the images this study delivered “completely changed my scientific understanding of what happens at the most critical moments during sex.”
Of course, many disagree with this theory too, including Lloyd and Whipple, who both argue in their books that there are methodological flaws in the Baker-Bellis research.
Lloyd, in fact, argues against twenty different theories that suggest an evolutionary purpose behind female orgasm, concluding that the right theory is one first advanced by an anthropologist named Donald Symons in 1979: namely, that female orgasm is an accident. The argument is straightforward. Male orgasm is essential to male reproductive performance; female orgasm is simply the result of sharing the same basic wiring, left over from embryonic development during the first eight weeks of pregnancy, before sexual differentiation kicks in. “Females get the nerve pathways for orgasm by initially having the same body plan [as males],” says Lloyd. “Without a link to fertility or reproduction, [female] orgasm cannot be an adaptation.” In other words, she seems to be arguing that if it doesn’t help a woman get pregnant, it can’t be a product of natural selection.
On the other hand, female orgasms are clearly implicated in forging stronger pair-bonds with men. As discussed earlier, women have better orgasms when they’re in love, and more orgasms—so naturally I believe, regardless of sexual orientation, the possibility exists that orgasms in women could serve to strengthen the bonds that lead to love. Once again, evolution may have pushed sexuality in twin directions for men and women—male orgasms to encourage frequent sex and female orgasms to encourage attachment. Of course it’s not so black and white. There exists a spectrum of gradations when it comes to everything in life, and so it is with human sexuality.
The bottom line is that the pleasurable payoff of sex may be more than just an end in itself. It may also be one of the means to creating enduring bonds between partners, driving people to become loving. “Recreational sex is thus supposed to function as the glue holding a human couple together while they cooperate in rearing their helpless baby,” says Pulitzer Prize–winning author and physiologist Jared Diamond in his book, Why Is Sex Fun?
Remember how the chemistry of attraction may drive us to select genetically dissimilar, but genetically fit, mates in order to give our children a leg up in the genetic sweepstakes? Now, couple that with the notion that sex and orgasm help to create the kind of bonding with this new partner, a bond that you would otherwise only have with family members, and you can see how the combination may produce the outcome that gives us the best chance to have and raise children while coping with all the challenges of life. Instead of allowing the search for a prime genetic partner to isolate you, the resulting pair-bonding helps us to create a new family. And that not only helps us to survive and reproduce; it sweetens the process immensely.
Over time, regardless of gender or sexual orientation, the drive for sex can certainly change, but the bonding it helps to produce endures. Many couples, of course, are sexually active even very late in life (and the advent of drugs like Viagra has made that more true today than ever before), but conversation after conversation with long-term married couples has led me to conclude that it’s not only great sex that keeps them together. Couples who are just as sexually active in their later years as they were when they first met are certainly the exception, not the rule. But the tenderness, affection, and abiding love that I have witnessed over and over again in hospitalized patients, as illness transforms one partner into patient and the other into caregiver, may have had some roots in sex.
One of the patients I cared for really brought home the power of love to help us endure hardship and suffering. He was an elderly man who had just lost his wife after fifty-seven years. This is what he told me:
Sex with my wife was good, especially when we were young, and then, you know, the bills come, the kids come, and, well, at times it makes you wonder how your penis can get you into such a mess. But then at some point you actually realize that if it wasn’t for that I would have missed out on so much in life, including my kids. And, boy, do I ever miss her.
It had been over two years since his wife passed away, and he still hadn’t taken off hi
s wedding ring.
GEORGE BURNS ONCE quipped, “Sex at age ninety is like trying to shoot pool with a rope.” But that’s changed for a lot of seniors, thanks in no small part to a little blue pill, Viagra. Its discovery was sort of an accident. Sildenafil citrate, the generic name for Viagra, which recently celebrated its tenth anniversary, was originally developed as a treatment for heart disease. During clinical studies, men who were taking the drug repeatedly reported a surprising, and generally most welcome, side effect: they were getting serious erections. Drug giant Pfizer, sildenafil’s developer, quickly realized that it had accidentally struck pharmaceutical gold and changed gears, bringing sildenafil to market as a treatment for erectile dysfunction. Recently, sildenafil has returned to its roots, as studies have shown it to be highly effective at treating a rare cardiovascular disorder called pulmonary arterial hypertension. Pfizer now actually sells the drug under two different brand names—Viagra, for erectile dysfunction, and Revatio, for pulmonary arterial hypertension.
