Hi, I’m Wendy Zukerman and you’re listening to Science Vs from Gimlet. This is the show that pits facts against FEELING GOOD. On today's show, Orgasms
MG: So I guess I’ll tell you about the first orgasm I experienced. You wanna just like dive into this like straight ahead or are we going to circle back or what?
Let's circle back for a sec. This is Malaka Grant, she grew up in Ghana and now lives in South Africa. And Malaka runs a blog about the sex lives of women in Africa - it's called Adventures from the Bedrooms of African Women. And one reason she started it is because growing up, women around her weren't talking about how to have orgasms - it was this big mystery..
MG because had so little education around sex and what to expect I thought an orgasm was supposed to look and feel one way like, you know, the shuddering on you know, in the movies and, you know, and the screaming,
And Malaka - had never felt that… as she went through her 20s. The guys she'd have sex with - they'd orgasm. No worries. But for her, it just didn't happen. No matter how hard some of her partners tried.
MG I had one partner that just did everything in his power. He was like flipping me up this way and turning me back that way, and, you know, going harder and going softer. And so finally, I was just like, oh, here I come. And so I start to like, vibrate and shudder and go boo, boo, boo, boo, boo, boo, boo, boo, boo, boo. And he was like, What are you doing? I'm like, I'm coming, but I wasn't. And so I was like, I was really trying to spare his feelings.
HHG Do you think he was convinced?
That's producer Hannah Harris Green.
MG I don't think he was convinced. I think he was smart enough to like to know. But then I've been with other people. They're like, okay, yeah, I was the first to do it. And I'm like, Yeah, but you weren't.
But after a lot of disappointment... things were about to change. It was just before her thirtieth birthday. She was working in a shoe store at the time … and one night in bed… that first, special, unforgettable moment.
MG I was in a dream and it was just rows and rows and rows of shoes like shoes as far as the eye could see. And someone some entity out of the middle of nowhere handed me a credit card and said, You can buy whatever you want, and you never have to pay back the balance. And so I'm running through these rows of shoes now mind you, I'm asleep. This is a dream. Running through these rows of shoes and picking up like these phenomenal heels and flats and everything fits and there's no competition for the shoes. I come so hard that this is my first orgasm. I came so hard in my sleep that it woke me up and I was like drenched between my
legs. I was like, What was that?
It made me understand the French term le petit mort because it literally felt like I was dying. I blacked out. And I felt like I was on the verge of death and it was fantastic. And then you come back to life.
HHG So the next day how did you feel?
MG Yeah, so the next day you know, it was like, well, am I gonna have to dream about shoes the next time I wanna experience pleasure during sex? Like what is it going to take?
What is it going to take -- to get us all orgasming like that? There are plenty of people who just can’t get there and they don’t always know why. And this is particularly a problem for women. So, for example, one survey of about 50,000 people it found that 95% of straight men said they almost always orgasm when they have sex. 95% !! But with straight women? It was just 65%. This is so well known in the science of sex that it has a name: The Orgasm Gap.
And there is this idea out there that the “female orgasm” is like a riddle, that it’s complicated and hard to reach -- while for a man with a penis it’s simple - a straight shot.
And it's not like orgasms are the only way to have fun during sex -- but they are really nice. So, on today’s show, we’re going to take a closer look at what's going on here? Why aren't women orgasming as much as men -- is there something different about us that makes the female orgasm elusive?
Because when it comes to orgasm there can be a lot of
MG: I’m coming! But I wasn’t
But then, there’s science
Science Vs Orgasm… After the break.
Welcome back. Today we're exploring the science of orgasms - and why it's harder for some to come. So we have this idea that making a woman orgasm is this huge accomplishment, much harder to do than getting a guy there. When we asked you, our audience, to send us your stories about orgasms, we heard this over and over again.
I love my husband, we have a wonderful relationship. But to this day, I have never had an orgasm.
I figured after I tried a couple times unsuccessfully that maybe it was just not for me.
I've tried using vibrators. I have tried looking up different resources to try to learn more about my anatomy. So far, no dice.
So what is going on here? And by the way, the research here often leaves out a lot of groups - including trans and queer folk. So unless we say otherwise, the science we’re discussing is about cis people having straight sex.. 
Ok - our first stop is to figure out - what exactly is going on when we have an orgasm. And for that, we’re starting with the biggest, most powerful, throbbing, veiny sex organ….
NW Uhhh the brain.
The brain! This is Nan Wise, she was a clinician helping people with their sex lives for decades, but there was something missing in her understanding of sex. And so
NW went back to grad school to become a neuroscientist, when I turned 50.
When Nan finished grad school - she set up one of the only studies we have of what's going on in the brain during an orgasm. Because she wanted to see what’s firing when we’re all fired up. First up, Nan got 14 women who said they were up for having an orgasm while in an MRI. But right away, she hit a big problem…
NW The number one enemy in brain studies is movement
To get a clean scan in an MRI -- your head needs to be perfectly still. Which is a bit tough when you're having a wank. So Nan had to invent something that the women would wear on their heads to keep it still. After a couple of years of trial and error - she settled on the design..
