Clitoral Orgasm Research Articles

Women’s Experiences of Different Types of Orgasms—A Call for Pleasure Literacy?

Background There is an ongoing controversy about women’s sexuality and the existence of different orgasms. The debate is tilted toward anatomical and physiological evidence, which often leaves subjective experiences out of the picture. The aim of the current mixed-methods study was to capture women’s accounts of their experiences of orgasmic states. Methods As part of a larger online survey, 513 women (M = 25.89 years, SD = 5.60) from a community sample filled in open-ended questions on their experience of different kinds of orgasms. Additionally, women rated semantic differentials with bipolar adjectives characterizing vaginal and clitoral orgasms. A sub-sample of n = 257 women (50%) had experienced both, vaginal and clitoral orgasms and rated both separately on the semantic differential. Results Wilcoxon signed-rank test showed significant differences in that clitoral orgasms were, amongst others, rated as sharper, easier, and more controllable, while vaginal orgasms were rated as wilder, deeper, more pulsating, and extending. In open-ended questions, women talked about various other orgasmic experiences, such as mixed clitoral/vaginal orgasms, whole body, cervical, anal, or mental orgasms. Some women were uncertain about their orgasmic experiences. Conclusion It is time to integrate anatomical, psychophysiological, and experiential data and conclude that either “all clitoral” or “clitoral and vaginal” falls short to do justice to the complexity of women’s orgasms. Understanding and defining these various types of orgasms and allowing for the apparent diversity to have its place in research and in social discourse is a task for future research and pleasure-positive sex education to increase pleasure literacy.

Changes in the extracellular matrix of the clitoris caused by aging: a stereological and comparative study.

IntroductionThe clitoris is partially responsible for sexual arousal. The integrity of the extracellular matrix is essential for clitoral erection. Sexual dysfunction is a phenomenon associated with age.MethodsThe clitoris of cadavers of 20- to 80-year-old women was excised and histologically processed. Stereological analysis was performed to quantify the volumetric density of collagen, elastic fibers, and smooth muscle.ResultsA significant increase in collagen and a decrease in smooth muscle and elastic fibers were observed in older women.ConclusionsIn short, these changes caused by aging could contribute to female sexual dysfunction concerning clitoral orgasm.

Anne Koedt: Politics of the Vaginal Orgasm and Female Sexuality

Abstract: This paper focuses on Koedt’s main discourse of female sexuality that develops out of the traditional phallocentric assumption in her critical essay “The Myth of the Vaginal Orgasm.” She argues that the centre of female orgasm is the clitoris, not the vagina. The paper examines how the nature of female sexuality is constructed and misrepresented by male hegemonic structure to subjugate and control women. The analysis uses a qualitative methodology in the form of the close reading of the text. It is a multidisciplinary study cutting across the disciplines of lesbian feminism, psychology, physiology, sexology, and psychiatry and attempts to investigate as to how female orgasm has previously been considered in an inadequate way. It tries to vindicate how female sexuality has politically been treated and how there exists a relationship between female sexuality and male domination. The paper also offers a very candid critique of female orgasm, female sexuality, the meaning of sexual pleasure, the vaginal orgasm, the clitoral orgasm, and different other forms of female orgasm. In the postmodern era, the main issue of gender equality is replaced by a category of sexuality. This paper provides an overview that sex in society revolves around the pleasure of men and women’s sexual desire is constructed according to the male interests. The result of the study reveals that extreme gender bias never lets women speak about their own sex lives. The analysis is intended to create awareness and education for both men and women about sexual pleasure and counter the previous misconceptions and doubts about female orgasm and female sexuality.