With all the attention focused on Viagra’s ability to dramatically improve the sex lives of seniors suffering from erectile dysfunction (not to mention their partners), not much focus has been on its other side effects. And one of them is pretty surprising: Viagra can cause serious nasal congestion, essentially by causing an erection…in your nose.
That’s right, there’s erectile tissue in your nose—the same type of tissue found in the penis and clitoris. The erectile tissue in the nose apparently regulates the intake of air between our two nostrils. Some of the latest thinking is that this allows us to smell in stereo, perhaps letting us better detect the direction a specific smell is coming from, in much the way that our brain calculates the direction of a sound by extrapolating from the difference in time between when the sound reaches each ear. This erectile tissue may also help to direct breathing to one side or the other when we are lying down to rest, ensuring that we get a full complement of air. If we lie on our right side, for example, perhaps partially obstructing airflow to the right nostril, the erectile tissue on that side will swell, ensuring that we get maximum air through our left—and unobstructed—nostril.
But in people who take Viagra, that erectile tissue can cause a surprising complication. Remember, nitric oxide triggers the dilation of those blood vessels so they flood the penis and fill its erectile tissue, causing it to expand and become hard. But when someone takes that little blue pill, it doesn’t just interact with the blood vessels in the penis; it also causes the vessels that feed the erectile tissue in the nose to dilate. Normally, the erectile tissue in our noses works like a pair of pistons, keeping airflow stronger in one nostril, then the other. But when all of it swells under the influence of Viagra, it reduces airflow through the nose, often leaving patients with a feeling of congestion.
MEN AREN’T THE only ones who have sexually important erectile tissue. The clitoris and inner labia both experience increased blood flow when stimulated.
That increase in blood flow is an important part of the arousal process. As any woman who has explored her sexual responsiveness knows (and any man or woman who has explored it with her knows as well), female orgasms come in many different shapes and styles. They can be single or multiple, they can seem to teeter on a knife’s edge for an excruciatingly long while, or they can explode all at once in a mad rush. And for some, they remain elusive. There are clitoral orgasms, which, for most women, are the most common type. There are Gräfenberg or G spot orgasms, described by many of the women who experience them as very different in intensity and character from a clitoral orgasm. There are blended orgasms, involving clitoral and G spot stimulation, there are orgasms from breast stimulation alone, and there are even mental orgasms, which can happen without any physical contact at all.
And there are ejaculatory orgasms. Yes, men are not the only half of humanity who can ejaculate. Women ejaculate too.
Now, if you’re like many men and women today, female ejaculation may be news to you—but recognition of female ejaculation isn’t actually new at all.
In his treatise On Seed and the Nature of the Child, Hippocrates explained his belief that the fluids released by women during sex were required, along with semen, to create life. The definitive Sanskrit text on love and sex, the Kama Sutra, says, “The semen of women continues to fall from the beginning of the sexual union to its end, in the same way as that of the man.” Even twentieth-century American literature on sex and marriage, like the 1928 handbook, Ideal Marriage: Its Physiology and Technique, included descriptions of female ejaculation: “It appears that the majority of laymen believe that something is forcibly squirted (or propelled or extruded) or expelled from the woman’s body in orgasm, and should happen normally, as in the man’s case.”
In the 1950s, as a wave of Puritanism flooded the United States, discussion of female ejaculation—and most matters sexual—disappeared. Female sexuality, in general, was relegated to the back burner, or shoved off the stove entirely. Men, their desires, and the satisfaction thereof were all that seemed to matter. Maxine Davis, author of a 1963 guide called Sexual Responsibility in Marriage, summed up the prevailing attitudes toward female sexuality when she asked, “Why all the hurrah about orgasm for women?”
Fortunately, the feminist movement declared a sexual revolution and demanded equality in the bedroom as well as the workplace, the voting booth, and the rest of society, reminding people what the authors of 1935’s Sex Practice in Marriage understood: “No matter how tired a husband may feel at the moment, it is too unfair to obtain gratification from his wife without giving back to her, her own reward.”
