sexology

ORGASM

Alfred Kinsey and his associates defined sexual climax, or orgasm, as an explosive discharge of neuromuscular tensions at the peak of sexual response. Most authorities attribute it to a reflex, but some focus on the subjective perception of activity in specific genital muscles and organs. After conducting extensive interviews with researchers studying the physiological components of orgasm, Gallager indicated that the consensus focuses on the involuntary response. The stimulus is usually thought to be physical, although recent research demonstrates that imagery is an adequate eliciting stimulus.

On the basis of the results of the research of others as well as their own findings, Komisaruk and Whipple have defined orgasm as the peak intensity of excitation generated by stimulation from visceral and somatic sensory receptors and cognitive processes, followed by a release and resolution of excitation. Under this definition, orgasm is characteristic of, but not restricted to the genital system.

There was little research concerning the physiology of orgasm until the pioneering work of Masters and Johnson, published in the 1960s. They reported that two major alterations in the genital organs—vasocongestion (engorgement with blood) and myotonia (muscle tension)—were the cause of orgasm. The response to these stimuli was specifically focused in the pelvic area, but there was also a total body response.

Orgasm for the male included contractions, beginning with the testes and continuing through the epididymis, vas deferens, seminal vesicles, prostate gland, urethra, penis, and anal sphincter; three or four powerful ejaculatory contractions at 0.8-second intervals, followed by two to four slower contractions; testes at their maximum elevation; sex flush at its peak; heart and respiratory rates at a maximum; general loss of voluntary muscle or motor control; and, in some instances, vocalization. For the female, strong muscle contraction started in the outer third of the vaginal barrel, with the first contraction lasting for two to four seconds and later contractions occurring at 0.8-second intervals; slight expansion of the inner two-thirds of the vagina; contraction of the uterus; peak intensity and distribution of the sex flush; frequently strong muscular contractions in many parts of the body; possible doubling of respiratory rate and heart rate; blood-pressure elevation to as much as a third above normal; and vocalization in some instances.

Masters and Johnson concluded that there were two major differences between the sexual responses of men and women: only men could ejaculate, and only women could have a series of orgasms in a short period. Subsequent findings by Hartman and Fithian have shown that men are capable of multiple orgasms, and research by Beverly Whipple and others has indicated that some women ejaculate a fluid from their urethra at orgasm. However, for the most part, later research has supported and expanded the findings of Masters and Johnson.

According to Mould, the clonic contractions of pelvic and abdominal muscle groups that characterize orgasm are initiated by a spinal reflex. Sherfey has proposed that the orgasmic response is initiated by the firing of stretch receptors in the pelvic muscles. Pelvic engorgement stretches the receptors, which, when reaching a certain point, initiate the spinal reflex.

Hartman and Fithian question the necessity of myotonia (muscle tension). They found that though myotonia was involved in the majority of their subjects, some individuals easily had orgasm without any signs of myotonia.

In a study of the orgasmic response among 751 volunteer research subjects, Hartman and Fithian found that male and female orgasmic patterns are undifferentiated within the orgasmic parameters measured. However, response patterns in individual subjects were individualized. Everyone had their own pattern. In a group of records that included several of the same subject, the records could be pulled out without looking at the name. Of all the parameters studied, the widest variation between people occurred in the cardiovascular functions.

Orgasm in both men and women consists of rhythmic muscular contractions that affect all the sexual organs and the whole body. A few people report spastic contractions of the voluntary muscles of the hands and feet. The respiratory rate may increase to 40 per minute, and pulse rates may increase to 110 to 180 beats per minute. The systolic blood pressure may be elevated 30 to 80 mm Hg. A sex flush, which parallels the intensity of orgasm, is present in about 75 percent of women and 25 percent of men. Extra heart beats and skipped beats are not uncommon in the sexual-response cycle of healthy people during sexual arousal or response. They are much more extensive in those who are not in good physical condition.

The length of an orgasm is variable. Male orgasm usually lasts about 10 to 13 seconds. Bohlen reported muscle contractions during female orgasm lasting between 13 and 51 seconds, although the same women reported their subjective perceptions that orgasm lasted between 7 and 107 seconds.

Ejaculation in men occurs in two stages, both of which involve contraction of the muscles associated with the internal sex organs. During the first stage of emission, sperm and fluid are expelled from the vas deferens, seminal vesicles, and prostate gland into the base of the urethra near the prostate. As the fluid collects, there is a consciousness of imminent ejaculation. During the ejaculation stage, the seminal fluid is propelled by the muscular contractions of orgasm into the portion of the urethra within the penis and then expelled from the urethra! opening.

Many people cannot tell if their partner is having orgasm, and both men and women have admitted to faking orgasm. Some women expel fluid at orgasm. This is because lubrication may pool in the back of the vagina and be expelled by the contractions at orgasm, or they may ejaculate from the urethra. In laboratory experiments, some women may need to stimulate themselves for an hour or more before reaching orgasm, but generally, with experience, the time grows shorter. The shortest time for a woman to reach orgasm recorded in the research laboratory is 15 seconds, but this, it should be emphasized, is rare. The average time for most women to reach orgasm in the laboratory is 20 minutes.

