The board was certainly right about one thing—female ejaculation has been and still is the subject of much controversy. Many scientists today agree that it does exist, but it’s taken a long time to get to this admission. Philadelphia gynecologist Dr. Martin Weisberg’s first response to Whipple and Perry’s report was: “Bull…I spend half my waking hours examining, cutting apart, putting together, removing or rearranging female reproductive organs…. Women don’t ejaculate.”
So Whipple and Perry set Weisberg up with a personal demonstration. Here’s what he saw, in his own words:
The vulva and vagina were normal with no abnormal masses or spots. The urethra was normal. Everything was normal. She then had her partner stimulate her by inserting two fingers into the vagina and stroking along the urethra lengthwise. To our amazement, the area began to swell. It eventually became a firm one by two cm [0.4 by 0.8 inches] oval area distinctly different from the rest of the vagina. In a few moments the subject seemed to perform a Valsalva maneuver [bearing down as if starting to defecate] and seconds later several cc’s of milky fluid shot out of the urethra.
Weisberg was a convert, but he didn’t take it on faith, or even just trust his own eyes. The fluid was analyzed in the lab, and there were clear chemical indicators that set it apart from urine, including some that provided a direct link to male ejaculatory fluid. It carried chemical markers connecting it to prostatic fluid, the fluid released by the male prostate gland that makes up between 10 to 30 percent of semen. That’s right, female ejaculate has a clear familial resemblance to prostatic fluid, chemically speaking, of course.
There’s a good chance you’ve heard of prostate-specific antigen, or PSA, especially if you’re a man over fifty or know someone who is. PSA is a protein made by the prostate gland that’s present in semen and, at low levels, in the blood of healthy men. A high PSA blood level is a possible warning sign for prostate cancer, and doctors recommend that men over fifty get regularly screened for prostate cancer through a simple blood test. Elevated PSA levels don’t always mean cancer. For example, benign prostatic hypertrophy (BPH) is a condition describing an enlarged prostate that can result in difficulty urinating and elevated blood levels of PSA. Why do men have PSA? The protein is a key chemical component of semen; it keeps semen from becoming too viscous, allowing sperm to swim freely. It is also thought to help dissolve mucus produced by the cervix, making it easier for sperm to make their way into the uterus.
Sure enough, when scientists conducted chemical analyses of female ejaculate in the laboratory, they found significant levels of PSA, as well as PAP, or prostatic acid phosphatase, an enzyme produced by the prostate gland. What they didn’t find was just as telling—the levels of urea and creatinine, the two main chemical signposts in urine, were very low, far lower than they would be if the liquid were urine. And finally they found glucose and fructose, two natural sugars. This could explain why people who have tasted female ejaculate have reported that it tends to be sweet. Fructose is also a key ingredient in semen, where it provides energy for sperm.
The most recent study of female ejaculate, published in 2007, was led by the Austrian urologist Florian Wimpissinger and his colleagues at Rudolfstiftung Hospital in Vienna. They examined two healthy women in their midforties who regularly reported ejaculating during orgasm. The liquid produced by these women was subjected to biochemical analysis, and the scientists also used sonography to image the female prostate of their subjects. The results were conclusive:
Biochemically, parameters of the examination of the fluid emitted were clearly different than urine voided prior to sexual activity. Biochemical parameters—with special reference to prostate-specific antigen (PSA)…show that the source of fluid expulsion during orgasm is not urine, but is rather similar to male ejaculate.
So where do all these prostatic compounds in female ejaculate come from? The female prostate, of course.
Reinier De Graaf, a seventeenth-century Dutch physician, made a series of discoveries in reproductive anatomy before his death at thirty-two, one of which modern medicine has only now returned to. In 1672, he documented a collection of glands and ducts around the female urethra that produces a “pituitoserous juice” that makes “women more libidinous with its pungency and saltiness and lubricates their sexual parts in agreeable fashion during coitus.”
According to Dr. Catherine Blackledge, author of The Story of V, prior to the 1880s, “it was generally accepted that women had a prostate too.” It was the Scottish born gynecologist, Alexander Skene who “chose to focus on just two of the many glands of the female prostate,” writes Blackledge. The Skene’s glands (also called the para-urethral glands) are thought to drain their fluid through two pinhole-sized openings just above the vagina. In 2001, after examining more than 250 peer-reviewed scientific studies, the Federative International Committee on Anatomical Terminology (the official namer of names when it comes to human body parts; as they say, “the only internationally accepted source for human anatomical terminology”) officially renamed the Skene’s glands and the mass of tissue behind them that surrounds the urethra as the “female prostate.”
In human males, the prostate is usually around the size of a walnut, weighing about four-fifths of an ounce. In men, the prostate surrounds the urethra like a doughnut. The female prostate, which surrounds the urethra, seems to come in a variety of shapes and sizes.