NW What we called the Hannibal Hector happy helmet.
NW And it really was a scary looking contraption...
Nan used plastic that molded to the shape of each subject’s head, and cut out eye and nose holes. It looks kind of like having your head wrapped in white construction fencing, or like you’re Kanye on the Yeezus tour.
So imagine - you're lying in this MRI, head all cased up - and inside an MRI?
NW it's loud, loud, loud.
It kinda sounds like
NW boom, boom Ba ba ba, ba, ba, ba, ba, ba ba bum bum.
So they put on earplugs. And now it's orgasm time! Women are lying down with their head in the MRI - and the lower half of their body is out of the scanner. In part of the experiment, Nan had the women's partners touch their genitals until they came. But there were complications here too - with the women stuck in the MRI with earplugs, with that loud noise -- they couldn't talk to each other .... So the women in the scanner would have to press a button to say they've started orgasming… . And Nan would relay that to the partners, who were wearing headphones ...:
NW The partner would hear - Your partner is having an orgasm. Then the participant would press a button orgasm was finished. And the partner would hear, stop stimulating - your partner's orgasm is complete.
WZ Oh my gosh so the partners have your voice in their ear? While they’re trying to give their partners an orgasm
NW Right! So I sounded a bit like a deranged I guess stewardess
WZ And so don't do you think that you could orgasm in that situation?
NW I had to. I was the test pilot for everything. I had more orgasms in that scanner to the point that I should have frequent flyer miles. And I actually had a very funny incident when I was in the scanner using a purple dildo and it slipped out of my hands and it went flying. So after the scanner went off, I said Houston we have a problem. The dildo went into orbit!
Orgasms! The final frontier!! Despite the Kanye helmet, ear plugs, the fact that these women were basically lab rats -- most of the women were able to orgasm in the MRI, either with their partner or on their own. And all the while, Nan was recording what was going on in their brain as they were climaxing… So what did she find?
NW So the big ticket item is that orgasm is a big brain event
NW One brain region that really went way up and stayed up for quite a while in the orgasm was activity in the hypothalamus…. it's like, Hello, wowza
The hypothalamus does a bunch of stuff. When it gets fired up - it can release the so-called cuddle chemical - oxytocin.  And the hypothalamus is at the base of the brain - and is involved in survival. In textbooks it's sometimes known for playing a big role in the big four Fs: Feeding Fighting, Fleeing and Fuc -ornication. In one study, rats had an electrode implanted in their brain, in the hypothalamus and they kept pressing a button to make it go off again and again. A few scientists even say that the brain during an orgasm - looks kinda similar to a brain having a seizure - another time when your brain's lighting up in many places all at once.
WZ If you were gonna commission a band to write a song of the brain in orgasm, who would you get it to do it
NW Led Zeppelin doo doo doo, doo doo doo, doo doo doo
Of the little research we have into what's going on in the brain during the moment of climax - there is some debate here. Some research backs up Nan's study - but other work has found that just as people were about to orgasm - their brain starts winding down … It's not clear exactly what’s up with these differences - Nan and others have said that the techniques that those other studies were using might not have been so good.. but generally speaking, academics agree that at least in the lead up to orgasm - a ton of stuff is going on in your brain.
But the big question for us -- is through all this - is there anything that can help explain why men are having more orgasms than women? Well… Nan has done some similar work in a small group of men… It’s not published yet, but she told us she saw a lot of the same stuff…
NW A lot more similarities than differences. It’s a whole big brain event for the guys too.
Other than Nan's early research - the only study we could find that compared men and women reaching orgasm - found that while there were some differences in how the brains responded to genital stimulation -- but once they hit orgasm, things looked pretty similar. .
And we also found some research on our furry friends  suggesting the same thing. For example, when scientists in Germany stimulated the genitals of male and female rats they saw the same amount of brain space lighting up. It didn't matter if the rats have a penis or a clit. Yes, rats have clitoris. Just little ones.
So -- while the research in this space on this is pretty barenaked - … from what we know: it's not like men have some giant orgasm chunk in their brain that women don’t have... and bottomline - it doesn't look like the brain can explain the huge orgasm gap. But that's just the Brain - what about differences in the body? There’s the vagina, and the clitoris, and the penis. Could the physical differences between us explain why some people orgasm more than others?
WZ And what is currently your favorite tool that you're using to study the sexual experience?
NP My favorite tool, I am somewhat enamoured of our anal contraction device right now.
This is Nicole Prause she used to work at UCLA and now runs her own sex research lab - with fun toys.. like this.. anal contraction device?
WZ Wait, tell me more about this. So how do you use it?
NP So we basically fashioned a small as possible, butt plug if you're familiar with the sexual toy,
NP We think eight to 12 contractions and the first two are about point eight seconds apart, and then they get further and further apart until they stop.
