Q: Can I experience vaginal orgasm?

I’ve got good news and bad news for you. The good news is that you’re just like 75 to 80 percent of women! The majority of women are not able to experience orgasm only with vaginal penetration or stimulation. Most of us need direct clitoral stimulation to orgasm, whether that stimulation is oral, digital, or with a vibrator.

You asked. Dr. Barb answered.A recent journal article on this topic described one factor of influence was the distance between the clitoris and the vaginal opening (read more in this blog post). A few millimeters can make a difference to how orgasm is experienced--and that’s an unmodifiable factor! Since each of us is individually made, the bad news is that if you haven’t experienced vaginal orgasm by now, you’re likely not going to.

There’s one option for you to try: Some vibrators, like the Gigi2 and the Celesse, are shaped specifically to put pressure on the “G spot.” If you’re one of the people for whom orgasm can happen through G-spot stimulation, one of those vibrators can help!

When Size Matters

A recent report in The Journal of Sexual Medicine caught my eye. “Vibrators and Other Sex Toys Are Commonly Recommended to Patients, but Does Size Matter? Dimensions of Commonly Sold Products” is the title. First, I was happy to see that the authors are furthering the discussion about health care providers telling patients about “vibrators and other sex toys” (and, full disclosure, my article in OBG Management is footnoted as among the voices encouraging physicians to consider what they offer women through their practices).

Beyond that encouragement, the researchers compiled dimensions of vibrators and dildos, noting that not every source provides accurate or complete information. The conclusions they reached were that while the size of products varied, the dimensions, overall, “approximated mean penile dimensions.” They further suggested that further familiarity with the product category among clinicians, which is never a bad idea.

Since I’ve been recommending vibrators to women (and men) for some time, I’ve got some practical observations to share, for both patients and clinicians.

First, don’t do anything that hurts. Really.

The corollary to that is that you get to decide what hurts and what feels good. There are no “shoulds.” That’s true even if someone has a chart of dimensions and predictions.

I find that women like vibrators that can be inserted into the vagina for three reasons:

  • They like the feeling of fullness (and for them a dildo is also effective)
  • They like direct stimulation of the G-spot (which, as we’ve said before, has a mystique all its own)
  • While they don’t specifically think of the G-spot, they like the internal stimulation

Their favorite toys are as varied as the women themselves, and dimensions are only one part of that equation. Materials, pulse patterns, and vibration strength also count. Sexual partners and history can have an influence, as can progression of menopause, which can mean narrowing and shortening of the vagina. Over time, women may want a shorter, narrower vibrator, quite possibly with a stronger motor for more intense sensations.

But, again: Using a vibrator should feel good. If a vibrator is too large to comfortably insert, don’t insert it—or wait until you’re more fully aroused before you try again. And regardless of “insertable length,” don’t feel like there’s anyone but you who decides how deep to go.

And if insertion doesn’t sound good or feel good, remember there are a number of vibrators designed to stimulate the clitoris, which is where the nerve endings are concentrated that 70 percent of us need for orgasm.

So if your health care provider is still studying up, don’t be discouraged. Women have more than 100 years of experience using their own judgment with vibrators and pleasure, and you can do the same.

Reading between the Lines

I have a lot of conversations with women about sex, given my line of work. And, because of that little pink “Ask Dr. Barb” button on our website, I get some cryptic emails, too. Sometimes I have to read between the lines, both in person and online, to understand what the situation—and therefore the question—might be.

One recent email referred to male partners who were not especially “gifted.” As I think about it, I suspect that my correspondent was wondering about her own orgasm—or her failure to experience it. That’s not the topic we corresponded about, since she went on to ask a different question, but because I’m sure that woman is not alone, let me lay it out here.

In spite of the passionate scenes we see in movies, most of us—70 percent—don’t experience orgasm during intercourse without additional stimulation. For most of us, it’s the clitoris that’s the key to orgasm, and most positions for intercourse just don’t provide enough stimulation. There are other sources of stimulation that can lead to orgasm—some of us have very sensitive nipples, for example, and some of us have found success with the G-spot.

