Editing Orgasm (section)

=== Female ===
{{anchor|In females}}
==== Factors and variability ====
[[File:Phases of sexual arousal and female orgasm.png|thumb|right|Schematic representation of the phases of female sexual arousal and female orgasm]]
In women, the most common way to achieve orgasm is by direct sexual stimulation of the [[clitoris]] (meaning consistent [[Fingering (sexual act)|digital]], [[Cunnilingus|oral]], or other concentrated friction against the external parts of the clitoris). General statistics indicate that 70–80 percent of women require direct clitoral stimulation to achieve orgasm,<ref name="Rosenthal" /><ref name="Flaherty">{{cite book |author = Joseph A. Flaherty |author2 = John Marcell Davis |author3 = Philip G. Janicak |title = Psychiatry: Diagnosis & therapy. A Lange clinical manual |isbn = 978-0-8385-1267-8 |publisher = Appleton & Lange (Original from Northwestern University) |date = 1993 |page = [https://archive.org/details/psychiatrydiagno00flah/page/217 217] |quote = The amount of time of sexual arousal needed to reach orgasm is variable&nbsp;— and usually much longer&nbsp;— in women than in men; thus, only 20–30% of women attain a coital climax. b. Many women (70–80%) require manual clitoral stimulation... |url = https://archive.org/details/psychiatrydiagno00flah/page/217 }}</ref><ref name="Kammerer-Doak">{{cite journal |first1 = Dorothy |last1 = Kammerer-Doak |first2 = Rebecca G. |last2 = Rogers |title = Female Sexual Function and Dysfunction |journal = Obstetrics and Gynecology Clinics of North America |volume = 35 |issue = 2 |pages = 169–183 |doi = 10.1016/j.ogc.2008.03.006 |date = June 2008 |pmid = 18486835 |quote = Most women report the inability to achieve orgasm with vaginal intercourse and require direct clitoral stimulation ... About 20% have coital climaxes... }}</ref> although indirect clitoral stimulation (for example, via [[vagina]]l penetration) may also be sufficient.<ref name="O'Connell" /><ref name="Lloyd">{{cite book |author = Elisabeth Anne Lloyd |title = The Case of the Female Orgasm: Bias In the Science of Evolution |isbn = 978-0-674-01706-1 |publisher = Harvard University Press |date = 2005 |page = 53 |access-date = January 5, 2012 |url = https://books.google.com/books?id=6GFNvA6TvlwC&pg=PA53 |author-link = Elisabeth Lloyd |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227065057/https://books.google.com/books?id=6GFNvA6TvlwC&pg=PA53 |url-status = live }}</ref> The [[Mayo Clinic]] states, "Orgasms vary in intensity, and women vary in the frequency of their orgasms and the amount of stimulation necessary to trigger an orgasm."<ref name="Anorgasmia">{{cite web |url = http://www.mayoclinic.com/health/anorgasmia/DS01051 |title = Anorgasmia in women |publisher = [[Mayo Clinic]] |access-date = November 23, 2010 |url-status = live |archive-url = https://web.archive.org/web/20140102052814/http://www.mayoclinic.com/health/anorgasmia/DS01051 |archive-date = January 2, 2014 }}</ref> Clitoral orgasms are easier to achieve because the [[Clitoris#Glans|glans of the clitoris]], or clitoris as a whole, has more than 8,000 sensory [[nerve]] endings, which is as many (or more in some cases) nerve endings as are present in the human penis or [[glans penis]].<ref name="Di Marino">{{cite book |last = Di Marino |first = Vincent |title = Anatomic Study of the Clitoris and the Bulbo-Clitoral Organ |publisher = [[Springer Publishing|Springer]] |date = 2014 |page = 81 |isbn = 978-3-319-04894-9 |access-date = September 4, 2014 |url = https://books.google.com/books?id=wKMpBAAAQBAJ&q=gbs_navlinks_s |url-status = live |archive-url = https://web.archive.org/web/20150318213354/http://books.google.com/books?id=wKMpBAAAQBAJ&dq=gbs_navlinks_s |archive-date = March 18, 2015 }}</ref><ref name="Carroll">See [https://books.google.com/books?id=5f8mQx7ULs4C&pg=PA271 pages 270–271] {{Webarchive|url=https://web.archive.org/web/20231021114159/https://books.google.com/books?id=5f8mQx7ULs4C&pg=PA271 |date=October 21, 2023 }} for anal sex information, and [https://books.google.com/books?id=5f8mQx7ULs4C&pg=PA118 page 118] for information about the [[clitoris]]. {{cite book |author = Janell L. Carroll |title = Sexuality Now: Embracing Diversity |isbn = 978-0-495-60274-3 |publisher = [[Cengage]] |date = 2009 |pages = 629 pages |access-date = June 23, 2012 |url = https://books.google.com/books?id=5f8mQx7ULs4C&q=Sexuality+Now:+Embracing+Diversity |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227065106/https://books.google.com/books?id=5f8mQx7ULs4C&q=Sexuality+Now:+Embracing+Diversity |url-status = live }}</ref><ref>{{Cite book |last = Crooks |first = Robert |url = https://www.worldcat.org/oclc/456838969 |title = Our sexuality |date = 2011 |publisher = Wadsworth/Cengage |others = Karla Baur |isbn = 978-0-495-81294-4 |edition = Eleventh |location = Belmont, CA |oclc = 456838969 }}</ref> As the clitoris is [[Homology (biology)|homologous]] to the penis, it is the equivalent in its capacity to receive sexual stimulation.<ref name="Schünke">{{cite book |first1 = Michael |last1 = Schünke |first2 = Erik |last2 = Schulte |first3 = Lawrence M. |last3 = Ross |first4 = Edward D. |last4 = Lamperti |first5 = Udo |last5 = Schumacher |title = Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System, Volume 1 |publisher = [[Thieme Medical Publishers]] |date = 2006 |isbn = 978-3-13-142081-7 |url = https://books.google.com/books?id=NK9TgTaGt6UC&pg=PA192 |access-date = December 15, 2013 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227065111/https://books.google.com/books?id=NK9TgTaGt6UC&pg=PA192 |url-status = live }}</ref><ref name="Francoeur">{{cite book |last = Francoeur |first = Robert T. |date = 2000 |title = The Complete Dictionary of Sexology |publisher = The Continuum Publishing Company |page = [https://archive.org/details/completedictiona0000unse_w1u0/page/180 180] |isbn = 978-0-8264-0672-9 |url = https://archive.org/details/completedictiona0000unse_w1u0/page/180 }}</ref>

