sexology

G SPOT AND FEMALE PLEASURE

The Grafenberg spot, or G spot, is a sensitive area identified through the anterior vaginal wall. It is usually located about halfway between the back of the pubic bone and the cervix, along the course of the urethra and near the neck of the bladder. It swells when it is stimulated, although it is difficult to palpate when in an unstimulated state. It was named by John Perry and Beverly Whipple in 1981 to commemorate the research of Ernst Graefenberg, a German-born obstetrician and gynecologist, who in 1944, along with Robert L. Dickinson, described a zone of erogenous feeling located along the suburethral surface of the anterior vaginal wall. In 1950, Graefenberg wrote that

an erotic zone could always be demonstrated on the anterior wall of the vagina along the course of the urethra, [which] seems to be surrounded by erectile tissue like the corpora cavernosa [of the penis].... In the course of sexual stimulation the female urethra begins to enlarge and can be easily felt. It swells out greatly at the end of orgasm. The most stimulating part is located at the posterior urethra, where it arises from the neck of the bladder.

Though Graefenberg and others had written about this phenomenon, it was more or less ignored until Perry and Whipple focused renewed attention on it. The two researchers were encouraged to investigate the subject through conversations with women who described what was sexually pleasurable to them. Since the original report the spelling of Grafenberg has been anglicized.

Perry and Whipple reported that they had a physician or nurse examine more than 400 women who had volunteered to be research subjects, and a sensitive area in the vagina was found in each of these women. They cautioned, however, that they could not state with certainty that every woman had such a sensitive area.

Women have reported that it is difficult for them to locate and stimulate the Grafenberg spot in their own bodies (except with a dildo or similar device). A number of women who reported that they were able to locate the Grafenberg spot by themselves say they have done so while seated on a toilet. After emptying the bladder, they explore along the anterior (upper front) wall of the vagina with firm pressure, pushing up toward the navel. Some women have also found it helpful to apply downward pressure on the abdomen with the other hand, just above the pubic bone or top of the pubic hairline. As the Grafenberg spot is stimulated and begins to swell, it can often be felt between the two sets of fingers.

It is easier for women to identify the erotic sensation when the area is stimulated by a partner. The partner inserts one or two fingers (palm up) into the woman's vagina while the woman lies on her back, then applies firm pressure through the upper vaginal wall with a "come here" motion. At the same time, the woman can also apply firm downward pressure on her abdomen just above the pubic hairline. This way the woman and her partner can both feel the swelling: the partner through the vaginal wall and the woman through her abdomen. If a penis is used to stimulate the G spot, the positions most likely to provide effective stimulation are the female sitting on top of the male's penis or the vaginal rear-entry position.

The G spot feels like a small lump or a spongy bean. Stimulation causes it to swell and to increase in diameter from the size of a dime to, in some women, the size of a half-dollar. When the Grafenberg spot is first touched, many women state that it feels as though they have to urinate, even if they have just emptied the bladder. However, within 2-10 seconds of massage, the initial reaction is replaced in some women by a strong and distinctive feeling of sexual pleasure.

Some women report an orgasm from stimulation of this area, and some also report an expulsion of fluid from the urethra when they experience this type of orgasm. Others report the expulsion of fluid following stimulation of the G spot without orgasm, and there have been a few reports of fluid expulsion with stimulation of other genital areas. The fluid looks like watered-down skim milk and does not smell or taste like urine.

Chemical analysis of the fluid and comparison of it to urine have been conducted, and the results have been published in six separate research reports. In three of these studies, the fluid expelled from the urethra was observed by the researchers and subjected to chemical analysis. In two of these studies, the ejaculated fluid was chemically different from urine samples from the same subject, while in the third study no difference was observed. The chemical analysis reported on concentrations of prostatic acid phosphatase, urea, creatinine, glucose, fructose, and pH.

Three additional studies comparing ejaculate and urine have been reported, but in these the expulsion of fluid was apparently not observed by the researchers. Two of these studies demonstrated a statistically significant difference between the ejaculate specimens and urine, while in the third no significant differences were observed. The question of female ejaculate is still being examined and opinions vary, with many arguing that the ejaculate is simply due to the relaxation of muscles, allowing for some urinary incontinence.