It’s rare for a partner, whether “gifted” or not, to be psychic; and most women I know would prefer that their partner not be too widely experienced in the varieties of women’s responses. And that’s why I encourage women to know their own bodies, exploring either on their own or in the presence of their partners (many of whom find the experience quite erotic, by the way). Vibrators have proven to be very effective in clitoral stimulation; adding internal stimulation is helpful for about a third of us.

When you find what works for you, you can give your partner some suggestions, which will be much appreciated. (If, by the way, you’re wondering whether you’ve experienced an orgasm, keep exploring. You’ll know when you have.)

Ninety-six percent of us can experience orgasm. Be assured of that and relax. Being focused on that goal can inhibit your ability to achieve it. And let’s affirm one more time that sex can be pleasurable without orgasm, too, for the intimacy you share with your partner, for the feeling of wholeness and power it gives you.

Another email exchange—with a woman who experienced her first orgasm at 70—confirms that it’s never too late.

Q: What's the G-spot got to do with orgasm?

Great question! Unfortunately, there's enough controversy about the answer to have warranted a whole blog post on the subject. The short answer, though, is that the G-spot (named for the German gynecologist Ernst Grafenberg, who talked about it in the 1950s) is a sexually sensitive area about a third of the way up the anterior (front) vaginal wall. There seems to be a rich plexus of nerves just beneath the vaginal surface in that area, which, when stimulated, may produce a variety of feelings: discomfort, urge to urinate, or pleasure. Some believe–and experience–that stimulation in that area leads to orgasm; this may be the specific source of vaginal orgasm (as opposed to the more-common orgasm from clitoral stimulation).

Being aware of the discussion of and theories of the G-spot is great; so is experimenting to see what sensations are present for you, in a spirit of creativity. Don't assume there's a "should" or an "ought" that you're missing. Please explore your own body, and embrace your own personal sexuality!

To ask your own question, use the pink “Ask Dr. Barb” button top and center on our website. You’ll receive a confidential reply via email, and your question may be used as the basis for a Q&A post here on our blog. 

Q: What might help me orgasm?

First of all, know you're not alone. By some estimates, as many as one in ten of us has never experienced orgasm, and among those of us who have, it happens in only about half of our sexual encounters. I'm not suggesting that makes it okay that you're struggling; knowing the facts, though, can lessen your stress about what's happening—or not happening.

In spite of what you see in the movies, most women—up to 80 percent—cannot have an orgasm with intercourse alone. Most women need direct stimulation of the clitoris, and the mechanics of intercourse just don't provide that. Oral or manual stimulation of the clitoris tends to lead to orgasm, and vibrators give the kind of stimulation needed—as variety or because it's easier. Especially as we grow older, many women need the extra stimulation a vibrator provides.

Vibrators can be for external or internal use. External vibrators (Fin, and Kiri) work extremely well for women who respond to direct clitoral stimulation. Other women like the internal stimulation of the vagina and G spot, too, for which some vibrators (Gigi, Raya, Celesse) are designed for insertion. Those vibrators can also be used externally on the clitoris. If you want the extra stimulation during intercourse, the external type will work best.

There are additional features you might think about, too; I've written whole blog posts on the topic. Whatever you might choose, I often recommend to women that they try self-stimulation to see what kind of touch where feels best. That, too, lessens the pressure when you're with your partner.

Enjoy the exploration! It's never too late to learn even more about your body.

The G-spot: Defined but Not Demystified

Remember the G-spot brouhaha?

Yes, there is one. No, there isn’t. Is. Isn’t.

If you were aware of that controversy you might wonder whatever happened to it. Was anything about the mysterious G-spot ever resolved?

For all intents and purposes, after a flurry of attention in the 1980s, the G-spot seemed to go underground for a decade or two, but lately, with the advent of newfangled imaging devices, the search for the G-spot has resurrected once again. So, in case you’ve been wondering, let us bring you up to date on this mysterious region.

The G-spot is defined (and yes, there is a definition) as an erogenous area about the size of a nickel located 2 to 3 inches inside the front wall of a woman’s vagina.

The name comes from the German gynecologist Ernst Gräfenberg, who first wrote about its existence in 1950. But a mysterious pleasure center in roughly the same place had also been mentioned in ancient Indian texts and by Regnier de Graaf, a Dutch physician, in 1672, who wrote that secretions from this area “lubricate their sexual parts in agreeable fashion during coitus.”