One misconception, particularly in older research publications, is that the vagina is completely insensitive.<ref name="Pappas">{{cite web |last = Pappas |first = Stephanie |title = Does the Vaginal Orgasm Exist? Experts Debate |publisher = [[LiveScience]] |date = April 9, 2012 |access-date = November 28, 2012 |url = http://www.livescience.com/19579-vaginal-orgasm-debate.html |url-status = live |archive-url = https://web.archive.org/web/20161011211945/http://www.livescience.com/19579-vaginal-orgasm-debate.html |archive-date = October 11, 2016 }}</ref> In reality, there are areas in the anterior vaginal wall and between the top junction of the [[labia minora]] and the [[urethra]] that are especially sensitive.<ref name="Lief and Berger">{{cite book |last = Lief |first = Harold I. |editor-last = Berger |editor-first = Milton Miles |chapter = Discussion of the Paper by Helen Singer Kalplan |title = Women Beyond Freud: New Concepts of Feminine Psychology |isbn = 978-0-87630-709-0 |publisher = [[Psychology Press]] |date = 1994 |pages = [https://archive.org/details/womenbeyondfreud00milt/page/65 65–66] |access-date = July 22, 2012 |chapter-url = https://books.google.com/books?id=By3n48Gqt_kC&pg=PA65 |url = https://archive.org/details/womenbeyondfreud00milt/page/65 }}</ref> With regard to specific density of nerve endings, while the area commonly described as the [[G-spot]] may produce an orgasm,<ref name="Rosenthal" /><ref name="Acton" /> and the [[urethral sponge]] (area in which the G-spot may be found) runs along the "roof" of the vagina and can create pleasurable sensations when stimulated, intense sexual pleasure (including orgasm) from vaginal stimulation is occasional or otherwise absent because the vagina has significantly fewer nerve endings than the clitoris.<ref name="Weiten" /><ref name="Sloane">{{cite book |first = Ethel |last = Sloane |title = Biology of Women |publisher = [[Cengage]] |date = 2002 |pages = 32–33 |access-date = August 25, 2012 |isbn = 978-0-7668-1142-3 |url = https://books.google.com/books?id=kqcYyk7zlHYC&pg=PA32 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227065037/https://books.google.com/books?id=kqcYyk7zlHYC&pg=PA32 |url-status = live }}</ref><ref name="Kilchevsky">{{br}}{{bull}}{{cite journal |title = Is the Female G-Spot Truly a Distinct Anatomic Entity? |journal = [[The Journal of Sexual Medicine]] |volume = 9 |date = January 2012 |pmid = 22240236 |doi = 10.1111/j.1743-6109.2011.02623.x |vauthors = Kilchevsky A, Vardi Y, Lowenstein L, Gruenwald I |issue = 3 |pages = 719–26 }}{{br}}{{bull}}{{cite news |date = January 19, 2012 |title = G-Spot Does Not Exist, 'Without A Doubt,' Say Researchers |work = [[The Huffington Post]] |url = http://www.huffingtonpost.com/2012/01/19/g-spot-does-not-exist_n_1215822.html |access-date = March 2, 2012 |archive-date = March 10, 2019 |archive-url = https://web.archive.org/web/20190310161629/https://www.huffingtonpost.com/2012/01/19/g-spot-does-not-exist_n_1215822.html |url-status = live }}</ref> The greatest concentration of vaginal nerve endings are at the lower third (near the entrance) of the vagina.<ref name="Rosenthal" /><ref name="Weiten" /><ref name="Greenberg">{{cite book |vauthors = Greenberg JS, Bruess CE, Oswalt SB |title = Exploring the Dimensions of Human Sexuality |pages = 102–104 |isbn = 978-1-4496-4851-0 |date = 2014 |access-date = October 30, 2014 |publisher = [[Jones & Bartlett Publishers]] |url = https://books.google.com/books?id=hm3aTuANFroC&pg=PA102 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227065038/https://books.google.com/books?id=hm3aTuANFroC&pg=PA102 |url-status = live }}</ref><ref name="Sex and Society">{{cite book |title = Sex and Society, Volume 2 |isbn = 978-0-7614-7907-9 |publisher = Marshall Cavendish Corporation |date = 2009 |page = 590 |access-date = August 17, 2012 |url = https://books.google.com/books?id=YtsxeWE7VD0C&pg=PA590 |author = Marshall Cavendish Corporation |archive-date = February 26, 2023 |archive-url = https://web.archive.org/web/20230226053114/https://books.google.com/books?id=YtsxeWE7VD0C&pg=PA590 |url-status = live }}</ref>