Something fun to think about next time you're having an orgasm. Ok - so Nicole has poked and prodded dozens of people in her lab to explore how the body reacts to orgasm. And she told us when we're thinking about the orgasm gap - there's a bunch of things that are pretty similar between people with penises and vaginas… So, for example, when we get aroused … blood rushes to the genitals - whether it's the penis or vulva - which includes the clitoris and labia.
NP And this is often something, like pornography hardly ever shows the vulva aroused, I think
One small study found that the vagina had 4-11 times more blood in it when it was stimulated compared to when it was just sitting around . Yknow.. watching Frasier, or whatever. And when men have wet dreams. - this is the kinda thing that's happening… blood is flowing to their genitals while they're asleep. But guess what?
It's probably what happened to Malaka during her erotic shoe dream. And it's more common for men to have orgasms in their sleep- two studies have found that almost 40% of women surveyed said they've gotten their rocks off in their dreams.
But of course not everything is the same here. And two things we want to look at to explain the orgasm gap are hormones, and the physical differences between the penis and the clitoris. Let's start with hormones. And specifically - testosterone. Whether you've got a penis or a vagina - testosterone plays an important role in sex drive. And generally speaking, if you were born with a penis - your body probably makes more testosterone. So maybe that's helping dudes get more orgasms? Well... Nicole says it's actually a lot more complicated… so if you . have clinically low levels of testosterone - there is some evidence that taking more of it can help your sex life . But…
NP It really looks like as long as you have enough, so long as you don't have a disease, that level of testosterone that you have doesn't really influence sexual response much..
WZ: That's interesting so much of what we hear is testosterone like and a high sex drive is driving orgasms, but that's not the case.
And the research in trans folks also shows that this testosterone thing? It isn't clear cut. So one study found that for trans men taking testosterone it did tend to make them horny, but another study found that it didn't.
Plus it's not like testosterone is the only game in town here. Meet Estrogen. Estrogen helps women get wet arse pussies. Seriously, it helps with vaginal lubrication. And trans women who take estrogen have reported orgasms that are more intense and even multiple orgasms. 
Next up. We’re looking at the bits. Like, maybe it's easier to get a penis to spring a leak -- than a clit?
WZ Because there is this kind of idea out there that a penis is like an enlarged clitoris. And that the clitoris is like a concentrated penis - is that right?
NP It's not entirely false
In the fetus our bits come from the same star stuff -- whether your genitals burst on the scene as a clitoris or a penis or something in between. In fact for roughly the first 2 months of gestation our genitals look exactly the same. And then, once we're born and all grown up? What happens then?
Well - when you picture the clitoris you might be thinking of a tiny little bump -- and a penis as a BIG MAGIC WAND… but in fact, that little bump is just the tip of the iceberg .The full clitoris? It wraps around the vaginal canal… like a wizard in a cloak! Now we don't know if the penis is more sensitive than the clitoris - no one has done this study, and when scientists analysed tissue from the genitals of a handful of human cadavers… the nerves looked pretty similar in all the bits. But there is something dangling in the wind here -- a big difference. Even though the clitoris is bigger than you might think - A lot of it is hidden away and hard to reach. While with penises?
NP there's more opportunity, more area that's clearly easier to stimulate. People with the penis may have have more sensitivity at the tip, maybe on the base, maybe more so on the backside
We found a rat study - where scientists tickled around 200 spots on the genitals of male and female rats… and they couldn't find as many sensitive spots on the females - which funny enough, is something that Nicole says happens in her lab too.. This isn't from a formal study, but she said, with her team always knows how to find the sensitive spots on guys… with ladies, sometimes it's not so easy.
NP So if we're struggling to figure out where the sensitivities are, then it makes sense that it might be very difficult for someone, who's not hooked up to sensors either, to have those experiences as easily as someone who has entirely external visible structures…It's just easier to see the penis!
Ok -- so maaaybe some of this physical stuff can help explain the orgasm gap -- maybe with more research we will find that the penis is more sensitive than the vulva... But Nicole and Nan and other researchers we spoke to - told us that so much is unknown about the orgasm it’s this giant mystery. And we're still learning things… And in the new frontiers of orgasm research… we're seeing people of all genders, with all sorts of bodies, getting off in the most remarkable ways. Like, this one thing that we heard over and over from you lot - our listeners...
So my freshman year of college, I was in a pilates class. And I was really pushing myself during the abs section,
Yeah, when I was doing the sit ups, I started feeling something.
And I remember doing pull ups and feeling really good down there.
I was like oh god do i need to pee?
And I just had this building feeling that felt really good. I was like, Wow, awesome. I'm working so hard.
It would just feel really good. So I'd keep doing pull ups.
Bam, I just have my first orgasm in the basement of my college gym, in a room full of 20 other people.
And I never actually thought to google it until now. And I realized it's called a coregasm. Like your core.
The coregasm?! Yeah, there’s pretty much no research on the coregasm, and we can’t say why it happens. But despite all of these orgasm mysteries - there is one big thing science does have data on … when it comes to our orgasms. It’s a looming issue that affects every aspect of our lives… And it could be getting in the way of your orgasm.
And it is Coming up. After the break.
