Am I pregnant?

Dear Anxious,
It’s not unusual for the possibility of pregnancy to stir up some anxiety. Taking a store-bought urine pregnancy test is a quick and accurate way to know your pregnancy status and to plan next steps. And while feeling queasy in the morning can certainly be a symptom of pregnancy, nausea and the "moving" feeling in your intestines could also be linked to having a stomach bug, food poisoning, a food sensitivity, or a number of other conditions that aren’t related to pregnancy at all. If you're a college student, your student health center may offer pregnancy tests. Costs may vary based on how your school funds its health services and your insurance, and as required by law, the services they provide you would be confidential unless you tell them otherwise. That being said, since it was only last week, it may be too soon to detect on a pregnancy test.
Some people may experience pregnancy-related nausea and vomiting (often called morning sickness) as early as two weeks after conception, but others may not. Keep in mind that early symptoms of pregnancy vary from person to person and pregnancy to pregnancy. Even if some signs point to "yes," you won't know until you take a pregnancy test and find out for sure. 
When used correctly, urine pregnancy tests are 99 percent accurate and can help quell your anxiety or allow you to proactively plan out next steps for carrying out or terminating a pregnancy. To ensure accuracy, make sure you read the instructions and follow them as closely as possible. You may also find peace of mind visiting a health care provider to confirm a positive home pregnancy test.
Urine pregnancy tests are most accurate after your period is late, even if the label says it can detect pregnancy prior to a missed period. There’s no harm in taking a pregnancy test at any time. However, be aware that if you haven’t missed your period yet, you’re more likely to get a false positive or negative result, which might cause you some unnecessary stress. If you don’t menstruate or aren’t on a regular cycle, waiting three weeks after sex may produce more accurate home test results.

Pregnancy tests work by detecting a hormone called human chorionic gonadotropin, or hCG. The production of hCG begins when a fertilized egg implants in the uterus (typically around ten days after the egg is fertilized by sperm). It takes time for hCG levels to build up, so taking a pregnancy test right away can lead to an inaccurate result.
You don’t have to go through this alone. If you prefer, you can choose to schedule a pregnancy test with a health care provider. If you have more questions, or you’re not sure how to find a provider, you can visit the Planned Parenthood website for more information about clinics that provide pregnancy testing and can help you navigate your options if you're pregnant. If you have more questions or as a student, pregnancy testing services aren’t available on campus, you could try to seek services off-campus to access pregnancy testing and assistance with navigating options if you’re pregnant. Associated costs would be dependent on the type of test, and due to the Health Insurance Portability and Accountability Act, all information shared with a health care provider is confidential unless you give permission for it to be shared with others.
Although it may be a bit early now, taking a home pregnancy test in a few weeks may provide some answers. Even if the result is a surprise, the sooner you find out, the sooner you can learn what options are available to you.
Alice!

Menstrual synchrony: Fact or fiction?

Dear Hopes She's Right,
You and your mother aren’t the only ones debating the facts surrounding menstrual synchrony (the tendency of women's menstrual cycles to converge). A heavy flow of controversy has existed since 1971, when a researcher studied the menstrual cycles of menstruating women living in the same residence hall. The findings suggested that there were factors, such as pheromones, that influenced the timing of a person’s period, causing it to shift and synchronize among women who live together. Researchers who have tried to replicate this study indicated that there may have been some methodological errors in the original study design. Furthermore, recent research on menstrual synchrony doesn't support the 1971 finding. What’s likely happening is that individuals with different menstrual cycle lengths live together long enough that there are times when their periods occur at the same time. 
While it’s unlikely that pheromones are shifting the timing of menstruation, there are some other factors that might have an impact:
Birth control pills: The birth control pill operates by altering the levels of progesterone and estrogen in the body, thereby influencing if, and when, menstruation occurs.

Extreme stress: Having high levels of stress, worry, or anxiety can lead early or late periods.
Chronic illness: If living with a chronic illness or taking certain medications, it may cause periods to be irregular.
Eating disorders: Anorexia, bulimia, binge eating, and other calorie-controlled patterns of eating can impact the timing of periods or whether it even comes.
List adapted from Cleveland Clinic.
Until more is known about good ol’ Aunt Flo, it’s difficult to definitively say whether menstrual cycles can sync up. In the meantime, you can check out the various studies on the topic, or you can start your own investigation among your close friends to see how you all align.
Here’s to getting on the same page, if not the same cycle!

Safer sex between women

Dear Reader,
It’s great that you’re asking these questions because it's a common misperception that sex between female-identifying partners is without risk. While women who have sex with women (WSW) are typically at lower risk for sexually transmitted infections (STIs), including HIV, they’re still at risk for some infections. As such, practicing safer sex is still a good idea to keep both you and your potential partner(s) safe. Read on for more about infections for which WSW may be at risk, how they’re transmitted, and prevention strategies to utilize while still keeping it fun in the bedroom.
Though there are a number of STIs that are less common among WSW, sexual contact between female partners does still provide opportunities for exposure. Infections may still be passed in a number of ways, including through skin-to-skin contact, vaginal fluids or menstrual blood, and shared use of sex toys. STIs that are less likely to be transmitted between female sex partners include gonorrhea, hepatitis B, syphilis, and HIV. It’s been noted, though, that WSW who have been diagnosed with any of these less common STIs often have previously had sex with male-identifying partners at some point in their lives.
The STIs that WSW are at a higher risk for include:
•Bacterial vaginosis
•Chlamydia
•Genital herpes
•Human papillomavirus (HPV)
•Trichomoniasis 
•Pubic lice

List adapted from the U.S. Department of Health & Human Services Office on Women’s Health.
With this in mind, it’s wise to consider how you and your partners might protect each other and reduce the risk of infection. Safer sex between women involves many of the same strategies as for any set of partners, and the ideas below could be part of your sex life while keeping it safe and fun:
•During oral sex, cover the entire vaginal or anal area with a dam (a square of thin material, often latex or polyurethane), a cut-open condom, or latex or nitrile glove. Use creative means of keeping the material or wrap in place, such as a garter belt, to leave your hands free to roam. During vulva-to-vulva contact, a similar barrier may be placed over the vaginal area.
•If you or your partner plan on getting handy (i.e., manual penetration or fingering), a pit stop in the restroom to wash your hands is a wise decision. For the penetrating partner, making sure to cover cuts or sores on the hands may also help to reduce the risk of infection; this may be done by using gloves, condoms, or finger cots. It’s also recommended that you swap out for new materials when moving from the anus to the vagina or between partners.
•Is a little playtime with sex toys in order? Then it’s good to make sure that the toys you’re using have been washed before and after use, particularly if you plan on sharing. You might also choose to use a condom to cover the toy when in use (and use a new one if you swap with a partner).
This isn’t an exhaustive list of all the creative activities you may get into between the sheets. The bottom line here is that you might use some of the tools and strategies to limit contact with your partner’s skin, mucous membrane(s) (such as your mouth or vagina), or bodily fluid(s) that may put either of you at risk for infection during sex. Lastly, one more critical tool in your safer sex toolbox is having a frank conversation with your partner about STIs, safer sex methods, what activities are of interest, and whether or how often to get tested. You can check out the related Q&As for more information and tips on talking about safer sex. And now that you're informed, it’s not a bad idea to stock up on some supplies of your choice and enjoy!
Alice!

Can you get pregnant the first time?