[[Sex educator]] Rebecca Chalker states that only one part of the clitoris, the urethral sponge, is in contact with the penis, fingers, or a [[dildo]] in the vagina.<ref name="Cornforth">{{cite web |first = Tracee |last = Cornforth |title = The Clitoral Truth. Interview with author and sex educator Rebecca Chalker |publisher = [[About.com]] |date = July 17, 2009 |access-date = April 21, 2010 |url = http://womenshealth.about.com/cs/sexuality/a/clitoraltruthin.htm |url-status = dead |archive-url = https://web.archive.org/web/20160203174804/http://womenshealth.about.com/cs/sexuality/a/clitoraltruthin.htm |archive-date = February 3, 2016 }}</ref> Hite and Chalker state that the tip of the clitoris and the inner lips, which are also very sensitive, are not receiving direct stimulation during penetrative intercourse.<ref name="Cornforth" /><ref name="Hite">{{cite book |last = Hite |first = Shere |author-link = Shere Hite |title = The Hite Report: A Nationwide Study of Female Sexuality |publisher = [[Seven Stories Press]] |date = 2003 |location = New York, NY |isbn = 978-1-58322-569-1 |access-date = March 2, 2012 |url = https://books.google.com/books?id=s3OZaVn2wfkC&q=The%20Hite%20Report%3A%20a%20Nationwide%20Study%20of%20Female%20Sexuality&pg=PP1 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227065044/https://books.google.com/books?id=s3OZaVn2wfkC&q=The%20Hite%20Report%3A%20a%20Nationwide%20Study%20of%20Female%20Sexuality&pg=PP1 |url-status = live }}</ref> Because of this, some couples may engage in the [[Woman on top|woman on top position]] or the [[coital alignment technique]] to maximize clitoral stimulation.<ref name="Roberts">{{cite book |title = Sex |publisher = Lotus Press |date = 2006 |page = 145 |isbn = 978-81-89093-59-4 |access-date = August 17, 2012 |url = https://books.google.com/books?id=zDS9kC03x2IC&pg=PA145 |author = Keath Roberts |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227065052/https://books.google.com/books?id=zDS9kC03x2IC&pg=PA145 |url-status = live }}</ref><ref name="Hurlbert">{{cite journal |title = The coital alignment technique and directed masturbation: a comparative study on female orgasm |journal = [[Journal of Sex & Marital Therapy]] |volume = 21 |pages = 21–29 |date = 1995 |pmid = 7608994 |doi = 10.1080/00926239508405968 |vauthors = Hurlbert DF, Apt C |issue = 1 }}</ref> For some women, the clitoris is very sensitive after climax, making additional stimulation initially painful.<ref name="Rathus">{{cite book |last1 = Rathus |first1 = Spencer A. |last2 = Nevid |first2 = Jeffrey S. |last3 = Fichner-Rathus |first3 = Lois |last4 = Herold |first4 = Edward S. |last5 = McKenzie |first5 = Sue Wicks |date = 2005 |title = Human Sexuality In A World Of Diversity |edition = Second |publisher = Pearson Education |location = New Jersey, USA }}</ref>

[[Masters and Johnson]] argue that all women are potentially multiply<!--do not change to "multiple"!--> orgasmic, but that multiply<!--do not change to "multiple"!--> orgasmic men are rare, and stated that "the female is capable of rapid return to orgasm immediately following an orgasmic experience, if re-stimulated before tensions have dropped below plateau phase response levels".<ref name="Dunn" /> Though generally reported that women do not experience a [[refractory period (sex)|refractory period]] and thus can experience an additional orgasm, or multiple orgasms, soon after the first one,<ref name="Rosenthal" /><ref name=soc>{{Cite web |title = The Sexual Response Cycle |website = UCSB SexInfo Online |publisher = [[University of California, Santa Barbara]] |url = http://www.soc.ucsb.edu/sexinfo/article/the-sexual-response-cycle |access-date = August 6, 2012 |archive-url = https://web.archive.org/web/20110725051823/http://www.soc.ucsb.edu/sexinfo/article/the-sexual-response-cycle |archive-date = July 25, 2011 |url-status = dead }}</ref> some sources state that both men and women experience a refractory period because women may also experience a period after orgasm in which further sexual stimulation does not produce excitement.<ref name="Schacter">{{cite book |title = Psychology |publisher = [[Macmillan Publishers|Macmillan]] |date = 2010 |page = 336 |access-date = November 10, 2012 |isbn = 978-1-4292-3719-2 |url = https://books.google.com/books?id=emAyzTNy1cUC&pg=PA336 |author1 = Daniel L. Schacter |author2 = Daniel T. Gilbert |author3 = Daniel M. Wegner |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055134/https://books.google.com/books?id=emAyzTNy1cUC&pg=PA336 |url-status = live }}</ref><ref name="Weiner & Craighead">{{cite book |title = The Corsini Encyclopedia of Psychology, Volume 2 |publisher = [[John Wiley & Sons]] |date = 2010 |page = 761 |access-date = November 10, 2012 |isbn = 978-0-470-17026-7 |url = https://books.google.com/books?id=pa5vKqntwikC&pg=PA761 |author1 = Irving B. Weiner |author2 = W. Edward Craighead |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055138/https://books.google.com/books?id=pa5vKqntwikC&pg=PA761 |url-status = live }}</ref> After the initial orgasm, subsequent orgasms for women may be stronger or more pleasurable as the stimulation accumulates.<ref name="Rathus" />