Welcome back! Today we're talking about the Battle of the Orgasms. And why, if you're a man, chances are you're winning. We've talked about the differences in our brains and our bodies… But there's an elephant in this podcast - that could be getting in the way of your orgasms. And to tell us all about… is Candice Hargons, a psychologist and assistant professor at the University of Kentucky. Candice told us she was an early bloomer when it comes to sex research
CH so my grandmother had a set of Encyclopedia Britannica and as early as like 9-10, when puberty began to onset, I was like, What's going to happen to my body? And so I remember exploring this, and then us being a sex educator to my peers and telling them, okay, this is when we're going to get boobs. And this is when we’re going to get our periods.
WZ We too had Encyclopedia Britannica.
WZ And I'm like, why did I never look up breasts?
So Candice grew up. Stopped reading Britannica - and started looking into what society tells us about sex. And it might not surprise you - but when it comes to sex.. the thrust of our conversations, they can be a bit different for women and men... Candice remembers when she got this message…
CH Oh, I did so I have an older brother. His name is Terrence. He's four years older than I am. so I wanted to be a rapper when I was younger — don't judge. And the artists who were out that were women at the time, were predominantly talking about female sexual empowerment. You know, we're having that big discussion right now about Cardi B and Meg Thee Stallion and their new song, WAP. But that conversation was going on then. But also, Lauryn Hill was out. And so I was writing this rap,and I wanted to share my lyrics with him. And it was a very sexually oriented song. I was probably like 13 or 14. And he was like, don't be a Lil’ Kim when you can be a Lauryn Hill.
CH And so, I was like, I'm kind of both, though. But at the time I didn't feel that, I didn’t have that clap-back language, so I was like, ok
WZ: I have to admit when I just heard you say that I was like oh yeah that sounds classy. And then my second thought was why am I not pro Lil' Kim, like the sex positive?
This tale of Lauryn Hill and Lil Kim is as old as time -- academics sometimes call it the Madonna / whore dichotomy. The idea? That good women aren't proud and sexual. And all the controversy around WAP - tells you that this script hasn't gone anywhere.
CH But I always felt like there was something fucked up about the script, it didn't align with who I was and how I saw myself.
And Candice says that messages like this can get in your head, and really stick. A survey of thousands of teens found that girls felt more shame and guilt around sex compared to boys.
And we did a survey too! Just informal - of you guys, our listeners. Almost 7,000 of you responded! Telling us about your orgasms and what gets in the way of it. And we found this shame thing was happening too - men weren't immune from it. In fact one in ten men said that one of the things that was going on when they couldn't orgasm during sex was shame, and negative feelings around sex. But for women this was worse - one in 7 were affected by it.
Research is also finding that women often aren't putting their own orgasms first - they’re thinking of climaxing as YOURgasm - rather than MYgasm. Like, a Finnish survey of more than 2000 women - found that they consistently rated their partner’s orgasm as more important than their own.
CH they’re a vehicle of somebody else's pleasure and potential to orgasm as opposed to someone who has their own inherent worthiness and sexual pleasure worthiness.
Then there's this curly reason for the orgasm gap. It’s one we hear a lot - that in straight couples -- fellas aren't spending enough time with the clitty?  Studies have found that women are less likely to orgasm with just vaginal intercourse -- and in our survey - we found that the 500 women who defined sex exclusively as vag-to-penis, they were less likely to orgasm than those who included other stuff in their definition - like clitty touching.
And men! You can’t play dumb here — a large survey of college kids from a few years ago - found that men were equally if not more clit-savvy than women in the surveys! So it seems that a bunch of men know what to do - and they're just not doing it.
So there's a lot of reasons why the orgasm gap might exist without needing physical biological differences to explain it. And Candice reckons these social forces are a big piece of the puzzle here. And her best evidence for that. Is this. When men aren't anywhere near the bedroom -- guess what - the orgasm gap closes A LOT. So, in that big survey of 50,000 people - 65% of straight women said they usually or always orgasm during sex. 65%. BUT. For lesbians? It was 86%. And we found that pattern in our survey too.
CH It really is evidence that when you remove men from the equation that the gap closes a bit for women. So there's not this patriarchal presence in the bedroom, that then sets the tone for whose pleasure is prioritized
WZ your line it removes the patriarchal presence in the bedroom I feel like should be a poster and T shirts everywhere
CH so funny cuz I didn't even know I said that.
WZ I just wrote it in caps lock
CH I love it hahhah
And another time when straight men aren't responsible for the pleasure? When women are masturbating. And here again! We see that women are orgasming, for the most part, just fine. Almost as much as men. So for example, in our survey - 86% of women said they always or almost always orgasm when paddling the pink canoe. Compared to 96% of men.  
And our survey also looked at orgasms for people who aren’t cis - there were almost 200 in our sample... and we saw hints of the orgasm gap here too. During sex - trans men and nonbinary people orgasmed about as much as cis women - maybe a bit more. But trans women were orgasming the least - only about a third of them said they orgasm every time or almost every time they have sex.
