G-Spot, Squirting and Vaginal Orgasms - the Controversy and the Science

 

The Skene or peri-urethral gland

The controversy: two views about female orgasms

The official version, defended by sexologists and other experts (Kilchevsky et al., 2012; Puppo and Puppo, 2014), is that there is only one type of female orgasm: the one triggered by stimulation of the clitoris. Although some women are able to reach orgasm during penetration, this is because the penis stimulates the clitoris indirectly with its movements in the vagina. The vaginal walls are practically devoid of the nerve endings needed to trigger an orgasm (Kilchevsky et al., 2012). The G-spot does not exist and there are no vaginal orgasms. Similarly, female ejaculation is a myth (Shafik et al., 2009); what really happens is that some women produce a lot of vaginal lubrication.

However, there is another version, the one told by many women who have embarked on a deep exploration of their sexuality. It is also supported by scientific studies (Jannini et al., 2010; Schubach, 2002; Thabet, 2009). According to this view, there are at least two types of orgasms, clitoral and vaginal, which differ in their subjective qualities. The vaginal orgasm can be triggered independently of clitoral stimulation through a point on the front of the vagina, the so-called G-spot - an abbreviation of Grafenberg spot (Schubach, 2002). A vaginal orgasm is often accompanied by a stream of clear fluid that is different from urine or vaginal discharge. Although many women are unable to achieve vaginal orgasms at first, they can be trained to do so by sensitizing the G-spot with prolonged finger massage.

Who is right? Well, there is plenty of evidence to consider.

Orgasms vary widely among women

But first let me start by saying that women vary enormously in their sexual response (Prause et al., 2016). Many women find it difficult to achieve orgasm with anything other than clitoral stimulation. However, there is also a large group of women who prefer vaginal stimulation, not only during intercourse but also by masturbating using fingers or dildos inserted into their vaginas. Some women cannot stand direct clitoral stimulation because their clitoris is so sensitive that they find it unpleasant or even painful. For other women it is the opposite: their clitoris is a bit insensitive while their vagina provides a much more reliable source of pleasure.

Ideology seeps into sex research

In fact, the G-spot and female ejaculation have been known since ancient times in numerous cultures (Korda et al., 2010). They are described by Taoist texts of the 4^th century, in the Hindu Kamasutra and, in the Western world, by Aristotle and Galen. So why is there such a big controversy regarding its existence?

The reason is ideological. In 1976 the American feminist Shere Hite published The Hite Report, which became a best-seller. Based on informal questionnaires, it argued that the best way for women to reach orgasm is to masturbate by touching the clitoris and that internal stimulation of the vagina is not necessary. This was embraced by a group of radical feminists who viewed penis-in-vagina intercourse as a form of male domination. Some, following the writings of Andrea Dworkin, even went to the extreme of saying that “penetration is rape”.

This triggered vicious criticism of previous works on the female orgasm. Dr. Grafenberg was called a sexist and accused of having invented the G-spot in order to convince women to practice vaginal intercourse, thus relegating them to the roles of reproducers and providers of male pleasure.

Sigmund Freud was also called a sexist because in his “Three Essays on the Theory of Sexuality” he sustained that only women who had reached psychosexual maturity were able to enjoy sexual intercourse and that those who resorted to clitoral stimulation were immature. Thus, he was the first to categorize women as clitoral or vaginal. Of course, saying that women who prefer to stimulate their clitoris are immature is nonsense, but so is denying the existence of women who prefer vaginal stimulation.

Fortunately, sanity was eventually brought back by a new wave of sex-positive feminists who consider it worthwhile to derive pleasure from different types of sex. However, sexologists are still reluctant to talk about vaginal orgasms for fear of being politically incorrect.

Evidence for the G-spot

According to an increasingly popular view, the G-spot is an organ located below the anterior face of the vagina, called the Skene glands or periurethral glands (Dwyer, 2012). Its physiological function remains a mystery. However, it seems to be similar to the male prostate (Schubach, 2002). During sexual stimulation, the Skene glands produce a clear, odorless fluid that is different from vaginal lubrication, which is produced by different glands - the Bartholin's glands - and is more viscous and milky. A detailed study of 50 normal and 125 circumcised (without a clitoris) Egyptian women found that 82% could have an orgasm by stimulating the G-spot, which in 66% of the women was found as “two small flaccid balloon-like masses on either side of the lower third of the urethra” (Thabet, 2009). A recent meta-analysis (a systematic review of previous studies) (Ostrzenski, 2019) concluded that the G-spot exists as a distinct anatomical structure and that it becomes engorged with blood during sexual stimulation. However, it is still debated whether the G-spot is the same as the Skene glands.