Sex educator Deborah Sundahl describes those shapes and sizes in her book Female Ejaculation and the G-Spot, using research compiled by Milan Zaviačič, the Slovakian pathologist. According to his research, the great majority of women, around 70 percent, have a ramp-shaped prostate along the urethra with the thickest part near its opening. About 15 percent have the reverse, with the thickest part at the far end of the urethra, near the bladder. A smaller number, about 7 percent, have a prostate that is thickest in the middle, and about 8 percent of women have what he called a “rudimentary” prostate, with very few glands.
In the Wimpissinger study of the two women who regularly ejaculated, high-definition sonography revealed “A hyperintense structure surrounding the entire length of the urethra with the anterior wall of the vagina adjacent…. It closely resembles that of the male prostate.”
For those who believe in its existence, the G spot is located in the area of the vagina along the upper wall, but the precise location is said to vary from woman to woman. And the collection of glands and ducts that make up the female prostate run along the urethra on the same side of the upper wall of the vagina.
To many sex researchers, it’s beginning to look as if the G spot is actually the best spot in any given woman to stimulate her prostate.
In men, the prostate contributes some of the fluid that is present in male ejaculate. When some women become aroused, the anterior part of their vagina (behind which is female prostatic tissue) increases in size, exposing an erogenous zone that is otherwise less prominent. Given its placement, it’s easy to see that the best place to stimulate it would be the area on the anterior or upper wall of the vaginal canal where it’s easiest to access. As an anecdotal aside: some men can be brought to orgasm through prostate stimulation, and they describe an increase in intensity very similar to the terms women use to describe a G spot orgasm.
All told, it’s been estimated that about 90 percent of women may have a prostate. It’s quite possible that the range in size and location of the female prostate may contribute to the ease and frequency of female ejaculation.
The male prostate is entirely encased by a fibromuscular sheet made of smooth muscle cells that, when they contract, help to expel prostatic fluid into the urethra, where it mixes with other seminal fluid just before ejaculation. It’s not clear whether the female prostate is surrounded by similar tissue; but, in the same way that variation in size and location may contribute to a woman’s ability to ejaculate, it’s possible that the relative scarcity—or abundance—of these cells may account for the range of explosive force women experience when e
jaculating.
One thing is sure. As Dr. Wimpissinger’s report concludes: “Female ejaculation—first described as ‘love juice’ in ancient Indian textbooks—seems to be more common than generally recognized.”
It’s entirely a personal choice, of course, but if you want to experiment with female ejaculation, there are all kinds of guides and courses available. When I spoke with Whipple, she stressed the importance of encouraging women to enjoy what they find pleasurable and not to be set on finding the G spot or experiencing female ejaculations as the only goal. Her work has been to validate women’s experiences not to set new goals. Given that, she describes the best way to start:
Begin with clitoral stimulation, and at least initially this may be the best way to start getting aroused. One should never rush or feel pressured in any way. When she is ready it’s best to move on to stimulating the anterior wall of the vagina [which, if a woman is lying on her back, would be closest to her stomach], stimulating that area with one or two fingers making a “come here” motion. It’s perfectly normal if she feels as if she needs to urinate, because this area surrounds the urethra, the tube you urinate through. With time and practice and help of a partner a woman may experience female ejaculation.
If a woman wants to experience ejaculation, she has to let go and allow it to happen, which requires letting go of a lifetime of training when it comes to bodily fluids in bed. When I spoke to Deborah Sundahl about her experiences teaching hundreds of women to ejaculate for the first time, she said, “The biggest obstacle to women ejaculating is not letting go. That is also men’s biggest complaint about women sexually—they won’t let go. If they do they’re going to ejaculate all over you and that could be taboo.”
THE EVOLUTIONARY RATIONALES behind the male prostate and ejaculation are pretty clear. Male prostatic fluid helps to ensure that semen is the right viscosity for sperm to swim easily, and it may also help them to clear the cervix by thinning cervical mucus. And ejaculation, of course, is what sends sperm on their one-way swimming race. But is there a purpose for female ejaculation? Is the female prostate a gland with a mission or a biological leftover from those early stages of common male and female embryonic development, not unlike the male nipple?
The answer to why our bodies would produce a fluid ought to be found in what that fluid does. Let’s start by taking a look at the male prostate and prostatic fluid, which has been studied extensively, for some clues into the nature of the female prostate and prostatic fluid.
The prostate has the highest concentration of zinc in the body, and prostatic fluid is exceptionally rich in zinc. So what does zinc do, you ask? Well, it does a lot, but one of the main things it does is cause trouble for bacteria. Bacteria feed on iron, which they get from the organisms they’ve infected, including ours. Chemically, zinc is something of an iron mimic, which can confuse bacteria, gumming up their cellular machinery and making zinc a potent antimicrobial. It’s so effective that it’s used in commercial products—millions of mothers use Penaten baby cream to treat diaper rash. Penaten is thought to be so effective because it’s 18 percent zinc.
