Multiple Orgasm in the Human Male

<< Vagina and Cervix >>

Vestibule of Vagina
The labia minora continue inward to form a broad, funnel-shaped vestibule which leads to the actual entrance (the orifice or introitus) of the vagina (Figure 118f). The structure represents an inpocketing of external epidermis which is well supphed with end organs of touch. Nearly all females—about 97 per cent according to the gynecologic tests—are distinctly conscious of tactile stimulation applied anywhere in this vestibule, and only a very occasional female out of the 879 who were tested proved to be entirely insensitive in the area. For nearly all women the vestibule is as important a source of erotic stimulation as the labia minora or the clitoris. Since the vestibule must be penetrated by the penis of the male in coitus, it is of considerable importance as a source of erotic stimulation for the female.

The hymen of the virgin female is a more or less thin membrane which lies at the inner limits of the vestibule. It is attached by its outer rim, partially blocking the entrance to the vagina. It usually has a natural opening of some diameter located in the center of the membrane, but this may, of course, be enlarged either by coitus or by the insertion of fingers, tampons, or other objects. An unusually thick or tough hymen which might cause considerable pain if it were first stretched or torn in coitus, may be more easily stretched or cut by the physician who makes a pre-marital examination. Remnants of the hymen almost always persist even after long years of coital experience, and the remnant of the tissue is sometimes sensitive. It is not clear whether the sensitivity depends on nerves in the remnants of the tissue or on the fact that movements of the tissue may stimulate the underlying nerves.

A ring of powerful muscles (the levator muscles) lies just beyond the vaginal entrance. The cavity of the vagina extends beyond this point. The female may be very conscious of pressure on the levators. The muscles may respond reflexly when they are stimulated by pressure, and most females are erotically aroused when they are so stimulated.

Interior of Vagina
The vagina (Figure 118f) is the internal cavity which lies beyond the external genitalia of the female. Unlike its vestibule, the vagina is derived embryologically from the primitive egg ducts which, like nearly all other internal body structures, are poorly supplied with end organs of touch. The internal (entodermal) origin of the lining of the vagina makes it similar in this respect to the rectum and other parts of the digestive tract. There is no functional homologue of the vagina in the male.

In most females the walls of the vagina are devoid of end organs of touch and are quite insensitive when they are gently stroked or lightly pressed. For most individuals the insensitivity extends to every part of the vagina. Among the women who were tested in our gynecologic sample, less than 14 per cent were at all conscious that they had been touched. Most of those who did make some response had the sensitivity confined to certain points, in most cases on the upper (anterior) walls of the vagina just inside the vaginal entrance. The limited histologic studies of vaginal tissues confirm this experimental evidence that end organs of touch are in most cases lacking in the walls of the vagina, although some nerves have been found at spots in the vaginal walls of some individuals.
Relative lack of nerves and end organs in the vaginal surface is noted by : Dahl acc. Kuntz 1945:319. Undeutsch 1950:447. Dr. F. J. Hector (Bristol, England) and Dr. K. E. Kranz (University of Vermont) have furnished us with histologic data on this point. Vaginal sensitivity applying primarily to the area on the anterior wall at the base of the clitoris is also noted in: Lewis 1942:8. Grafenberg 1950:146, 148.

This insensitivity of the vagina has been recognized by gynecologists who regularly probe and do surface operations in this area without using anesthesia. Under such conditions most patients show little if any awareness of pain. There is some individual variation in this regard, and clinicians are aware of this, for they ordinarily stand prepared to administer a local anesthetic if the patient does register pain.
From our gynecologic consultants, we have abundant data on the limited necessity of using anesthesia in vaginal operations. See also Döderlein and Krönig 1907:88.

The relative unimportance of the vagina as a center of erotic stimulation is further attested by the fact that relatively few females masturbate by making deep vaginal insertions. Fully 84 per cent of the females in the sample who had masturbated had depended chiefly on labial and clitorial stimulation. Although some 20 per cent had masturbated on occasion by inserting their fingers or other objects into the vagina, only a small portion had regularly used that technique. Moreover, the majority of those who had made insertions did so primarily for the sake of providing additional pressure on the introital ring of muscles, or to stimulate the anterior wall of the vagina at the base of the clitoris, and they had not made deeper insertions. As we shall note below, there is satisfaction to be obtained from deeper penetration of the vagina by way of nerve masses that lie outside of the vaginal wall itself, but all the evidence indicates that the vaginal walls are quite insensitive in the great majority of females.
Simone de Beauvoir 1952:373 says vaginal pleasure certainly exists, and proposes (without specific data) that vaginal masturbation seems more common than we have indicated.

In most of the homosexual relations had by females, there is no attempt at deep vaginal insertions. Once again, the insertions that are made are usually confined to the introitus or intended to stimulate the anterior wall of the vagina at the base of the clitoris. Occasionally there are deeper penetrations in order to reach the perineal nerves. This restriction of so much of the homosexual technique is especially significant because, as we have already noted, homosexual females have a better than average understanding of female genital anatomy.