The Clitoris: Anatomical and Psychological Issues

ABSTRACTThe anatomy of the clitoris is much larger than commonly believed. Besides the small tip of the clitoris known as the glans, which protrudes in the external genitalia, the crura (or legs) of the clitoris extend 9 cm inside the body, with erectile tissue adjacent to the vagina and urethra. This finding has significance for theories of female sexual responsiveness, including the differentiation of clitoral and vaginal orgasms. It also offers guidelines for preserving erotic response during pelvic surgery in women. The facts of clitoral anatomy, clarified with modern scanning procedures by surgeon Helen O’Connell and colleagues (2005), have been repeatedly discovered, forgotten, and rediscovered, at least since 1844, when the German anatomist Kobelt made accurate drawings. Psychological reasons for why the true anatomy of the clitoris has so often been repressed or misrepresented by anatomists, psychologists, and other scientists are proposed. That most anatomists have historically been men may have led to disregard for precise charting of the clitoris that might lead to greater preservation of female sexual response. Envy by male anatomists of female sexual response may also play a role. Correct anatomical knowledge may significantly alter psychoanalytic theory and practice.

Vaginal orgasm is associated with indices of women's better psychological, intimate relationship, and psychophysiological function

A recent study by Therrien and Brotto (2016) examined the associations of orgasm during intercourse, concordance of laboratory genital and subjective arousal, and demographic variables in a group of sexually dysfunctional women. The authors claimed that their results cast doubt on the large body of multi-method multi-national research demonstrating that women's orgasm from penile-vaginal intercourse, and specifically vaginal orgasm are associated with a broad range of indices of women's better psychological, intimate relationship, and psychophysiological health. The problems with Therrien and Brotto's (2016) conclusions are discussed, and include that they did not even measure vaginal orgasm (they measured orgasm during intercourse, which can in some cases consist of orgasm elicited by clitoral masturbation during intercourse), and the non-generalisability of their findings from a sexually dysfunctional sample to the general population of women. Evidence is also presented against their claims that findings regarding orgasm during intercourse have not been investigated by other researchers, and their denial of differences between vaginal orgasm and clitoral orgasm. Denial of the myriad benefits of vaginal orgasm undermines women's sexual and general health potential, and serves only the demands of political correctness.

Emerging evidence for a discrete genital site for orgasm?

Grafenberg and Dickinson first described a sensitive area felt through the anterior wall of the vagina and difficult to palpate when unstimulated. In 1950, Grafenberg noted that when this area was stimulated it caused the female urethra to enlarge and swell, and was sometimes associated with expulsion of fluid different from urine. Perry and Whipple in 1981 described this sensitive area on the anterior vagina wall as the G-spot. Despite this, Whipple acknowledges (Curr Sex Health Rep 2015;7:59-62) that some sexologists have heavily disputed the presence of a discrete anatomical entity, or ‘spot’. An anatomical G-spot was described in a prospective descriptive case series on 11 consecutive female cadavers (Ostrzenski A. Eur J Obstet Gynecol Reprod Biol 2014;180:186-191). Histological features of the G-spot were defined microscopically as a neurovascular structure with its own nerve ganglion. The absence of cavernous or spongiosum tissue excluded the concept that the anterior wall engorgement was in some way related to expansion of erectile tissue. Ostrzenski argued that electric vaginal waves originated from within the G-spot, effectively enabling it to produce vagina-activated (internal) orgasm independent of clitoral orgasm. Reviewing the biological and physiological background of the pharmacology of the human female orgasm, Levin (Levin RJ. Pharmacol Biochem Behav 2014;121:62-70) describes areas of activity of the brain during orgasm but notes that the genital sites ‘responsible’ for activating orgasm may be diverse and that there may be a ‘cusp or tipping point’ for induction of orgasm, citing the concept described by Michael Perelman. The great variability in the subjective experience of orgasm and the possibility of maturation and ‘learning’ alongside environmental factors results in a lack of clarity of the complex role of the neural pathway and expression in the brain. The interconnections between the anterior vagina, the pelvic floor and the brain remain under investigation but for many women these combine to produce a pleasurable and often ecstatic sensation at orgasm. The article by Maratos et al. (2016;123:1542–49) describes a retrospective study of MRI imaging for women with routine medical indications. The failure to obtain any basic sexual history or discover whether the women had ever described ‘G-spot’ orgasms is an obvious limitation of the study, and is more frustrating than the opportune sample of cadaveric dissections reported by Ostrzenski, where the sexual history was elusive. The authors describe a higher detection rate of the ‘G-spot’ in those women with distension of the vagina and in 62% of cases overall. Further studies in women with and without sexual dysfunction, including orgasmic disorder and orgasmic anhedonia, and where there is distension of the normally collapsed vaginal wall, may enable additional understanding of the structures of the anterior vaginal wall, urethra and clitoral complex, as well as an understanding of why some women report differences in their sexual experiences that could be at least partly explained by inherent anatomical differences. If these can be identified with limited invasive out-patient ultrasound investigations this will markedly enhance the diagnostic opportunities for clinicians. The sexual medicine clinician will always attempt to recognise the multitude of factors contributing to a particular sexual experience, but having a greater appreciation of inherent differences and how pharmacological agents may influence these will widen the opportunities for a successful clinical consultation. None declared. Completed disclosure of interests form available to view online as supporting information. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Resurrecting Germaine’s theory of cuntpower