==== Clitoral and vaginal categories ====
[[File:Vulva - Sexual response.png|thumb|right|Images of the female vulva in various stages of the sexual response cycle]]
Discussions of female orgasm are complicated by orgasms in women typically being divided into two categories: clitoral orgasm and vaginal (or G-spot) orgasm.<ref name="Mah" /><ref name="Sex and Society" /> In 1973, [[Irving Singer]] theorized that there are three types of female orgasms; he categorized these as [[vulva]]l, uterine, and blended, but because he was a philosopher, "these categories were generated from descriptions of orgasm in literature rather than laboratory studies."<ref name="Rosenthal" /> In 1982, Ladas, [[Beverly Whipple|Whipple]] and Perry also proposed three categories: the tenting type (derived from clitoral stimulation), the A-frame type (derived from G-spot stimulation), and the blended type (derived from clitoral and G-spot stimulation).<ref name="Bolin & Whelehan">{{cite book |title = Human Sexuality: Biological, Psychological, and Cultural Perspectives |isbn = 978-0-7890-2672-9 |publisher = [[Taylor & Francis]] |date = 2009 |page = 276 |access-date = February 11, 2012 |url = https://books.google.com/books?id=lDQoIhOwwdYC&pg=PA276 |author1 = Anne Bolin |author2 = Patricia Whelehan |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055140/https://books.google.com/books?id=lDQoIhOwwdYC&pg=PA276 |url-status = live }}</ref> In 1999, Whipple and Komisaruk proposed [[cervix]] stimulation as being able to cause a fourth type of female orgasm.<ref name="Bolin & Whelehan" />

Female orgasms by means other than clitoral or vaginal/G-spot stimulation are less prevalent in scientific literature,<ref name="Mah" /> and most scientists contend that no distinction should be made between "types" of female orgasm.<ref name="Sex and Society" /> This distinction began with [[Sigmund Freud]], who postulated the concept of "vaginal orgasm" as separate from clitoral orgasm.<!-- NOTE: Rules are "promulgated"; theories are "postulated."--> In 1905, Freud stated that clitoral orgasms are purely an adolescent phenomenon and that upon reaching puberty, the proper response of mature women is a change-over to vaginal orgasms, meaning orgasms without any clitoral stimulation. While Freud provided no evidence for this basic assumption, the consequences of this theory were considerable. Many women felt inadequate when they could not achieve orgasm via vaginal intercourse alone, involving little or no clitoral stimulation, as Freud's theory made penile–vaginal intercourse the central component to women's sexual satisfaction.<ref name="Zastrow">{{cite book |author = Charles Zastrow |author-link = Charles Zastrow |title = Introduction to Social Work and Social Welfare: Empowering People |publisher = [[Cengage]] |date = 2007 |page = 228 |access-date = March 15, 2014 |isbn = 978-0-495-09510-1 |url = https://books.google.com/books?id=tco4YjyZab4C&pg=PT248 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055146/https://books.google.com/books?id=tco4YjyZab4C&pg=PT248 |url-status = live }}</ref><ref name="Irvine">{{cite book |title = Disorders of Desire: Sexuality and Gender in Modern American Sexology |isbn = 978-1-59213-151-8 |publisher = Temple University Press |date = 2005 |pages = 37–38 |access-date = January 3, 2012 |url = https://books.google.com/books?id=uIJXT7ZCTCsC&pg=PA37 |author = Janice M. Irvine |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055146/https://books.google.com/books?id=uIJXT7ZCTCsC&pg=PA37 |url-status = live }}</ref><ref name="Difference">{{cite web |title = Difference between clitoral and vaginal orgasm |publisher = [[Go Ask Alice!]] |date = March 28, 2008 |access-date = April 21, 2010 |url = http://goaskalice.columbia.edu/difference-between-clitoral-and-vaginal-orgasm |url-status = live |archive-url = https://web.archive.org/web/20150729172459/http://goaskalice.columbia.edu/difference-between-clitoral-and-vaginal-orgasm |archive-date = July 29, 2015 }}</ref><ref name="Gould">{{cite book |author = Stephen Jay Gould |title = The Structure of Evolutionary Theory |publisher = [[Harvard University Press]] |date = 2002 |pages = 1262–1263 |access-date = August 27, 2012 |isbn = 978-0-674-00613-3 |url = https://books.google.com/books?id=nhIl7e61WOUC&pg=PA767 |author-link = Stephen Jay Gould |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055152/https://books.google.com/books?id=nhIl7e61WOUC&pg=PA767 |url-status = live }}</ref>

The first major national surveys of sexual behavior in the U.S. were the [[Kinsey Reports]].<ref name="Andersen" /> [[Alfred Kinsey]] was the first researcher to harshly criticize Freud's ideas about female sexuality and orgasm when, through his interviews with thousands of women,<ref name="Andersen" /> Kinsey found that most of the women he surveyed could not have vaginal orgasms.<ref name="Irvine" /> He "criticized Freud and other theorists for projecting male constructs of sexuality onto women" and "viewed the clitoris as the main center of sexual response" and the vagina as "relatively unimportant" for sexual satisfaction, relaying that "few women inserted fingers or objects into their vaginas when they masturbated." He "concluded that satisfaction from penile penetration [is] mainly psychological or perhaps the result of referred sensation".<ref name="Irvine" />

