Women can achieve orgasm through a number of means and types of stimulation.

The female orgasm remains a subject of intense scientific interest. Doctors are puzzling over the various ways women can achieve orgasm and what can prevent them from achieving it.

Orgasm in women: what exactly happens?

When women climax, “there are changes throughout the body, a head-to-toe experience,” says Michael Ingber, MD, a physician in urology and female pelvic medicine and reconstructive surgery at Garden State Urology in New Jersey, and a fellow of the International Society for the Study of Women's Sexual Health.

How Women Achieve Orgasm

One of the ways women experience orgasm is through a purposeful, four-step process first described decades ago by sex researchers William Masters and Virginia Johnson.

Excitement

In a state of desire or arousal, the woman initiates or consents to sex, and once it begins, she focuses primarily on sexual stimulation. Blood begins to fill the clitoris, vagina, and nipples, creating a sexual flush throughout the body. Heart rate and blood pressure increase. Testosterone and neurotransmitters like dopamine and serotonin are involved in these processes, says Dr. Ingber.

Plateau

Sexual tension builds as a precursor to orgasm. The outer third of the vagina, in particular, becomes engorged with blood, creating what researchers call the "orgasmic platform." Focusing on sexual stimulation overpowers all other sensations. Heart rate, blood pressure, and breathing continue to rise.

Orgasm

A series of rhythmic contractions occurs in the uterus, vagina, and pelvic floor muscles. The sexual tension caused by intercourse or self-stimulation dissipates, and muscles throughout the body can contract. A feeling of warmth usually originates in the pelvis and spreads throughout the body.
The body relaxes, and blood flows away from the swollen genitals. Heart rate, blood pressure, and breathing return to normal.

10 facts about the female climax

It's time to clear up all the mysteries and confusion surrounding female orgasms!

The orgasm gap

While researchers have carefully studied what happens to women during orgasm, they have also taken into account that women don't orgasm as often as men during heterosexual encounters. This is known as the "orgasm gap" and is a well-documented phenomenon among those who study sexuality.

However, a recent study by PhD candidate Grace Wetzel found that women who don't have orgasms start to believe they won't, and subsequently experience fewer of them. This self-fulfilling sexual prophecy causes them to deprioritize their orgasms, potentially making their sex lives less satisfying.

"The more orgasms you have in your relationship, the more you expect to have and the more you want or desire them in that relationship," says Wetzel. "The lower frequency of the orgasm gap works against women, which may explain why women devalue orgasms. And that's important, because if they place less emphasis on orgasm, they'll experience less pleasure. And if they continue to have fewer orgasms and expect less, the cycle will continue." Because orgasm is one of the biggest predictors of sexual satisfaction and therefore of a satisfying relationship, Wetzel says, "it's beneficial to work on this within people's relationships."

How do you close the orgasm gap? You should emphasize sexual communication between partners,

priority clitoral stimulation for couples,

"It's not that women have difficulty reaching orgasm," says Wetzel, adding that there's nothing about their anatomy, genetics, or hormones that prevents women from achieving orgasm—most women can achieve orgasm while masturbating. Women should use the technique that works best for them during masturbation and apply it to their partner.

Different types of stimulation, different types of orgasm

Women's bodies are capable of experiencing orgasm in more than one way. The most common type is a clitoral orgasm, says Ingber.

Clitoral stimulation has been shown to be the surest route to orgasm. "I think clitoral stimulation is probably the closest thing to a male orgasm, where you get erectile tissues, release, and after release, it's uncomfortable to continue."

Medical treatments

If behavioral methods don't work and a woman is interested in other interventions, solutions related to male erectile dysfunction may help.

Ingber says that "for women who have difficulty with arousal, just like men, sildenafil (Viagra) can be used." The U.S. Food and Drug Administration (FDA) hasn't approved it for that purpose, but it is sometimes prescribed off-label. The drug can increase blood flow to the vulva and clitoris. Furthermore, clinical data on whether sildenafil has any effect on female sexual dysfunction are mixed.

For postmenopausal women experiencing low sexual desire and for whom other psychosocial and medical causes of decreased libido have been ruled out, off-label use of topical testosterone may be helpful. Ingber notes that several studies have shown it to be safe and effective, although, as a review in the Journal of Women's Health indicates, the long-term effects on cardiovascular risk and breast cancer incidence are not yet known.

The International Society for the Study of Women's Sexual Health endorses testosterone therapy for postmenopausal women and notes that limited data also support its use in premenopausal women of late reproductive age with hypoactive sexual desire disorder (HSDD).

For premenopausal women with HSDD, two FDA-approved therapies, flibanserin (Addyi) and bremelanotide (Vyleesi), can be effective, says Ingber. The former is a daily pill, and the latter is an injectable medication that can be used as needed, he adds.

Acupuncture

You may also consider acupuncture. Although research on acupuncture for sexual dysfunction is limited, it is a topic of interest among researchers. Sexuality is a complex intersection of biological, psychological, spiritual, and other factors. Some believe that traditional Chinese medicine offers a more integrated approach than Western medicine and is therefore more effective for sexual health.

Larger, higher-quality studies are still needed, but early research suggests there may be something to this. For example, a pilot study published in August 2022 in Sexual Medicine examined the effects of acupuncture on 24 women experiencing sexual dysfunction. Results showed that the treatment was associated with significant improvements in sexual desire and arousal, vaginal lubrication, orgasm, sexual satisfaction, and pain during sex.

While it remains unclear whether and why acupuncture helps sexual health, Baljit Khamba, ND, assistant professor of naturopathic medicine at Bastyr University and a naturopathic physician in San Diego, believes the key may be acupuncture's ability to restore qi. Qi refers to the life energy that practitioners of Chinese medicine believe improves health and libido.

the 3 phases of the female orgasm

Sex researchers have described that female orgasms develop in four stages:

excited excitement,

a plateau in which tension is building,

final orgasm.

Women can achieve orgasm from a variety of stimulation, including clitoral, vaginal, and sensory stimulation, and female orgasms can even occur without any physical contact.

Anxiety, depression, guilt, distraction, and physical problems resulting from changes like menopause can all make it difficult to achieve orgasm. However, behavioral interventions like sex therapy, targeted masturbation, behavioral therapy, and the use of sexual devices can help, and some medications and acupuncture can help address physical problems with the help of a healthcare provider.