With a renewed focus on female sexuality and female orgasm, some people turned their attention to female ejaculation. The real groundbreaker was a paper by sexologists Beverly Whipple and John Perry published in 1981, reporting a case of one woman ejaculating. The paper described the woman being vaginally stimulated by her husband until she reached orgasm. And there, under the watchful eye of a team of researchers, she climaxed—and ejaculated, releasing noticeable amounts of fluid. As Dr. Whipple and her coauthors reported, “On one observed occasion, [the] expulsion was of sufficient force to create a series of wet spots covering a distance of more than a meter [over three feet].”
Today, the existence of female ejaculation is more accepted in the scientific community, although it still has its detractors. From survey results, some sexologists estimate that about 10 percent of women ejaculate during orgasm, although some put the number as high as 69 percent. In a 1988 study by Slovak researcher Dr. Milan Zaviačič, twenty-seven women were stimulated to the point of orgasm, and ten of them ejaculated, suggesting a prevalence of 37 percent. That study was followed by a 1,300-woman survey two years later in which 40 percent of the respondents indicated they experienced ejaculation during orgasm. I believe that the number of women who can ejaculate may be a lot higher. If that’s the case, why don’t more women experience ejaculation? It seems that the initial sensation, especially when the anterior wall of the vagina (the part of the vaginal canal that is just underneath the abdomen) is stimulated, is similar to the feeling women get when they need to pee. Not surprisingly, many women put a stop to the stimulation right there. They don’t know it’s leading to ejaculation, and they don’t want to pee in the presence of their partners. Just like everything else we’ve discussed, when it comes to sexuality, variation is the rule. There are people who take part and enjoy urinating on their partners. It’s called “water sports” or “golden showers.”
The fluid produced during female ejaculation can be clear or milky white, almost like skim milk. It can range from a few drops to a quarter of a cup, and even more in some reported cases. Ernst Gräfenberg, the German doctor after whom the G spot is named, wrote about the potential scale of female ejaculation in a 1950 paper called, The Role of Urethra in Female Orgasm: “Occasionally the production of fluids is so profuse that a large towel has to be spread under the woman to prevent the bedsheets getting soiled.”
In some women, it seeps out and is barely noticeable, contributing to the challenge scientists face in determining exactly how prevalent female ejaculation is. In other women, ejaculation can be incredibly forceful. One woman reported leaving “a patch of wetness some 2 feet in diameter.” For some women, it happens once per orgasm; others can ejaculate over and over. One woman in Zaviačič’s study ejaculated 160 times while under laboratory observation, with as little as thirty seconds of G spot stimulation.
Before Dr. Whipple’s landmark report, many women who were ejaculating were wrongly diagnosed with urinary incontinence. Women obviously do produce liquid on a regular basis from their genitals—every time they pee. So, ignorant of female ejaculation, some doctors believed the source of all that liquid had to be the only source they were familiar with, the bladder. Essentially, they believed the ejaculatory liquid was a rush of urine produced by women who lost a little more control than others when their bodies were overcome with excitement during orgasm. Some women even underwent surgery in order to “cure” their incontinence.
Doctors aren’t the only ones who mistake female ejaculation for urination, of course—and, in at least one case, that has made for pretty unlikely role reversals. In 2002, the British Board of Film Classification ordered six minutes and twelve seconds cut from a little nugget of high culture called British Cum Queens—and found themselves under attack by a group called Feminists Against Censorship. And what turned a small group of feminists into unexpected defenders of pornography? Female ejaculation education, of course.
The offending six plus minutes of video showed women producing liquid from their genitals. The film board said that was obviously golden showers, or urination, which is banned under Britain’s Obscene Publications Act. That’s not urination, it’s ejaculation, responded the feminist group. Not necessarily, said the film board. The feminists presented a series of scientific studies in rebuttal, arguing strongly that female ejaculation exists. The board backed down from its claim, but maintained that it is a “controversial and much debated area.” But it stood by its position that the scenes in question were illegal, “nothing other than straightforward scenes of urination masquerading as female ejaculation.” In the film board’s defense, most of the pornographic images that depict women ejaculating—often referred to as gushing—are faked using urine or a liquid inserted into the vagina prior to an orgasm or female ejaculation scene.
How Sex Works Page 11