Perry and Whipple estimated that perhaps 10 percent of women ejaculate. Subsequent questionnaire responses have yielded higher estimates, from 40 percent to 68 percent. The questionnaire data, however, may be biased because those women who believed that they experienced this phenomenon might have been more likely to complete the questionnaires.

Some women have reported that they had surgery to stop the expulsion of fluid, while other women reported deliberately avoiding orgasm because they thought there was something wrong with them for enjoying vaginal stimulation. Disseminating information about current research findings, even though the issue remains controversial, is important in lessening anxiety and in allowing women both to feel better about sexuality and to find pleasure in their sexual responses.

In a physical examination for vaginal sensitivity, Perry and Whipple found that among 47 subjects, 90 percent reported being highly sensitive in their vaginas at the 12 o'clock position (upper or anterior wall of the vaginal vault), 57 percent at the 11 o'clock position, 47 percent at the 1 o'clock position, 30 percent at the 4 o'clock position, and 37 percent at the 8 o'clock position. The G spot is not normally felt during a gynecological examination, because the area must be sexually stimulated in order for it to swell and be palpable. Physicians do not sexually stimulate their patients and therefore do not find the G spot.

Other researchers have also reported findings of vaginal sensitivity, among them Hoch, Alzate and London, and Alzate and Hoch, but the latter concluded that although there is a zone of tactile erotic sensitivity, evidence remains inconclusive. The Federation of Feminist Women's Health Centers describes this area as the "urethral sponge," a sheath of erectile tissue around the urethra that becomes engorged during sexual excitement and protects the urethra during sexual activity. Zaviacic and colleagues in Czechoslovakia reported a specifically sensitive site with a manually detectable tumescence in 27 women who were palpated. Masters, Johnson, and Kolodny observed that only 10 percent of 100 women had an area of heightened sensitivity in the anterior wall or possessed tissue mass that resembled this sensitive area. Hartman and Fithian reported finding sensitivity in large numbers of women at the 12 o'clock, 4 o'clock, and 8 o'clock positions.

In an anonymous questionnaire distributed to professional women in the United States and Canada, Davidson and colleagues found that 786 (66 percent) of their 1, 245 respondents perceived an especially sensitive area in their vagina that, if stimulated, produced pleasurable feelings. Whipple found that of the 800 women who completed a sexual-health questionnaire, 69 percent of the subjects reported 12 o'clock as the most sensitive area.

Perry and Whipple hypothesized that the G spot is probably composed of a complex network of blood vessels, the paraurethral glands and ducts, nerve endings, and the tissue surrounding the bladder neck, but they did not conduct any anatomical studies in this area. Zaviacic and his colleagues have conducted the most extensive immunohistochemical analysis of the paraurethral, or Skene's, glands in women; they found that there was a cross-antigenicity between the male prostate gland and the Skene's gland and that the enzymatic reactions of the male and female prostatic tissues are similar—so similar that Zaviacic held that the term "female prostate" was appropriate. Alzate and Hoch disagreed with such a term, claiming that it is confusing to call the Skene's gland the female prostate.

Despite the evidence that specific anatomical structures correspond to the area defined as the Grafenberg spot, its exact anatomical identity remains inconclusive. All we can say with certainty is that some women report pleasurable vaginal sensitivity and that the anterior wall appears to be the most sensitive area of the vagina. A distinct area identified through the anterior vaginal wall that swells when stimulated has not been found universally by all researchers who have conducted sexological examinations. This seems to imply either that not all women have this distinct area or that perhaps different criteria have been used to identify it. Those women who report having a G spot say the orgasm resulting from stimulation of this sensitive area is different from that resulting from clitoral stimulation, the main difference being that it is "deeper" inside. Some also report a bearing-down feeling during orgasm from G-spot stimulation.

Obviously, women do not have to fit one monolithic model of sexual response, and there might well be individual variations. Women also have been socialized to believe and accept traditional views about their sexuality and female pleasure, and often what they have been taught is different from what they experience. For women, the whole body can be sexual, and women have the potential to experience sexual pleasure from their thoughts, feelings, beliefs, fantasies, and dreams. Each woman has to be aware of what is pleasurable to her, acknowledge it to herself, and then communicate it to her partner. Women should not be encouraged to set up G-spot stimulation or orgasm as a goal, since by setting such goals they miss a lot of pleasure along the way. They should focus on the process rather than the goal of a particular sexual response.