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Female Ejaculation, G Spot, A Spot, and Should

We Be Looking for Spots?

Article in Current Sexual Health Reports June 2015

DOI: 10.1007/s11930-015-0041-2


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Beverly Whipple
Rutgers School of Nursing


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Female Ejaculation, G Spot, A Spot, and
Should We Be Looking for Spots?

Beverly Whipple

Current Sexual Health Reports

ISSN 1548-3584

Curr Sex Health Rep

DOI 10.1007/s11930-015-0041-2

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Author's personal copy
Curr Sex Health Rep
DOI 10.1007/s11930-015-0041-2


Female Ejaculation, G Spot, A Spot, and Should We Be

Looking for Spots?
Beverly Whipple

# Springer Science+Business Media, LLC 2015

Abstract This review considers research concerning the phe- Organs of Women, De Graff described the female prostate
nomenon of female ejaculation, the G spot, and the A spot. and the fluid from the urethra in some detail. Female ejacula-
These topics have been the object of controversy in recent tion was a tradition in ancient cultures of China, India, Japan,
decades. Female ejaculation has been written about for more and other areas of Asia and Africa. The Romans called these
than 2000 years. The area of the Grafenberg or G spot was fluids liquor vitae, and in ancient India, the fluids were known
named by Drs. John Perry and Beverly Whipple in the early as a amrita (nectar of the gods). Many authors have described
1980s in honor of Dr. Ernst Grafenberg, and the A spot was the history of female ejaculation, such as Grafenberg [1],
identified by Dr. Chua Chee Ann in 1997. The goal of this Sevely and Bennett [2], Addiego et al. [3], Perry and Whipple
authors research program has been to validate, in a laboratory [4], Ladas, Whipple, and Perry [5, 6], Belzer, Whipple, and
setting, womens reports of pleasurable sensual and sexual Moger [7], Stifer [8], Zavaicic and Whipple [9], Cabello [10],
experiences, not to create new goals, new spots, or Zavicac [11], Korda, Goldstein, and Sommer [12], and Rubio-
controversy. Casillas and Jannini [13].
The area of the Grafenberg spot in women is located about
Keywords Female ejaculation . G spot . Grafenberg spot . A halfway between the back of the pubic bone and the cervix,
spot . Gushing . Squirting . Female prostate gland . along the course of the urethra. It is a sensitive area that is felt
Clitourethrovaginal complex . CUV through the anterior wall of the vagina, which swells when it is
stimulated, although it is difficult to palpate in an un-
stimulated state. Drs. John Perry and Beverly Whipple named
this area the Grafenberg spot to commemorate the research of
Dr. Ernst Grafenberg, a German-born obstetrician and gyne-
cologist, who developed the first IUD. In 1944, Grafenberg
and Robert L. Dickinson described a zone of erogenous feel-
Female ejaculation refers to the expulsion of fluid from the
ing located along the suburethral surface of the anterior vagi-
urethra that is different from urine. The fluid is described as
nal wall [14]. In 1950, Dr. Grafenberg wrote about the sensi-
looking like watered-down fat-free milk, tasting sweet, and
tive area on the anterior wall of the vagina, which when stim-
usually about a teaspoon (35 cc) in volume. The biological
ulated seems to cause the female urethra to enlarge and swell.
phenomenon of female ejaculation has been a normal and
He also described a fluid from the urethra that is different from
pleasurable experience of many womens sexuality. Aristotle
urine [1].
was probably the first to write about female ejaculation and
Galen is said to have known about it in the second century C.E.
In 1672 in his New Treatise Concerning the Generative
Female Ejaculation
This article is part of the Topical Collection on Current Controversies
Perry and Whipple rediscovered the sensitive area they named
B. Whipple (*)
the Grfenberg spot while teaching women Kegel exercises
Rutgers, The State University of New Jersey, 87 Matlack Drive,
Voorhees, NJ 08043, USA using biofeedback for stress urinary incontinence. Some of the
e-mail: women who reported that they lost fluid from their urethra had
Author's personal copy
Curr Sex Health Rep

