O is for Orgasm

Welcome to the A to Z of Sex. I’m Dr Lori Beth and I am your host.  We are working our way through the erotic alphabet one letter at a time.  Just a reminder this podcast deals with adult content, so if you don’t have total privacy, you might want to put on your headphones.  Today the letter is O and O is for Orgasm.

Orgasm is the climax of sexual activity.  Some believe it is only centred on the genitals.  However, many experience full body orgasm.  Orgasms differ in intensity, length and even location.

Orgasm is often seen as the goal of sexual activity and although orgasm is incredible, the best sex involves being present throughout and enjoying each phase.    Often people present for help because of issues surrounding orgasm, either failure to reach orgasm or in men pre-mature ejaculation. 

Many people don’t understand the anatomy of orgasm.  Physiologically, the brain and the circulatory system are deeply involved in orgasm in both men and women.  The brain is the centre of sexual excitement and the brain stimulates increased blood flow into the genitals.  The central nervous system fully engages the nerves that feed the genital area which are hooked into the brains reward system and a feedback loop builds until the peak is reached. 

Both men and women experience some of the same physiological phenomena.  Blood fills the penis, nipples and lips for men and for women the labia, clitoris, nipples and lips.  Both experience rhythmic pulses during orgasm.  Many women also ejaculate.    There are so many ways to make orgasm happen.

Many women have painfully little knowledge about orgasm when they first start having sex.  I had almost none when I first started having sex.   Sex education didn’t include anything about pleasure and unfortunately in many places it still doesn’t.  Up to 37% of women are either unable to have orgasm or have extreme difficulty having an orgasm.

All orgasms are not alike.  They can be effected by cognitive state, psychological state and what chemicals are in your body at the time (including hormones, drugs, alcohol, other medications).  Your genitals are enervated by several pairs of nerves and when different combinations are stimulated, you have different sensations. 

So – called blended orgasms occur when a bunch of areas in the genital area are stimulated – clitoris, vagina and G-spot for example and each level of sensation is additive so the orgasm is layered, deep and can last longer.  There is such a thing as a cervix orgasm as well!  This can occur through stimulation of the cervix and is known for being extremely intense. 

There is such a thing as a nipple orgasm just as orgasms can come as a result of playing with the anus, visual imagery, breasts, auditory stimulation and fantasising. The length of time an orgasm lasts gets longer as you get older (Isn’t that a great reason to keep having lots of sex as you age?)

Cumming can relieve pain.  Endorphins block pain receptors in the brain and oxytocin (released during orgasm) also suppressive pain and perception of pain.

The types of difficulty women have include:

Primary anorgasmia – when a woman has never been able to reach orgasm

Secondary anorgasmia – when a woman who previously was orgasmic is now not able to reach orgasm.

Situational anorgasmia –when not reaching orgasm is as a result of the situation.

Medications can have a negative effect on the ability or each orgasm.    This includes SSRI antidepressants like Prozac and Citalopram which are notorious for inhibiting orgasm.

The biggest difficulty people have in my experience is letting go.  In order to have an orgasm, you have to let go.  One of the great joys of orgasm is that you cannot control it.  You have to relax and be open to the sensations and let your body, mind, heart and spirit respond to the stimulation and love you are experiencing.

If you have trouble relaxing, try releasing some of the pressure. If you don’t reach orgasm, you haven’t failed. Just enjoy the experience you are having. 

If you practice meditation, this is a good time to employ your strategies to quiet your mind. Allow your breathing to deepen. Focus on one sensation only — that point where your bodies are connecting, the smell of her, the taste of his lips. Breathe into the sensation and just enjoy.

Kegel exercises do lead to better orgasms. It appears that the stronger your pelvic floor muscles are, the better your orgasms are likely to be.

It takes an average of about 20 minutes of stimulation for women to reach orgasm. Some women are able to reach orgasm within 30 seconds of self-stimulation, but this is unusual. Keep in mind that stimulation doesn’t only mean physical stimulation, but includes mental stimulation as well. Orgasms last on average 18 – 22 seconds.

