How our anatomy impacts orgasm - and what (if anything) we can do about it!
By Alyssa Quimby, MD
Last week I wrote about some surprising facts about orgasm such as how common issues with orgasm truly are and how exercise can improve orgasm in several key ways. This week, we’ll talk about how our anatomy impacts our ability to orgasm by looking at a scientific review on the topic. And if the term “scientific review” makes your eyes glaze over already – don’t worry! This is about orgasm afterall. I promise, even science can be sexy.
The study I’ll be discussing is called “Anatomic Variation and Orgasm – could variations in anatomy explain orgasmic success” And spoiler alert – the answer is absolutely yes…yes…yes!
Perhaps even more interesting (or at least helpful) is that even though there isn’t a ton we can do to modify the anatomy we’re born with (aside from major surgery) – there are still changes we can make that impact how our anatomy can improve orgasm.
So let’s get into it!
This was a review study looking at literature from almost 60 studies on aspects of pelvic anatomy and how they related to orgasm. It was put out by the University of Indiana in 2016 in collaboration with The Mayo Clinic department of Neurology. And what they found was the following:
Citoral location: The closer the clitoris is to the urethral meatus (opening of the urethra where urine comes out), the higher frequency of orgasm.
Clitoral nerve innervation: The pudendal nerve endings that are stimulated in the clitoris are responsible for orgasm – so the more in number, and the more sensitive these nerve endings are, in theory, the more frequent the orgasm.
Location of the G Spot: The Grafenberg spot or “G Spot” as most people know it is on the anterior (or front) wall of the vagina. It’s the location where the pudendal nerve branches that innervate the clitoris extend into the vagina. Because this is thought to be unique to each woman it has been postulated that by mapping the pudendal nerve branches individuals could determine where their erogenous zones are and modify sexual positions to stimulate these areas. Though none of the studies reviewed showed that location or size of the G spot impacted frequency of orgasm.
Penile Size: Penile size impacts frequency of orgasm for men (shorter length is associated with more difficulty with orgasm) but not for women. For women with male partners, their attractiveness to their partner more strongly correlates with orgasm success than penile size.
Clitoral size: No studies reviewed looked at clitoral size and it’s impact on orgasm. Though my hunch is that it’s not so much about the size but the location and nerve stimulation that’s more important.
Impact of the pelvic floor: Women with pelvic pain disorders from endometriosis, scarring from previous pelvic surgery or other causes, tend to have more pelvic floor muscle spasm. Pelvic floor muscle spasm, particularly of the levator ani muscle, is associated with sexual dysfunction. By injecting botox into this muscle as a means to relax it – sexual satisfaction scores increase!
Obesity/waist circumference: Obesity was looked at in how it relates to orgasm. The study found that the larger the waist circumference, the less frequency of vaginal (partner induced) orgasm but no difference in self-stimulated orgasm. Which presumably shows that obesity itself doesn’t change your anatomy to prevent orgasm but it can change your body image and/or your relationship with your partner and sex.
So data is fine and dandy, but what practical information can we take away from all of this?
For one, while anatomy is important, this study highlights for me a lot that we’ve already discussed in previous blogs and certainly in our sexual wellness workshop. Orgasm is COMPLICATED and it’s likely not just one thing that makes or breaks your orgasm.
But in terms of anatomy and the location of the clitoris, the fact that the closer the clitoris is to the urethral meatus the more likely you are to orgasm makes sense.
This means your clitoris is closer to the vaginal opening and therefore more likely to be stimulated during penetration.
But if this isn’t the case for you – you need to figure out a different way to stimulate your clitoris. It can be a finger or a vibrator (wearable or otherwise) or something else entirely.
Regarding nerve innervation of the clitoris and G-spot, while we can’t change this, we can increase blood flow and sensitivity in this area before penetration which can help with orgasm. We can do this in several ways. For some it’s with exercise. For some it’s with foreplay with oral sex, fingering or a vibrator to get to the point of increased sensitivity but not orgasm. And for some it’s with a suction type vibrator that brings more blood flow to the clitoris. Whichever starting point you choose, you can then move on to penetration to seal the deal.
The studies reviewed on penile size are interesting to me because they show what most women have always felt – size doesn’t really matter as much as men think it does. This also highlights the importance of our emotions on our ability to orgasm – if we feel attracted and connected to our partner we’re much more likely to orgasm regardless of the size of their penis.
So working on your relationship with more date nights, quality time together, seeing a couples therapist, time away from your kids/life stress is not only good for your relationship, it will also likely give you better orgasms. How cool is that?!
And in a similar vein, the less confident we feel in our own body, the less likely we are to orgasm – as evidenced by the data on obesity and orgasm. Which means, doing some deep diving into your body image and how you can feel better in your own skin will benefit your mind, your body, and your orgasm.
And lastly, let’s talk about pelvic floor work and how this impacts orgasm. As we discussed last week, strength of orgasm is tied to strength of the pelvic floor. However, there can be too much of a good thing here. When women have pelvic floor muscle spasms or pelvic floors that are too tight, this can interfere with orgasm as well. This is why finding a pelvic floor physical therapist who can help you determine if your pelvic floor is too weak or too tight (or perhaps both – yes this is a thing!) can be such a game changer when it comes to better sex.
So there you have it – a scientific review with practical tips you can try now to improve your orgasms. As I’ve said before, orgasm does not need to be the end all be all of sexual activity. But, they are still pretty great none the less.