On the other hand, many females, and perhaps a majority of them, find that when coitus involves deep vaginal penetrations, they secure a type of satisfaction which differs from that provided by the stimulation of the labia or clitoris alone. In view of the evidence that the walls of the vagina are ordinarily insensitive, it is obvious that the satisfactions obtained from vaginal penetration must depend on some mechanism that lies outside of the vaginal walls themselves.

There is a parallel situation in anal coitus. The anus, like the entrance to the vagina, is richly supplied with nerves, but the rectum, like the depths of the vagina, is a tube which is poorly supplied with sensory nerves. However, the receiving partner, female or male, often reports that the deep penetration of the rectum may bring satisfaction which is, in many respects, comparable to that which may be obtained from a deep vaginal insertion.

There may be six or more sources of the satisfactions obtainable from deep vaginal penetrations, and several or all of these may be involved in any particular case. The six sources are:

      1.    Psychologic satisfaction in knowing that a sexual union and deep penetration have been effected. The realization that the partner is being satisfied may be a factor of considerable importance here.
      2.    Tactile stimulation coming from the full body contact with the partner, and from his weight. This may result in pressures on various internal organs which can produce “referred sensations.” These may be incorrectly interpreted as coming from surface stimulation.
      3.    Tactile stimulation by the male genitalia or body pressing against the labia minora, the clitoris, or the vestibule of the vagina. This alone would provide sufficient stimulation to bring most females to orgasm. The location of this stimulation may be correctly recognized, or it may be incorrectly attributed to the interior of the vagina.
      4.    Stimulation of the levator ring of muscles in coitus. Such stimulation may bring reflex spasms which may have distinctly erotic significance.
      5.    Stimulation of the nerves that lie on the perineal muscle mass ( the so-called pelvic sling), which is located between the rectum and the vagina (see the discussion of the perineum, below).
      6.    The direct stimulation, in some females, of end organs in the walls of the vagina itself. But this can be true only of the 14 per cent who are conscious of tactile stimulation of the area. There is, however, no evidence that the vagina is ever the sole source of arousal, or even the primary source of erotic arousal in any female.

Some of the psychoanalysts and some other clinicians insist that only vaginal stimulation and a “vaginal orgasm” can provide a psychologically satisfactory culmination to the activity of a “sexually mature” female. It is difficult, however, in the light of our present understanding of the anatomy and physiology of sexual response, to understand what can be meant by a “vaginal orgasm.” The literature usually implies that the vagina itself should be the center of sensory stimulation, and this as we have seen is a physical and physiologic impossibility for nearly all females. Freud recognized that the clitoris is highly sensitive and the vagina insensitive in the younger female, but he contended that psychosexual maturation involved a subordination of clitoral reactions and a development of sensitivity within the vagina itself; but there are no anatomic data to indicate that such a physical transformation has ever been observed or is possible.
For Freud’s interpretation of the relative importance of the clitoris and vagina, and the adoption of this interpretation by many of the psychoanalysts, see, for instance; Freud 1933:161 (“. . . in the phallic phase of the girl, the clitoris is the dominant erotogenic zone. But it is not destined to remain so; with the change to femininity, the clitoris must give up to the vagina its sensitivity, and, with it, its importance, either wholly or in part”). Freud 1935:278 (“The clitoris in the girl, moreover, is in every way equivalent during childhood to the penis. . . . In the transition to womanhood very much depends upon the early and complete relegation of this sensitivity from the clitoris oyer to the vaginal orifice”). Hitschmann and Bergler 1936:15 (“. . . the girl . . . must undertake a removal of the leading sexual zone from the clitoris to the vagina. . . . If this transition is not successful, then the woman cannot experience satisfaction in the sexual act. . . . The first and decisive requisite of a normal orgasm is vaginal sensitivity”). Deutsch 1945(2):80 (“. . . the clitoris preserves its excitability during the latency period and is unwilling to cede its function smoothly, while the vagina for its part does not prove completely willing to take over both functions, reproduction and sexual pleasure”). Fenichel 1945:82 (‘‘The significance of the phallic period for the female sex is associated with the fact that the feminine genitals have two leading erogenous zones: the clitoris and the vagina. In the infantile genital period the former and in the adult period the latter is in the foreground. The change from the clitoris as the leading zone to the vagina is a step that definitely occurs in or after puberty only”). Kroger and Freed 1950:528 (“Hence, in the child the clitoris gives sexual satisfaction, while in the normal adult woman the vagina is supposed to be the principal sexual organ . . . . in frigid women the transference of sexual satisfaction and excitement from the clitoris to the vagina, which usually occurs with emotional maturation, does not take place). See also: Chideckel 1935:39. Ferenczi 1936: 255-256. Knight 1943:28. Abraham (1927) 1948:284.