very strong pelvic floor muscles, while women with stress from the same subjects. Specifically, the ejaculate contains
urinary incontinence usually have weak pelvic floor muscles. high levels of prostatic acid phosphatase, prostatic specific
The women with strong pelvic floor muscles also reported that antigen, glucose, and fructose, but low levels of urea and
they only lost fluid from their urethra during sexual stimula- creatinine. The chemical composition of healthy urine is the
tion and some during orgasm. This led Perry and Whipple to opposite of female ejaculate, so they are easily differentiated
conduct a study comparing the pelvic muscle strength of from each other. That is, healthy urine contains high levels of
women who they called Bfemale ejaculators^ to women who urea and creatinine and no prostatic acid phosphatase, prostat-
did not experience female ejaculation [4]. The results of this ic specific antigen, or glucose (of course, the urine of persons
study demonstrated that the pelvic muscle strength of women with diabetes may contain glucose). Other researchers have
who experience female ejaculation was significantly stronger described the occurrence of female ejaculation without
than the women who did not have this experience. These performing any chemical analysis. There are many films and
women described the fluid as looking like watered-down fat- books claiming to teach women to ejaculate, but these films
free milk, tasting sweet, not smelling like urine, and about a and books do not report an analysis of the fluid, and the
teaspoon (35 cc) in volume. amounts shown to be expelled in these films are much larger
The woman who experienced female ejaculation also re- than those collected and analyzed in laboratory settings.
ported that there seemed to be a sensitive area felt through the Rubio-Casillas and Jannini [13] have reported on the
anterior wall of their vagina and stimulation of this area caused chemical composition of three fluids expelled from the
the expulsion of fluid from their urethra and in some cases an urethra: urine, large amounts of a clear fluid that has
orgasm that felt different from their orgasm from clitoral stim- been called squirting or Bgushing,^ and what Perry,
ulation. They reported that the orgasm felt deeper inside their Whipple, and Zaviacic have all called female ejacula-
body and produced a bearing down sensation, with the uterus tion. Their biochemical evidence demonstrates that the
pushing down into the vagina, rather than the tenting effect of clear and abundant fluid that is ejected in gushers is
the vagina (where the end of the vagina balloons out and the different from the real female ejaculation, and all are
uterus pulls up), as reported at orgasm by Masters and John- different from urine from the same subject. Consequent-
son in 1966, in response to clitoral stimulation [15]. Perry and ly, it is questionable as to whether in those cases the
Whipples team of medical doctors and nurse practitioners large amounts of fluid are female ejaculate or, more
examined over 400 women and found this sensitive area, likely, as Rubio-Casillas and Jannini demonstrated, di-
which swells when it is stimulated with a Bcome here^ motion, lute urine [17].
in all women tested [5, 6]. The women were lying on their From these studies, it is evident that some women ex-
back and the stimulation of the area felt through the anterior pel a fluid that is different from urine during sexual ac-
vaginal wall was done with two fingers, with the palm of the tivities and orgasm and some women may also expel
hand up, of the person doing the stimulation. They then named urine. In a review of the literature in 1991, Whipple and
this area the Grfenberg spot after Dr. Ernst Grfenberg, who Komisaruk [18] reported that in some women, G spot
wrote about the sensitive area that surrounds the urethra and stimulation, orgasm, and female ejaculation are related,
the expulsion of a fluid from the urethra that is different from while in others they are not. There are reports that some
urine [3, 4]. women have experienced female ejaculation with orgasm
Dr. Milan Zaviacic and Dr. Beverly Whipple started an from clitoral stimulation and some women have reported
email correspondence after Perry and Whipple first published experiencing ejaculation without orgasm [3, 5, 6].
their findings in 1981. They met personally when Whipple
visited Zaviacic in Bratislava in 1986 and again in 2005. They
had mutual interests in female expulsion of fluid from the The A Spot
urethra and thus began an almost 30-year history of collabo-
ration and consultation. Unfortunately, Dr. Milan Zaviacic, The A spot, the anterior fornix erogenous zone or AFE zone,
passed away on January 9, 2010. (unpublished data). was described by Chua Chee Ann, a Malaysian physician, as a
Dr. Milan Zaviacic, after conducting hundreds of studies, possible sexual stimulatory region in women. It is a region of
concluded that the fluid expelled through the urethra comes sensitive tissue on the anterior vaginal wall, proximal to the
from the female prostate gland. His book, The Human Female area of the vaginal wall through which the area of the G spot is
Prostate [11], cites most of his anatomical studies as well as stimulated, and just before the cervix [19]. Dr Chua suggests
chemical analysis of the fluid [16]. This fluid has been ana- that not all women will find this area spontaneously sensitive.
lyzed chemically by others, such as Addiego and colleagues He says that some women need a fair amount of practice with
[3], Belzer, Whipple, and Moger [7], and Rubio-Casillas and the A spot stimulation technique before the area becomes
Jannini [13], all of whom found that the chemical components erotically sensitized. He has a website about this area (www.
of the ejaculated fluid were significantly different from urine
Author's personal copy
Curr Sex Health Rep

