The orgasm is widely regarded as the peak of sexual excitement. It is a powerful feeling of physical pleasure and sensation, which includes a discharge of accumulated erotic tension.
Overall though, not a great deal is known about the orgasm, and over the past century, theories about the orgasm and its nature have shifted dramatically. For instance, healthcare experts have only relatively recently come round to the idea of the female orgasm, with many doctors as recently as the 1970s claiming that it was normal for women not to experience them.
In this article, we will explain what an orgasm is in men and women, why it happens, and explain some common misconceptions.
Fast facts on orgasms
- Orgasms have multiple potential health benefits due to the hormones and other chemicals that are released by the body during an orgasm.
- Orgasms do not only occur during sexual stimulation.
- People of all genders can experience orgasm disorders.
- An estimated 1 in 3 men have experienced premature ejaculation.
- Trans people are able to orgasm after gender reassignment surgery.
- Medical professionals and mental health professionals define orgasms differently.
Orgasms can be defined in different ways using different criteria. Medical professionals have used physiological changes to the body as a basis for a definition, whereas psychologists and mental health professionals have used emotional and cognitive changes. A single, overarching explanation of the orgasm does not currently exist.
Alfred Kinsey’s Sexual Behavior in the Human Male(1948) and Sexual Behavior in the Human Female (1953) sought to build “an objectively determined body of fact and sex,” through the use of in-depth interviews, challenging currently held views about sex.
The spirit of this work was taken forward by William H. Masters and Virginia Johnson in their work, Human Sexual Response (1986) – a real-time observational study of the physiological effects of various sexual acts. This research led to the establishment of sexology as a scientific discipline and is still an important part of today’s theories on orgasms.
Sex researchers have defined orgasms within staged models of sexual response. Although the orgasm process can differ greatly between individuals, several basic physiological changes have been identified that tend to occur in the majority of incidences.
The following models are patterns that have been found to occur in all forms of sexual response and are not limited solely to penile-vaginal intercourse.
Master and Johnson’s Four-Phase Model:
Kaplan’s Three-Stage Model:
Kaplan’s model differs from most other sexual response models as it includes desire – most models tend to avoid including non-genital changes. It is also important to note that not all sexual activity is preceded by desire.
Potential health benefits of orgasm
A cohort study published in 1997 suggested that the risk of mortality was considerably lower in men with a high frequency of orgasm than men with a low frequency of orgasm.
This is counter to the view in many cultures worldwide that the pleasure of the orgasm is “secured at the cost of vigor and wellbeing.”
There is some evidence that frequent ejaculation might reduce the risk of prostate cancer. A team of researchers found that the risk for prostate cancer was 20 percent lower in men who ejaculated at least 21 times a month compared with men who ejaculated just 4 to 7 times a month.
Several hormones that are released during orgasm have been identified, such as oxytocin and DHEA; some studies suggest that these hormones could have protective qualities against cancers and heart disease. Oxytocin and other endorphins released during male and female orgasm have also been found to work as relaxants.
Unsurprisingly, given that experts are yet to come to a consensus regarding the definition of an orgasm, there are multiple different forms of categorization for orgasms.
The psychoanalyst Sigmund Freud distinguished female orgasms as clitoral in the young and immature, and vaginal in those with a healthy sexual response. In contrast, the sex researcher Betty Dodson has defined at least nine different forms of orgasm, biased toward genital stimulation, based on her research. Here is a selection of them:
- Combination or blended orgasms: a variety of different orgasmic experiences blended together.
- Multiple orgasms: a series of orgasms over a short period rather than a singular one.
- Pressure orgasms: orgasms that arise from the indirect stimulation of applied pressure. A form of self-stimulation that is more common in children.
- Relaxation orgasms: orgasm deriving from deep relaxation during sexual stimulation.
- Tension orgasms: a common form of orgasm, from direct stimulation often when the body and muscles are tense.
There are other forms of orgasm that Freud and Dodson largely discount, but many others have described them. For instance:
- Fantasy orgasms: orgasms resulting from mental stimulation alone.
- G-spot orgasms: orgasms resulting from the stimulation of an erotic zone during penetrative intercourse, feeling markedly different to orgasms from other kinds of stimulation.
The following description of the physiological process of female orgasm in the genitals will use the Masters and Johnson four-phase model.
When a woman is stimulated physically or psychologically, the blood vessels within her genitals dilate. Increased blood supply causes the vulva to swell, and fluid to pass through the vaginal walls, making the vulva swollen and wet. Internally, the top of the vagina expands.
Heart rate and breathing quicken and blood pressure increases. Blood vessel dilation can lead to the woman appearing flushed, particularly on the neck and chest.
As blood flow to the introitus – the lower area of the vagina – reaches its limit, it becomes firm. Breasts can increase in size by as much as 25 percent and increased blood flow to the areola – the area surrounding the nipple – causes the nipples to appear less erect. The clitoris pulls back against the pubic bone, seemingly disappearing.
The genital muscles, including the uterus and introitus, experience rhythmic contractions around 0.8 seconds apart. The female orgasm typically lasts longer than the male at an average of around 13-51 seconds.
Unlike men, most women do not have a refractory (recovery) period and so can have further orgasms if they are stimulated again.
