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sex, sex myths

The term vaginal orgasm is imprecise and offensive, why does the Sexual Medicine Society of North America accept it?

I was reading through abstracts from the Sexual Medicine Society of North America’s meeting. It took a while to get to the abstracts as I was temporarily distracted by photos of medical professionals posing with the CEO of Sprout. BTW if I wanted to sell a dubious sexual product for women  I’d cosy up the the SMSNA too! I found this abstract on a potential negative effect of sling surgery for incontinence and the potential effect on orgasm interesting as the impact of slings (specific surgery for stress incontinence) has been well-studied when I was distracted by the term “vaginal orgasm” in the abstract.

Before we get to the “vaginal orgasm is a bad term” part of the post, don’t panic about sling surgery and sex just yet. This abstract is a review and the methods are not spelled out. I have read several randomized controlled trials that look at slings and sexual satisfaction and have not reached the same conclusion as the authors of this abstract. This randomized trial shows a net benefit and this study and this one. Mid urethral slings are one of the most studied GYN surgeries (as this 2015 Cochrane review points out). One should never jump to any conclusion with an abstract, especially a review (like this one), because knowing which studies were included/excluded and why and the statistical analysis is imperative. However, I will maintain an open mind as it also possible that some of the studies asked about sex too broadly or were not powered to answer questions about orgasm. It is not implausible that for some women a sling could affect the periurethral tissues and thus impact indirect clitoral stimulation from vaginal penetration, so when or if this abstract becomes a peer-reviewed paper I will look at it.

However, the authors make a point of noting the impact of the surgery on “vaginal orgasm” and this bothers me. Here’s why.

Vaginal orgasm means orgasm through penile penetration alone and it is a Freudian term. Freud believed that clitoral orgasms (i.e. stimulating the clitoris to reach orgasm) were immature, basically what we women had to make do with until we encountered the supreme majesty of the penis!  In fact, if a women required clitoral stimulation to have orgasm and coitus alone didn’t cut it she was diagnosed as being frigid and should have “psychiatric assistance.” Freud drew these conclusions not by studying sex or through detailed anatomy reviews, but because of how he felt about women.  His idea that women can not achieve ultimate sexual satisfaction without penile penetration is A) inaccurate and B) misogynistic.

Women require some form of clitoral stimulation for orgasm. For some it is direct with fingers, a sex toy, or the mouth, and sometimes it is rubbing from the shaft of the penis or pressure against the partner’s pubic bone. When the tissues around the urethra are engorged and stimulated (this is contact with the front wall of the vagina, either with a sex toy, fingers, or a penis) this can also lead to orgasm for some women, but this is by indirect clitoral stimulation.

Betty Dodson said it best:

…the clitoral body is the primary source of orgasm whether it’s stimulated externally, internally, or both at the same time. I prefer both. Once a woman understands she can have both clitoral stimulation with vaginal penetration, it ends this discussion.

There is no distinction between “vaginal” or “clitoral” or “G spot” orgasms since all orgasms are centered in the clitoris. It doesn’t matter if it’s direct clitoral contact or indirect G spot stimulation.

So getting back to the abstract, I highly doubt any study looking at slings and sex specifically asked women how they achieved orgasm before and after sling surgery (basically how you came to the party before surgery versus after surgery). In fact, I can’t find a questionnaire about the frequency or quality of orgasms from direct clitoral stimulation versus vaginal penetration, most just look at satisfaction with the encounter. If the questionnaire doesn’t exist I’m not sure how studies can exist, so I am really curious to see this paper if it gets published.

I don’t think the SMSA should allow “vaginal orgasm” as a terminology. I agree that sexual satisfaction post surgery should be studied, but to use terminology born from a misogynistic view of female sexuality that essentially maintains that thinking is, in my opinion, wrong.

An orgasm from penile penetration doesn’t come from the vagina, it comes from indirect clitoral stimulation. It’s an important distinction and given he myths about sex I think accuracy is essential especially from an organization devoted to sexual health. I see women now and then who are distressed that they don’t have an orgasm with penile penetration. Yes, they can orgasm with a vibrator or fingers, but not with a penis but somehow they think they are broken. This makes me sad. For this reason alone the term vaginal orgasm should be abandoned, because it is bandied about as some kind of ideal as opposed to just one way that some women get to the party.