As for the claimed lack of nerve terminals in the vagina, it should be kept in mind that number of nerves does not necessarily correlate with intensity of sensation. Numerous nerve terminals are required for precise tactile sensations, like the ones in our fingertips, but not for diffuse sensations like pain and pleasure. Amazingly, women with spinal cord injuries - and thus unable to feel anything from the waist down - can have orgasms through vaginal stimulation. Studies using fMRI (Komisaruk and Whipple, 2005; Komisaruk et al., 2004) on these women showed that the usual neuronal pathways ascending the spinal cord were not necessary for orgasms because the sensations traveled from the vagina to the brain via the vagus nerve. The vagus is a nerve that originates in the brain and meanders through the middle of the body contacting all major organs. Its functions are both efferent (sending information from the brain) and afferent (sending information to the brain). Therefore, it seems that vaginal stimulation can trigger orgasms through the vagus nerve and does not require the presence of numerous terminals of the pudendal nerve, like the clitoris, which connects to the brain via the spinal cord.

Evidence for female ejaculation

I have witnessed female ejaculation on several occasions. I've also seen plenty of videos showing it, although these could be of women peeing. Still, 40% of women report ejaculating during orgasm, and 82% of women who report having a G-spot also report ejaculating (Darling et al., 1990).

In contrast to the vaginal lubrication produced by the Bartholin's glands, the secretion of the Skene glands contains biochemical markers similar to those produced by the prostate, such as the PDE5 enzyme (cGMP-specific phosphodiesterase type 5) and PSA (prostate-specific antigen). The prostate is a male organ that makes the semen, the liquid in which the sperm cells produced by the testicles are suspended. Therefore, the Skene glands would produce a semen-like fluid in women, so it would be appropriate to call their secretion "female ejaculate."

The problem is that the Skene glands are quite small and so they do not seem to be able to produce the large amount of liquid observed when women squirt. The same meta-analysis (Ostrzenski, 2019) that showed the existence of the G-spot also ruled out that it is responsible for female ejaculation. This has led to the speculation that squirting is really urinating, something called coital incontinence. However, there is evidence that female ejaculate is different from urine (Pastor, 2013).

In one study, two women who reported ejaculating during orgasm were thoroughly examined (Wimpissinger et al., 2007). Ultrasound revealed a gland lining the whole length of the urethra, and urethroscopy showed openings into the urethra. Biochemical markers of the prostate were found in their ejaculate, but not in their urine. This was taken as evidence for the existence of the female prostate and female ejaculation.

However, another study on seven women (Salama et al., 2015) reached different conclusions. Before sexual stimulation, the women were asked to empty their bladders, which was confirmed with ultrasounds. The same method was used to observe that their bladder filled up during sexual stimulation and that it was empty after squirting. Biochemical analyses of the ejaculate showed that it contained urine but also PSA. Before sexual stimulation, their urine did not contain any PSA.

There is a way to reconcile these two apparently contradictory results. According to this interpretation, in women who squirt sexual stimulation causes the Skene glands to release their secretions into the urethra. Since the exit of the urethra is closed by the sphincter, all that liquid is directed into the bladder, where it accumulates. At the same time, the kidneys keeps filling the bladder with urine. When the women have an orgasm all this liquid is released from the bladder as female ejaculation. Depending on how large the contribution of the Skene glands is in relation to that of the kidneys, the ejaculate will contain more PSA or more urine. This explains why both PSA and urine is found in the ejaculate.

Then, why do women ejaculate? It has been hypothesized that the biological function of squirting is to clean the urethra to avoid the urinary tract infections that are common after sexual intercourse (Moalem and Reidenberg, 2009). Another possibility is that this is just another signal that the woman has had an orgasm, which increases bonding with her sexual partner.

Conclusion

Based on this evidence and my own personal experience, I am convinced that the G-spot, vaginal orgasms and squirting are real.

I would go even further by saying that women are capable of many other types of orgasms: anal, from nipple stimulation, from spanking and other forms of pain, from exercise, and even to have full-body orgasms. But I will leave these topics for future articles.

Take-home messages

1.      Female sexuality varies widely, much more so than male sexuality. When making love with a woman whom you have just met, you should not assume that her sexuality will be similar to your previous lovers.

2.      Discarding vaginal orgasms because they are politically incorrect does a disservice to women because it denies them an important source of pleasure.

3.      Beware of the opinion of sexologists, especially if they seem to be ideologically motivated.

4.      The G-spot and vaginal orgasms do exist. If you have only had clitoral orgasms so far, it may be worthwhile to experiment with vaginal stimulation to have new sexual experiences.