And as we were poking around in the research -- a few other things came up as to why people in general might have a hard time orgasming. Being sexually assaulted, as you might imagine, can make it harder to enjoy sex    Some antidepressants can get in the way of orgasms as well.
And as a sex therapist and for her research - Candice has noticed something else going on with some of her Black patients: Racist ideas about Black sexuality are getting in the way here. Like this idea that Black men are super sexual - it really affected an undergrad in one of her studies.
CH And he talked about being with a white woman for his first sexual encounter. And he was like, I didn't know what I was doing. But I felt like I should know what I was doing because I know she had an expectation of me that I was going to be good at sex. And, you know, he was like, I felt paralyzed.
And Candice says learning about all this bedroom baggage - can help people
CH And so therapeutically when I see clients, they feel relief, I think at first and feel validated. They feel like that makes sense. That's why I believe this. That's why I'm struggling in this way.
And the thing is - Candice says even if you know all this, it can still be an orgasm blocker.
WZ So as someone who is constantly thinking about racial expectations, gender expectations, does that affect your ability to enjoy sex?
CH You know what, sometimes it does. Because I could think about all of this stuff cognitively and philosophically and intellectually, all day, but I'm still a full human woman. And I want to be in my body, although I do very heady work. So it absolutely can get in the way for me too. I'm not exempt from it just because I have insight about it.
WZ And what do you do when it is getting in your head?
CH I do some deep breathing. My partner and I talk about it so we have very open sexual communication. And I'll just say straight up, I'm in my head right now, even if we're in the act. And he'll say, All right come out of your head. What do you need for me? What do you need me to do to help you come out of your head and I'm in the heart, I need to breathe deeply. And then he'll walk me through like focus on this focus on the way I'm touching you right here. And then if that's the case for him, I can do the same.
So that's some advice, if you've got a partner in the bedroom. But what about those times when you're tackling this on your own. And you're still struggling. We asked Malaka - from the start of the show - what she's doing..
MG I don't have to have dreams about shoes in order to climax, for me it's just putting myself in a space where I feel like I'm being surrounded with pleasure, it could be anything, like surrounding myself with sheets that that feel really good against my skin. It was just getting out of my head about what orgasms are supposed to look like and accepting that for me it’s something else completely different.
That’s Science Vs.
If you want more of Malaka’s work, check out Adventures From the Bedrooms of African Women, at Adventures From dot com (adventuresfrom.com). It’s a safe space for African women to share their stories and questions about sex anonymously… Malaka runs it along with her best friend Nana Darkoa Sekyiamah. We'll add a link in our show notes.
And while we're sharing great stuff -- On the latest episode of Dope Labs, our mates - Titi and Zakiya - took a deep dive into investigating political ads - and the advertising machine behind the 2020 United States' election. Check it out! That's Dope. Labs.
This episode was produced by Hannah Harris Green, with help from me, Wendy Zukerman, Michelle Dang, Rose Rimler and Nick DelRose. We’re edited by Blythe Terrell. Fact checking by Eva Dasher. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Marcus Bagala, Emma Munger, and Bobby Lord. Data Analysis by Morgan Green. Consulting by Rebecca Kling. Thanks to everyone we got in touch with for this episode including Dr. Adam Safron, Professor Larry Baskin, Professor Caroline Pukall, Dr. Laurence Levine, Dr. Jasmine Abrams, Dr. Justin Garcia, Dr. Laurie Mintz, Dr. Michael Brecht, Dr. Marcalee Alexander and Dr. Erica Marchand. A special thanks to the Zukerman family, Patty Harris, Richard Green and Joseph Lavelle Wilson.
I'm Wendy Zukerman, fact ya next time.
"Heterosexual men were most likely to say they usually-always orgasmed when sexually intimate (95%), followed by gay men (89%), bisexual men (88%), lesbian women (86%), bisexual women (66%), and heterosexual women (65%)."
 . Although our data reveal ‘‘faking’’ not exclusively to be the domain of women (see also Jagose, 2010; Zilbergeld, 1999), it was practiced by a majority of (female) participants
 Fourteen healthy women were recruited for this study by word of mouth. Data from two of the participants were excluded because they did not experience orgasm during the scanning session. Two additional datasets were discarded because of technical problems with the scans. Data from 10 participants were used (age range = 29–74 years, mean = 43.6, SD = 14.9).
[From call with NW] There was a very specific script that was projected via a mirror to the woman for pressing the button. They were to only press the button once stimulation was started, again when orgasm started, again when orgasm stopped, and lastly when they were back to baseline. Those were the only communications (nothing about how she liked the stimulation, etc.). Nan relayed this information to the partner via headphones that were fMRI-compatible, not a speaker system.
 The fMRI results revealed that TM stimulation most strongly activated the pregenual anterior cingulate cortex (pgACC). These results are consistent with findings showing pgACC activation during various rewarding pleasant stimulations.