ABSTRACTIn the early years of the second wave, two very different approaches to female sexuality and feminist politics were in circulation, Anne Koedt’s ‘The Myth of the Vaginal Orgasm’ and Germaine Greer’s theory of cuntpower. While the clitoral orgasm became the ‘feminist orgasm’ during these years, Greer’s more open and genitally inclusive theory of cuntpower encouraged women to explore the variations of their own heterosexuality in the name of women’s and sexual liberation. This article will argue that Greer’s ideas about cuntpower are worth resurrecting and integrating into our understanding of second wave feminist sexual politics. It will also argue that Greer’s utilisation of the media allowed her ideas to influence ordinary women’s understanding of the potential of their sexuality, their right to orgasm and its connection to women’s liberation.

Unearthing “New” Eroticisms: Feminist Theory as Transformational in “Aberrant” Sexual Desires and Practices

This paper examines three elements of female sexuality: the clitoral orgasm, lesbianism, and feminist pornography. All three of these elements have traditionally been viewed as deviant in hegemonic discourse. Over the years, feminist theory and practices have transformed (or are transforming) each element from aberrant sites of desire to new modes of feminist knowledges. The female orgasm and lesbian identities were once “new” knowledge within feminism, and now feminist pornography emerges as an entirely reconceptualized way of exploring women’s desires, sexuality, and eroticism. With the aid of Elizabeth’s Grosz’s essay “The Future of Feminist Theory: Dreams for New Knowledges,” this paper demonstrates how feminist theory has served in re-imagining female sexual desires, practices, and identities.

The Use of Specific Myofascial Release Techniques by a Physical Therapist to Treat Clitoral Phimosis and Dyspareunia

Introduction: Clitoral phimosis is adherence of the clitoral prepuce to the glans and can result from inflammatory dermatoses, blunt trauma, chronic infection, and inadequate hygiene. Aim: The aim of this report was to demonstrate myofascial release (MFR) techniques utilized by a physical therapist to treat clitoral phimosis. Methods: The patient was a 41-year-old woman with low back pain, a bruised sensation of her pubic region, vulvar pain provoked by sexual arousal, decreased clitoral sensitivity, dyspareunia, and anorgasmia. The patient sustained a blunt trauma injury to the vulva. Examination revealed lumbosacral and pelvic dysfunction, pelvic floor muscle dysfunction, bone bruise of the pubic bone, and decreased retractability of the clitoral prepuce and scarring. Eleven physical therapy sessions over 16 weeks included stretching, joint mobilization, muscle energy techniques, transvaginal pelvic floor muscle massage, clitoral prepuce MFR techniques, biofeedback, Integrative Manual Therapy (IMT) techniques, nerve mobilization, and therapeutic and motor control exercises. The patient applied topical clobetasol 0.05% cream for 30 days. Results: The low back pain was reduced and full resolution of her vulvar pain, dyspareunia, and pubic bone bruised sensation resulted. Mobility of the clitoral prepuce was restored. Normal clitoral sensitivity and clitoral orgasm returned. Symptom resolution was confirmed upon telephone evaluation at 6 months. Conclusion: With proper training, physical therapists managing patients with dyspareunia can identify clitoral phimosis and use specific MFR as a conservative treatment approach. Physical therapy techniques can be performed alone or in concert with medical therapy.