5.      However, you should not become frustrated if you are not able to squirt or cum by stimulating your G-spot. Skene's glands appear to vary greatly from woman to woman. About 18% of women do not seem to have a functional G-spot (Thabet, 2009).

6.      Vaginal orgasms and squirting are different things. It is OK to squirt. It is OK to not squirt.

7.      Do not consider your sexuality as something static but something that can be changed with practice. Keep learning and exploring.

The orgasm gap is a terrible idea, scientifically, personally and politically

I have wanted to write about the orgasm gap for a long time. However, the subject seemed rife with political landmines. As a neuroscientist specializing in pain and sensations, I gathered many scientific papers on sexual pleasure and orgasm. Female orgasms are so complex, so controversial and so ideologically loaded that they seemed impossible to tackle in a short article. Nevertheless, I am giving it a try, leaving a lot of information for future posts.

The ‘orgasm gap’ can be understood as two interconnected ideas:

1. Women have fewer orgasms than men during sex.
2. Men are to blame for this.

You may object, saying that the orgasm gap is only the first idea and that the second is a strawman. However, since its inception, the orgasm gap always referred to men as the culprits of women not being able to reach orgasm [1].

Although the orgasm gap is presented as a call for women being more aware of the inequality they suffer during sex and as the remedy to this inequality, I think that it achieves exactly the opposite by perpetuating some wrong ideas about the female orgasm and how to achieve it. Not only that, this idea damages feminism by increasing the divide between women and men.

The ‘orgasm gap’ idea is wrong scientifically

I am not contesting the idea that women achieve orgasm less frequently than men during sexual intercourse. That is a statistical fact [2-4]. However, an idea can be wrong scientifically even when based on fact: when it provides the wrong conceptual frame to understand a problem. The ‘orgasm gap’ idea does that by looking at orgasms through only one variable, their frequency, when in fact orgasms are complex phenomena in which intensity, quality, and emotional impact are as important as frequency. When we consider these crucial properties we come to realize that there is, in fact, another orgasm gap in the opposite direction: female orgasms are often more intense, more enjoyable and have a greater emotional impact than male orgasms. Of course, this second orgasm gap is not to be blamed on women but on some basic physiological differences between the sexes. This is not a new finding, people have been aware of it since antiquity, as I humorously pointed out in my article The Orgasm Gap According to the Ancient Greek.

Of course, if you do not reach orgasm at all it does not help that it would have been better than a male orgasm. Here we are faced with a third orgasm gap, one that exists between women: some women are multiorgasmic and cum easily, others are anorgasmic, and most are between these extremes with different levels of difficulty in achieving orgasms. To complicate things even more, the ease, frequency and intensity of female orgasms change through life, notably after menopause, but also depending on factors like childbirth, motherhood, emotional health and quality of romantic relationships. Emotions like anger, indignation and shame have a great impact on the ability to orgasm and orgasm quality.

The other way the ‘orgasm gap’ is wrong scientifically is in its second part. It discusses orgasms as something that happens only during sex with another person, ignoring orgasms achieved through masturbation. However, the inability of a woman to achieve orgasm through masturbation is a different problem that her inability to get it with a sexual partner. The first could point to a serious physiological or psychological disorder, whereas the second may or may not be caused by her sexual partner. By framing female orgasms as something exclusively related to sexual interaction, the idea of the orgasm gap may direct women in the wrong direction to solve their problem.

Approaching sex with an ‘orgasm gap’ mentality is bad personally 

Many people come to sex with a lot of emotional baggage. They may have grown up in a sexuality repressive culture that has left them filled with sexual guilt and shame. They may have been abused sexually. They may come from previous relationships with people that disregarded their sexual needs or that were sexually incompatible with them. And yet, for sex to be fulfilling, healthy and fun we have to leave that baggage behind and try for a fresh start. That may not always be possible, but at least we should be aware of our problems and not blame them on our sex partner. Here, an ‘orgasm gap’ mentality is likely to increase instead of remedy our previous problems. It makes women look at men with suspicion, which is a bad place to start. Even worse, it presents sex as a transactional act: “I give you pleasure if you give me pleasure”, when sex should be an act of generosity. A fundamental thing to understand about sex is that giving pleasure IS pleasure. Pleasure is not just the sensations arising from our genitals, is the whole emotional feedback, the upward spiral of ‘I enjoy that you enjoy that I enjoy that you enjoy…’.

In my experience, the biggest obstacle to orgasm is anger. That’s why I think the revindicative approach to orgasm brought by the concept of the orgasm gap gets it completely backward. If you start having sex with the frame of mind that you are going to blame your partner if he doesn’t give you an orgasm, most likely you are not going to get one. You may add other negative emotions to anger, shame and craving, for example, but nothing drives sexual pleasure away as effectively as anger. There is no amount of sexual expertise that can overcome those walls in your head.

