Sexual Health, Anorgasmia

I am honored to have the opportunity to discuss some of our interdisciplinary research concerning female sexual response and to talk about where do we go from here. I will be summarizing 20 years of research in the next hour, from vaginal orgasm to PET scans of the brain during orgasm.

Before I can discuss research findings, it is important to me to put these findings into a context of how I view sexuality and sexual expression. In the past, sexuality was viewed as having one purpose, and that purpose was reproduction. Today it is seen as an important aspect of health; it enhances the quality of life, fosters personal growth and contributes to human fulfillment. When the term sexuality is viewed holistically, it refers to the totality of a being.

It refers to human qualities, not just to the genitals and their functions. It includes all the qualities--biological, psychological, emotional, cultural, social and spiritual---that make people who they are. And people have the capacity to express their sexuality in any of these areas, it doesn't have to be just through the genitals.

It is important for....sexual health care providers, to consider what the person and/or the couple view as their goal of sexual expression. Whenever I discuss our research, I always present it in terms of "Timmers model." That is, I do not want to have people set up our findings as a goal that they or the individual or couple they are counseling must achieve. Our objective has been to validate women's sexual experiences, not create new goals.

According to Timmers et al. there are two commonly held views.

{mosbanner:id=1:right:0}The most common view is goal-directed, which is analogous to climbing a flight of stairs. The first step is touch, the next step kissing, the next steps are caressing, then vagina/penis contact, which leads to intercourse and the top step of orgasm. There is a goal that both or one partner has in mind, and that goal is orgasm.

If the sexual experience does not lead to the achievement of that goal, then the couple or the person who is goal oriented does not feel good about all that has been experienced.

The alternative view is pleasure-directed, which can be conceptualized as a circle, with each expression on the perimeter of the circle considered an end in itself. Whether the experience is kissing, oral sex, holding, etc., each is an end in itself and each is satisfying to the couple. There is no need to have this form of expression lead to anything else.

If one person in a couple is goal-directed (and this is typically the male) and the other person is pleasure-directed (and this is typically the female, although it could be vice versa), problems may occur if they do not realize their goals or do not communicate their goals to their partner.

It was with the concept of pleasure-oriented sexual expression that John Perry and I listened to what women described as pleasurable to them. Listening to the reports of women who said they did not fit into the monolithic pattern of sexual response, that is, they had sexual pleasure, orgasm and in some cases an expulsion of fluid from vaginal stimulation, not clitoral stimulation, led to our rediscovery of a sexually sensitive area felt through the vaginal wall, which we called the Grafenberg or "G spot."

This sensitive area is usually located about halfway between the back of the pubic bone and the cervix, along the course of the urethra and near the neck of the bladder. It swells when it is stimulated, although it is difficult to palpate in an unstimulated stated. (published in Journal of Sex Research 1981 by Perry and Whipple and The G spot 1982 by Ladas, Whipple and Perry)