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Try out PMC Labs and tell us what you think. Learn More. In men and women sexual arousal culminates in orgasm, with female orgasm solely from sexual intercourse often regarded as a unique feature of human sexuality. However, orgasm from sexual intercourse occurs more reliably in men than in women likely reflecting the different types of physical stimulation men and women require for orgasm. In men, orgasms are under strong selective pressure as orgasms are coupled with ejaculation and thus contribute to male reproductive success.

By contrast, women's orgasms in intercourse are highly variable and are under little selective pressure as they are not a reproductive necessity. The proximal mechanisms producing variability in women's orgasms are little understood. In Marie Bonaparte proposed that a shorter distance between a woman's clitoris and her urethral meatus CUMD increased her likelihood of experiencing orgasm in intercourse. She based this on her published data which were never statistically analyzed. In Landis and colleagues published similar data suggesting the same relationship, but these data too were never fully analyzed.

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We analyzed raw data from these two studies and found that both demonstrate a strong inverse relationship between CUMD and orgasm during intercourse. Unresolved is whether this increased likelihood of orgasm with shorter CUMD reflects increased penile-clitoral contact during sexual intercourse or increased penile stimulation of internal aspects of the clitoris. CUMD likely reflects prenatal androgen exposure, with higher androgen levels producing larger distances. Thus these suggest that women exposed to lower levels of prenatal androgens are more likely to experience orgasm during sexual intercourse.

This gender disparity in the reliability of reaching orgasm during sexual intercourse has been thought to reflect evolutionary Lloyd, or social Hite, processes. An anatomical explanation for this disparity has also been proposed such that variation in the distance between a woman's clitoral glans and her vagina predicts the likelihood that she will experience orgasm in intercourse Narjani, Specifically it was proposed that if this distance is less than 2.

This relationship has not been statistically evaluated, but two historical studies provide data supporting such a relationship Narjani, ; Landis, Landis, and Bowles, We use an unconventional approach to investigate the proposed relationship between variation in women's genitals and orgasm during intercourse. We first explore the history of this idea in the scientific and popular literature and then present statistical analysis of the two available historical datasets with data relevant to the proposed relationship Narjani, ; Landis, Landis, and Bowles, While there are challenges to the validity of these data, we find them sufficiently supportive of a relationship between women's genital anatomy and the occurrence of orgasm in intercourse to feel that they can serve as the basis for developing modern well-controlled studies of the relationship between women's genital anatomy and the occurrence of orgasm in intercourse.

Orgasm is the culmination of sexual arousal, and the promise of orgasm may provide primary motivation Lady looking sex Crouch individuals to engage in sexual intercourse. However, sexual arousal itself is rewarding and likely common to the sexuality of all mammals. Studies of animals have shown Lady looking sex Crouch sexual arousal is rewarding even when sexual intercourse doesn't occur Meisel, Camp and Robinson, Certainly humans, at least men, sometimes seek out activities, such as strip clubs, where sexual arousal without orgasm is the primary goal and where sexual intercourse is unlikely to occur.

In male mammals, sufficient sexual arousal le to ejaculation and orgasm. Thus it is possible that orgasm occurs in all male mammals. The case in females is less clear. While there is evidence that female sexual arousal is rewarding Meisel, Camp and Robinson,it is unclear whether humans, or possibly primates, Goldfoot, et al. Even in primates female orgasm is not universal, with little evidence of its occurrence outside of humans. To further complicate matters, there remains a lack of complete agreement on what constitutes female orgasm Meston, et al.

Although sexual arousal precedes orgasm in women, the specific sexual stimulation that triggers orgasm varies greatly among women. Women reach orgasm from direct clitoral stimulation, indirect clitoral stimulation, vaginal stimulation or stimulation of internal areas surrounding the vagina.

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Some women experience orgasm solely from sexual intercourse, whereas other women require concurrent stimulation of the external parts of the clitoris in order to reach orgasm during sexual intercourse, and some women never experience orgasm in intercourse under any conditions. A period of increasing sexual arousal precedes orgasm, typically from genital stimulation, in those women who experience orgasm.