Chirurgie génitale féminine, les techniques d’amplification du point-G–État de la science

The G-spot amplification is a process of "functional" intimate surgery consisting of a temporary physical increase of the size and sensitivity of the G-spot with a filler injected into the septum between the bladder and the vagina's anterior wall, in order to increase the frequency and importance of female orgasm during vaginal penetration. This surgical technique is based on the existence of an eponymous anatomical area described by Dr Gräfenberg in 1950, responsible upon stimulation of systematic orgasm different from the clitoral orgasm, referring to the vaginal orgasm as described by Freud in 1905. The purpose of this article is to review the scientific basis of the G-spot, whose very existence is currently a debated topic, and to discuss the role of G-spot amplification surgery.

New Technique for Management of Relaxed Vagina –Preliminary Study

Sexual health is vital to overall well-being. Orgasm is a normal psycho-physiological function of human beings and every woman has the right to feel sexual pleasure. Vaginal and clitoral orgasms are essential for heightened sexual pleasure for which tight vagina having the capability of exerting sufficient pressure over glans penis is essential. Relaxed vagina cannot apply enough pressure over penis during sex and so both vaginal and clitoral orgasms are diminished in intensity. Gynaecologists world over do not recognize the loose vagina in isolation and therefore no proper procedure had been described for correction of loose vagina. We for the first time described a new technique for management of loose vagina in 21 patients and achieved good results.

Multiple (types of) female orgasm

The female orgasm is a controversial entity, in terms of its origin, forms and even its mere existence. The concept that all orgasms are clitorally mediated is well-known but understudied, and the existence of vaginally-activated orgasm (VAO) as a distinct phenomenon remains to be proven. Some sexologists, including Emmanuele Jannini from L'Aquila University, Italy, believe that the sensory arm of the female orgasm is mediated by the clitorourethrovaginal (CUV) complex. In a recently published study, Jannini and Buisson used echography—a noninvasive ultrasonographical technique—to image the CUV complex during clitoral orgasm and VAO. Three women, all of whom reported VAO during coitus, were included in the study. Echographic imaging was carried out during both manual stimulation of the external clitoral glans and internal stimulation using a wet tampon.

Women Who Prefer Longer Penises Are More Likely to Have Vaginal Orgasms (but Not Clitoral Orgasms): Implications for an Evolutionary Theory of Vaginal Orgasm

Research indicates that (i) women's orgasm during penile-vaginal intercourse (PVI) is influenced by fitness-related male partner characteristics, (ii) penis size is important for many women, and (iii) preference for a longer penis is associated with greater vaginal orgasm consistency (triggered by PVI without concurrent clitoral masturbation). To test the hypothesis that vaginal orgasm frequency is associated with women's reporting that a longer than average penis is more likely to provoke their PVI orgasm. Three hundred twenty-three women reported in an online survey their past month frequency of various sexual behaviors (including PVI, vaginal orgasm, and clitoral orgasm), the effects of a longer than average penis on likelihood of orgasm from PVI, and the importance they attributed to PVI and to noncoital sex. Univariate analyses of covariance with dependent variables being frequencies of various sexual behaviors and types of orgasm and with independent variable being women reporting vs. not reporting that a longer than average penis is important for their orgasm from PVI. Likelihood of orgasm with a longer penis was related to greater vaginal orgasm frequency but unrelated to frequencies of other sexual behaviors, including clitoral orgasm. In binary logistic regression, likelihood of orgasm with a longer penis was related to greater importance attributed to PVI and lesser importance attributed to noncoital sex. Women who prefer deeper penile-vaginal stimulation are more likely to have vaginal orgasm, consistent with vaginal orgasm evolving as part of a female mate choice system favoring somewhat larger than average penises. Future research could extend the findings by overcoming limitations related to more precise measurement of penis length (to the pubis and pressed close to the pubic bone) and girth, and large representative samples. Future experimental research might assess to what extent different penis sizes influence women's satisfaction and likelihood of vaginal orgasm.