 Oxytocin is also clearly involved; oxytocin serum levels measured before and after sexual stimulation in 12 healthy women were significantly elevated . Although intravenous apomorphine, a centrally acting dopaminergic agent, has been shown to cause increased peak clitoral and vaginal wall blood flow , the role of dopamine in female sexual behavior is not established.
 Oxytocin serum levels were measured before and after sexual stimulation in 12 healthy women. Values of oxytocin 1 min after orgasm were significantly higher (p < 0.05) than baseline levels. https://www.karger.com/article/pdf/10075
 Oxytocin, which is secreted from hypothalamic paraventricular nucleus and posterior pituitary, is a hormone in the bloodstream and a neurotransmitter in the brain. Acute oxytocin release induces many behavioral changes; it is the specific neurotransmitter of love, sexual pleasure, orgasm, bonding, empathy, attachment, and motherhood
 “For example, when rats press a key and receive electrical stimulation through an electrode implanted in the hypothalamus, they try to press the key as continuously as they can to get more electrical stimulations, which is the well documented”
 "Another very small study of women with spinal cord injuries- found that when they could orgasm - the hypothalamus also lit up: Brain regions activated during orgasm included hypothalamus, medial amygdala, cingulate cortex, and insular cortex.
 Personal Communication with Dr Nan Wise "Our male orgasm brain data being prepared for publication shows the same thing."
 E.g. Difference group of researchers: During visual erotic stimuli, a larger activation was observed for the patient group in the left superior
parietal lobe, ventromedial prefrontal cortex, and posterior cingulate cortex, whereas the control group showed larger activation in the right middle insula and dorsal anterior cingulate cortex and hippocampus
 Genital responses were observed in an area around 2.5 mm lateral and 2.5 mm posterior from bregma. A similar location of genital responses was seen in a female animal (Figure 1D). Pure genital responses (black) were rare, and in most instances genital responses overlapped with responses to different body parts https://www.sciencedirect.com/science/article/pii/S0960982215014359
 1980 paper uses anal probe in men, demonstrating rhythmic anal contractions during orgasm: At orgasm each subject produced a characteristic series of contractions starting abruptly at an inter- contraction interval of about 0.6 seconds, and continued for 10 to 15 contractions at an increasing increment of about 0.1 second per contraction."
 The earliest detectable sign of sexual arousal based on studies with experimental models is a significant increase in vaginal wall and clitoral blood flow - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907491/
 Pressure stimulations (20-160 mm Hg) along the lower third of the vagina increased blood velocity and flow into clitoral arteries in 9 of the 10 women. The latency and duration of the Doppler responses ranged from 0.1 to 1.6 sec and from 3.2 to 9.5 sec, respectively, and the response was associated with a blood flow increase of 4 to 11 times the baseline prestimulation level. https://pubmed.ncbi.nlm.nih.gov/7733803/
 Though the mechanism of SRE [sleep-related erection] is unclear, it is well-known that 80% of SREs occurs during rapid eye movement sleep
 A study of blood flow during erections in men: it was found that in cases showing a complete erection in response to VSS, the quantity of blood within the penis increased as much as 4.2- 11.2 times the level in a flaccid state-an 8.0-fold increase on the average. (VSS=visual sexual stimulation)
 The main results highlighted differences in relation to sex—men have more sexual dreams than women and place more importance on them.
Multivariate analysis on predictors of female nocturnal orgasms (1986, N=245): A study looking at 245 women attending a large midwestern university found that 37% of them had experienced a nocturnal orgasm
Sexual Behavior in the Human Female (Alfred C Kinsey, 1953) Page 215: By age 45, 37% of women reported sex-dream-induced orgasms, versus 83% of men. Statistic also cited, here, by the International Society for Sexual Medicine: https://www.issm.info/sexual-health-qa/do-women-have-wet-dreams/
 "Testosterone modulates nearly every component involved in erectile function. It also regulates the timing of the erectile process as a function of sexual desire, coordinating penile erection with sex.
 Lower testosterone levels in women due to hypopituitarism and premature ovarian failure are related to a decreased sexual desire typical in hypoactive sexual disorder and female sexual arousal disorder; With regard to endocrine alterations, both low testosterone and low estradiol states have been associated with orgasm dysfunction
 Gender Differences in Sexual Attitudes and Behaviors: A Review of Meta-Analytic Results and Large Datasets: Despite the research suggesting that men and women are similar in many aspects of their sexual expression, researchers continue to emphasize gender differences, rather than similarities, in sexuality.
 “"Testosterone modulates nearly every component involved in erectile function. It also regulates the timing of the erectile process as a function of sexual desire, coordinating penile erection with sex. Furthermore epidemiologic studies confirm the significant association between hypogonadism and erectile dysfunction. Testosterone substitution has positive effect on male sexual function in hypogonadal persons, but the role of substitution is uncertain in men who are not clearly hypogonadal."
 This review paper found that "there is lack of association between serum testosterone levels, when present in normal or moderately low levels, and erectile function“ ..Thus, available correlation studies do not support a major role of testosterone in erection.