Masters and Johnson's research into the female [[Human sexual response cycle|sexual response cycle]], as well as [[Shere Hite]]'s, generally supported Kinsey's findings about female orgasm.<ref name="Hite" /><ref name="Irvine" /><ref name="Archer, Lloyd">{{cite book |title = Sex and Gender |publisher = [[Cambridge University Press]] |date = 2002 |pages = 85–88 |access-date = August 25, 2012 |isbn = 978-0-521-63533-2 |url = https://books.google.com/books?id=BJ1V9r_J0sUC&pg=PA85 |author1 = John Archer |author2 = Barbara Lloyd |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055101/https://books.google.com/books?id=BJ1V9r_J0sUC&pg=PA85 |url-status = live }}</ref><ref name="Masters and Johnson">{{cite book |last = Federation of Feminist Women's Health Centers |date = 1991 |title = A New View of a Woman's Body |publisher = Feminist Heath Press |page = 46 }}</ref> Masters and Johnson's research on the topic came at the time of the [[second-wave feminism|second-wave feminist movement]] and inspired feminists such as [[Anne Koedt]], author of ''[[The Myth of the Vaginal Orgasm]]'', to speak about the "false distinction" made between clitoral and vaginal orgasms and women's biology not being properly analyzed.<ref name="Koedt">{{cite news |first = Anne |last = Koedt |title = The Myth of the Vaginal Orgasm |publisher = [[Chicago Women's Liberation Union]] (CWLU) |date = 1970 |access-date = December 12, 2011 |url = http://www.uic.edu/orgs/cwluherstory/CWLUArchive/vaginalmyth.html |url-status = dead |archive-url = https://web.archive.org/web/20130106211856/http://www.uic.edu/orgs/cwluherstory/CWLUArchive/vaginalmyth.html |archive-date = January 6, 2013 }}</ref>

==== Clitoral and vaginal relationships ====
{{Further|G-spot#Society and culture}}
Accounts that the vagina is capable of producing orgasms continue to be subject to debate because, in addition to the vagina's low concentration of nerve endings, reports of the G-spot's location are inconsistent—it appears to be nonexistent in some women and may be an extension of another structure, such as the [[Skene's gland]] or the clitoris, which is a part of the Skene's gland.<ref name="O'Connell" /><ref name="Pappas" /><ref name="Kilchevsky" /><ref name="Balon, Segraves">{{cite book |vauthors = Balon R, Segraves RT |title = Clinical Manual of Sexual Disorders |publisher = [[American Psychiatric Association|American Psychiatric Pub]] |date = 2009 |access-date = January 24, 2014 |page = 258 |isbn = 978-1-58562-905-3 |url = https://books.google.com/books?id=YuP3Hb0TMLQC&pg=PA258 |url-status = live |archive-url = https://web.archive.org/web/20140627021747/http://books.google.com/books?id=YuP3Hb0TMLQC&pg=PA258 |archive-date = June 27, 2014 }}</ref> In a January 2012 ''[[The Journal of Sexual Medicine]]'' review examining years of research into the existence of the G-spot, scholars state that "[r]eports in the public media would lead one to believe the G-spot is a well-characterized entity capable of providing extreme sexual stimulation, yet this is far from the truth".<ref name="Kilchevsky" />

Possible explanations for the G-spot were examined by Masters and Johnson, who were the first researchers to determine that the clitoral structures surround and extend along and within the labia. In addition to observing that the majority of their female subjects could only have clitoral orgasms, they found that both clitoral and vaginal orgasms had the same stages of physical response. On this basis, they argue that clitoral stimulation is the source of both kinds of orgasms,<ref name="Archer, Lloyd" /><ref name="Masters and Johnson" /> reasoning that the clitoris is stimulated during penetration by friction against its hood; their notion that this provides the clitoris with sufficient sexual stimulation has been criticized by researchers such as [[Elisabeth Lloyd]].<ref name="Lloyd" />