The concept of a vaginal orgasm may mean, on the other hand, that the spasms that accompany or follow orgasm involve the vagina; and in much of the psychoanalytic literature there is an implication that the vagina must be chiefly involved before one may expect any maximum and “mature” psychosexual satisfaction. This is an equally untenable interpretation for, as most parts of the nervous system, and all parts of the body which are controlled by those parts of the nervous system, are involved whenever there is sexual response and orgasm. In some individuals the spasms or convulsions that follow orgasm are intense and prolonged, and in others they are mild and of short duration. The individual differences in patterns of response are quite persistent throughout an individual’s lifetime, and probably depend upon inherent capacities more than upon learned acquirements. Those females who have extensive spasms throughout their bodies when they reach orgasm are the ones who are likely to have vaginal convulsions of some magnitude at the same time. Those who make few gross body responses in orgasm are not likely to show intense vaginal contractions. No question of “maturity” seems to be involved, and there is no evidence that the vagina responds in orgasm as a separate organ and apart from the total body. Whether a female or male derives more or less intense sensory or psychologic satisfaction when the vaginal spasms are more or less extreme is a matter which it would be very difficult to analyze.
The shift from clitoris to vagina is sometimes stated to be psychologic rather than physiologic, and in psychoanalytic theory the failure to effect this change is frequently considered the chief cause of frigidity. For example, see: Freud 1935:278 (“In those women who are sexually anaesthetic, as it is called, the clitoris has stubbornly retained this sensitivity”). Hitschmann and Bergler 1936:20 (“Under frigidity we understand the incapacity of woman to have a vaginal orgasm. . . . The sole criterion of frigidity is the absence of the vaginal orgasm”). Deutsch 1944(1):233 (“The competition of the clitoris, which intercepts the excitations unable to reach the vagina, and the genital trauma then create the dispositional basis of a permanent sexual inhibition, i.e., frigidity”). Abraham (1927) 1948:359 (“In . . . frigidity the pleasurable sensation is as a rule situated in the clitoris and the vaginal zone has none”). Kroger and Freed 1950:526 (“However, as a general rule, the question of what constitutes true frigidity depends on whether clitoric or vaginal response is achieved. It is believed that the clitoris does not often come into contact with the male organ during intercourse, and, if a transfer in sensation occurs from the clitoris to the vagina, it is purely psychologic and unconscious. In completely frigid women this psychologic transmission is always disturbed. Therefore, the problem of frigidity is reduced to a psychologic basis”). See also: Lundberg and Farnham 1947:266. Stokes 1948:39. Bergler 1951:216 (transfer is purely psychologic). Beauvoir 1952:372 (“the clitorid orgasm . . . is a kind of detumescence . . . only indirectly connected with normal coition, and it plays no part in procreation”).

This question is one of considerable importance because much of the literature and many of the clinicians, including psychoanalysts and some of the clinical psychologists and marriage counselors, have expended considerable effort trying to teach their patients to transfer “clitoral responses” into “vaginal responses.” Some hundreds of the women in our own study and many thousands of the patients of certain clinicians have consequently been much disturbed by their failure to accomplish this biologic impossibility.

Cervix
The cervix (Figure 118f) is the lower portion of the uterus. It protrudes into the deeper recesses of the vaginal cavity, and stands out from the vaginal wall as a rounded and blunt tip about as large or larger than the tip of a thumb. It has been identified by some of our subjects, as well as by many of the patients who go to gynecologists, as an area which must be stimulated by the penetrating male organ before they can achieve full and complete satisfaction in orgasm; but most females are incapable of localizing the sources of their sexual arousal, and gynecologic patients may insist that they feel the clinician touching the cervix when, in reality, the stimulation had been applied to the upper (anterior) wall of the vestibule to the vagina near the clitoris. All of the clinical and experimental data show that the surface of the cervix is the most completely insensitive part of the female genital anatomy. Some 95 per cent of the 879 women tested by the gynecologists for the present study were totally unaware that they had been touched when the cervix was stroked or even lightly pressed. Less than 5 per cent were more or less conscious of such stimulation, and only 2 per cent of the group showed anything more than localized and vague responses.

Histologic studies show that there are essentially no tactile nerve ends in the surfaces of the cervix. This is further confirmed by gynecologic experience, for the surfaces are regularly cauterized and operated upon in other ways without the use of any anesthesia—and nearly all such patients are unaware that they have been touched. Cutting deeper into the tissue of the cervix may lead an occasional patient to register pain, and the dilation of the cervical canal causes most patients to feel intense pain. In none of these instances, however, is there any evidence of erotic response.
Our data on the insensitivity of the cervix come from the abundant experience of our gynecologic consultants. See also: Döderlein and Krönig 1907:88. Malchow 1923:183. Lewis 1942:8. Dickinson ms.

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