Doors of Female Orgasmic Consciousness: New Theories on the Peak Experience and Mechanisms of Female Orgasm and Expanded Sexual Response

Although there are many forms of female orgasms described in the literature, there are still debates about the female orgasmic response and no unified theory to explain those orgasmic reflexes and sexual responses have been proposed. Also, there are inconsistent reports and comments about the ‘vaginal versus clitoral orgasm controversy’. Recently, a novel form of female orgasms has been coined as “Expanded Sexual Response” (ESR), and defined as: “being able to attain long lasting and/or prolonged and/or multiple and/or sustained orgasms and/or status orgasmus that lasted longer and more intense than the classical orgasm patterns defined in the literature”. Expanded orgasms induce a different state of consciousness, or “orgasmic consciousness”, whereas many forms of altered states of consciousness (ASC) can be observed. There are lots of reports, coming from the data accumulated during last decades on the female orgasm and orgasmic consciousness, which confirms the fact that “clitoral and vaginal orgasms are two separate entities”, while their unification may induce a stronger and intense form of female orgasm, coined as “blended orgasm”. As we have hypothesized in our other publications, at least six orgasmic reflex pathways may take part in the development of single or multiple clitoral, vaginal, blended orgasms, and expanded, enhanced, prolonged ESR orgasms. Pudental, pelvic, hypogastric and vagus nerves play major roles in the development of single or ESR orgasms, as well as at least two oxytocin pathways may contribute to it. In blended, ESR orgasms and/or status orgasmus, more than one ‘orgasm reflex arch pathway’ may trigger the orgasm at the same time, while other pathways play a supplementary role. We have investigated the ESR phenomenon using a specific ESR-Scale in a series of surveys among ESR-women, compared to the control groups and defined the main characteristics of ESR phenomenon in the human female. ESR women seem to have higher libido, higher masturbation frequency, more erotic fantasies, stronger and more intense, prolonged orgasms or expanded orgasms (EO); while they experience multiple clitoral, vaginal and blended orgasms separately, as well as status orgasmus. Also ESR women are more aware of their bodies and their deep vaginal erogenous zones (DVZs), which comprises inner clitoris, G-Spot, A-Spot, O-Spot, PC-Muscles and Cervix. “Four nerve-six pathway theory of female orgasm” and oxytocinergic system may seem to explain ESR phenomenon. NeuroQuantology | December 2012 | Volume 10 | Issue 4| Page 692-714

Pratique de la chirurgie plastique reconstructrice du clitoris après mutilations génitales au Burkina Faso. À propos de 94 cas

To describe and evaluate the results of reconstructive plastic surgery of the clitoris in order to promote reproductive health.We conducted a retrospective study from 2007 to 2010. Ninety-four women were included in our study.The mean age was 32.3 years. The evaluation of the experience of sexuality before reconstruction showed that 41.5 % of patients had never had a sexual desire before surgery, more than half did not have a clitoral orgasm and dyspareunia was experienced by about a third of them. The main reason for consultation in our series was related to sexual dysfunction in more than half of our study population. All patients were operated using the technique of Dr Pierre Foldès. Evaluation with a decline of at least 6 months after surgery showed us a massive restoration of the clitoris at 89.7 %. There was a significant difference between sexual desire before and after surgery. A significant improvement in sexuality was observed in 83.6 % of patients. However, there was no significant difference between orgasm before and after surgery. This showed us that getting an orgasm is multifactorial and it is not enough to have a clitoris to have an orgasm, you have to use it.Regardless of the anatomical and functional results, all women were satisfied with respect to body found.