Now, zinc isn’t the only compound in prostatic fluid that has a family connection to the microbe-fighting business, so let’s follow this thread for a moment. Prostasomes are small, vesicle-like structures with multiple functions, many related to fertilization. One of their principal roles is to protect sperm and improve their ability to swim. Prostasomes are coated with a chemical compound hCAP-18, which is thought to be produced by cells in the testes. The compound hCAP-18 is the chemical precursor (or forerunner) of a powerful antimicrobial compound called LL-37, which is found in many places throughout the body.
So why would women’s urethras need an antimicrobial wash, with compounds not normally found in urine, every time they ejaculate? To prevent urinary tract infections, of course.
Urinary tract infections are incredibly common in women, much more common than in men. Half of all women will develop at least one urinary tract infection at some point in their lives, and the risk of recurrence increases with each subsequent infection. For many women, they are a recurring, painful, fact of life: 20 percent of the women who have a first urinary tract infection will have a second; 30 percent of those who have a second infection have a third; and for those unlucky women, 80 percent have additional recurrences in store.
Why are women so much more likely to suffer from urinary tract infections than men? It probably comes down to anatomical geography. The female urethra, with its opening just above the vagina, is close to bacteria that normally reside there, making it easier for them to get in.
Female urinary tract infections are so common that they’ve given rise to a host of myths, about both what causes them and what cures them. Women have been told that failure to pee after sex, and even failure to douche, can lead to an increased risk of infection. But study after study has shown that one behavior widely thought to increase the risk of recurrent urinary tract infections does exactly that—sexual intercourse. There’s a pretty logical explanation for how that could occur, of course, and, rest assured, it’s nothing specific to your partner. Although the possibility exists that some partners may harbor strains of certain microbes that are more adept at causing urinary tract infections. What seems to happen is that the actual act of intercourse, especially if it involves changing positions during sex, can introduce and move microbes into the urethra, where they can even make their way into the bladder.
There are other behavioral risk factors for recurrent infections. Studies have shown that using a diaphragm and certain spermicides can also increase risk, so if you have a problem with urinary tract infections and use either type of product, be sure to talk to your doctor about it. And new research has shown that there is probably a genetic component to risk, involving the susceptibility of the wall of your bladder to colonization and infection.
Still, an active sex life is definitely one of the most common risk factors. As one sufferer said to Dr. Judith Reichman, a physician who specializes in women’s health issues, “I seem to get bladder infections every time I have sex. What would you suggest? (I hope it’s not abstinence!)”
I too hope it’s not abstinence—and it doesn’t have to be. But there certainly does seem to be merit in doctors’ common nickname for recurrent urinary tract infections, or UTIs. They call it “honeymoon cystitis,” and it can certainly wreck at least that part of your honeymoon. Urinary tract infections definitely get in the way of sex. “Obviously, it is difficult to enjoy sex with excruciating suprapubic pain,” writes clinical psychologist Naomi McCormack in the journal Sexuality and Disability. “One of the most popular sexual self-care strategies is to avoid sexual activity, especially intercourse.”
If a single episode of sexual intercourse would cause an infection that made women avoid sex, wouldn’t evolution do something about it?
That’s exactly what I think happened. It turns out I’m not the only one who came to this conclusion. Whipple and Perry hypothesized back in 1982 that female ejaculation may have evolved to help prevent urinary tract infections in sexually active women. New research needs to be done, and that’s why I’ve begun to investigate this very issue. It’s not yet known, for example, whether zinc, LL-37, or any other antimicrobial compounds are present in female ejaculate in appreciable amounts, as they are in male ejaculate. But, if studies demonstrate a significant antimicrobial character in female ejaculatory fluid, and I believe they will, it would be strong evidence that female ejaculation has a real purpose.
Of course, if you do suffer from recurrent urinary tract infections, ejaculation isn’t your only hope. Infections can be treated with antibiotics. But the old tale about peeing after sex to clean out bacteria won’t help—numerous studies have shown that regular urine does nothing to decrease the risk. There is one folk remedy that shows signs of standing up under scientific scrutiny, at least for women who suffer from bouts of symptomatic recurrent UTIs. Cranberry juice.
Profe
ssor Itzhak Ofek of Tel Aviv University has been studying cranberries and their healing properties for more than twenty years. He and his colleagues published a widely disseminated report in the New England Journal of Medicine that documented their identification of a molecule in cranberries called nondialyzable material, or NDM.
NDM basically acts as a shield for some cells, coating them and insulating them from infection by preventing microbes from attaching and setting up shop. Professor Ofek says, “We understood that there was something in cranberry juice that doesn’t let infections adhere to a woman’s bladder. We figured it was a specific inhibitor and proved this to be the case.” Not to discount Professor Ofek’s research, but it’s at least worth noting that a majority of his research was funded by Ocean Spray, the cranberry juice giant.
Speaking of legends and folk remedies, the idea that oysters are an aphrodisiac is said to have first sprung from the lips of legendary lover and sometime author Giacomo Girolamo Casanova de Seingalt, or just plain Casanova for short. Guess what food contains more zinc per serving than any other? Oysters.
Whether you find your zinc in your ejaculate or in your oysters, it’s bound to help keep the microbes away.
How Sex Works Page 12