The G Spot shows, Dr. Puppo has not conducted any research studies
himself. In addition, he states that Bthe correct anatomical term
The tissues that compose the area of the G spot have been to describe the erectile tissues response for female orgasm is
reported by many. In 1982, Perry and Whipple wrote that BThe the female penis^ [26, p.134]. When Dr. Komisaruk published
G spot is probably composed of a complex network of blood a letter to the editor about Dr. Puppos criticism of our re-
vessels, the parauretheal glands and ducts (female prostate), search, Dr. Puppo asked why our subjects used self-stimula-
nerve endings, and the tissue surrounding the bladder neck^ tion. He stated BWe have challenged him to repeat his exper-
[5]. In the Orgasm Answer Guide, Komisaruk, Whipple et al. iment on other women in our presence, and in the presence of
[20] noted that the area Jannini and colleagues call the clitoris- colleagues and journalists, but the women must not be self-
urethra-vaginal complex (also known as the area of the G spot) stimulated. Dr. Komisaruk rejected our proposal^ [27 p.1]. Dr.
contains several different organs in this highly complex body Komisaruk and I do not conduct research with journalists
region. BThese include 1) the anterior vaginal wall, 2) the ure- watching, and we would not request IRB approval for a study
thra, 3) the Skenes glands (also called the para-urethral glands as proposed by Dr. Puppo.
or female prostate gland), 4) perhaps other glands in this region
(vestibular glands, Bartholins glands), 5) the surrounding mus-
cle and connection tissue, and 6) perhaps even portions of the Conclusion
clitoris.^ [20, p. 101].
In 2010, in the section of the Journal of Sexual Medicine It is important for women and their male and female partners
called BControversies in Sexual Medicine,^ Jannini, Whipple to know that the phenomenon of female ejaculation is a nor-
et al. presented information about the area of the G spot. The mal part of healthy sexuality. Many women reported that they
conclusion was that although a huge amount of data have been had surgery to correct this fluid expulsion and others reported
accumulated in the last 60 years, more research is still needed that they stopped experiencing orgasm [4]. It is also important
[21]. In 2012 in the same journal, Kilchevsky et al. [22] reported for health care providers to be aware of this phenomenon and
that the female G spot is not a distinct anatomical entity found in to help their patients to realize that this is a normal, healthy
the anterior vaginal wall. Perry and Whipple [4], Ladas, Whipple part of female sexual responses. When writing about my re-
and Perry [5], Addiego et al., [3], Jannini et al. [21], and other search findings, I have ended one article with the following, BI
researchers have not defined it as a distinct anatomical entity in want to conclude by saying that orgasm in women is in the
the anterior vaginal wall. Again in 2012 in the BControversies in brain, it is felt in many body regions, and it can be stimulated
Sexual Medicine^, in the Journal of Sexual Medicine, research from many body regions as well as from imagery alone. Or-
was reviewed in which it was demonstrated that women can gasm is not a just a reflex, it is a total body experience. We
experience orgasm from many forms of stimulation and that the need to continue to be open to documenting the various plea-
assumption that women may experience only the clitoral, external surable sensual and sexual experiences reported by women. It
orgasm is not based on the best available scientific evidence [23]. is important to be aware of the variety of sexual responses that
Using modern imagery techniques, Jannini et al. [24] pro- women report and that have been documented in the labora-
vide data to support the anatomical relationships and dynamic tory. It is also important not to put women into a model of only
interrelations between the clitoris, urethra, and anterior virgin- one or two ways to experience sensual and sexual pleasure,
al wall, which led them to calling the region of the Grafenberg satisfaction, and orgasm. Women need to be encouraged to
spot the clitourethrovaginal (CUV) complex. feel good about the variety of ways they experience sexual
pleasure, without setting up specific goals (such as finding the
G spot, experiencing female ejaculation, or experiencing an
Controversy orgasm from vaginal stimulation). Healthy sexuality begins
with acceptance of the self, in addition to an emphasis on
Since at least 2006, Dr. Vincenzo Puppo has been publishing the process, rather than the goals of sexual interactions^ [23,
papers saying that the G spot does not exist. He states that p.959]. We need scientific studies and then acceptance of the
BGrafenberg discovered no G-spot in 1950; the supposed G- reports of womens sensual and sexual pleasure, we do not
spot must not be identified with Grafenbergs name^ [25 p.7]. need any more spots.
Drs. Perry and Whipple named this sensitive area to honor Dr.
Grafenberg for his earlier findings and his findings published Compliance with Ethics Guidelines
in 1950, Dr. Grafenberg did not name this area after himself.
Conflict of Interest Beverly Whipple declares no conflict of interest.
Puppo further states that Bthe claims by Frank Addiego, Bev-
erly Whipple, Emmanuele Jannini, Odile Bussion, Helen
Human and Animal Rights and Informed Consent This article does
OConnell, Irwin Goldstein, Barry Komisaruk and others not contain any studies with human or animal subjects performed by the
have no scientific basis^ [25 p.8]. As far as the literature author.
Author's personal copy
Curr Sex Health Rep

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