Female genital mutilation/cutting and orgasm before and after surgical repair

Summary Introduction Female genital mutilation/cutting (FGM/C) is often performed to decrease women's sexual pleasure. Removal of the external clitoris may particularly impair pleasure and orgasmic functioning. Aims and methods This review evaluates the literature on: the orgasmic functioning of women with FGM/C whose clitorises have and have not been excised and; the effect of surgical repair on orgasm. A PubMed search was performed to identify all published studies of FGM/C that included an assessment of orgasm. Results While three of the seven FGM/C studies that included a control group found decreased orgasmic functioning in affected women, no study fully controlled for demographic differences between groups or separated the FGM/C group by clitoral integrity. The impact of FGM/C on orgasm therefore remains unknown; however, indirect evidence suggests that orgasm rates would be reduced in women who cannot engage in direct stimulation of the external clitoris. Surgical defibulation releases the infibulation scar and appears to improve global sexual functioning but not orgasm. Clitoral reconstructive surgery, which creates a new external clitoris, restores a more normal genital appearance, resolves pain at the excision site, and increases clitoral pleasure. One large study found that it enabled clitoral orgasm in approximately 40% of patients. Since rates of orgasm from all forms of stimulation (e.g., vaginal) were not assessed, it is unclear for how many women an external clitoris is necessary for orgasm. Conclusions Future studies on FGM/C and orgasm should address the methodological limitations of previous research. Although clitoral reconstruction allows many women with FGM/C to become clitorally orgasmic, it does not guarantee orgasm. Women should be offered psychotherapy to improve their sexual or orgasmic functioning regardless of their genital integrity.

Women on the Couch: Genital Stimulation and the Birth of Psychoanalysis

Following Freud's emphasis on his rejection of hypnosis as leading up to the development of psychoanalysis, there has been little mention in the psychoanalytic literature of the larger context of the somatic medical treatment of hysteria within which Freud treated his hysterical patients, and which Freud himself practiced. We contend that Freud's emphasis obscured his association with massage, electrotherapy, and the procedure of genital stimulation practiced by his medical colleagues in the treatment of hysteria. We show that the history of genital stimulation—including its obfuscation, desexualization, medicalization, and co-option from traditional women healers by an exclusively male medical establishment—provides us with the background for a more sophisticated understanding of the context in which Freud developed his theories. Specifically, we examine the contribution of this understanding to Freud's theoretical emphases on autonomy and individuality, abstinence and the renunciation of gratification, penis envy, clitoral versus vaginal orgasm, mature genital sexuality, and the “repudiation of femininity” as the “bedrock” of psychoanalysis. We demonstrate that Freud's position as a Jew in an anti-Semitic milieu fueled his efforts to distance his psychoanalytic method from the more prurient practices of his day, including one his society associated with Jewish doctors and patients.

Male-to-Female Transsexualism: Technique, Results and 3-Year Follow-Up in 50 Patients

Aim: To evaluate the functional and cosmetic results of male-to-female gender-transforming surgery. Patients and Methods: Between May 2001 and April 2008 we performed 50 male-to-female gender-transforming surgeries. All patients had been cross-dressing, living as women, and receiving estrogen and progesterone for at least 12 months, which was sufficient for breast development and atrophy of the testes and prostate to occur. This hormonal therapy was suspended 1 month before the operation. Results: The mean operative time was 190 min and the mean depth of the vagina was 10 cm. On follow-up, the most common complication (10%) was shrinkage of the neovagina, which could be corrected by a second surgical intervention. Of the 50 patients, 45 (90%) were satisfied with the esthetic results; 42 patients (84%) reported having regular sexual intercourse, 2 of whom had pain during intercourse. Of the 50 patients, 35 (70%) reported achieving clitoral orgasm. Conclusion: Male-to-female gender-transforming surgery can assure satisfactory cosmetic and functional results, with a reduced intra- and postoperative morbidity. Nevertheless the experience of the surgeon and the center remains central to obtaining optimal results.