Dear Reader,
The short answer is yes; someone can absolutely get pregnant the first time they have vaginal sex. And many people have. When one partner’s semen (cum) comes into contact with another partner’s vagina, pregnancy is theoretically possible — regardless of whether it’s anyone’s first time or their thousandth. Fertility, however, can be fickle. Some people who desperately wish to conceive have to try for months or years before success. Other people unexpectedly conceive the first time they have sex. Ready for some more baby-making biology? Read on!
In a typical menstrual cycle, hormones stimulate the ovaries to release an egg, a process known as ovulation. Ovulation most often happens around day 14 of the typical 28-day cycle. It’s good to note that many people’s cycles fall between 26 to 32 days but the exact timing of ovulation can vary from person to person. After ovulation, the egg journeys down the fallopian tube where it has about 24 hours to meet up with a sperm cell. If fertilized by sperm, the egg moves to the uterus, where it attaches to the uterine lining. At that point, early pregnancy symptoms begin and periods generally stop.

Fertility basically comes down to this: pregnancy is most likely to occur any time someone has unprotected sex during ovulation (or on the days just before ovulation, since sperm can live in the reproductive tract for up to six days). That said, determining when someone is ovulating isn't an exacting process. Since many people don’t have perfectly regular cycles, physical signs of ovulation are often more reliable than an expected calendar date. If you’re interested in becoming pregnant, you may find it useful to learn to recognize the times when you're most fertile. You can learn more about the menstrual cycle and fertility awareness in the Go Ask Alice! Sexual and Reproductive Health archives. A health care provider can also be a useful resource about menstrual history and cycle.
What's the take home message? When sperm and egg cells get to minglin’, pregnancy is a possibility regardless of anyone's previous sexual activity. If pregnancy isn't in your plans, have no fear! Condoms, when used consistently and correctly, can offer reliable protection against pregnancy and many STIs. Lots of other forms of birth control, both hormonal and non-hormonal, are available as well. You can check out the Contraception category for more information about different options. Using this information can help to help plan ahead, whether the goal is to increase or decrease the risk of pregnancy. Having an open conversation with sexual partners can help to ensure that they're on the same page and that they're maximizing pleasure between the sheets.

Masturbating before sex: Males, females, and more

Masturbation is a natural activity that many people enjoy. It can help people discover their sexual preferences, learn about their body, and provide themselves with pleasure.
Some people may have heard that masturbating before sex can desensitize the penis and make males “last longer.” However, there is no scientific proof of this.
It may work for some people, however, and there are plenty of anecdotal claims to support this.
Masturbating before sex can also be enjoyable foreplay. It may help a person become both physically and mentally turned on before sex. Some people believe that masturbating with another person can help them feel more open and connected to their partner.
In this article, learn about the benefits of masturbating before sex for males and females, as well as some of the things to be aware of.

Males
Many males choose to masturbate before sex because they feel that it can help prolong the duration of sex. However, there are some things to consider.
Sexual dysfunctions are common among males.
As a study in the journal Fertility and Sterility notes, ejaculatory dysfunctions are one of the most common types of sexual dysfunction. These types of dysfunctions include premature ejaculation, no ejaculation, or other problems surrounding ejaculation and orgasm.
Many people are familiar with the claim that masturbating before sex can help a male “last longer” during the act of sexual intercourse itself.
There may be a few reasons for this. Much of the issue may be psychological. For example, a person may feel pent up or have unreleased sexual tension. This may cause them to have hurried sex, wherein the person may focus on releasing this tension in the form of an orgasm.
By masturbating beforehand, the person can release that built up sexual energy and then feel that they can focus more on enjoying the entire sexual act, rather than just the orgasm.
Refractory period
A phenomenon called the refractory period may help support this idea. The refractory period is the recovery time a person has to go through after an orgasm before they can orgasm again.
Following an orgasm, males usually cannot have another orgasm right away. Their penis will become flaccid and lose its ability to stay erect. The penis can also be very sensitive to touch after orgasm, causing pain and throbbing if the person or their partner continues with stimulation.
As a study in the journal BJU Internationalnotes, this is partly because the body releases more of the hormone prolactin after orgasm. This hormone seems to block off the sexual pleasure a person can feel during the refractory period.
Because of this, some people think that masturbation can desensitize them to the pleasure of sexual intercourse.

In reality, the refractory period is typically short — though it can vary. As the International Society for Sexual Medicine note, the refractory period of younger males is usually only a few minutes. However, older men may need 12–24 hours to recover. After this, they can achieve erections and have orgasms again.
Everyone is different. Some males do feel that it is harder to have a second orgasm than the first one, and they may last much longer during sex because of this.
For older males who experience refractory periods that last hours, masturbating before sex may help prevent them from having an orgasm during sexual intercourse. This may allow them to enjoy much longer periods of sexual intercourse.
This may make masturbating before sex beneficial for some males who tend to experience early ejaculation.
Other issues
For males who experience softer erections or who find it difficult to achieve an erection, masturbating before sex may make it even more challenging to get a second erection in time for intercourse.
People who find it difficult to get or maintain an erection may want to avoid masturbating before sex.
Masturbating before sex may also be a good way for females to reduce tension and find release before the act of sex.
Some females also experience a refractory period after orgasm. However, females have a slightly different experience to males.
Most males can only have one orgasm before their refractory period, and they experience a long refractory period.
Females, on the other hand, tend to experience much shorter refractory periods. During these short phases, the vagina and clitoris may still be very sensitive, and the person may not enjoy stimulation.
However, this phase tends to end quickly. This is why it is not uncommon for females to experience multiple orgasms per sexual encounter.
Some may experience a longer refractory period than others, and they may feel less sexual desire during this time. In these cases, masturbating before sex may not be a good idea, as it may reduce how much a person wants to have sex.
Benefits
Masturbating before sex does have some additional benefits for both males and females, though each person may experience them in different way.
We cover some of these benefits in the sections below:
Stress or tension relief
Pleasuring oneself before a sexual encounter may help reduce stress, as the brain releases feel-good endorphins after orgasm. This may be helpful for people who are nervous around their partner or who experience sex anxiety.
Masturbating before sex may also help remove any tension from the situation, as a person no longer feels that they have to orgasm to enjoy themselves sexually.
This may be beneficial for both partners, as the sex may become more about the act itself rather than simply orgasm.
Comfort and avoiding premature ejaculation
In males who experience premature ejaculation, masturbation before sex may help them last longer, as it may take them longer to reach their second orgasm. This is not a guarantee, however.
Those who masturbate before sex may also feel greater relaxation and less tension about the act of sex itself.
For females, the vagina may also be more lubricated following sufficient arousal, making sex a more enjoyable experience.
Intimacy and achieving orgasm
Masturbating before sexual intercourse may also help some people achieve orgasm.
People who find it difficult to climax from sexual stimulation may find that masturbation warms them up to sexual intercourse. This may make it more enjoyable or make it easier for them to orgasm.
Masturbating with a partner before sex can also bring two people closer together.
For many people, masturbation is something done alone. However, masturbating with a partner is very intimate, and it allows each person to understand what stimulates their partner.

Masturbation before a workout: Is there any effect?

Masturbation before a workouMasturbation is a healthy and safe sexual activity that has links to numerous health benefits, such as pain relief and stress reduction. Opinions on how masturbation affects exercise vary, but there is not enough evidence to support one view over the other.
Some members of the health and fitness community are in a debate about the potential risks and benefits of masturbation before a workout.
Some people believe that masturbation can influence levels of testosterone, which plays a crucial role in promoting overall physical fitness. They also think that masturbation and other sexual activities can lead to improvements in mood and lower stress, which can indirectly improve physical performance.
However, other people think that masturbation adversely influences physical performance due to excess energy expenditure. Continue reading to learn about the possible benefits and side effects associated with masturbating before a workout.

