The Big O (And We Don’t Mean Oprah!)

Orgasm. Such a complicated topic; so many questions, so few answers. But let’s focus on the most important point, which is, that for women, the biggest obstacle to experiencing orgasm is anxiety. How can anyone relax while having sex if she’s thinking, “Will it happen this time or won’t it?”

As you can imagine, research on this topic is somewhat limited. But the renowned sex researchers William Masters and Virginia Johnson, who were the first to describe the four-step process of experiencing orgasm (during intercourse) many decades ago, said there are four steps involved:

1) Excitement. During foreplay, blood begins to engorge the clitoris, vagina, and nipples, and creates a full body sexual blush. Heart rate and blood pressure increase.

2) Plateau. Sexual tension builds as a precursor to orgasm. The outer one-third of the vagina becomes particularly engorged with blood, creating what’s called "the orgasmic platform."  Heart rate, blood pressure, and respiration continue to increase.

3) Orgasm. A series of rhythmic contractions occur in the uterus, vagina, and the pelvic floor muscles. Sexual tension releases, and muscles throughout the body may contract. A feeling of warmth usually emanates from the pelvis and spreads throughout the entire body.

4) Resolution. The body relaxes, with blood flowing away from the engorged sexual organs. Heart rate, blood pressure, and respiration return to normal.

(For another model of sexual arousal, remember Rosemary Basson's, which takes into account women's more complicated reality.)

Another good thing to know is that experiencing orgasm during intercourse takes time. In one study of 1,000 women, the “mean duration” was about 13 minutes. So trying to hurry it along or time it to coincide with your partner’s is probably not going to help.

It all gets back to the whole idea of relaxing—of letting go and focusing on the moment, enjoying the closeness and intimacy itself without worrying about what the outcome will be every time you have sex.

And, too, most women—two thirds of us—never experience orgasm at all during intercourse; some say the only way they ever get there it is through hand stimulation (their own or their partner’s) or with a vibrator, which often is the quickest route.

If you’re having trouble experiencing orgasm, try some things on your own to see what works and what doesn’t, not just physically, but mentally. Some women, for example, find that fantasizing puts them in a “zone” where they can escape the distractions of life. (Imagine yourself on a desert island with the one you love!)

This is one of those things that can only get better with honest, open communication. Talk with your partner about your feelings, your reactions—everything—so that you both have a good understanding of what’s going on and why.

Let us know your questions about experiencing orgasm; we’ll do our best to answer them (if you’d rather not post them here, use the “Ask Dr. Barb” button on our site). And in the meantime, relax and enjoy the journey.