Women have reported a variety of orgasmic experiences. Some women have sequential orgasms, a series of orgasms with short breaks in between; others have multiple orgasms with no break in between while stimulation is continued. Women make subjective distinctions between orgasms resulting from stimulation of different areas of their body. A vaginally induced orgasm is described as feeling more internal and deeper than an orgasm resulting from clitoral stimulation. The Singers described three types of female orgasm. They called the orgasm described by Masters and Johnson a vulval orgasm because it was characterized by involuntary rhythmic contractions of the vaginal entrance and was produced by clitoral stimulation. The second kind, the uterine orgasm, results from vaginal stimulation. This type of orgasm appears very similar to the orgasm triggered by stimulation of the Graefenberg spot, a sensitive area felt through the anterior wall of the vagina. The Singers' third type of orgasm, the blended orgasm, is a combination of the vulval and uterine orgasm, usually resulting from stimulation of the clitoris and the vagina.

For most men, orgasm remains concentrated in the genital region. Many men ejaculate rapidly. This is the norm since Kinsey reported that three-quarters of all males reach orgasm within two minutes of the beginning of sexual intercourse. The problem is that this does not give most women enough time to reach orgasm. Men, however, can learn to delay orgasm.

Bohlen found little correlation between perception of orgasm and the physiological parameters measured in the laboratory. The reported intensity of orgasm did not correlate with increases in physiological parameters. This means that pleasure may not be correlated positively with changes in autonomic activity. He monitored women in the laboratory who reported that they experienced orgasms but experienced no contractions. Whipple and colleagues also reported that in their laboratory, some of the women who had orgasm from imagery appeared to be lying still. It may be that these women have isometric skeletal muscular tension during orgasm, or muscle contractions may not be necessary for orgasm to occur.

Similarly, Hartman and Fithian monitored a group of 20 female therapy clients who claimed they were not orgasmic. Three-fourths were found to be undergoing the physiological responses associated with orgasm. Once the women had these changes identified for them as equivalent to an orgasm, all but one were able to identify it for themselves the next time they were monitored. Many had read extensively on orgasm, and they perceived their response to be different from what they believed the literature reported; their preconceived notions about orgasm did not fit the reality.

Orgasm has been reported to occur in response to imagery in the absence of any physical stimulation. Whipple and colleagues compared orgasms from self-induced imagery and from genital self-stimulation. Each generated significant increases over resting control conditions in systolic blood pressure, heart rate, pupil diameter, and pain thresholds. Additionally, the increases in the self-induced-imagery orgasm were comparable in magnitude to those in the genital-self-stimulation-produced orgasm. On the basis of this study, it appears that physical genital stimulation is not necessary to produce a state that is reported to be an orgasm.

Not everyone has an orgasm. It has been estimated that about one-third of women do not have orgasm at all, one-third have orgasm part of the time, and one-third fairly consistently have orgasm. Some men who can have an orgasm through masturbation have difficulty in heterosexual intercourse. One reason might be that they use heavy pressure in masturbating, far stronger than the pressure of vaginal intercourse. Until they learn to have orgasm with lighter pressure, they typically have problems in ejaculating or having orgasm during coitus.

There are other factors related to a lack of orgasm. Some of these are stress, anxiety, anger, fear of loss of control, medication, fatigue, and time pressure. Anger in some individuals can result in such strong emotional feelings against their partners that it inhibits orgasm, while in others it can provide the stimulation that produces arousal. This is why some couples fight and then have sex. For them, the fighting acts as an erotic stimulus. If they seek therapy to end the fighting, they may end their marriage unless they develop other methods of erotic stimuli to replace the fighting they have given up.

Erotic stimulation, in various forms, including overall body stroking, caressing, and fondling, is an important part of lovemaking activity. It produces the engorgement in the vascular tissue of the vagina and the penis. This results in erection in the male and the sweating effect that produces vaginal lubrication in the female. The engorgement also often masks areas that are painful or uncomfortable in the vagina. Where there is insufficient engorgement and lubrication, there may be abrasion from the penile thrusting, pain, or discomfort where the stimulation is of areas that are uncomfortable in an unengorged state.

Large numbers of women who have orgasm do so with manual or oral stimulation or masturbation. Many couples do not have intercourse with sufficient frequency, or do not take enough time, for the women to learn to have orgasm through intercourse.

Orgasm, in a sense, is a learned behavior, and it is learned by trying different activities. Masturbation is the easiest way to learn. Orgasm with intercourse does not feel the same as it does with masturbation, since different areas are usually being stimulated. Actually, orgasm can be elicited from various parts of the body and even by imagery alone. Such orgasms can also produce a pelvic response. The most nerve endings tend Co exist in the clitoris in women and the penis in males, although about 10 percent of women have more nerve endings in the labia than in the clitoris. Subjects have been seen to have orgasm in a back caress, as well as through stimulation of other parts of their body. That is why it is suggested that a total body caress be done as a part of erotic stimulation to enhance the probability of response.

There is a hormonal connection between the vagina and breast in the female. Oxytocin (the hormone that triggers the breast milk reflex in women) is released at orgasm. If she is a nursing mother, she may exude milk from her nipples, while even nonnursing mothers may see a drop of fluid on their nipples. Nursing itself has been reported to give genital sensations of pleasure and even orgasm in some women.

When asked to describe an orgasm, most people will smile and say it's like an expulsion, like paradise, like a release, like a volcano, or like a big shiver. People can describe what an orgasm is like, but they cannot say what it is. The scientific explanations for orgasm have clarified the process somewhat, and contemporary researchers are studying the neurophysiology of orgasm and the role of hormones in orgasm, as well as determining the areas of the brain involved in orgasm. Perhaps in future editions we will be able to answer further the question as to what orgasm is.