How masturbation and abstinence affect testosterone
The debate about whether masturbation is beneficial before exercise seems to focus on how masturbation influences testosterone.
Testosterone is the primary male reproductive hormone, but females also produce it. It plays a crucial role in promoting physical fitness among both males and females. According to one animal study, it plays a vital role in muscle protein synthesis.
Another review that included studies on humans suggests that testosterone also plays a role in bone formation.
With that said, the question remains whether masturbation significantly affects testosterone levels.
What do the studies say?
Testosterone levels naturally increase during sexual arousal and decrease after orgasm, but it appears that masturbation does not significantly impact a person’s level of testosterone.
The findings of a 2001 study showed that orgasm due to masturbation did not affect plasma testosterone levels. However, the authors observed higher concentrations of testosterone in men who abstained from sexual activity for 3 weeks. This was a small study with only 10 participants.
In another early study from 2003, researchers observed that testosterone levels fluctuated minimally during the first 5 days of sexual abstinence, peaked at 7 days, and then remained constant. The findings of this study suggest that short periods of abstinence may result in temporary fluctuations in testosterone levels.
Benefits of masturbation
Although masturbation has little to no effect on testosterone levels, it may still benefit a person’s workout performance.
However, there is not enough scientific research to support a direct link between masturbation and better physical performance.
Current scientific research does suggest, however, that sexual activity may enhance people’s overall health.

A recent study on adults who had experienced a heart attack suggests that those who frequently engaged in sexual activity had better long term survival rates.
Hormones, such as dopamine, norepinephrine, and oxytocin, increase during and following sexual climax
. These hormones positively affect mood and could influence the mental aspect of exercise by improving a person’s frame of mind and motivation during a workout.
Side effects of masturbation
Masturbation is a safe sexual activity that has few, if any, long term side effects.
One 2016 review looking at sexual activity and competitive sports concludes that there is not any evidence to suggest that masturbation has a direct adverse effect on overall physical fitness or sports performance in males or females. Anecdotal evidence also indicates that having sexual intercourse about 10 hours before taking part in a sports competition may have a positive effect on performance.
Masturbating too frequently can lead to temporary side effects, including:
overly sensitive or tender skin near the genitals
swelling or edema of the penis
decreased sensitivity
fatigue
It appears that masturbation induces similar effects in both males and females. Engaging in sexual activity increases testosterone levels, reduces stress, and relieves pain.
Male and female bodies respond differently to testosterone. Males naturally have higher levels of testosterone than females, which leads to the development of some typical male characteristics, such as body and facial hair.
These characteristics do not usually occur in females producing normal levels of the hormone. Testosterone also plays an essential role in sperm production and egg development.
Currently, scientific research has not revealed a direct relationship between masturbation and exercise performance in males or females.
However, the findings of one recent study
suggest that regular sexual activity may improve levels of life satisfaction and enjoyment among older adults.
Summary
Masturbation has little to no direct effect on people’s workout performance. Although testosterone levels fluctuate immediately after orgasm, the change is temporary and unlikely to affect a person’s physical fitness.
Masturbation may stimulate the release of endorphins and other feel-good hormones. These hormonal changes can help reduce stress and improve mood.
People should structure their routines accordingly. If masturbating makes someone extremely tired, they may want to avoid it before a workout. Masturbating has few, if any, side effects.

t: Is there any effect?

Some Women Orgasm During Exercise

Some women reach orgasm during exercise, especially those that involve the core abdominal muscles, researcher Debby Herbenick, and J. Dennis Fortenberry, M.D., both from Indiana University, wrote in the journal Sexual and Relationship Therapy. Exercises most likely to be associated with female orgasms are abdominal exercises, weight lifting, spinning/biking, and climbing poles or ropes, the author added.
The researchers explain that “coregasm” – reaching an orgasm from exercising the core abdominal muscles – has been mentioned in the media for some time. However, they add that the findings in this latest study are new.

Herbenick said:Herbenick, and Fortenberry carried out online surveys which included 124 adult females who said they had had an orgasm while exercising, known as EIO (exercise-induced orgasm), and another 246 who reported having experienced exercise-induced sexual pleasure (EISP). They were aged form 18 to 63 years, the majority of whom were either married or in a relationship. Approximately 69% of them said they were heterosexual.The researchers found that:
Approximately 40% of those who had experienced an orgasm or sexual pleasure during exercise had done so at least ten times
Those who reached orgasm while exercising said they felt self-conscious when exercising in public places.
About 20% of those who experienced orgasm while they exercised said they were not able to control their experience
The majority of those who reached orgasm during exercise said they were not having any sexual fantasy or thinking about an attractive person during their experience
In the EIO group, 51.4% said they reached orgasm in connection with abdominal exercises they had done during the previous ninety days
26.5% of those in the EIO group linked their experience to weight lifting
20% of the EIO women associated their experience to yoga
15.8% of the EIO females linked their experience to bicycling
13.2% of the EIO women connected their experience to hiking/running
The most likely abdominal exercise to produce a female orgasm was the “captain’s chair”. The exerciser rests her elbows on padded arm rests with her back against a support – her legs hang free – she raises her knees upwards towards her chest several times.
Herbenick says that nobody is sure what mechanisms are involved during exercise to induce an orgasm or sexual pleasure. Future studies, hopefully, will be able to determine that.

The authors hope that women who experience either orgasm or sexual pleasure during exercise may feel, after reading about this study, that their responses are normal experiences.

Whether or not specific exercises may help improve a female’s sexual experiences was not an aim of this study. The authors caution readers to make no assumptions until other more specific studies have been carried out.Even though they had not set out to determine how common orgasms or sexual pleasure are during exercise among women, the authors believe it is not rare – in just five weeks they managed to recruit 370 adult females who had such experiences.

How do orgasms affect the brain? Study investigates

When it comes to the human orgasm, research has primarily focused on how this intense feeling of sexual pleasure has evolved. In a new study, one researcher has delved into a relatively understudied area of human climax: how orgasms affect the brain.Described as a powerful, pleasurable release of accumulated sexual tension, the orgasm is perceived as the epitome of sexual pleasure for both men and women.
During orgasm, an individual may experience a rise in blood pressure, an increased heart rate, heavy breathing, and rhythmic muscular contractions.
But while the signs and sensations of an orgasm might be clear, the underlying mechanisms of this sexual response – particularly its neurophysiological effects – remain uncertain.
Study author Adam Safron, Ph.D., of the Weinberg College of Arts and Sciences at Northwestern University in Evanston, IL, notes that the majority of research relating to the orgasm has focused on its evolutionary functions.
A study reported by Medical News Today earlier this year did just that; researchers suggested that the female orgasm once played a role in ovulation.
For this latest study – recently reported in the journal Socioaffective Neuroscience and Psychology – Safron set out to gain a better understanding of how the human orgasm affects the brain.

How rhythmic stimulation can induce a ‘sexual trance’
To reach his findings, Safron analyzed an abundance of studies and literature that have investigated the brain and body’s response to sexual stimulation.
He used the information to create a model that sheds light on how rhythmic sexual activity affects rhythmic activity in the brain.
Safron explains that rhythmic sexual stimulation – if intense enough and if it lasts long enough – can boost neural oscillations at correlating frequencies, a process called “neural entrainment.”
This process may be responsible for what Safron describes as a “sexual trance,” where sole focus is on the immediate sensation experienced.
Brain responses to orgasms and rhythmic music, dance are comparable
Interestingly, Safron also identified similarities between orgasms and reflex seizures, noting that both of these experiences can be triggered by rhythmic stimulation that induces rhythmic activity in the brain.
Additionally, the researcher found that the way the brain reacts to rhythmic sexual stimulation is comparable to the way it responds to rhythmic music and dance.
“[…] although obvious in retrospect, I wasn’t expecting to find that sexual activity was so similar to music and dance, not just in the nature of the experiences, but also in that evolutionarily, rhythm-keeping ability may serve as a test of fitness for potential mates,” says Safron.
He adds that rhythmic music and dance have served as a key part of mating for hundreds of millions of years, and his findings are consistent with this fact.
Safron says much more work needs to be done to fully understand the neurophysiological effects of orgasms, but he hopes his study paves the way for such research.
“Before this paper, we knew what lit up in the brain when people had orgasms, and we knew a lot about the hormonal and neurochemical factors in non-human animals, but we didn’t really know why sex and orgasm feel the way they do,” he says. “This paper provides a level of mechanistic detail that was previously lacking.”