Given the differences in male and female genitals it is likely that the nature and extent of genital stimulation necessary for orgasm differs between men and women. This appears to certainly be the case for orgasms which occur solely from sexual intercourse.

A striking sex difference in the onset of the occurrence of orgasm has been known for more than 50 years Figure 1. Post-pubertal males routinely, and apparently easily, experience orgasm, as indicated by their reliable ejaculatory reflex, but female orgasm appears to develop more slowly and is less predictable than male orgasm. While there are women who reach orgasm as easily and routinely as do men, and some women who experience orgasm more easily and multiple times during a single session of sexual intercourse, this is not women's typical experience with orgasm.

This sex difference in Lady looking sex Crouch onset of orgasm is illustrated by when the maximum of men or women have experienced orgasm. Figure 1 illustrates the cumulative incidence, across time, of males ejaculating Kinsey, Pomeroy and Martin, in comparison to the cumulative occurrence of orgasm in women Kinsey, Pomeroy, Martin, and Gebhard, Taken together these data suggest that orgasm is a different phenomenon in women than in men, occurring under different developmental influences and likely reflecting genital differences between men and women.

Illustrates the sex difference in the occurrence of orgasm in males and females in relation to age.

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Males show a rapid transition from few boys experiencing orgasm prior to puberty to all men experiencing orgasm soon after puberty. Women, by contrast show a much more gradual developmental curve. Male data are adapted from Kinsey, Pomeroy, and Martin, and the female data are adapted from Kinsey, et al. Lloyd argued that this sex difference in the distribution of orgasm supports strong evolutionary selective pressure on orgasm during intercourse in men, but not women.

The direct connection between male ejaculation during intercourse and reproductive success makes understandable the almost certainty of male orgasm during intercourse. However, the source of the striking variability in the occurrence of orgasm in intercourse among women is unknown, though a of theories have been proposed concerning its origin. Freud posited that women's capacity to experience orgasm during intercourse varied according to their psychoanalytic development. In his view, girls initially experienced clitoral eroticism analogous to boy's penile eroticism.

As girls matured psychologically they transitioned from clitoral eroticism to vaginal eroticism, which allowed them to experience orgasm during vaginal intercourse Freud, In Freud's view, orgasm from vaginal intercourse reflected mature, psychologically healthy, sexuality whereas continued reliance on clitoral arousal for orgasm reflected psychologically immature development. The names don't actually indicate different types of orgasms, but indicates the type of genital stimulation triggering the orgasm.

Since a majority of women do not routinely and reliably experience orgasm solely from sexual intercourse Lloyd,Freud's psychoanalytic arguments have resulted in feelings of sexual inadequacy for those many women whose orgasms do not result from vaginal stimulation. This view, that there is a mature and psychologically healthy form of female orgasm, has become less prevalent, but is still promoted more than years after Freud's proposals. For example, there are those who argue that women experiencing orgasms in intercourse have better mental health than women who reach orgasms through other means Brody and Costa, Similarly, there are self-help programs whose goal is for women to achieve orgasm solely from vaginal intercourse Kline-Graber and Graber, Thus orgasm solely from sexual intercourse continues to occupy a ificant place in women's sexuality.

Given that a majority of women do not routinely experience orgasm from such stimulation Lloyd,it seems incomprehensible that this reflects that a majority of women are psychologically immature. Instead this demonstrates the variability in women's orgasms and that orgasm solely from sexual intercourse is not routine for most women. The question remains unanswered as to why a minority of women routinely experience orgasm solely from sexual intercourse, whereas most women require other types of stimulation.