 Out of 414 men, 294 had a regular sexual partner and androgen measurements at the 14th year of follow-up. Total testosterone and erectile function were significantly correlated even after adjustment for age (r = 0.12, P = 0.04). Conversely, total testosterone was not significantly correlated with sex drive (r = 0.08, P = 0.17). Bioavailable testosterone was significantly correlated with both erectile function and sex drive (r = 0.16, P = 0.01 and r = 0.20, P = 0.001, respectively). However, these associations disappeared after age adjustment (r = 0.04 and r = 0.09).
 Our findings show a positive relation between stimulation and Testosterone along with indications of a positive relation between arousal and Tse r when the comparison refers to the period prior to taking the sample. In contrast, no substantial relations were found with respect to the period following a sample. This supports the view that actually the degree of sexual stimulation experienced and the duration of sexual arousal increase the Tse r level, and not the converse.
 Testosterone and sexual function: If you don't have enough Testosterone - it can lead to erectile dysfunction. But if you're healthy - it's not clear whether having more can help "but the role of substitution is uncertain in men who are not clearly hypogonadal".
 Study from the 1970s - Testosterone concentration did not correlate with the sexual activity and interest variables. These results provide evidence that differences among men in circulating testosterone concentration within the normal range do not account for differences in sexual activity and interest
 In Normal adult males ..circulating testosterone levels do not seem to be linked in any meaningful way with individual differences in drive or sexual behaviour … Among males with normal testosterone levels, testosterone has not been shown to facilitate erection
 For FtM transgender persons, who received hormone treatment - their frequency of masturbation was higher than in the group without treatment desire not receiving any testosterone. https://www.tandfonline.com/doi/full/10.1080/0092623X.2017.1405303
 Most female-to-male transsexual persons report on a marked increase in sexual desire after testosterone treatment and SRS. No direct associations between levels of testosterone and solitary or dyadic sexual desire were found.
 "Items regarding 'satisfaction with frequency of sexual activity, sexual fantasies. degree of enjoyment. vaginal lubrication and pain during intercourse' were positively influenced in the E group compared to the P group. Items not affected were ‘frequency of orgasm and sexual arousal’.
 Estrogens are necessary for normal vaginal lubrication, and vaginal dryness associated with menopause can be decreased using hormone replacement therapy.
 55.8% rated their orgasms to be more intensive than before, with 20.8% who felt no difference.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994261/
 Additionally, prior to commencing HRT, the majority of patients in both pre- and post-vaginoplasty surgery groups reported their orgasms as a short, single-peak event but following HRT these same patients reported longer and multiple-peak orgasms. https://www.auajournals.org/doi/abs/10.1097/JU.0000000000000900.020
 During early development the gonads of the fetus remain undifferentiated; that is, all fetal genitalia are the same and are phenotypically female. After approximately 6 to 7 weeks of gestation, however, the expression of a gene on the Y chromosome induces changes that result in the development of the testes. Thus, this gene is singularly important in inducing testis development. The production of testosterone at about 9 weeks of gestation results in the development of the reproductive tract and the masculinization (the normal development of male sex characteristics) of the brain and genitalia.- https://www.ncbi.nlm.nih.gov/books/NBK222286/
We explored the ontogeny and precise location of the androgen receptor (AR), estrogen receptors alpha (ERα) and beta (ERβ) and the progesterone receptor (PR) in the developing human penis and clitoris from the indifferent stage at 8 weeks gestation to the fully differentiated penis and clitoris at 16–17 weeks of gestation https://www.sciencedirect.com/science/article/pii/S0301468119300830
 As in the human penis, nerves in the clitoris form an extensive network around the tunica of the corporeal body with a nerve-free zone at the midline 12 o'clock position…. Not surprisingly the human fetal clitoris has many of the same anatomical features as the human fetal penis.
 We found that males show a significantly higher fraction of genital responses ∼28% (55 out of 194 sites) than females, which showed genital responses only at ∼16% (30 out of 183 sites, p = 0.007, Fisher’s exact test)." https://www.sciencedirect.com/science/article/pii/S0960982215014359
men are often taught to view sexual activity as a positive element in their life… This is contrasted against women often learning that sexual activity can be dangerous for both their bodies and their reputations and should, therefore, take place only within the context of “meaningful” relationships.
 Consistent with a traditional sexual double standard, female adolescents who reported having sex had significant decreases in peer acceptance over time, whereas male adolescents reporting the same behavior had significant increases in peer acceptance.
 The results of the studies showed that the sexual double standard still can be identified nowadays, although it seems that sexual behaviors and situations influenced by this phenomenon are changing
 Greater numbers of sexual partners are positively correlated with boys’ peer acceptance, but negatively correlated with girls’ peer acceptance. Our results thus support the existence of an adolescent sexual double standard and suggest that sexual norms vary by both gender and socioeconomic origins.