The body gradually returns to its former state, with swelling reduction and the slowing of pulse and breathing.
The following description of the physiological process of male orgasm in the genitals uses the Masters and Johnson four-phase model.
When a man is stimulated physically or psychologically, he gets an erection. Blood flows into the corpora – the spongy tissue running the length of the penis – causing the penis to grow in size and become rigid. The testicles are drawn up toward the body as the scrotum tightens.
As the blood vessels in and around the penis fill with blood, the glans and testicles increase in size. In addition, thigh and buttock muscles tense, blood pressure rises, the pulse quickens, and the rate of breathing increases.
Semen – a mixture of sperm (5 percent) and fluid (95 percent) – is forced into the urethra by a series of contractions in the pelvic floor muscles, prostate gland, seminal vesicles, and the vas deferens.
Contractions in the pelvic floor muscles and prostate gland also cause the semen to be forced out of the penis in a process called ejaculation. The average male orgasm lasts for 10-30 seconds.
The man now enters a temporary recovery phase where further orgasms are not possible. This is known as the refractory period, and its length varies from person to person. It can last from a few minutes to a few days, and this period generally grows longer as the man ages.
During this phase, the man’s penis and testicles return to their original size. The rate of breathing will be heavy and fast, and the pulse will be fast.
It is commonly held that orgasms are a sexual experience, typically experienced as part of a sexual response cycle. They often occur following the continual stimulation of erogenous zones, such as the genitals, anus, nipples, and perineum.
Physiologically, orgasms occur following two basic responses to continual stimulation:
- Vasocongestion: the process whereby body tissues fill up with blood, swelling in size as a result.
- Myotonia: the process whereby muscles tense, including both voluntary flexing and involuntary contracting.
There have been other reports of people experiencing orgasmic sensations at the onset of epileptic medicine, and foot amputees feeling orgasms in the space where their foot once was. People paralyzed from the waist down have also been able to have orgasms, suggesting that it is the central nervous system rather than the genitals that is key to experiencing orgasms.
A number of disorders are associated with orgasms; they can lead to distress, frustration, and feelings of shame, both for the person experiencing the symptoms and their partner(s).
Although orgasms are considered to be the same in all genders, healthcare professionals tend to describe orgasm disorders in gendered terms.
Female orgasmic disorders
Female orgasmic disorders center around the absence or significant delay of orgasm following sufficient stimulation.
The absence of having orgasms is also referred to as anorgasmia. This term can be divided into primary anorgasmia, when a woman has never experienced an orgasm, and secondary anorgasmia, when a woman who previously experienced orgasms no longer can. The condition can be limited to certain situations or can generally occur.
Male orgasmic disorders
Also referred to as inhibited male orgasm, male orgasmic disorder involves a persistent and recurrent delay or absence of orgasm following sufficient stimulation.
Male orgasmic disorder can be a lifelong condition or one that is acquired after a period of regular sexual functioning. The condition can be limited to certain situations or can generally occur. It can occur as the result of other physical conditions such as heart disease, psychological causes such as anxiety, or through the use of certain medications such as antidepressants.
Ejaculation in men is closely associated with an orgasm. Premature ejaculation is a common sexual complaint, whereby a man ejaculates (and typically orgasms) within 1 minute of penetration, including the moment of penetration itself.
Premature ejaculation is likely to be caused by a combination of psychological factors such as guilt or anxiety, and biological factors such as hormone levels or nerve damage.
The high importance that society places on sex, combined with our incomplete knowledge of the orgasm, has led to a number of common misconceptions.
Sexual culture has placed the orgasm on a pedestal, often prizing it as the one and only goal for sexual encounters.
However, orgasms are not as simple and as common as many people would suggest.
It is estimated that around 10-15 percent of women have never had an orgasm. In men, as many as 1 in 3 reports having experienced premature ejaculation at some point in their lives.
Research has shown that orgasms are also not widely considered to be the most important aspect of sexual experience. One study reported that many women find their most satisfying sexual experiences involve a feeling of being connected to someone else, rather than basing their satisfaction solely on orgasm.
Another misconception is that penile-vaginal stimulation is the main way for both men and women to achieve an orgasm. While this may be true for many men and some women, many more women experience orgasms following the stimulation of the clitoris.
A comprehensive analysis of 33 studies over 80 years found that during vaginal intercourse just 25 percent of women consistently experience an orgasm, about half of women sometimes have an orgasm, 20 percent seldom or ever have orgasms, and about 5 percent never have orgasms.
In fact, orgasms do not necessarily have to involve the genitals at all, nor do they have to be associated with sexual desires, as evidenced by examples of exercise-induced orgasm.
Another common misconception is that transgender people are unable to orgasm after gender reassignment surgery.
A 2005 study of transgender people who had undergone sex reassignment surgery found that all of the transgender men and 85% of the transgender women were able to orgasm.
Another study in 2014 showed that 82.4% of the transgender women who participated could climax after surgery. A further 55.8% of those also reported that they experienced more intense orgasms post-procedure.
The journey to an orgasm is a very individual experience that has no singular, all-encompassing definition. In many cases, experts recommend avoiding comparison to other people or pre-existing concepts of what an orgasm should be.