Dr Elmari Mulder Craig
EFS/ESSM Certified Sexologist and Relationship Expert

‘That moment during sexual experience where my body completely takes over and is out of my conscious control, moving and feeling according to its own pleasure and taking my mind for a wonderful ride’. Anonymous

The big O…

It is a powerful feeling of physical pleasure and sensation, which includes a discharge of accumulated erotic tension. Orgasms have been 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, over-arching explanation of the orgasm does not currently exist.


Psychological Definition of Orgasm

Psychologists, psychiatrists, and other mental health professionals and researchers define orgasm based on subjective experiences of satisfaction, release, and other emotional and/or cognitive changes. By these measurements, someone has had an orgasm either when they say they have or when they describe an experience that matches what some expert proposes orgasm to be.


Medical/Physiological Definition of Orgasm

Medical researchers have tried to define orgasm based on what happens in our bodies.
They’ve measured increase in heart rate, body temperature, skin flush, hormonal changes and changes in sensitivity, muscle contractions, ejaculation, and more. Research can tell us the “average” measurements for orgasm, but we always need to remember that these are only “average” for people who can get into a lab and have an orgasm. Even though there are no universally agreed upon measurements or limits for orgasm all of these measurements have been used to “prove” that an orgasm has occurred. By these definitions, if you’re body responds in a certain way, you’ve had an orgasm.


Anal sex correlates with orgasm

It is suggested that women who have anal sex more often reaches orgasm. As sexologists we are also aware of the fact that more women are having anal sex than ever before. New research described by William Saletan suggests that since 1992, the percentage of women aged 20-24 who say they’ve tried anal sex has doubled to 40 percent. The percentage of women aged 20-39 who say they’ve done it in the past year has doubled to more than 20 percent. And 94 percent of women who received anal sex in their last encounter said they reached orgasm—a higher rate of orgasm than was reported by women who had vaginal intercourse or received oral sex.


Women who engage in anal sex are often also open to, and comfortable with other sexual acts including vaginal intercourse, cunnilingus and the use of sexual aids like vibrators and anal stimulators and partnered masturbation. Couples who have consensual, playful and open-minded sex lives tend to do things that result in the women in these relationships having orgasms AND to experiment with (and possibly find they enjoy) anal sex. It’s not one causing the other, but a common cause that results in the two being correlated.
It is important to note that anal sex does not necessarily mean anal penetration with a penis, but more often anal sphincter stimulation and the use of a finger or anal toy and often with simultaneous stimulation of the clitoris. We should always also keep in mind that sex is complex and people and their preferences differ.


Orgasms Facts

  • Greater behaviour diversity is related to ease of orgasm
  • Women who are sexually empowered, in touch with their bodies and open to asking for what they need, find it easier to reach orgasms regularly
  • Love, trust feeling safe emotionally and physically leads to easier orgasms
  • Researchers estimate that 10-15% of women have never experienced an orgasm
  • 47% of women reach their first orgasm through masturbation at the average age of 18
  • 70% of women need clitoral stimulation in order to reach orgasm
  • Many women find it easier to reach orgasm if they use the ‘women on top’ position as they can control the angle and level of penetration
  • Less than a third of women regularly orgasm through penetration alone
  • Women need on average 21 minutes of foreplay to reach orgasm
  • Women who’s pelvic floor muscles are strong find it easier to achieve orgasm and also find those orgasms to be more intense. Do your Kegal Exercises!
  • Research has found 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.
  • The clitoris has 8000 nerve endings and stretched 7 centimeters into the pelvic floor
  • The hypothalamus, the middle brain, the hippocampus and the cerebellum gets activated during orgasm.


Influential Research

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 (1966) – 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.


Orgasm models

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:

  1. Excitement
  2. Plateau
  3. Orgasm
  4. Resolution



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 than not all sexual activity is preceded by desire.

  1. Desire
  2. Excitement
  3. Orgasm


Health benefits of sex and orgasm

  • Several hormones that are released during orgasms have been identified, such as oxytocin and DHEA, and some studies have suggested that these hormones could have protective qualities against cancers and heart disease.
  • After orgasm the body produces a quadruple amount of Oxytocin (the bonding hormone)
  • Oxytocin and other endorphins released during orgasm have also been found to work as relaxants. It is ten times more effective than Valium
  • It is a good sleeping pill
  • It is good for your hair and skin
  • It is a natural light anti-depressant
  • It relieves pain, headache, sinusitis and hay fever
  • It is good exercise and firms all the muscles in your body


Types of orgasms

Today sexologists agree that an orgasm is an orgasm and that there is no difference between a vaginal or a clitoral orgasm. Although their might be a distinguished between mild, normal and intense orgasms.

The male orgasm

The following description of the physiological process of male orgasm in the genitals utilizes the Masters and Johnson four-phase model.


When a man is stimulated physically or psychologically, they can get an erection. Blood flows into the corpora – the spongy tissue running the length of the penis – leading to the penis growing in size. 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 also increases.


Semen – a mixture of sperm (5%) and fluid (95%) – 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 between 10 to 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.

The female orgasm

The following description of the physiological process of female orgasm in the genitals utilizes 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 leads to the vulva swelling and fluid passing through the vaginal walls, making the vagina wet. 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% 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 to 51 seconds.

Unlike men, most women do not have a refractory 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.

What causes orgasms

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.

However, an article published in 2011 examined the occurrence of exercise-induced orgasm in women; when orgasms occur during physical exercise such as climbing and lifting weights. The findings of this study among others challenge the belief that orgasms are purely a sexual experience.
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 the experiencing of orgasms.


Orgasm disorders

There are a number of disorders that are associated with orgasms. These disorders can lead to distress, frustration and feelings of shame, for both the person experiencing the symptoms and their partner. Although orgasms are considered to be the same in all genders, health care professionals tend to describe orgasm disorders on gendered lines. Orgasm disorders can potentially cause feelings of distress, shame and frustration for anyone involved.


Male orgasmic disorders

Delayed Ejaculation/Inhibited male orgasm

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.

Premature ejaculation

Ejaculation in men is closely associated with an orgasm. Premature ejaculation is a common sexual complaint, whereby a man ejaculates (and typically orgasms) within one 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.


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.
Female orgasmic disorder can occur as the result of physical causes such as gynecological issues or the use of certain medications, or psychological causes such as anxiety or depression.


Common misconceptions

It is probable that the high importance that society places on sex, combined with the incomplete nature of what is currently known about 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% of women have never had an orgasm. In men, as many as one in three reports having experienced premature ejaculation at some point in their lives.

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.

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.

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.

Some of the above information from James McIntosh, published in Medical News Today.

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