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minora, and clitoris. The uterus is lifted up, increases in size, and vaginal secretions increase. The nipples harden and become erect.

The next phase is the plateau phase. This happens just before an orgasm with increasing stimulation of the genitals. Muscle tension further increases and involuntary vocalizations occur. Being in this phase too long will lead to some people feeling uncomfortable and sexually frustrated.

Males in the plateau phase have contraction of the urethral sphincter to prevent semen from mixing with urine. Rhythmic contraction of the pelvic muscles begins and preejaculate can be released. In women, the clitoris is increasingly sensitive and there is increased lubrication. This is the peak of sexual excitation if an orgasm isn’t reached.

The orgasm phase involves cyclical contraction of the anal and perineal muscles, uterine contractions, and vaginal contractions. Muscle spasms happen throughout the body, the heart rate increases further and a sensation of euphoria is experienced. Males will ejaculate during orgasm. Women also experience the same sexual pleasure as men, even though most do not ejaculate.

MORE ON ORGASM

Orgasm is also referred to as sexual climax. It discharges the sexual excitement built up in the excitement and plateau phases of the sexual response cycle. Its physiological activity is under the control of the autonomic nervous system. There is a natural euphoric response that releases oxytocin, prolactin, and endorphins, which contribute to a relaxing experience.

The muscular contractions, particularly of the pelvic muscles, are a key feature of an orgasm, which help to dissipate sexual tension. The exact definition of what an orgasm is cannot, however, be agreed upon by doctors and researchers. There are physical, neurological, endocrine, and psychological definitions included under the umbrella of the word “orgasm”.

An orgasm can be achieved with anal, vaginal, oral sex. It can also be achieved without penetration and can involve both masturbation and sex toys. While orgasms usually

mean genital stimulation is required, some can achieve orgasm through stimulation of other erogenous zones. Multiple orgasms are more common in females but are not universal. Dreaming can lead to orgasms and psychological orgasms can be gotten among people with spinal cord injuries. Sexual assault and rape can lead to involuntary orgasms.

Males generally require penile stimulation to have an orgasm and ejaculation usually occurs. With dry orgasms in men, retrograde ejaculation, which is the passage of semen into the bladder rather than to the outside, is usually the underlying cause. Men can also have an orgasm by stimulating the prostate and can have ejaculation without an orgasm.

There are two stages of male orgasm. The first is emission and the second is called the refractory period. In the refractory period, it is impossible to have an orgasm. Males can feel ejaculation coming on and will not be able to delay or stop this. This knowing that an ejaculation is coming happens about three seconds before it happens. Young men have a shorter refractory period than older men. Multiple orgasms in men are rare. The hormone oxytocin is responsible for the refractory period.

Women usually require clitoral stimulation to achieve an orgasm. There are differences in how much stimulation is required to achieve one. The vagina is much less sensitive but the anterior wall and the area between the labia minor and the urethra will be sensitive. The G-spot is believed to be a spot called the urethral sponge along the anterior of the vagina. Some women have increased sensitivity of the clitoris after an orgasm that can be painful. Women can have a refractory period but are also capable of multiple orgasms. Most women cannot have a vaginal orgasm.

Remember that the corpora cavernosa of the female clitoris extends downward on either side of the vaginal introitus. Because of this, some women will experience clitoral arousal from vaginal penetration but, rather than being a true vaginal orgasm, it is actually the clitoris that is being stimulated. The root of the clitoris extends to the anterior vaginal wall, which may explain arousal in this area.

Anorgasmia is the inability to attain an orgasm after sexual stimulation. Some of this is due to an increased amount of time it takes for some women to attain an orgasm. Women experience orgasm about 25 percent of the time with vaginal penetration alone

but 81 percent will achieve an orgasm through cunnilingus, which is oral stimulation of the female clitoris. It was also once suggested that exercise alone could bring about an orgasm but this is hotly debated.

There are nerve endings in and around the anus so sexual pleasure can be gotten through this type of sexual activity. We will talk more about anal sex in the next chapter. The prostate gland is also very sensitive in men so it can be stimulated with a perineal vibrator, perineal massage, or anal sex. Many men feel longer and more satisfying orgasms through stimulation of the prostate gland. In women, the shared sensory nerves among the clitoris and anus will lead to some clitoral stimulation with anal penetration. It is, however, rare to have an orgasm in females with anal sex alone.

Nipple stimulation can happen as part of foreplay but can sometimes lead to breast or nipple orgasms. This is not a common phenomenon. What is known, however, is that nipple stimulation is received by the same parts of the brain that get sensations from the cervix, clitoris, and vagina. Oxytocin is released in nipple stimulation, which increases excitement and sexual arousal.

The length of the male orgasm is between ten and fifteen seconds but it can be longer. The contractions of the pelvic muscles and anal sphincter happens along with contraction of the prostate. The euphoria rapidly dissipates after ejaculation and the amount of ejaculate decreases as the orgasm progresses. The duration of orgasms and the amount of semen released will decrease over time. In older males, the refractory period can last several days.

Women have longer orgasms, lasting an average of twenty seconds. There will be muscle contractions of the anus, vagina, and uterus. Shuddering can also occur and pelvic contractions can be absent. The clitoral glans will retract under the clitoral hood and the inner labia darken. The outer vagina tightens while the total length of the vagina increases. The vagina will become congested with blood. The tipples will be erect and the feeling of contractions are felt to be pleasurable. Muscle contractions are the most reliable measure of an orgasm in women.

Brain activity and orgasms have not been well studied. PET scanning or positron emission tomography has been used of the brain to assess orgasms in women. The