Masturbation: Do Boys Do “It” More and Better Than Girls?

One might argue that given the context of Sweden’s high degree of gender equality, an open and positive approach to sex education, and sexually liberal attitudes, that anything Swedish adolescents might say about sexual issues will not be applicable to U.S. adolescents. Any differences between Swedish and American youth might be the result of reporting styles—perhaps just as many American youth masturbate and begin doing so at about the same age but they are less likely than Swedish youth to report it given the more conservative sexual attitudes and values of American culture. On the other hand, those same attitudes/values might inhibit not only reporting masturbatory activities but also might actually prevent some adolescents from engaging in masturbation, experiencing orgasms, or having positive feelings about their orgasms.

What did Swedish high school seniors report (Driemeyer et al., 2017)?
Over 3,000 seniors (mean age 18.3 years) from public and private schools completed an anonymous questionnaire regarding various aspects of sexual attitudes and behaviors. Nearly all boys (98.9%) and most girls (85.5%) reported that they had masturbated, usually beginning during early adolescence. Most youth had positive attitudes about masturbation and enjoyed the experience. There were several differences between boys and girls.

Boys
1. Began masturbating a year earlier than girls—12.5 versus 13.7 years of age
2. Were more likely to have fantasies during masturbation
3. Were more likely to orgasm during masturbation
Girls
1. Were more likely to experience their most pleasant orgasms during masturbation
2. Were more likely to use objects such as sex toys and vibrators during masturbation

Three Clusters of Masturbation Experiences
The authors found three clusters of adolescents.
The first typified the majority of both boys and girls: they had positive attitudes about masturbation and orgasmed during masturbation. However, their preference was to have orgasms during “other activities” (sex). Some of those who preferred their orgasms alone might have felt this way because they “use a certain technique during masturbation that cannot be, or is not intended to be transferred to sex with a partner.”

The second cluster, characteristic of a minority of boys and girls, was generally the inverse of the first.
The third was experienced by about one-quarter of the girls: they had the lowest frequency of orgasms during masturbation, more orgasms during partnered sex, positive attitudes about masturbation, fantasies and object use about average, late onset of masturbation, and a large number of sex partners. Though orgasm frequency was low, their attitudes toward masturbation remained positive. The authors speculated that these sexually active and open-minded girls connected sexual pleasure (including orgasms) to romantic relationships rather than to solo sex.

Reflections
Although it’s difficult to directly compare these Swedish students with populations of adolescents from other countries and previous generations, the general patterns were consistent with what we know. It is worth noting that the questionnaire administered would be extremely difficult to give in many U.S. school districts because of our fears about asking youth about their sexuality—at least without parental approval.

Although there is value in these massive questionnaires given anonymously, I believe that we should supplement them with in-depth discussions/interviews with adolescents about their sexuality, including masturbation. For example, here are questions that I asked young men regarding their first masturbation:
•How and when did your first masturbation occur? What happened to provoke it? What were the circumstances?
•What did you do?
•Did you fantasize? What was the content of the fantasy?
•How did you learn how to masturbate? Who taught you?
•How did you feel afterwards?
•Who did you tell? How did they react? Why did you choose to tell or not tell others?
•Did this lead to future masturbation? Why or why not? Please elaborate.
•What were the impacts of these activities for you then and now?

I have discovered little information about these issues—for boys or girls. No surprise here.
My hope is that adolescents of all “clusters” will feel, in the words of the authors, “more entitled to experience sexual pleasure just for themselves without feeling selfish, guilty, or dirty.”

Do Try This at Home

It’s tough recruiting people for sex
research. Oops. Small typographical blip there. But this slight Freudian penis…I mean “father”…sorry…”slip” illustrates something important about sex research. Our recent paper looking at a proof of concept for investigating orgasmic function in women (1) has attracted a bit of press interest. The first reporter (2) wanted to check that I wasn’t some sort of pervert (lucky guess on his part, but I think I managed to put him off the scent) so I thought it was worth an explanatory blog.

Faster, Harder, Deeper
Nothing takes us to the heart of human nature faster than sex research. We are intensely interested in it, yet we find it very tough to think about it clearly. Without giggling. Or guilt. Uninhibited responses usually require privacy and/or trusted partners. This means that for an ethologist—someone who tries to study natural behavior in natural settings—we have a problem. Lab-based research has lots of control but clinical settings are not typically erotic hot-beds of passion (unless you are into that sort of thing). Humans typically have sex in private (unless you are into that sort of thing) and this makes natural sexual behavior tough to study.

On the Horniness of a Dilemma
The brave voyager Odysseus had to navigate between the monster Scylla—who would habitually munch half a dozen sailors if you got too close, and the whirlpool Charybdis, who would suck your entire ship down to its doom. To be caught “between Scylla and Charybdis” is often translated as “between a rock and a hard place” or “between the devil, and the deep blue sea” but that’s not really what the original story implies. There is nothing much to choose between a rock and a hard place, and the devil will devour you just as surely as will the deep blue sea. Let’s face it, to lose half a dozen sailors is bad, but to lose the whole ship is game over. To be between Scylla and Charybdis then is really to accept a lesser evil as the price of transit.

Sex research is caught between the Scylla of lack of control over variables, and the Charybdis of not studying actual sex at all. Masters and Johnson, two of the giants upon whose shoulders sex research stands, carried out investigations into female orgasm in the laboratory. (3) The essence of their research was to take a half dozen (very confident) female participants, insert a glass tube containing a camera (a piece of kit appropriately called “Ulysses”) inside them, and then have them masturbate the outer part of the clitoris (the glans) until they orgasmed. They reported that they had not filmed anything of interest, and on the back of this research rests the bulk of modern research into female orgasm.


State of Play
The bulk—but not the entirety. At roughly the same time as Masters and Johnson were getting women to masturbate in a laboratory, the husband and wife team of Fox and Fox were measuring themselves having actual sex in their actual bedroom (with their actual selves) with telemetry devices inserted to measure pressure changes attendant on the female partner orgasming. (4) I’ve discussed all this research before here and here. And it is still a vexed question as to what, if anything, female orgasm might do. Very, very roughly there is a dispute between

1) The majority: Who think female orgasm does nothing, which I discuss here (5)
 2) A group of researchers who think that it cements bond between partners (6)
 3) Another group of researchers who think that it contributes to fertility in some way—either by making sperm more active, or by directly speeding up sperm transport. (7)
 4) Some combination of the second and third possibilities

Here’s how we tried to navigate the Scylla of laboratory control and the Charybdis of the loss of validity.
How to Not Lose Love's Labor
One of Master’s and Johnson's original selection for participants had this to say about their methodology
“I just know that if someone would watch me copulate with a partner, the best I could do would be a little outer clitoral climax, as fast as possible to get the silly situation over with. I do not call that an orgasm." (7)

In other words—lack of privacy is likely to inhibit sexual response.
We probably wouldn’t divide orgasm into clitoral and vaginal these days, knowing now that the clitoris is a large complex organ most of which is inside. However—not all of it is always aroused during sex, and this means that there is considerable variation in the nature of the experiences that women report during various forms of sexual behavior.(8) We wanted to measure possible sperm retention (options 3 and 4) and we did this by having women (in the privacy of their own relaxed settings) insert gel with similar properties to sperm, along with a device for collecting said substance—much of which gets ejected in a process called back flow—up to an hour following sex. But this presents a problem. If the majority of sensitive tissue is internal, how do we stimulate these areas while maintaining the ability to measure whatever is ejected in back flow?

