ll set the scene.

There will be a man and a

woman and they are having sex. Up
against a wall, in a bed, in a car,
anywhere. Vertically, horizontally. Clothed
or unclothed. None of that matters,
because the outcome will be the same.
Within a minute, usually, the man and
woman will have an orgasm at the same
time. It will be visible, spectacular,
satisfying. Then perhaps, she will have
another and another and another.
This scene will be familiar because it has
been enacted ever since sex was allowed
onscreen. But it is fiction. Not because
women can’t have multiple orgasms. But
if they do, it is unlikely to be because of
thrusting. That’s if they get an orgasm in
the first place.
The orgasm: “A feeling of intense sexual
pleasure that happens during sexual
activity.”
That much is known.
Things are better than they were in the
19th century, when male gynaecologists
examined women while standing behind a
cloak
But dive any deeper into the science of
women’s genitalia, and how they work,
and there will be surprises. We’re still in
a black hole of not knowing very much
about the sexual health and mechanisms
of half the population. A few things that
scientists and academics are still fiercely
debating: how a female orgasm is
triggered, what it does and what it’s for.
Things are better than they were in the
19th century, when male gynaecologists
examined women while standing behind a
cloak. But in the late 1970s, medical men
were still having earnest discussions in
the pages of medical journals about
whether menstruating women emitted a
poisonous substance called menotoxin,
that made flowers wilt. The US National
Institutes of Health only set up a
programme to research vaginal health in
1992 – the male orgasm was first
researched a century earlier.
There are just nuggets of information for
women: a paper from the 1930s
establishing that women reported having
several orgasms. In the 1960s, studies by
the superstars of sexology, Masters and
Johnson, and others that found 14-16 per
cent of women had multiple orgasms. Or
they said they did: proper analysis of
even the single female orgasm has only
become possible with the advent of
diagnostic tools such as the fMRI scanner
or EEG, which can see what happens in
the brain. Before that, researchers were
dependent on what women told them,
always an inadequate method (as humans
don’t tell the truth about sex) even when
– as in one survey by Florida State
University in 1991 – the respondents were
nurses, chosen for their articulacy about
body parts. (Nearly half of the 805 nurses
questioned reported multiple orgasms.)
Blood flow to the genitals, an important
part of orgasm, can now be tracked. We
can watch over 30 areas of the brain light
up, including ones that govern emotion
and joy, and release oxytocin, a feelgood
chemical that enables bonding. We can
see the physiological process of orgasm:
the tensing of muscles, the acceleration
of heart-rate, the blood flowing to the
genital area, and then the blessed feeling
of release and pleasure. At this point,
women and men diverge. For a start, the
man is more likely to have had an orgasm
than a woman.
A recent national study in the US found
that 95 per cent of heterosexual men and
89 per cent of gay men said they always
climaxed during sex. In heterosexual
women, the rate was 65 per cent (but in
lesbians 86 per cent). This is called the
“orgasm gap” and it is usually filled by
lying: 67 per cent of heterosexual women
admitted faking an orgasm in a 2010
study, while 80 per cent of men were
convinced their partner never faked it.
I look at that gap, and see the clitoris.
This mighty, magnificent organ, that has
more nerve endings than the penis,
exists, as far as we know, only to give
pleasure. As possibly the female orgasm
does: it has no known reproductive
purpose, but there is no clarity. One
theory: that the orgasm is a way for the
female body to capture more sperm with
the contractions of climax. This is called,
delightfully,“insucking” or “upsucking.”
The role of the female orgasm in
reproduction, or even human behaviour,
is, wrote one baffled researcher in the
journal Socioaffective Neuroscience &
Psychology, “a vexed question”.
After climax, or resolution, the man
enters a “refractory period,” where he
has to recover. This varies from a few
minutes in young men to 20 hours in
older ones, but however long it is, there
will be no response to sexual stimulation.
A woman has no such barrier. If she has
had an orgasm, and not faked it, she may
“plateau”, but within seconds or minutes,
or when she feels like it, given the right
stimulation – probably (but not only)
clitoral – she can feasibly orgasm again.
The circumstances required include her
environment, her partner (if she needs
one), and her knowledge of her own body.
It’s surprising, says Prof Linda Cardozo, a
spokesperson for the Royal College of
Obstetricians and Gynaecologists, “how
many women don’t even know what their
genitalia are called”.