Australian [[Urology|urologist]] Helen O'Connell's 2005 research additionally indicates a connection between orgasms experienced vaginally and the clitoris, suggesting that clitoral tissue extends into the anterior wall of the vagina and that therefore clitoral and vaginal orgasms are of the same origin.<ref name="O'Connell" /> Some studies, using [[medical ultrasound]], have found physiological evidence of the G-spot in women who report having orgasms during vaginal intercourse,<ref name="Acton" /><ref name="Buss, Meston">{{cite book |vauthors = Buss DM, Meston CM |title = Why Women Have Sex: Understanding Sexual Motivations from Adventure to Revenge (and Everything in Between) |publisher = [[Macmillan Publishers|Macmillan]] |date = 2009 |access-date = January 24, 2014 |pages = 35–36 |isbn = 978-1-4299-5522-5 |url = https://books.google.com/books?id=slyflT85lXIC&pg=PA35 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055118/https://books.google.com/books?id=slyflT85lXIC&pg=PA35 |url-status = live }}</ref> but O'Connell suggests that the clitoris's interconnected relationship with the vagina is the physiological explanation for the conjectured G-spot. Having used [[Magnetic resonance imaging|MRI]] technology which enabled her to note a direct relationship between the legs or roots of the clitoris and the erectile tissue of the "clitoral bulbs" and corpora, and the distal [[urethra]] and vagina, she stated that the vaginal wall is the clitoris; that lifting the skin off the vagina on the side walls reveals the bulbs of the clitoris—triangular, crescental masses of erectile tissue.<ref name="O'Connell" /> O'Connell et al., who performed dissections on the female genitals of [[cadaver]]s and used photography to map the structure of nerves in the clitoris, were already aware that the clitoris is more than just its glans and asserted in 1998 that there is more erectile tissue associated with the clitoris than is generally described in anatomical textbooks.<ref name="Sloane" /><ref name="Archer, Lloyd" /> They concluded that some females have more extensive clitoral tissues and nerves than others, especially having observed this in young cadavers as compared to elderly ones,<ref name="Sloane" /><ref name="Archer, Lloyd" /> and therefore whereas the majority of females can only achieve orgasm by direct stimulation of the external parts of the clitoris, the stimulation of the more generalized tissues of the clitoris via intercourse may be sufficient for others.<ref name="O'Connell" />

French researchers Odile Buisson and Pierre Foldès report similar findings to that of O'Connell's. In 2008, they published the first complete 3D sonogram via medical [[ultrasound]] of the stimulated clitoris, and republished it in 2009 with new research, demonstrating the ways in which erectile tissue of the clitoris engorges and surrounds the vagina, arguing that women may be able to achieve vaginal orgasm via stimulation of the G-spot because the highly innervated clitoris is pulled closely to the anterior wall of the vagina when the woman is sexually aroused and during vaginal penetration. They assert that since the front wall of the vagina is inextricably linked with the internal parts of the clitoris, stimulating the vagina without activating the clitoris may be next to impossible.<ref name="Pappas" /><ref name="Acton">See here [https://books.google.com/books?id=amNcvrLCGZEC&pg=PT98] {{Webarchive|url=https://web.archive.org/web/20230227055137/https://books.google.com/books?id=amNcvrLCGZEC&pg=PT98|date=February 27, 2023}} for the 2009 King's College London's findings on the G-spot and [https://books.google.com/books?id=kP9bCflZpVkC&pg=PA145 page 145] {{webarchive|url=http://archive.wikiwix.com/cache/20151028201436/https://books.google.com/books?id=kP9bCflZpVkC&pg=PA145|date=October 28, 2015}} for ultrasound/physiological material with regard to the G-spot. {{cite book |author=Ashton Acton |url=https://books.google.com/books?id=slyflT85lXIC&pg=PA35 |title=Issues in Sexuality and Sexual Behavior Research: 2011 Edition |date=2012 |publisher=[[ScholarlyEditions]] |isbn=978-1-4649-6687-3 |access-date=January 24, 2014 |archive-url=https://web.archive.org/web/20230227055118/https://books.google.com/books?id=slyflT85lXIC&pg=PA35 |archive-date=February 27, 2023 |url-status=live}}</ref><ref name="Carroll2">{{cite book |last = Carroll |first = Janell L. |title = Discovery Series: Human Sexuality |edition = 1st |publisher = [[Cengage]] |isbn = 978-1-111-84189-8 |date = 2013<!-- NOTE: Copyright date is 2013 inside of the book. --> |page = 103 |url = https://books.google.com/books?id=gU3SZSh-eXsC&pg=PT135 |access-date = October 21, 2015 |archive-date = February 27, 2023 |archive-url = https://web.archive.org/web/20230227055158/https://books.google.com/books?id=gU3SZSh-eXsC&pg=PT135 |url-status = live }}</ref><ref name="Buisson and Foldès 2009">{{cite journal |last1 = Buisson |first1 = Odile |last2 = Foldès |first2 = Pierre |title = The clitoral complex: a dynamic sonographic study |journal = [[The Journal of Sexual Medicine]] |volume = 6 |issue = 5 |pages = 1223–31 |date = 2009 |pmid = 19453931 |doi = 10.1111/j.1743-6109.2009.01231.x |s2cid = 5096396 }}</ref> In their 2009 published study, the "coronal planes during [[Perineum|perineal]] contraction and finger penetration demonstrated a close relationship between the root of the clitoris and the anterior vaginal wall". Buisson and Foldès suggest "the special sensitivity of the lower anterior vaginal wall could be explained by pressure and movement of clitoris's root during a vaginal penetration and subsequent perineal contraction".<ref name="Acton" /><ref name="Buisson and Foldès 2009" />

Supporting a distinct G-spot is a study by [[Rutgers University]], published 2011, which was the first to map the female genitals onto the sensory portion of the brain;<ref name="Komisaruk 2" /> brain scans showed that the brain registered distinct feelings between stimulating the clitoris, the cervix and the vaginal wall&nbsp;– where the G-spot is reported to be&nbsp;– when several women stimulated themselves in a [[Functional magnetic resonance imaging|functional magnetic resonance]] (fMRI) machine.<ref name="Komisaruk 2" /><ref name="Pappas" /> "I think that the bulk of the evidence shows that the G-spot is not a particular thing," stated [[Barry Komisaruk]], head of the research findings. "It's not like saying, 'What is the thyroid gland?' The G-spot is more of a thing like New York City is a thing. It's a region, it's a convergence of many different structures."<ref name="Kilchevsky" /> Commenting on Komisaruk's research and other findings, [[Emmanuele&nbsp;A. Jannini]], a professor of endocrinology at the University of Aquila in Italy, acknowledges a series of essays published in March 2012 in ''[[The Journal of Sexual Medicine]]'', which document evidence that vaginal and clitoral orgasms are separate phenomena that activate different areas of the brain and possibly suggest key psychological differences between women.<ref name="Pappas" />