But it was the publication of The G-Spot and Other Discoveries about Human Sexuality in the 1980s that ignited a frenzy. Couples contorted themselves into pretzels seeking the elusive mind-blowing orgasms that accompanied just the right stimulation. (Leaving many women feeling inadequate and their partners frustrated, I’m sure.) Researchers, too, overheated their Bunsen burners trying to find the darned thing.

Then, without further fuel to fan the fire, the short attention span of popular culture wandered, and interest in the G-spot waned.

In 2008, however, Italian researchers using new ultrasound technology discovered a thickened area on the front vaginal wall of about half of 20 women. Women with this thickened tissue were more likely to experience vaginal orgasms. In 2010, a group of British researchers asked 90 pairs of twins if they had a “so called G-spot, a small area the size of a 20p coin on the front wall of your vagina that is sensitive to deep pressure?”

Unsurprisingly, given the subjective nature of that question, the results from the British study were ambiguous and were challenged by other scientists. The following month French researchers, askance at the sloppy work from the boys across the channel, declared that 56 percent of women did indeed have “un point G.”

Physiologically, a G-spot has not been definitively identified by gynecologists, nor in dissections nor consistently in ultrasounds. So the mystery remains, according to urologist Dr. Amichai Kilchevsky, who led an extensive review of all research on the issue. “Without a doubt, a discreet anatomic entity call the G-spot does not exist,” says Dr. Kilchevsky.

Yet, women consistently report that stimulating the front of the vaginal wall produces a deep, pleasurable orgasm. “…it has been pretty widely accepted that many women find it pleasurable, if not orgasmic, to be stimulated on the front wall of the vagina," said Debby Herbenick, researcher at Indiana University and author of Because It Feels Good.

According to Australian researcher Dr. Helen O’Connell, the clitoris, urethra, and vagina all work together during sexual stimulation, creating a “clitoral complex.” Since the urethra lies along the outside of the vagina and the clitoris has deep “roots” within the vaginal walls it’s no stretch to imagine that all the parts work together during sex.

Some doctors compare the G-spot controversy to obsession over penis size—much ado about nothing. Lots of women don’t orgasm with vaginal penetration alone; indeed, most of us need both vaginal and clitoral stimulation to orgasm. So, if “we don't even have orgasm all figured out yet, I don't know why we would expect to have the G-spot figured out,” Herbenick said in an article on Netdoctor.

Because of its approximate location, the G-spot is devilishly hard to reach, especially in the standard missionary position. However, if you’d like to spice up your bedtime routine with a little research of your own, try sitting astride your partner, on a sturdy chair or firm surface. Lean backward so the penis has a better chance of connecting with the front of the vagina.

If this sounds too acrobatic for a fun Friday night, you can always fall back on the trusty index finger. Lie on your back while your partner inserts his finger, using a “come hither” motion to stimulate front of the vagina. Or try a toy. Special G-spot vibrators are available that are longer with a kink at the end. Results are still mixed, so focus on the exploration, not a specific result.

And remember to be well-lubricated and relaxed. Light a few candles and some incense. Research has never been so fun.

Her First Vibrator (Pt 3)

Part 3 of 3
Shopping for vibrators can be fun, and really very interesting. These devices come in many configurations and with many options, because, well, we’re all different. What one woman or couple likes and needs can be a real turnoff for the next.

While my partners and I shopped for the collection we offer at our online store, we kept these factors in mind:

Size and Shape Vibrators come in sizes and shapes destined for specific as well as general use. You will find mini vibrators great for clitoral and prostate stimulation. These small devices may fit in the palm of your hand or strap to a finger (especially good for making love in the dark).

There are larger clitoral vibrators shaped to cup the clitoris and labia. These can be combined with a dilator or dildo, used during intercourse, or used on their own to help stimulate vulvo-vaginal tissues.

Midsized vibrators are often wand-shaped for vaginal and g-spot stimulation. Large women find these useful for the reach they provide, and they can also provide leverage for women who have difficulty with hand strength.