Women differ markedly in the type of genital stimulation that reliably induces orgasm. On the one hand are women who reliably trigger orgasm through vaginal or cervical stimulation without any direct contact with the clitoral glans or shaft Alzate, ; Komisaruk, et al. On the other hand are women who reliably reach orgasm during intercourse only when there is concurrent direct clitoral stimulation Masters and Johnson, ; Fisher, ; Hite, Thus there is a long history of the notion that clitoral stimulation, direct or indirect, is required for women to experience orgasm in intercourse. Unfortunately, survey data on the occurrence of orgasm in intercourse do not typically distinguish intercourse without concurrent clitoral stimulation from intercourse with concurrent clitoral stimulation see Lloyd, for a more complete discussion of this issue.

Thus current estimates provide imprecise information on the proportion of women who routinely experience orgasm solely Lady looking sex Crouch vaginal intercourse without concurrent direct clitoral stimulation. Still, whether or not concurrent clitoral stimulation is specified, only a minority of women report reliably experiencing orgasm from vaginal intercourse.

It seems unlikely that most women in these studies have concurrent clitoral stimulation during intercourse because such stimulation is almost uniformly successful in inducing orgasm Fisher, ; Hite and thus the percentages of women experiencing orgasm in intercourse would be correspondingly higher. It Lady looking sex Crouch clear, however, that some of the variability in female orgasm during intercourse stems from whether or not intercourse itself produces clitoral stimulation. Clitoral stimulation during sexual intercourse might reflect how closely the clitoral glans and shaft are positioned relative to the vaginal opening, affecting the likelihood that the male's penis would stimulate the clitoris during Lady looking sex Crouch thrusting.

This distance varies markedly among women, ranging from 1. However the relationship between variation in this distance and variation in the occurrence of orgasm during intercourse is not fully known. The notion that women's orgasm during intercourse is related to the location of the clitoral glans in relation to a woman's vagina was suggested more than 85 years ago Narjani,Dickinson,Landis, Landis, and Bowles, Marie Bonaparte, using the pseudonym Narjani, published the first data relating clitoral glans position to the occurrence of women's orgasm during sexual intercourse Narjani, Bonaparte measured the distance between the underside of the clitoral glans and the centre of the urinary meatus CUMD 2 and compared that distance to the likelihood that the woman experienced orgasm during sexual intercourse.

Published inBonaparte's data were never subjected to statistical analysis, as the appropriate statistical tests had not yet been invented. Thus Bonaparte's conclusion of a relationship between CUMD and orgasm in intercourse was based on inspection of the data leaving unresolved whether there really is such a relationship and if there is, the reliability and magnitude of the relationship.

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With the Austrian surgeon, Josef Halban, Bonaparte created the Halban-Narjani procedure Bonaparte, in which the suspensory ligament of the clitoris was transected allowing repositioning of the clitoral glans closer to the vagina.

Bonaparte, who reported having high sexual interest, but never experiencing orgasm from intercourse, received this treatment three times when the initial treatment was ineffective Thompson, Her genital surgeries were ineffective in allowing her to experience orgasm from intercourse.

Similar to Bonaparte's experience, the surgical procedure was not effective in the five women who received the clitoral surgery one of whom may have been Bonaparte because they did not experience orgasm during intercourse. Of the five, two disappeared from follow-up, two experienced no clear change in their sexual response, and one improved somewhat, but only while the surgical site was healing from an infection. Once the surgical site healed, she no longer experienced orgasm from intercourse Bonaparte, These do not necessarily invalidate the theoretical premise of the surgery, as the clitoral area is heavily innervated O'Connell, Sanjeevan, and Hutson, and it is likely that the surgical procedure, while repositioning the clitoris closer to the vagina, may have also deinervated the clitoris.

Whatever the reality of the surgery, byBonaparte was unconvinced by her data and rejected her earlier anatomical interpretation as inaccurate. Making an argument that Dickinson would later employ against the anatomical argument, Bonaparte pointed out that there were women in her sample with short CUMD who did not experience orgasm in intercourse and women with long CUMD who did.