==== Other factors and research ====

Regular difficulty reaching orgasm after ample sexual stimulation, known as [[anorgasmia]], is significantly more common in women than in men ([[#Dysfunction and satisfaction|see below]]).<ref name="Anorgasmia" /> In addition to sexual dysfunction being a cause for women's inability to reach orgasm, or the amount of time for sexual arousal needed to reach orgasm being variable and longer in women than in men, other factors include a lack of communication between sexual partners about what is needed for the woman to reach orgasm, feelings of sexual inadequacy in either partner, a focus on only penetration (vaginal or otherwise), and men generalizing women's trigger for orgasm based on their own sexual experiences with other women.<ref name="Weiten" /><ref name="Wallen K, Lloyd EA" /><ref name="Flaherty" />

Scholars state "many couples are locked into the idea that orgasms should be achieved only through intercourse [vaginal sex]" and that "[e]ven the word ''[[foreplay]]'' suggests that any other form of sexual stimulation is merely preparation for the 'main event.'...Because women reach orgasm through intercourse less consistently than men, they are more likely than men to have [[Fake orgasm|faked an orgasm]]".<ref name="Weiten" /> Sex counselor [[Ian Kerner]] states, "It's a myth that using the penis is the main way to pleasure a woman." He cites research concluding that women reach orgasm about 25 percent of the time with intercourse, compared with 81 percent of the time during oral sex ([[cunnilingus]]).<ref name="Rob Baedeker">{{cite web |last = Rob |first = Baedeker |title = Sex: Fact and Fiction |website = [[WebMD]] |pages = 2–3 |access-date = November 28, 2012 |url = http://men.webmd.com/features/sex-fact-fiction?page=2 |url-status = dead |archive-url = https://web.archive.org/web/20140112134913/http://men.webmd.com/features/sex-fact-fiction?page=2 |archive-date = January 12, 2014 }}</ref>

In the first large-scale empirical study worldwide to link specific practices with orgasm, reported in the ''[[Journal of Sex Research]]'' in 2006, demographic and sexual history variables were comparatively weakly associated with orgasm. Data was analyzed from the Australian Study of Health and Relationships, a national telephone survey of sexual behavior and attitudes and sexual health knowledge carried out in 2001–02, with a representative sample of 19,307 Australians aged 16 to 59. Practices included "vaginal intercourse alone (12%), vaginal + manual stimulation of the man's and/or woman's genitals (49%), and vaginal intercourse + manual + oral (32%)" and the "[e]ncounters may also have included other practices. Men had an orgasm in 95 percent of encounters and women in 69 percent. Generally, the more practices engaged in, the higher a woman's chance of having an orgasm. Women were more likely to reach orgasm in encounters including cunnilingus".<ref name="Richters J">{{cite journal |title = Sexual practices at last heterosexual encounter and occurrence of orgasm in a national survey |journal = [[The Journal of Sex Research]] |date = August 2006 |pmid = 17599244 |doi = 10.1080/00224490609552320 |volume = 43 |issue = 3 |pages = 217–26 |vauthors = Richters J, Visser R, Rissel C, Smith A |s2cid = 7469378 }}</ref> Other studies suggest that women exposed to lower levels of prenatal [[androgen]]s are more likely to experience orgasm during vaginal intercourse than other women.<ref name="Wallen K, Lloyd EA" />

