Australian Doctor Australian Doctor 12 May 2017 | Page 25

Therapy Update
The facts on female orgasm
A
LICE is a healthy
28-year-old with
a great job and
a wide circle of
friends. She has recently
begun a new relationship
with a man she described as
her soulmate, and it is obvi-
ous that she is very much in
love.
However, there is one
problem, and that is why
Alice has come in for advice.
She explains she has never
had an orgasm during vagi-
nal penetration. This has not
bothered her previous part-
ners, who had been happy to
bring her to orgasm through
oral sex, which she really
enjoyed.
Last week, however, her
present partner gently let her
know that all his previous
partners had no problems
achieving orgasm through
intercourse and that there
must be something wrong
with her. She wanted to
know how she could learn
to achieve orgasm with inter-
course alone.
Alice isn’t alone. Explore
any search engine and you
will find postings from
women who feel somehow
inadequate because they can’t
achieve the ‘right’ kind of
orgasm and question whether
they are normal.
Unfortunately, this sense of
inadequacy can be reinforced
WOMEN’S HEALTH
Vaginal orgasm is clouded in myths and
misunderstanding. This article examines the
evidence.
DR TERRI FORAN
by a popular culture in which
both movie and porn stars
appear to achieve the height
of orgasmic ecstasy with only
a few penile thrusts from
their partner.
So let’s look more closely
at the question of female
orgasm and try and put
some evidence behind the
fantasy.
Why female orgasm?
This question has teased
sociologists and anthro-
pologists for years. While
orgasm and its accompany-
ing ejaculation is broadly
essential for species survival
for males, it is not so for
females. In 1966, Masters
and Johnson described the
clitoris as “truly unique in
the human organ system in
that its only known func-
tion is that of serving as an
erotic focus for both affer-
ent and efferent forms of
sexual stimulation”. 1 The
Dutch biologist Edouard
Van Beneden wasn’t so
impressed with it, however,
when, in 1875, he pro-
nounced the clitoris as an
organ of “no utility”.
All female mammals have
a clitoris, and a number of
primate species have been
stimulated in a laboratory
setting to what appears to
be orgasm.
standing couples. In some
primate communities, such
as the bonobos, this erotic
pleasuring extends to female
peers and juveniles.
However, there is a more
pragmatic explanation for
the existence of the clitoris
— that mammals are pheno-
typically female for the first
WHILE ORGASM AND ITS
ACCOMPANYING EJACULATION IS
BROADLY ESSENTIAL FOR SPECIES
SURVIVAL FOR MALES, IT IS NOT SO
FOR FEMALES.
However, when most ani-
mals copulate, it tends to be
a brief and sometimes quite
brutal encounter. So perhaps
we have to decouple female
orgasm and procreation.
One theory is that mutual
sexual pleasuring reinforces
pair bonding between long-
six weeks of existence. This
makes the presence of an
embryonic clitoris essential as
a blueprint for later modifica-
tion in the male fetus.
Vaginal vs clitoral orgasm
We have Sigmund Freud to
thank for this controversy.
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Before the publication of his
psychoanalytical theories in
the early 1900s, most medical
authorities agreed that female
sexual pleasure originated
from the vulva generally and
in the clitoris specifically.
However, in 1905, Freud
decreed clitoral orgasms
“immature”. He also coined
the term “frigid” for women
who could not achieve an
orgasm through vaginal
intercourse alone.
Let’s not forget that, in
the 1800s, many female ill-
nesses, both physical and
psychological, were attrib-
uted to a ‘wandering uterus’.
Clinicians of the day claimed
to be able to cure it by pro-
longed genital massage, and
this was made easier with the
invention of the mechanical
vibrator in the late 1870s. 2
Interestingly, such therapies
were not considered sexual at
all since generally there was
no vaginal penetration.
However, the introduc-
tion of these devices to the
home market saw many
women realise that they
could achieve orgasm more
reliably without the interven-
tion of either their physician
or their partner. This must
have been quite confronting
to psychoanalysts of Freud’s
ilk, who held that female
masturbation and the inabil-
ity to achieve orgasm through
intercourse were sympto-
matic of a woman trapped in
sexual infancy. Freud’s unsci-
entific musings on female
orgasm were nevertheless
accepted as fact until Mas-
ters and Johnson’s work was
published in the 1960s. 1
At the same time, the rise
of feminism saw many con-
ventional assumptions about
women’s roles and sexuality
challenged.
Then in 1976, a book by
a young American gradu-
ate student, Shere Hite,
attempted to quantify wom-
en’s experience of orgasm by
actually asking them. 3 She
found that 95% of women
were able to achieve orgasm
though clitoral stimulation
but that only 26% of the
thousands of women she
interviewed for her research
project reported ever (not
routinely) achieving orgasm
through intercourse without
additional clitoral stimula-
tion.
cont’d next page
12 May 2017 | Australian Doctor |
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