Robust studies about sexual outcomes for women after GYN surgeries are needed, but please let’s focus on female sexual satisfaction not use imprecise terms born of misogyny that perpetuate sex myths.

 

 

 

 

 

 

 

 

Discussion

12 thoughts on “The term vaginal orgasm is imprecise and offensive, why does the Sexual Medicine Society of North America accept it?

  1. Well thanks for that. I have long wondered what a vaginal orgasm even could be. Got it.

    Posted by Melanie McNeil | December 5, 2015, 1:59 pm
  2. A question: as there is only one type of female orgasm, why do some women say that they can recognise the difference between a clitoral and a vaginal one? They seem quite clear about this; why?

    Posted by korhomme | December 5, 2015, 3:23 pm
    • As the article says, there is direct stimulation of the clitoris and indirect stimulation. It is easy to notice if one’s clitoris is being stimulated directly or not.

      Posted by Anat | December 5, 2015, 3:37 pm
      • Sure, I get that. But yet some women say there is a qualitative difference between a clitoral and a vaginal orgasm; they feel different. That I don’t understand.

        Posted by korhomme | December 5, 2015, 3:50 pm
      • So, I’m one of the women who would say there’s a difference in orgasm-feeling depending on what’s being stimulated. For me, direct clitoral stimulation is a necessary part of sex for me to satisfactorily orgasm, and vaginal penetration is icing on the cake. And the orgasms do feel different from external clitoral to internal stimulation.

        I can’t give you a medical reason for the difference, but think about how touching the top of your arm versus the bottom of your arm feels. Does it feel the same? No, but it’s both parts of your arm.

        The clitoris is a much larger organ than people tend to visualize. The bit that you can see is really only the tip of the iceberg, literally. So it would make sense that stimulate lot different parts of it would feel different, just like touching different parts of your arm feels different.

        The point in this article (as I see it), is that, medically it’s still the clitoris being stimulated in both instances, not the clitoris in one and the vagina in the other. So a medical paper or review that assumes the vagina is being stimulated doesn’t know what it’s talking about and is using outdated and inaccurate terms and assumptions. It’s not that there’s only one type of orgasm, it’s that there’s only one organ causing orgasm. (Ignoring, for the moment, people who can orgasm from other erogenous zones being touched.)

        Posted by mybodymystory | December 5, 2015, 7:11 pm
      • It may not be a “medical explanation”, but I think your description makes sense. I do know a bit about the clitoris, and how it’s anatomy has been better described in recent years. (I taught – demonstrated – anatomy many years ago.)

        Posted by korhomme | December 6, 2015, 12:37 am
    • this is not well documented, but it is possible to reach orgasm (for women) through stimulation of the vagus nerve, which enervates the uterus and cervix. this is an entirely different type of orgasm than the clitoral. it is the full body, mystical, mind altering climax. it is the same nerve that is stimulated during peak ecstatic spiritual experience/meditation. to say there is only one type of female orgasm is incorrect, just like there is not only one type of male orgasm (men can orgasm from prostate and anal stimulation without an erection, from a different nerve bundle than that which enervates the penis). i’m sure it would be difficult to document a vagal orgasm in a clinical setting, as it often requires lots of time, intense relaxation/surrender, and high amounts of oxytocin being released (through an intimate bonding connection)….all things i’m sure it is difficult to recreate in a lab setting when your lady parts are hooked up to electrodes. our cultural (historically puritanical, patriarchal, quick-fix, porn-influenced) lens limits what we see as possible in terms of the body and sexuality, and pleasure in general. it determines what science will and won’t see as valid and worth investigating. eastern sexual and yogic practices (qi qung, kundalini yoga, kriya yoga) have acknowledged the reality of these different experiences for a long long time.

      Posted by Hannah | December 19, 2015, 6:56 pm
  3. Thank you. Please teach as many people as possible about this, especially young girls.

    Posted by Esther | December 7, 2015, 1:26 pm

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