Four pairs of nerves are involved in orgasm in women.

These nerves all take information back to the brain and provide differing sensations and types of orgasm. This is one reason why all orgasms don’t feel a like. If you stimulate all four pairs of nerves, the ‘blended’ orgasm will be far more intense than an orgasm that is the result of stimulating one pair of nerves. Three of the pair of nerves first transmit information to the spinal cord which is then sent to the brain. The vagus nerve transmits straight to the brain — which means even women with complete spinal cord bisection can experience orgasm if this pair of nerves is stimulated. 

There are so many ways for us to get off!

Many women ask how often they should be having orgasms, and if their current frequency is "normal."

When I was in my first, sexless marriage, I thought I was the only married woman who was having no sex at all. Even the clients I was seeing reported having sex at least monthly. When I finally plucked up the courage to talk to a friend, I found out that I was not alone. 

Havelock Ellis was a researcher in the early 1900s who spent a lot of time studying sex and sexual behaviour. In his research about frequency of sex (in married couples, of course), he reported these recommendations according to various religious and cultural groups:

• Zoroaster, the Persian religious leader decreed sex should occur once in nine days.
• Hindu authorities decreed three to six times per month.
• Solon, an Athenian statesman stated three times per month.
• The Koran decrees once per week.
• The Talmud decrees once per day to once per week depending on the occupation of the husband.
• Martin Luther, founder of Protestantism states twice per week.

In my practice, I see that rhythms vary over time, mainly related to health, stress levels, how relationships are going, and whether or not a woman is single. One thing I can clearly say is that when in a relationship, more sex and more orgasms are definitely better.  

More orgasms increase emotional intimacy, as well as positive feelings about your mate, your relationship, yourself — and often the whole of your life.

The good news is that research suggests a clear relationship between the age of the person and the likelihood of experiencing orgasm when having sex. 

This means it isn't too late to get yourself into your maximum orgasmic prime!

Here is a look at the many ways to reach orgasm

Some people can have orgasm through fantasy alone without ever laying hands on flesh.  The brain is the centre of orgasmic potential.

You can have an orgasm through nipple stimulation or stimulation of the anus.  In fact, you might have another spot on your body that causes you to go wild.

Some women learn to come on command.   This isn’t actually difficult to learn as it is just a matter of conditioning.  The same way Pavlov’s dogs learned to salivate at the sound of a bell, we can learn to come at the sound of our lover’s voice.  As orgasm is a complex response, it is likely to take more trials to make the association but with persistence it will happen.

Some women can ejaculate when they have an orgasm.

The fluid they release comes from the urethra, but is not urine. It may feel like there is a lot but in reality it is only usually about a teaspoon of fluid. It is sweet tasting as it is made of lots of glucose, as well as an enzyme called prostatic acid phosphatase.

Though it is not universal for a woman to ejaculate (also known as "squirting"), it is more common that was previously thought, and is perfectly normal. Women who do this routinely report that it feels extremely pleasurable. There is some research that suggests that G-spot stimulation is more likely to lead to female ejaculation, although many women report that clitoral stimulation will lead to ejaculation as well.    

Both men and women can have multiple orgasms.  

It's really all about timing. Men who learn not to ejaculate when they have an orgasm can have multiple orgasms before finally ejaculating. When men do ejaculate, they usual feeling overwhelmingly sleepy. This is a physiological response and therefore difficult for them to resist.

Hence my advice to women who are having sex with men — make sure you attend to your satisfaction first and then look to his, or you may find that you are left to finish yourself off.

Thanks for joining me for the A to Z of Sex this week. Write to me with suggestions for the show, questions you want answered at drloribeth@atozofsex.com , follow me on twitter, Instagram and Facebook.

Check out my YouTube channel: Dr Lori Beth Bisbey.

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