If you are trapped in anorgasmia, the way out is in not to find a man that can ‘give you an orgasm’. Barred a medical or psychological problem, the path to better orgasms is creative masturbation. You should be able to give yourself orgasms, and in the process map out the places in your body, the touching, the rhythms, the fantasies, the words and the sounds that get you off [3]. Only then you will be able to tell them to your partner, so you can travel together on a landscape of pleasure. And remember, orgasms are only one more feature in that landscape.

Regarding men's behavior, there is an issue regarding female orgasms that has been ignored by the orgasm gap warriors. As analyzed in the book A Billion Wicked Thoughts [5], many men do seek to give women orgasms with single-minded determination. However, they do not do it in the spirit of good, giving and game (GGG) sex, but because they consider it an act of conquest, a personal achievement demonstrating their sexual skills. Here the giving of pleasure comes from the ego, not from a place of generosity. The ‘orgasm gap’ ideology encourages this, adding to the ‘making her cum’ ego boost the additional reward of being politically correct.

Genesis did a great satire of this attitude in their song Counting Out Time:

I'm counting out time, hoping it goes like I planned it,
'cause I understand it.
Look! I've found the hotspots, Figures one and nine.
Still counting out time. Got my finger on the button.
"Don't say nuttin' just lie there still
And I'll get you turned on just fine".
Erogenous zones I love you!
Without you, what would a poor boy do?

The ‘orgasm gap’ hurts the political goals of feminism

I have always defined myself as a feminist, but I look at modern trends in feminism with increasing unease. Some feminists seem to be hell-bent in starting a gender war. This is not new, of course. There is an undercurrent of misandry (hate of men) in some forms of feminism that goes back to the 70s. In particular, anti-porn feminism tried to condemn male sexual desire as inherently violent, exploitative and objectifying of women (culminating in the “penetration is rape” nonsense). I suspect that the ‘orgasm gap’ comes from this ideological current in a last desperate attempt to fend off sex-positive feminism. After all, this idea is consistent with a view of male sexuality as being inherently selfish.

However, if feminism is to succeed, it needs to recruit men to its cause instead of alienating them. And this is what the ‘orgasm gap’ idea does when it blames men from the sexual problems of women. Of course, there are some selfish men who only seek their own sexual pleasure. More often, however, men fail at giving pleasure out of ignorance and lack of skill. As the practice of casual sex becomes more common, pleasuring women is not an easy task because their sexual responses vary enormously [2, 4, 6]. And no, it is not as easy as stimulating her clit; many women do not like their clits to be directly stimulated. And yet some others do. Others vastly prefer vaginal stimulation and do not care if this is politically incorrect. There are submissive women who fall on their knees and beg to be used for your pleasure. I’ve met sadistic women who were much more interested in my pain than in their own pleasure. Every woman is different, so go figure! As sex adviser Dan Savage once said, sex should be like a five-page dinner menu where each person gets to pick their favorite dish, and then share it.

Just like in a relationship, sex should be the glue that binds women and men together to fight for progressive political causes. Including, of course, women equality. Tossing blame and shame back and forth across an artificially-created gender gap is foolish and counterproductive. Equality is not a zero-sum game, and nowhere is this truer than when it comes to sex.

References:

[1] E.A. Armstrong, P. England, A.C.K. Fogarty, Accounting for Women’s Orgasm and Sexual Enjoyment in College Hookups and Relationships, American Sociological Review, 77 (2012) 435-462.
[2] K.L. Blair, J. Cappell, C.F. Pukall, Not All Orgasms Were Created Equal: Differences in Frequency and Satisfaction of Orgasm Experiences by Sexual Activity in Same-Sex Versus Mixed-Sex Relationships, The Journal of Sex Research, 55 (2018) 719-733.
[3] D.A. Frederick, H.K.S. John, J.R. Garcia, E.A. Lloyd, Differences in Orgasm Frequency Among Gay, Lesbian, Bisexual, and Heterosexual Men and Women in a U.S. National Sample, Arch. Sex. Behav., 47 (2018) 273-288.
[4] J.R. Garcia, E.A. Lloyd, K. Wallen, H.E. Fisher, Variation in orgasm occurrence by sexual orientation in a sample of U.S. singles, J Sex Med, 11 (2014) 2645-2652.
[5] S.G. Ogi Ogas, A Billion Wicked Thoughts: What the Internet Tells Us About Sexual Relationships.
[6] R. King, J. Belsky, K. Mah, Y. Binik, Are there different types of female orgasm?, Arch Sex Behav, 40 (2011) 865-875.