==== Exercise-induced ====

Kinsey, in his 1953 book ''Sexual Behavior in the Human Female'', states that exercise could bring about sexual pleasure, including orgasm.<ref name=1990Rev>{{cite journal |last1 = Butt |first1 = DS |title = The sexual response as exercise. A brief review and theoretical proposal |journal = Sports Medicine |date = June 1990 |volume = 9 |issue = 6 |pages = 330–43 |pmid = 2192423 |doi = 10.2165/00007256-199009060-00002 |s2cid = 6035585 }}</ref> A review in 1990 on the sexual response as exercise states that the field was poorly researched and that [[Aerobic exercise|aerobic]] or [[Isotonic contraction|isotonic]] exercise that resembles sexual activity or sexual positions can induce sexual pleasure, including orgasm.<ref name=1990Rev/> A 2007 review of the relationship between [[pelvic floor]] dysfunction and sexual problems in men and women finds that they are commonly linked and suggests that [[physical therapy]] strengthening the pelvic floor could help address the sexual problems but that it was not well studied enough to recommend.<ref>{{cite journal |last1 = Rosenbaum |first1 = TY |title = Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review |journal = The Journal of Sexual Medicine |date = January 2007 |volume = 4 |issue = 1 |pages = 4–13 |pmid = 17233772 |doi = 10.1111/j.1743-6109.2006.00393.x }}</ref> Starting in at least 2007, the term, "coregasm" was used in popular media to refer to exercise-induced orgasm<ref name=2012primary/><ref>{{cite magazine |last1 = Campbell |first1 = Alan |title = MH The Fitness Insider: Exciting Fitness News: The Coregasm |url = http://thefitnessinsider.menshealth.com/2007/03/back_in_our_dec.html |magazine = Men's Health |archive-url = https://web.archive.org/web/20070610045647/http://thefitnessinsider.menshealth.com/2007/03/back_in_our_dec.html |archive-date = June 10, 2007 |date = March 29, 2007 }}</ref> or in academic parlance termed ''exercise-induced sexual pleasure'',<ref name=twsTand11>Volume 26, 2011, Debby Herbenick, [https://www.tandfonline.com/doi/abs/10.1080/14681994.2011.647902 Exercise-induced orgasm and pleasure among women] {{Webarchive|url=https://web.archive.org/web/20200106154009/https://www.tandfonline.com/doi/abs/10.1080/14681994.2011.647902 |date=January 6, 2020 }}, retrieved March 16, 2020, "...A secondary purpose was to understand and assess women's experiences of exercise-induced sexual pleasure (EISP)..."</ref> and an extensive discussion of the "yogasm" occurred in a 2011 ''[[Daily Beast]]'' posting.<ref name=2012primary/><ref>{{cite news |last1 = Crocker |first1 = Lizzie |title = Are Yogasms Real? |url = http://www.thedailybeast.com/articles/2011/09/28/yogasms-on-the-rise-instructors-say-yoga-related-orgasms-are-real.html |newspaper = The Daily Beast |archive-url = https://web.archive.org/web/20110928212544/http://www.thedailybeast.com/articles/2011/09/28/yogasms-on-the-rise-instructors-say-yoga-related-orgasms-are-real.html |archive-date = September 28, 2011 |date = September 28, 2011 }}</ref> A paper published in 2012 presents results of an online survey of women who had experienced an orgasm or other sexual pleasure during exercise.<ref name=2012primary>{{cite journal |last1 = Herbenick |first1 = Debby |last2 = Fortenberry |first2 = J. Dennis |author-link1 = Debby Herbenick |title = Exercise-induced orgasm and pleasure among women |journal = Sexual and Relationship Therapy |date = March 2012 |volume = 26 |issue = 4 |pages = 373–388 |doi = 10.1080/14681994.2011.647902 |s2cid = 145405546 }}</ref><ref>{{cite web |last1 = Herbenick |first1 = Debby |title = SURVEY: Pleasure/Orgasm During Exercise? |url = http://mysexprofessor.com/sex-in-the-news/survey-pleasureorgasm-during-exercise/ |publisher = mysexprofessor.com |archive-url = https://web.archive.org/web/20150709195335/http://mysexprofessor.com/sex-in-the-news/survey-pleasureorgasm-during-exercise/ |archive-date = July 9, 2015 |date = November 8, 2010 |access-date = December 22, 2016 |url-status = dead }}</ref> The paper was widely discussed in popular media when it was published.<ref name="twsBostonGlobe1">{{cite news |author = Deborah Kotz |date = March 22, 2012 |newspaper = Boston Globe |url = http://archive.boston.com/2012/03/22/coregasm/KYQsgEeS8c9iAWDcZNAoiI/story.html |title = Orgasms when you exercise? Research suggests it's possible |access-date = August 31, 2016 |url-status = dead |archive-url = https://web.archive.org/web/20160915060604/http://archive.boston.com/2012/03/22/coregasm/KYQsgEeS8c9iAWDcZNAoiI/story.html |archive-date = September 15, 2016 |df = mdy-all }}</ref><ref name="twsWashPost1">{{cite news |author = Jennifer LaRue Huget |date = March 22, 2012 |newspaper = Washington Post |url = https://www.washingtonpost.com/blogs/the-checkup/post/research-looks-into-exercise-induced-orgasm-phenomenon/2010/12/20/gIQA54BRSS_blog.html |title = Research looks into 'exercise-induced orgasm' phenomenon |url-status = live |archive-url = https://web.archive.org/web/20160917053650/https://www.washingtonpost.com/blogs/the-checkup/post/research-looks-into-exercise-induced-orgasm-phenomenon/2010/12/20/gIQA54BRSS_blog.html |archive-date = September 17, 2016 |df = mdy-all }}</ref><ref name="twsHealth1">{{cite web |author = Kristine Thomason |date = March 22, 2016 |publisher = Health magazine |url = http://news.health.com/2016/03/22/yes-you-can-have-an-orgasm-while-working-out/ |title = Yes, You Can Have an Orgasm While Working Out |access-date = August 31, 2016 |url-status = live |archive-url = https://web.archive.org/web/20161020013826/http://news.health.com/2016/03/22/yes-you-can-have-an-orgasm-while-working-out/ |archive-date = October 20, 2016 |df = mdy-all }}</ref><ref name="twsCosmo1">{{cite magazine |author = Heather Wood Rudulph |date = June 1, 2015 |magazine = Cosmopolitan |url = http://www.cosmopolitan.com/health-fitness/interviews/a41281/coregasm-debby-herbenick-orgasm/ |title = The Truth About Having an Orgasm at the Gym: Sex researcher Debby Herbenick says both men and women can experience "coregasms" |url-status = live |archive-url = https://web.archive.org/web/20160913225210/http://www.cosmopolitan.com/health-fitness/interviews/a41281/coregasm-debby-herbenick-orgasm/ |archive-date = September 13, 2016 |df = mdy-all }}</ref> The authors of the paper said that research on the relationship between exercise and sexual response was still lacking.<ref name=2012primary/>