Step forward the Hitachi Magic Wand™. Hitachi deny that this device is anything other than a body massager. Well, that’s up to them. But some people have discovered that its deep tissue massaging properties (all 6000RPM of them) are just the thing for stimulating sensitive internal clitoral tissue through the outer walls of the body. In other words, we could create deep orgasms from the outside while keeping a collecting device in place.

And this is what we found.
In summary, when women orgasm deep inside, they appear to retain about 15 percent more material than when they do not. This is an interesting figure, and corresponds very nicely with the figures reported in the farming industry (who are lot less squeamish than us) when they use various techniques to maximize sperm retention during artificial insemination. (1)

Conclusions
But—some words of caution. The sample is, as yet, too small to draw firm conclusions. Also, the methodology does not distinguish between the rapid sperm transport theory of the Foxes, and the increasing of sperm viability theory of Levin (because both predict reduced back flow following female orgasm). It’s also entirely possible (likely even) that female orgasm has pair bonding features as well as sperm-retention ones—a sort of “try before you buy” function and our methodology has completely side-lined some potentially important partner characteristics such as attractive smell (9) which we think may advertise immune system compatibility.

But—you can’t have everything. With those caveats in mind we are cautiously excited. This suggests a protocol that is relatively easy to try at home, and could have a small but significant impact if rolled out with (say) persistently infertile couples, if we get access to larger samples to perform randomized control trials (the gold standard of clinical work). Time will tell.

Are You an Animal Person? It Could Be In Your Genes

Occasionally a sentence will change your life. In my case, it was when the doctor looked up from the sonogram screen and said “Congratulations. You’re having twins.” After the shock wore off, I realized that twins are gift to a biological psychologist. I was going to experience the nature-nurture issue up close and personal.
Our son Adam and his younger sisters Betsy and Katie (fraternal twins) were raised in the same home, exposed to the same foods, went to the same schools, and had the same family pets And, all three turned out great. In many ways they are similar, but in some ways they are very different. Oddly, Adam is the only one with a Southern accent. And he and Katie became extreme whitewater kayakers. Betsy, on the other hand, had no interest in running waterfalls in the middle of winter.
Our children also differ in their relationships with other species. Adam is the only real animal person. He and his wife are devoted to their two cats, and for ethical reasons, he refuses to take his son to the zoo. Katie is not particularly concerned with animal welfare, but she has not eaten meat since she was 12. Her twin sister, on the other hand, has scarfed down crickets in Mexico, worms in Thailand, and (gasp) whale meat in Japan. All three were exposed to snakes early on when I maintained a reptile behavior lab. But, in recent years Katie has developed a mild snake phobia.
Why Are Children In The Same Family So Different?
The patterns of similarities and differences seen in my children are common; you probably see them in your own family. Why are children in the same family so different from one another? This question was the title of a classic 1987 article by the behavior geneticists Robert Plomin and Denise Daniels. Behavior geneticists love twins. The reason is that identical twins develop from the same fertilized egg and share 100% of their genes while fraternal twins develop from separate fertilized eggs, and, like non-twin sibs, have 50% their genes in common.
If genes play a role in the development of psychological traits, pairs of identical twins should be more similar than pairs of fraternal twins. Differences in the similarities of identical and fraternal twins can be used to calculate a statistic is called heritability. A high heritability indicates that most individual differences in a trait are due to genes while low heritability means that genes have little influence on behavioral differences. For example, genes account for about 99% of differences in eye color, 0% of differences in religious denominations, and 34% of differences in the frequency that women have orgasms during sex (see this article).
Studying Vets With Pets

You may be asking yourself, “What does twin research have to do with human-animal interactions?” Studies have found that kids who were raised with pets tend to keep pets as adults. Further, adults tend to stick with the type of pet they grew up with. These results, however, could be due to either genes or early experience. That’s where twin studies come in. I am happy to report that, for the first time, a group of twin researchers has made a stab at untangling the roles of heredity and environment in our relationships with companion animals.
The research, which will appear in the December issue of the journal Anthrozoos, was conducted by a team lead by Dr. Kristen Jacobson of the University of Chicago. The subjects were part of the Vietnam Era Twin Study of Aging, an ongoing study of over 1,000 male twins who served in the military between 1965 and 1975. Roughly equal numbers of identical and fraternal twins participated in the research. Every couple of years, the men spend several days undergoing physical exams and filling out questionnaires. In a recent session, they were asked, “During the past 30 days, how often did you play with pets?” Bingo! Kristen’s team realized that this question could be used to assess the role of genes in human-pet interactions.
The research team found that the identical twins pairs were more similar than the fraternal twins in whether they had played with pets. After crunching the numbers, Kristen determined that about 35% of differences in whether the participants played with pets was inherited. (Interestingly, genes have the same degree of influence on differences in the percent of time women experience orgasm during sex.) So it appears that a throw of the genetic dice plays a substantial role in whether men are “animal people” (and whether women regularly have orgasms).
Was I surprised by these findings? No. After all, genes influence a wide array of human traits. But I was surprised at what Kristen’s group discovered about the effects of family environment on human-pet interactions.
The Surprise
Factors like living in the same house, eating the same food, and playing with the same pets constitute what behavior geneticists call shared environment. These factors tend to make siblings alike. In contrast, idiosyncratic events that kids experience like having different kindergarten teachers or being bitten by dog tend to make siblings different from each other. These are called non-shared environment.
So what is more important in how kids turn out - shared environment or non-shared environment? You would think that being raised in the same home by the same parents with the same companion animals would make siblings alike when it comes to playing with pets. But you would be wrong. Indeed, the big surprise of Vietnam Era Twin Study was that shared environment had virtually no influence on the frequency that the vets played with pets. (By the way, shared environment also plays no role in the percent of time female twins have orgasms during sex.)
So when it comes to interacting with companion animals (and female orgasm), non-shared environment and random factors are considerably more important than genes. In Kristen's study, they explained a whopping 70% of differences in playing with pets. These results suggest that being raised in “pet friendly” family has surprisingly little impact on how people interact with companion animals when they grow up. Go figure.
What’s Next?
This initial foray into the behavior genetics of human-animal interactions produced some fascinating results. First, the results are consistent with other studies showning that enviromental factors tend to make children in the same family different rather than similar. Kristen’s findings also lead to a host of other questions. For example, are genetic differences in playing with pets rooted in differences in love for animals or unrelated factors? These might include general health and fitness, playfulness, or sensation-seeking. And what specific early experiences produce differences in attachment to pets in adults? Finally, the results suggest that heredity might explain why some people derive health benefits from living with pets while other do not.
While I cringe when I say it… ”More research is needed.”
                            *     *     *     *     *
Jacobson, K., Hoffman, C., Vasilopoulos, T., Kremen, W.S., Panizzon, M. S., Grant, M.D., Lyons, M. L., & Franz, C. E. (in press). Genetic and environmental influences on individual differences in frequency of play with pets among middle-aged men: A behavioral genetic analysis.  Anthrozoos.
Hal Herzog is Professor of Psychology at Western Carolina University and the author of Some We Love, Some We Hate, Some We Eat: Why It's So Hard To Think Straight About Animals.