We say vagina (the internal passage
leading to the cervix) when it’s the vulva
(external genitalia). We see images of
women with improbably shaven genitalia,
and supposedly female dolls with no
external labia. The authors of one study
that attempted to understand how
women’s genitalia varied in appearance
marvelled that “even some recent
textbooks of anatomy do not include the
clitoris on diagrams of the female pelvis”.
Using the right words is important too.
Vulva, not vagina
When women come to her thinking they
are dysfunctional in some way, says Sarah
Martin, executive director of the World
Association of Sex Coaches, one of the
most powerful things she can do is send
them away to look at their vulva in a
mirror. Using the right words is important
too. Vulva, not vagina. Otherwise, says
Vincenzo Puppo, a sexologist at the
University of Florence, women think of
their vagina as “just a hole”.
Martin also tries to get women to relax.
Before orgasm, alpha waves in our brains
slow down. A recent documentary on the
“super-orgasm” – actually multiple
orgasms – found that women who had
multiple orgasms had slower alpha waves
than the average woman. Their brains
were quieter, making more room for
pleasure. “The thing about sex of all
sorts,” says Martin, “is that sex takes
place in the body. It’s very hard to think
about pleasure if you are worrying
instead of focusing on your body.”
What might you be worrying about?
Probably whether you’re going to have an
orgasm.
Only about 20% of women can reach
orgasm by penetration alone; the rest of
us need clitoral stimulation. The vagina is
marvellous, but it is not packed with
nerve endings like the clitoris.
You may think differently about the
vagina if you believe in the G-spot. Puppo
has little patience with it, and labels
anatomical illustrations with: “the
invented zone for the G-spot”. It is named
after Ernest Gräfenberg, who wrote a
paper in 1950 about an erogenous zone
on the vaginal anterior wall. This was
launched into popular perception by an
eponymous 1981 book written by two
psychologists and a nurse, and by
countless articles since. The nurse was
Beverley Whipple, who told the Science
Vs podcast that her team had
investigated by inserting fingers into
women’s vaginas and feeling around the
clock. “Between 11o’clock and 1 o’clock,”
Whipple says, “we got a lot of smiles”.
What a great thought. Except Gräfenberg
never wrote about a G-spot. He did write
about women he called “frigid,” and
reported that some women were
stimulated by inserting hat pins. There is
still no good scientific data to prove its
existence, although plenty of women
believe they have one. “The G-spot,”
wrote the neuroscientist Terence Hines in
2001, “will remain a sort of gynaecologic
UFO, much searched for and discussed,
but unverified by objective means.” The
debate matters, says Puppo, because
“women who fail to ‘find’ their G-spot,
because they fail to respond to
stimulation as the G-spot myth suggests
that they should, may end up feeling
inadequate or abnormal”.
Cardozo, is circumspect. “There is some
doubt as to whether a particular spot in
the anterior vaginal wall is relevant in
terms of orgasm. When women have had
that part of the anterior wall excised,
they have still been able to orgasm.”
The G-spot debate hasn’t prevented
cosmeto-gynaecologists from offering
procedures such a G-spot amplification, a
concept first offered by the Californian
gynaecologist David Matlock, who
decided injecting collagen into the
vaginal wall would enhance sensation for
four months and the chance of single or
multiple vaginal orgasms. The American
College of Obstetricians disagreed,
deciding that the procedure had no
scientific basis, and anyway, Cardozo
says, “the herd of cows that provided the
collagen died out”.
Now the money-maker is the O-shot (O for
orgasm), an injection into the vaginal wall
of platelet-rich plasma (PRP) derived from
the woman’s blood.
“There is no scientific data on this,” says
Cardozo, with some finality, although PRP
has worked in dental patients, allegedly
enhancing the healing process.
You probably want tips for how to get a
multiple orgasm here. Or even a single
one. I prescribe better research, of
course. But also, better talking.
Communication is as powerful as lube,
whether it’s with a partner or a doctor.
For women who think they need to
surgically alter their vulva because they
are abnormal, the American College of
Obstetricians prescribes “a frank
discussion” about the wide range of
normal genitalia.
I also prescribe a feminisation of
gynaecology, but that is already
happening. I prescribe better knowledge:
women can orgasm singly and multiply
orgasm, but often it has to be learned.
The clitoris should be placed on equal
standing with the penis.
All these prescriptions can combine for as
pleasing an outcome as an orgasm, single
or multiple. Because it matters. The
female orgasm may have a reproductive
role or not: I’ll leave that up to scientists
to debate, and celebrate the fact that
they are debating it. Perhaps it’s enough
to know that an orgasm feels good, and in
these dark times you deserve it, or many.