Massagers are dual use devices, used for vulvar stimulation as well as massaging muscles anywhere in the body (really!). Attachments for these devices can transform them into vaginal and g-spot stimulating wonders.

Power Older women generally need more power, both a stronger vibration and a longer session time. For that reason, rechargable batteries or plug-in devices are usually a better bet than disposable battery-operated devices.

Materials Hard plastics and stainless steel are easy to clean. Look for materials that are guaranteed to be phthalate-free. Silicone surfaces are wonderfully warm to the touch, with a skin-like feel. They clean up with soap and water or with cleaners made especially for sex aids, but owners need to be careful not to use them with silicone-based lubricants. Some manufacturers now use anti-microbial plastics, medical-grade materials formulated to discourage bacterial growth.

Heat Feature Vibrators that warm up before and during use are great for those of us who flinch from the cold.

If that’s too many variables to maneuver in one shopping experience, may we make a recommendation? If this is your first vibrator ever, why not start with one designed specifically for clitoral and labial stimulation? That way you’re sure to have a device that will help you improve circulation, keeping your vulvar tissues responsive and ready for sex when you are.

When you have your new device in hand, be sure to charge it fully before you use it. Start slowly and gently, using plenty of lubricant with the device, learning what your device will do and how your body likes it. If it’s been awhile since you have had any sexual stimulation at all, be patient. Give your body time and a number of sessions to awake to this new sensation. And if you’re bringing this new toy into an old relationship, talk through it, explore this device together. The more communication, the better.

And you tell us! What advice or questions or stories do you have about selecting a vibrator or bringing one into your sex life for the first time? We would love to hear from you!

Return to Pt 1 of 3

Her First Vibrator (Pt 2)

Part 2 of 3
Of course, I can explain why we need more vulvo-vaginal stimulation at our age to nearly any woman in my office, and she may understand and fully accept what I’m telling her. But her next step is to go home and discuss this with her partner, if she has one.

Many times, at our age, we’re talking about spouses — sexual partners we’ve had for a very long time. And if that sexual partnership has not included the use of any sexual aids, bringing that first vibrator to bed can be a daunting change.

The truth is, we don’t know how our partners will respond to our need or desire to use a vibrator until we raise the subject. One good way to do that is to say — "Well, Dr. Barb said this could help." Show your partner these blog posts, and browse the MiddlesexMD.com website together, where you’ll find lots of information that can help you communicate what your body is going through and what you and your partner can do about it to continue to enjoy your sex life.

It can help to shop for your first vibrator together, whether in a store or online. The lines of vibrators we’ve gathered at MiddlesexMD.com are designed especially for women in midlife who need vibrators that will hold a long charge and deliver a strong vibration.

But even with all this information at the ready, one or both of you may be suffering from some vibrator mythology that will make you hesitate to use one of these devices. So let me do a little dispelling:

Myth 1: Vibrators are for people whose relationships aren’t strong — Actually vibrators work best for couples whose intimacy is solid and secure, playful and creative. Introducing a vibrator at our age can awaken those qualities in a strong relationship, and underscore an important lesson, that the nature of our sexuality shifts as we age, period. Accepting that with grace and creativity is important for any partnership.

Myth 2: Vibrators make it hard to have an orgasm any other way — Actually the exact opposite is true. The more orgasms women have, the more easily we can achieve them. Every orgasm helps to strengthen the muscles and nerve pathways that ready us for our next one. While, having easier orgasms with a vibrator may encourage its regular use, no vibrator can ever replace human contact. Women generally crave intimacy first.

Myth 3: Vibrators are for masturbation — While that one is true, vibrators are not only for masturbation. They have gone mainstream among couples who have figured out that vibrators are great for stimulating every erogenous zone, and in addition to the boost they give women, are particularly good for stimulating a man’s prostate. They are great for foreplay, during sex, and for gentle stimulation after intercourse, too.

Myth 4: Vibrators are for sex maniacs — Sex maniacs may like them. But so may your neighbor, your pastor, your doctor, your auto mechanic. We’ve been using electronic vibrators since we harnessed electricity, and they are more mainstream than you might expect.

On to Part 3 of 3…
Or go back to catch Part 1.