Touch Me, Baby: When Skin Is the Biggest Sex Organ

Often when people think about the pleasures of sex, they think about genital arousal (e.g., erections or vaginal warmth or lubrication) or orgasm. While I certainly wouldn’t argue these, I would add that one of the most pleasurable parts of sexual intimacy is the experience of touching and being touched all over.
 Decades of research have shown that human babies and many animal babies need touch not only to survive, but to thrive. Touch can have psychological effects of helping people to feel loved, happy, accepted, calm or reassured. Touch can also have biological effects, such as by helping to promote the release of oxytocin (which has often been referred to as the “bonding hormone” or the “cuddle hormone”).
In sex, we have the uncommon opportunity to touch and be touched all over our bodies. When two people take their clothes off and press their bodies against each other in a hug, while kissing or in one of many possible sexual positions, they get to experience an enormous amount of skin closeness. They may touch cheeks, lips, chests, legs, and feel their partner’s hand along their back, thighs, or stomach. There is, after all, something qualitatively different about pressing two naked chests against each other compared to two chests that have even small or moderate amounts of clothing on. Even wearing a bathing suit, a bra or underwear can feel like a barrier to intimacy compared to the experience of being exposed – physically, and often emotionally – together.
 This week, I’d like to invite you to think more about the potential pleasures that lie in touching a partner or being naked together. How might you explore your bodies in ways that promote closeness, enjoyment, or excitement? Perhaps one of these suggestions will enrich your experience of sexuality this week:

•Bathe with a partner, using a soft body wash or soap to clean each others’ bodies. Body wash or soap adds a new texture to the feel of a partner’s touch on your breasts/chest or back. Take time to notice how it feels to be washed by someone and when it’s your turn, try to wash your partner with a feeling of love or affection.
•If you don’t feel up to sex – but suspect that deep down inside, you might be open to it – then when your partner initiates sex, suggest that you cuddle instead with as few clothes on as you’re comfortable wearing (or rather tossing aside). Spend as long as you’d like cuddling – letting your hands feel free to touch each other’s backs, hips or cheeks as you kiss.
•During sex, try using your hands to stroke your partner’s back, cup her breasts, or grab his or her butt. Do it with tenderness or with lust.
•After sex, try laying naked together, close – or if one of you gets uncomfortably warm after sex, try to at least touch feet and focus on what it feels like to stay connected.
•Consider sleeping without clothes on or in your underwear, feeling the sheets against so much of your skin.
•Set aside a few hours of nothingness and turn it into something remarkable: pack a picnic, head to the park and listen to music with one of you laying their head in the other’s lap. If you’re comfortable, kiss or make out. (Do keep your clothes on in the park, however).
•Kiss your partner from their toes all the way to their lips. This move isn’t just for chick flicks – when done slowly and with passion, it can be an incomparably luscious experience of foreplay.
•Massage your partner’s back while he lays face down on the bed. At times, press your breasts or chest to his back with the intent to seduce or to lie close.

These are just some ideas – surely you will think of others that will work as well if not better for you. The point is to not only try to work more touching into your intimate life and your sex life, but to learn to experience it with a mindfulness and a presence that may just bring you to tears, if you’re the sentimental type. Or at least to the point of more pleasure.

Debby Herbenick, PhD, MPH is a research scientist at Indiana University, a sexual health educator at The Kinsey Institute, and the author of Because It Feels Good: A Woman's Guide to Sexual Pleasure and Satisfaction.

Oh "Hedy" Days of Youth!

Do you want to see something really naughty?
Of course you do—or you wouldn’t be here. Rest assured, it’s coming. But first, a personal confession.
I think my father was always a bit disappointed in me. My father was an engineer, and I grew up thinking it was perfectly normal to live surrounded by draughtsman’s tables festooned with circuit diagrams and various half-finished projects. I think my father always wanted me to be an engineer too, and the fact that I went into soft science must have puzzled him.
Psychology (and biology) are soft sciences. But then, humans are soft. However, that doesn’t mean that engineering insights don’t apply to them.
More on this in a bit….
You have been patiently waiting for your naughtiness—and here it is. The first ever female orgasm committed to mainstream cinematic celluloid.
(You are wondering how I am going to tie this to the engineering theme, aren’t you?)
[copyright: Elektafilm]
That’s the great actress Hedy Lamarr—who would have turned 100 today. In the film Ekstase (Ecstasy), which horrified the Hays code censors of 1933, she abandons her staid husband and finds sexual fulfilment in the arms of another. After her character finds pleasure in her asserted sexuality, the abandoned husband kills himself.
Here it comes, the link you were waiting for
Source: Wiki patents
Hedy Lamarr, as well as being a taboo-breaking screen goddess, also thought it was normal to be surrounded by circuit diagrams and had a draughtsman’s table permanently installed in her home. This is because she had patents for radio technology inventions. She is most famous for the introduction of frequency hopping. This is a technique—based on music—to keep radio transmissions from being interpreted by the enemy. It is one of the insights that allows modern mobile phones to work. (1)
The world is full of apparent design. It’s a feast of the senses for those who enjoy engineering solutions. And, ever since Darwin, we know the only non-magical answer to the otherwise stark staring mystery of this. Things appear designed because millions of years of small changes, that respond to the environment, ratchet up to eventually create “endless forms most beautiful”. (2)
Whether I inherited a bunch of engineering genes, or I had all problems modelled to me by my father as basically engineering issues I don’t know. But Darwinian selection is fundamentally an engineering take on the world. Why does a thing look this way? What does it appear designed to do? Why is it apparently not working? The only natural mechanism that explains apparent design is natural selection. So, engineering, and Darwinian insights are close cousins.
How biologists send valentines cards
Source:

Orgasms and engineering.
Lots of scholarly ink has been spilled (and today, scholarly pixels rendered) on the subject of female inorgasmia. Lots of women don’t orgasm during sex. Most men do. Leaving aside the possible medical complications that might lead to this, there are several possible reasons for this orgasm gap.
1)      Women are broken. This is roughly Freud’s idea, that inorgasmic women are psychologically damaged and need therapy before they work properly. (3)
2)      Women are not designed to have orgasms at all. The "by-product" view (4) 
3)      The reason women don’t have orgasms every time is that the system is accurately separating males into wheat and chaff. (5)
I have blogged about why the first two ideas are probably wrong elsewhere (6). In essence—the broken/badly designed ideas don’t do justice to the complexity, intricacy and specificity of the female sexual system.
This leaves us with the 3rd idea. Females are working just fine. It’s males that are not.
Now this may seem a little harsh. But nature is harsh. More women than men become ancestors. (7) More men than women are consigned (or consign themselves) to reproductive oblivion.  It’s the central theme of Hedy Lamarr’s Ekstase. It’s the central theme of a lot of art, literature and myth. Female sexuality is powerful and potentially dangerous. 