A Woman's History of Vaginal Orgasm is Discernible from Her Walk

Research has demonstrated the association between vaginal orgasm and better mental health. Some theories of psychotherapy assert a link between muscle blocks and disturbances of both character and sexual function. In Functional-Sexological therapy, one focus of treatment is amelioration of voluntary movement. The present study examines the association of general everyday body movement with history of vaginal orgasm. The objective was to determine if appropriately trained sexologists could infer women's history of vaginal orgasm from observing only their gait. Women with known histories of either vaginal orgasm or vaginal anorgasmia were videotaped walking on the street, and their orgasmic status was judged by sexologists blind to their history. The concordance between having had orgasms triggered by penile-vaginal intercourse (not orgasm from direct clitoral stimulation) and raters' inferences of vaginal orgasm history based on observation of the woman's walk was the main outcome measure. In the sample of healthy young Belgian women (half of whom were vaginally orgasmic), history of vaginal orgasm (triggered solely by penile-vaginal intercourse) was diagnosable at far better than chance level (81.25% correct, Fisher's Exact Test P < 0.05) by appropriately trained sexologists. Clitoral orgasm history was unrelated to both ratings and to vaginal orgasm history. Exploratory analyses suggest that greater pelvic and vertebral rotation and stride length might be characteristic of the gait of women who have experienced vaginal orgasm (r = 0.51, P < 0.05). The discerning observer may infer women's experience of vaginal orgasm from a gait that comprises fluidity, energy, sensuality, freedom, and absence of both flaccid and locked muscles. Results are discussed with regard to previous research on gait, the effect of the musculature on sexual function, the special nature of vaginal orgasm, and implications for sexual therapy.

Vaginal Orgasm Is Associated with Less Use of Immature Psychological Defense Mechanisms

Freud implied a link between inability to have a vaginal orgasm and psychosexual immaturity. Since Kinsey, many sexologists have asserted that no such link exists. However, empirical testing of the issue has been lacking. The objective was to determine the relationship between different sexual behavior triggers of female orgasm and use of immature psychological defense mechanisms. Women reported their past month frequency of different sexual behaviors and corresponding orgasm rates and completed the Defense Style Questionnaire (DSQ-40). The association between ability to have vaginal intercourse orgasm (versus clitoral orgasm) and the use of DSQ-40 immature psychological defense mechanisms (associated with various psychopathologies) was examined. In a sample of 94 healthy Portuguese women, vaginal orgasm (triggered solely by penile-vaginal intercourse) was associated with less use of DSQ-40 immature defenses. Vaginal orgasm was associated with less somatization, dissociation, displacement, autistic fantasy, devaluation, and isolation of affect. Orgasm from clitoral stimulation or combined clitoral-intercourse stimulation was not associated with less use of immature defenses, and was associated with more use of some immature defenses. In one regression analysis, more masturbation and less vaginal orgasm consistency made independent contributions to the statistical prediction of immature defenses. In another regression analysis, any use of extrinsic clitoral stimulation for intercourse orgasm, and lack of any vaginal orgasm, made independent contributions to the statistical prediction of immature defenses. Vaginally anorgasmic women had immature defenses scores comparable to those of established (depression, social anxiety disorder, panic disorder, and obsessive-compulsive disorder) outpatient psychiatric groups. Results were not confounded by social desirability responding or relationship quality. The results linking penile-vaginal orgasm with less use of immature psychological defense mechanisms are consistent with both early psychoanalytic personality theory and recent advances in sexual physiology. Implications for diagnosis and sex therapy are noted.