 In Camerino’s (c. 1400) painting, The Madonna of Humility with the Temptation of Eve, the Virgin Mary—representing chastity and purity—holds the infant Jesus, while below Eve lies naked with a serpent and fur around her hips and legs, representing sexual lust and temptation
Paper says all respondents were ages 15-21, and refers to them as adolescents https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231516/
 https://www.jsm.jsexmed.org/article/S1743-6095(19)31385-2/fulltext (Others felt that their partner’s enjoyment was a bigger priority than their own. “I didn’t want to stop his pleasure,”)
 Around 60% of women considered having an orgasm at least ‘rather important’ in love-making, though less than 20% rated it as ‘very important’. … Almost all women said that it was at least ‘rather important’ to bring their partner to orgasm.
 The results of this study add further evidence to the literature suggesting that many of the noted gender differences in orgasm rates between men and women may be more clearly explained by differences in preferred and practiced sexual behaviors than by particular biological or physiological sex differences in the “ability” to achieve orgasm
 In the current study, only heterosexual men rated vaginal penetration as resulting in frequent and satisfying orgasms, while women, regardless of relationship type, reported less frequent and less satisfying orgasms resulting from vaginal penetration
 In FINSEX, women were asked if they usually achieve an orgasm during sexual intercourse via stimulating of the clitoris, of the vagina, or both. More than half of women (54%) responded that they usually achieve an orgasm via stimulating both the clitoris and vagina (Fig. 9). Orgasms that result from such stimulation have been called blended orgasms (Ladas, Whipple & Perry, 2005) or fusion orgasms (Otto, 1999). A third of women (34%) reported that they usually attained an orgasm via stimulating the clitoris. Only 6% of women reported that they usually have an orgasm via stimulating the vagina. (See Figure 9)
 In this orgasm frequency survey “Women were more likely to orgasm if their last sexual encounter included deep kissing, manual genital stimulation, and/or oral sex in addition to vaginal intercourse.”
 From the Hite Report, “Only approximately 30 percent of women in this study could orgasm regularly from intercourse.”
 Clitoral knowledge and the absence of orgasm in women. “[Clitoral] knowledge correlated significantly with the frequency of women’s orgasm in masturbation but not partnered sex.” With partnered sex, “unapplied knowledge about the clitoris suggests that knowledgeable women, or their partners, do not give priority to orgasm for women.”
 Heterosexual men were most likely to say they usually-always orgasmed when sexually intimate (95%), followed by gay men (89%), bisexual men (88%), lesbian women (86%), bisexual women (66%), and heterosexual women (65%). We analyzed a large US sample of adults (N = 52,588) who identified as heterosexual men (n = 26,032), gay men (n = 452), bisexual men (n = 550), lesbian women (n = 340), bisexual women (n = 1112), and heterosexual women (n = 24,102). https://link.springer.com/article/10.1007/s10508-017-0939-z?wt_mc=Affiliate.CommissionJunction.Authors.3.EPR1089.DeepLink&utm_medium=affiliate&utm_source=commission_junction_authors&utm_campaign=3_nsn6445_deeplink_PID3987228&utm_content=deeplink
 Analysising the data for singles pattern comes up too: For women, however, mean occurrence rate of orgasm varied significantly by sexual orientation: heterosexual women 61.6%, lesbian women 74.7%, bisexual women 58.0% (F2,1350 = 10.95, P < 0.001, η2 = 0.02).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035747/#:~:text=The%20overall%20mean%20occurrence%20rate,%2C%20%CE%B72%20%3D%200.12).
 Indeed, research has long suggested that women in same-sex relationships experience frequent and intense orgasms (Kinsey et al., 1953), perhaps to a greater extent than heterosexual women.. in this survey "women in same-sex relationships (M = 73.57, SD = 213.75) reported the greatest frequency of multiple orgasms,"
 In this survey of around 800 people "women reported no difference in the frequency with which they were able to reach orgasm on their own as a function of relationship type, but did report differences in frequency of orgasm during partnered sexual activities."
 Hite report (not available online) "Of the 82 percent of women who said they masturbated, 95% could orgasm easily and regularly, whenever they wanted."
 Survey from a sex toy company, 93% of men always or usually orgasm when they masturbate, vs 84% of women http://www.feelmore.global/wp-content/uploads/2019/05/TENGA-BCW-2019-Global-Survey-US-Report-5.10.19.pdf
 In our survey analysis, 33% of 15 trans women who replied to the survey always orgasmed or almost always orgasmed during sex
 “2015: Approximately 1 in 5 (21.3% or an estimated 25.5 million) women in the U.S. reported completed or attempted rape at some point in their lifetime, including completed forced penetration, attempted forced penetration, or alcohol/drug facilitated completed penetration. About 2.6% of U.S. men (an estimated 2.8 million) experienced completed or attempted rape victimization in their lifetime. https://www.nsvrc.org/statistics#:~:text=An%20estimated%2013%25%20of%20women,have%20experienced%20unwanted%20sexual%20contact.
 Contrary to expectations, women did not have orgasms that are more frequent by increasing their
experience and practice of masturbation, or by experimenting with different partners in their lifetime. The
keys to their more frequent orgasms lay in mental and relationship factors.
 Finnish national surveys found that better communication is associated with more orgasms,: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5087699/