A concept of female orgasm as a reflex

Orgasm is best thought of as a reflex whose lower neural center is probably located in the spinal cord. Like all reflex centers that serve other functions, the orgasmic reflex center is subject to multiple inhibitory and facilitating influences, both from direct sensory inputs and from higher neural centers. The sensory input that usually triggers the reflex appears to derive mainly from sensory nerves, probably tactile and pressure fibers, whose terminals are located in the clitoris. However, as with other reflexes. The level of stimulation needed for discharge can also be met by impulses coming from other areas, including the entrance to the vagina and nipples. The orgasmic reflex can also be triggered by sensory inputs from higher nerve centers.

Experiments in electrical stimulation of the brain have shown that an orgasm can be achieved in an animal, in the absence of stimulation of the genitals, by directing an electrical stimulus directly to a specific center in the brain. Clinical evidence in support of this finding consists of the fact mentioned above, that fantasy alone can climax some women who require low-level stimulation for orgasmic triggering.

Motor flow from the orgasmic reflex centers of the female orgasm goes to the circumvaginal muscles and the pelvic viscera, which respond with reflex spasm during orgasmic release. High pressure receptors in these vaginal muscles and perhaps also in the visceral sensory nerves transmit orgasmic sensations to the sensitive areas of the brain.

In summary, the sensory input that triggers orgasm may (but not exclusively) come from the sensory nerves of the clitoris, while the motor components are expressed and perceived in the circumvaginal muscles.

The normal level of stimulus intensity required for orgasmic discharge has not yet been determined. Therefore, we do not know what constitutes the expected average level of intensity and duration of stimulation to produce orgasm in the various normal and pathological female populations. It is extremely important to recognize our lack of information in this area, because this highlights the fact that the clinical criteria that govern our current concepts of normality and pathology of female orgasm are based only on speculation and not on sound physiological data. In the absence of certain facts, we have taken a temporary position regarding the treatment of female orgasmic dysfunction. This working hypothesis, which is necessarily based on clinical experience and intuition, will, of course, be modified in order to adjust to physiological information about female orgasm when it becomes available. -Helena Singer

Patients who suffer from specific inhibitions of the orgasmic reflex may also benefit from therapy. All women are capable of orgasm, as long as they are not suffering from a serious neurological, endocrinological or gynecological disease, which

has distributed the physical basis of orgasm. The vast majority of cases are of somatic emotional and psychic origin. Therefore, the treatment is clearly indicated for patients who suffer from absolute primary orgasmic inhibition and who have never had an orgasm.