The Ecstasy of St Theresa. It’s a religious thing. Stop sniggering at the back!
A recent paper showed that female orgasmic response (quantity and quality) accurately tracks a range of things that females desire in male partners—intelligence, drive, focus and determination. And, yes, it turns out that laughing at your jokes (although perhaps not at other things) is an important clue to whether your female partner will produce involuntary pleasurable muscle spasms at…err…other moments of social importance. (8)
This came as no surprise to us. (9) We found that female orgasm accurately tracked things like partner considerateness, dominance, vigour and even pleasant smell (which signals immune system compatibility). Previous research has linked female sexual response to attractiveness (10) and masculinity (11). A lot of these things probably co-vary.
So, what does an engineering insight offer to the mystery of female orgasm?
“If it ain’t broke, don’t fix it”, might be an admirable political motto. An engineer’s motto is “if it ain’t broke—it doesn’t have enough features yet”. Engineers tinker with things until they break. This is also the way of thought that someone doing conceptual engineering—like adaptationist thinking trains you to do. So, if we have a highly complex system (like the integrated set of nerves, muscles and physical structures making up the female sexual system) that appears to be broken, well, maybe, just maybe—it’s doing exactly what it was designed to do.
Source:
This insight would come as no surprise to Hedy Lamarr’s character in Ekstase either. In the movie, her wedding night is a disaster. The scene opens with her kind (but over-controlled) husband failing to open a locked door to the bedroom. He tries several keys, all to no avail. Cut to scene of Lamarr looking disappointed. Whatever could the symbolism be?
Later, the bored Lamaar runs free in the woods and encounters a man she finds more compelling. This leads to that scene, where the pearls break over the floor… The final scene is a fantasy one of her holding a baby. It’s hardly symbolism at all at this point.The oft-quoted statistic is that only 25% of women can orgasm through penetrative sex. (13) Now, we don’t know actually that. We only know that women orgasm through penetrative sex 25% of the time. That doesn’t mean that they are incapable of it. For starters, in our highly embarrassed culture, a huge amount of sex doesn’t take place without one or both parties being somewhat inebriated. All of that would need to be controlled for before we rush to conclusions about women being broken or badly designed.
There’s a reason why men suffer performance anxiety. Indeed—they suffer anxiety about a lot of things that affect their fitness as mates. Height, status, penis size. (12)This is no different. It also explains why men get defensive over female inorgasmia (“women are broken”, “women are badly designed”). But nature doesn’t care about your excuses or your ego. 

The Myth of Absentee Orgasms at the Top of the Org Chart

Endometriosis is defined as the growth, adhesion and progression of endometrial glands and supporting tissue outside of the uterine cavity, with cellular activity evident in lesions, nodules, cysts or endometriomas. Although it typically appears benign on microscopic examination, endometriosis has been likened to a malignant tumor since the lesions grow, infiltrate and adhere to adjacent tissues and interfere with normal physiologic processes. Ectopic endometriotic growths respond to cyclic changes of estrogen and proliferate and shed in a manner similar to the endometrium confined within the uterus, cycling right along with the uterine tissue. This cyclic ectopic activity results in internal bleeding, formation of scar tissue, inflammation and, of course, debilitating chronic pain.
Now, with all the medical science packed into the sentences you just read, why has society turned endometriosis into an almost psychiatric affliction of women? It could be that those who study this ailment fail to appreciate that unfortunately long interval between the onset of symptoms and the formulation of a diagnosis.

For most women living with endometriosis, the road to diagnosis and treatment can be long, painful and frustrating. The mean time from onset of symptoms to diagnosis for women with endometriosis in the United States is over 11 years. Women may delay seeking medical attention in the mistaken belief that painful symptoms are part of a “normal” menstruation, especially if there is a family history of painful menses, or fears of appearing unable to cope with “female problems.” Also, medical professionals who lack knowledge about the severity of pain that women with endometriosis often suffer may trivialize symptoms, attribute pain to being a normal part of menstruation or dismiss symptoms as being imaginary. These failures and misperceptions often delay referrals to gynecologists or other health professionals specializing in chronic pain management. And so follow increased frustration, depression and anger as these women experience the lack of understanding and empathy they deserve. During this time, patients must live with chronic pain that negatively affects their careers, sexual relationships and feelings of self-worth.
If anything, it is endometriosis that may negatively impact a career. The notion that women who delay marriage and pregnancy are those most prone to developing endometriosis is an outdated one; the label, “career woman’s disease” does not seem to be accurate. In fact, this label is fraught with stereotype, as studies have shown that women from lower socioeconomic backgrounds are often first thought to be suffering from the effects of a sexually transmitted disease—in reality, they, too, are suffering from endometriosis in many cases, right along with their upper middle class sisters.
All this begs for a special sensitivity when dealing with the endometriosis patient, and the emphasis on empathy is particularly important, as a study published in 2006 in the Journal of Psychosomatic Research found that patients with endometriosis were characterized by a higher level of emotional suppression compared with healthy controls. So, it is not surprising that a study published in 2008 in the European Journal of Obstetrics & Gynecology and Reproductive Biology did not show any differences in levels of anxiety/depression between endometriosis patients with pain and pain-free patients. This would otherwise be surprising, as anxiety and depression are known to be common emotional responses to endometriosis, and chronic pain in general.
The chronic pain of endometriosis is a major cause of suffering. It is not confined to “career women.” It is hiding in plain sight, emotionally and anatomically speaking, which in itself makes the pain even more painful to those who carry the diagnosis, and those considering the diagnosis.

The Myth of the Myth of the Vaginal Orgasm

Doris Lessing taught me a lot about female orgasms.
Lessing’s recent death has been somewhat overshadowed by that of another rather prominent African thinker and social reformer. However, in her time she was a fearless campaigner and expositor. Among her many awards was a Nobel prize for literature. Sometimes claimed as a feminist champion, she was actually a free thinker who would often say things that exasperated anyone who tried to pigeonhole her.
This is what she says about orgasms in the Golden Notebook
"A vaginal orgasm is a dissolving in a vague, dark generalised sensation like being   swirled in a warm whirlpool. There are several different sorts of clitoral orgasms, and they are more powerful (that is a male word) than the vaginal orgasm. There can be a thousand thrills, sensations, etc., but there is only one real female orgasm and that is when a man, from the whole of his need and desire takes a woman and wants all her response. Everything else is substitute and a fake, and the most inexperienced woman feels this instinctively… ‘ 'Do you know that there are eminent physiologists who say women have no physical basis for vaginal orgasm?’ ‘Then they don’t know much, do they?’ (Lessing, 1962, p. 200).
Tampering with Forces I Don’t Understand
I sometimes get asked—what is a guy doing investigating women’s orgasms anyhow? My answer is usually the same—I am reporting what women tell me. What they tell me seems to partially solve a vexed question in the biological literature—namely “what, if anything, are female orgasms for?” Maybe one of the reasons why some scholars are talking past each other at the moment might be simply this—female orgasm is not just one thing—it’s complicated. Lessing, more outspoken than most, was always unafraid to accurately report her experiences and her enjoyment of passionate sexuality.