Instead, she argued, psychoanalytical processes, not clitoral placement, determined whether or not a woman experienced orgasm in intercourse Bonaparte, Her changed viewpoint likely reflected her experience as Freud's student since Thompson,as her paper recapitulated Freud's conceptualizations of women's sexuality which were absent from her original study Bonaparte, Although Dickinson collected data on the genitalia of more than women during his career as a gynecologist, he never summarized or published his data, specifically the data on women where he recorded their CUMD and their occurrence of Lady looking sex Crouch in intercourse.

Dickinson claimed, as Bonaparte had inthat his sample had women with short CUMDs who never experienced orgasm in intercourse, and women with long CUMDs who routinely did Dickinson, However, Dickinson presented no actual data to support his argument and to our knowledge, no summary of the data from these women he measured has been published.

Thus it is unknown whether the cases Dickinson cites were isolated exceptions to a more common pattern in which CUMD predicted the occurrence of orgasm in intercourse or reflected the absence of a relationship between CUMD and orgasm in intercourse as Dickinson claimed. Carney Landis, along with his wife Agnes and a colleague Marjorie Bowles collected systematic data on Lady looking sex Crouch and the occurrence of orgasm in intercourse. Although there were nonmentally ill women in the study the other women in the study were psychiatric inpatientsdata on CUMD and orgasm were presented only for the 44 married women in the study, for which there were complete data for only However, neither the method of statistical comparison employed, nor how an exact probability of 0.

While this single analysis supports that short CUMD is associated with a higher probability of orgasm in intercourse, it is unclear whether there is more convincing evidence within this dataset that might be revealed by a more extensive statistical analysis. Van de Velde was specifically referring to the size of the clitoris as his book promoted clitoral stimulation by the husband as a crucial part of marital sexuality. Of course no evidence is presented, nor has any been found, that sexual activity permanently alters clitoral size.

Still, the clear message conveyed in these passages is that the configuration of women's genitals ificantly influences the likelihood that they will experience orgasm from intercourse. The higher the clitoris is located and the further away from the vaginal entrance the less contact there is apt to be and the greater the difficulty in obtaining a satisfactory Lady looking sex Crouch.

Thus the idea, first presented in Marie Bonaparte's work had widespread popular dissemination. The origin of this idea in popular marriage manuals is unclear as neither van de Velde, nor the Stones cite Bonaparte's, or any other, research, as the source of the principle that distance from the clitoris to the vagina influences the likelihood that a woman will experience orgasm in intercourse. Both of these authors present the same conclusion as did Van de Velde and the Stones, but do not cite any supporting data.

We could find no more recent data on the relationship between clitoral placement and women's orgasmic response in sexual intercourse than those presented in Narjani and the Landis study Landis, Landis, and Bowles, In exploring the history of the idea that variability in women experiencing orgasm in intercourse reflect genital variability we discovered that Bonaparte Narjani, published her raw data in her paper and that the raw data for the married sample in Landis, Landis, and Bowles were archived in the library of the Kinsey Institute for Research in Sex, Gender and Reproduction.

As both samples had either never been statistically analyzed Narjani, or only minimally analyzed Landis, Landis, and Bowles,we analyzed these samples using modern statistical techniques unavailable when these data were collected. The analyses presented here of both the Bonaparte Narjani, and Landis Landis, Landis, and Bowles, samples support Bonaparte's original contention that CUMD predicts the likelihood of women experiencing orgasm during sexual intercourse.

Although there are ificant differences between the two samples in both the characteristics of the data and the extent of the relationship revealed between CUMD and orgasm in intercourse, the support the likelihood than genital configuration contributes ificantly to a woman's potential to experience orgasm solely from sexual intercourse. The paper contained summaries of genital measurements on women in Vienna and France, but for these women no data were presented on orgasm occurrence. The raw data for an additional 43 women, likely from France, possibly a subset of the women, were presented in table 2 of the original article.

These data consisted of genital measurements cm and the occurrence of orgasm in intercourse yes or no along with occurrence of orgasm from masturbation, age of first intercourse, age of menarche, chronological age, and height. Women in Narjani ranged in age from 20 to 62 with a mean age of All women had experienced sexual intercourse.

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