I vividly remember when I first started my research I assumed that the fashionable story of the time—that vaginal orgasms were mythical beasts—had to be true. After all—I had seen Anne Koedt’s famous tract of that name quoted with approval by a number of scholars. Apparently it is received wisdom that only 25% of women are capable of vaginal orgasm. The official story is that the rest are somehow dysfunctional. Maybe worse than that—perhaps the female sexual system has never designed to function in that way? I have addressed these questions elsewhere.
I have a friend who I can always trust for frank appraisal. I handed her Koedt’s “The Myth of the Vaginal Orgasm” and asked for her opinion on it. “Why is she trying to spoil it for the rest of us?” was her reply.
A Word About Self-Report
Self-report can get a bad press in psychology—it has been referred to as psychology’s four letter word. It’s true that people are often bad at accurately reporting their own motives—even to themselves. However, subjective experience is a real part of the world and a complete scientific account of that world cannot leave it out.
The great neurologist Ramachandran made progress in understanding conditions like synaestheisa, phantom limb and Capgras’ delusion only when he started taking the self-report of sufferers of the conditions seriously. Other neurologists had dismissed these conditions out of hand.
Our quest for objectivity—often just a form of physics envy--can go too far. In a recent Cochrane review of obstetric interventions most had sophisticated objective measures of pain. Galvanic skin response, blood-pressure, cortisol levels. All these had been measured. However, in only two interventions had the only really important question been asked. Namely; “Does it hurt?”
The upshot of this is that if you don;t think self-report is worth anything please don't tell me about it. I won't take your self-report on this seriously.
Two Cheers for Self-Report
So, I think it’s worth listening to people’s experiences. Especially when we are trying to find out the details of an otherwise puzzling event.
When we sat down at interview and asked “What should scientists be asking women about their orgasms” we frequently got the following response:
“Well, that’s a dumb question—which ones do you mean?”
“Ok,” we said, “Why don’t you tell us which ones you mean?”
Terms like vaginal and clitoral have become so confused, emotionally charged, and politicized in relation to orgasm that we avoided using them when asking women about their experiences. As I have said elsewhere—the all female orgasms involve the clitoris--which is much larger than many folk suppose. However—many women themselves kept using such terms—and in ways that suggested that there was a qualitative difference in their sexual experiences. Some orgasms were described as occurring deep inside, accompanied by sensations of floating, even loss of self. Sometimes internal pulsing—perhaps indicating uterine peristalsis—were reported. Sometimes—but not always—ejaculation occurred. In contrast, other orgasms were reported as sharper—more localized and intense—and more on the surface.
All very interesting—sensations like floating, trust, loss of self and uterine peristalsis all sound like the action of oxytocin—a known correlate of orgasm. Also--associated with sperm transport.
“Alright”, we asked (after thanking the ladies for their valued participation—of course) “When do these orgasms occur?”
“Well, that’s a dumb question too”, the women replied, “They vary in response to what we are doing and with whom.”
“Umm..Ok”, we said, slightly chastened, “Please tell us about that”.
And they did. There is a well-known smorgasbord of characteristics that biologically minded behavioral scientists look for when examining mate selection of males by females. And we asked them all.
Were their partners big and muscular?
Didn’t matter.
Were they aggressive or masculine?
Meh. Not so much.
Being confident, passionate, and providing deep penetration certainly counted, as did being a considerate sexual partner—we assumed this meant at a minimum that they listened to what the females said that they liked—and acted accordingly.

What Brings You “Over the Edge” to Orgasm With a Partner?

“I am almost there, I can feel it! It’s so close… and then he’ll change the motion, or I’ll get distracted. It’s so frustrating. I just can’t get over the edge!”
This experience of not quite being able to get over that final lip to orgasm is all too common. “Why is this happening to me? I can usually reach orgasm when I masturbate...” This is a question I hear regularly in my sex therapy office. Not being able to get over the edge to orgasm is not a disease. In fact, it is so common that I can say it happens to everyone on occasion.
Now, I don’t want to put too much emphasis on the importance of having an orgasm every time you have sex. The journey can be just as fulfilling as the final moments of release; but for some more than others, that frustration of not “getting there” is too common.
Some of us experience more difficulty reaching orgasm in times of physical ailments, stress, anxiety, or when using medications (such as SSRIs). But for everybody, there is one particular factor that can make orgasm more difficult. In fact, it is one of the leading causes of orgasm difficulty—being with a partner.
Most people have a relatively easy time reaching orgasm with masturbation when they focus only on their own experience. Orgasm by masturbation takes approximately four minutes for both men and women. Yet, only one-quarter of women reach orgasm during unassisted intercourse (that is, with no external clitoral stimulation) in partnered sex. 1 And men can have trouble reaching orgasm with a partner too. The DSM-V states that only 25 percent of men routinely achieve orgasm in all sexual encounters.

So, what exactly are the scenarios that make it so difficult to get over the edge with a partner?
1. Not getting the stimulation you need.
Most heterosexual women do not get the right stimulation, which usually means their clitoris does not get enough attention. Why is this? It is likely because the clitoris tends to be downgraded in priority when women are with a male partner. In fact, most women masturbate exclusively on the clitoris. It is not surprising then, that women who focus on the clitoris in partnered sex (e.g. when they have women as lovers) have a significantly higher rate of orgasm.2
For men, the organ that does it for them—their penis—usually gets the focus during heterosexual intercourse, but it still may not be the correct pressure or level of friction to orgasm.
2. Distraction.
Dedicated attention to an erotic stimulus is essential for reaching orgasm. Distracting thoughts or interruptions can reduce arousal to a point where orgasm is simply not possible.
While the presence of a partner during sexual activity can heighten arousal with emotional connection, variety, and sensations we just can’t get on our own, their presence can also add distractions. When we are with a partner, the social parts of our brain kick in. “Are they having a good time? Can the kids hear us? Am I doing this right? This is getting boring.” These are some of the common thoughts that only occur when we are with a partner. Alone, it won’t cross most of our minds to consider whether we are doing it correctly or whether the other person is enjoying themselves.
Emotions can also be distracting. Even the good ones. The more we care about our partner, the more we might get distracted from arousal. Sex is just easier when we have ourselves as a partner.
So, what is the answer?
Popular advice for those struggling to get over the edge to orgasm can include valuable information, but it often does not make the distinction between solo and partnered sex. As a result, the advice can seem contradictory. For example:
Focusing on the sensation vs. finding something new to focus on
Staying on the sensation vs. changing up the sensation
Breathing vs. holding the breath
Contracting your PC muscles vs. relaxing the PC muscle
These apparent opposites may all be good options depending on the person and situation, but it can be confusing for those starting out to make sense of the contradictions.
The answer might lie in your past.
Which “cues” has your brain linked to orgasm? In other words, what worked for you when you were first learning the joys of orgasm can be the cue to what will work for your brain today. In an excellent article on orgasm, sex researcher Jim Pfaus explains that what brings us to orgasm is learned. This usually happens early in life with masturbation habits. Arousal patterns are established with our movements, positions, hand motions, etc. that are associated with high arousal, pleasure, and orgasm. 3
The good news is that we are all wired to be adaptive—especially women. Nothing is carved in stone. What is programmed to make us orgasm can be added to and re-learned. At any point in our lives, we can enhance our erotic pathways by adding new, positive experiences that can help shape our existing cues.
Where do you put your erotic focus?
Erotic cues, especially those associated with orgasm, have become a focus of my own recent study. I asked close to 3000 people what brings them over the edge to orgasm and the results were startling. It was not so much the techniques they used which were surprising (and will be published next year), but how precise their answers were. The responses were strikingly concrete. People who orgasm easily tend to have a clear idea of what “brings them over the edge.” They know exactly where to put their attentional focus.
Erotic cues are personal and idiosyncratic to every person. Each person develops a plethora of individual erotic cues that work for them, informing their own personal erotic pathways in the brain. So, what does your brain recognizes as “sexual”? Erotic cues can take the form of a position, a movement, the sight of a particular body part, performing an act, playing a role, visualizing a fantasy, or just a thought of anything your brain recognizes as “this is hot!” It is not surprising that people who orgasm easily, tend to have such a clear idea of what their erotic cue(s) are.
The way to orgasm with a partner, therefore, is to have some understanding of your own erotic cues and, better yet, let your partner in on this delicious piece of information. If you find a cue that works for you in masturbation, it may be possible to bring that cue or tailor it for a partnered situation. Just knowing your erotic cues can enhance communication and increase sexual confidence, so you can be the best lovers you can be for each other and yourself. Not to mention how much fun it is going to be as you explore the options of what your cues are with your partner.
Orgasm difficulty with a partner can simply be a sign that you need to know more about your own erotic cues and then let your partner in on the secret. And once you share that secret, you may find you and your partner going over the edge again and again and again.
Do you, or your partner, know what brings you over the edge to orgasm?
Take the quiz to find out your erotic cues with your erotic pathway.