What Is Orgasm

  • Olajide Otuyemi BPharm, Olabisi Onabanjo University, Nigeria; MPH University of Ilorin, Nigeria; MSc. Drug discovery, development, and delivery, Liverpool John Moores University, UK

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Indeed, an orgasm is highly personal and just as well, it is one of the most pleasurable experiences in life. Problems that concern orgasm have been ranked to be the second most popular sexual problem among people assigned female at birth (AFAB), according to a survey conducted in the United States of America. In a British survey assessing the perception of a population on the subject of sex and orgasm, almost half of the people assigned male at birth (AMAB) (48.7 %) agreed that sexual intercourse without an orgasm is not considered to be a satisfying experience. About half of the people AFAB respondents also share this opinion.1 

The characterisation of orgasm requires the collective input of the subject as well as health professionals such as the physiologist, psychologist, endocrinologist, and even a brain imager! It is a challenging task to provide a singular definition for orgasm because each specialist sees the phenomenon from its own perspective. Based on the existing studies, a consensus was reached internationally in 2004.  Orgasm was defined in people AMAB as “an experience that occurs from a buildup of pressure in the urethra, contraction of the smooth muscle accompanied by the emission of seminal fluid that is triggered by the stimulation of the glans penis”. Orgasm in People AFAB was defined as “a sensation that is usually transient which triggers a feeling of intense pleasure and an altered state of consciousness and is usually followed by involuntary contractions of the uterine and anal musculature and a feeling of satisfaction and well-being”. However, even these consensuses are considered very controversial.2 

As much as many would prefer that orgasms should remain indescribable and ‘out-of-this-world’, many others have made an attempt to define it. Still, many agree that there is no comprehensive definition. An orgasm is described as a pleasurable and intense physiological response to genital (or in some occasions, non-genital – breasts, nipples, anus and mouth) stimulation: the physical stimulation of the penis in people AMAB and the physical stimulation of the vagina or the clitoris in people AFAB. Some people AFAB have claimed that they have been brought to orgasm by their thoughts alone without any physical touch. This claim is further supported by the accompanying rise in blood pressure, increased heart rate, and pupil dilation observed in these people AFAB.3

Biological processes in male and female orgasms

Many studies have shown that orgasm is accompanied by contractions of the pelvic muscles, including the anal and perineal muscles. In people AMAB, this is simultaneously followed by contractions of the penile urethra and ejaculations while in people AFAB, a climax is characterised by vaginal haemodynamic (blood flow pattern) changes. Hyperventilation (rapid breathing), hypertension (high blood pressure), shivering, nipple hardening, and vocalisations are some other manifestations observed.2

For people AMAB, two phases following orgasm are described. The emission phase and the ejaculation phase. In the former, there is an expansion of the prostatic urethra from the release of sperm and seminal fluid from the vas deferens (sperm duct), seminal vesicles and the prostate gland. The ejaculation phase involves the ejection of semen out of the body. This is enabled by the contraction of the associated anatomical structures: the ischiocavernosal and bulbocavernosal muscles and the prostatic urethra. Essentially, different neurological processes are involved in the two phases and they involve the somatic and the autonomic nervous systems. Even though many clinical findings have indicated a marked distinction between emission, ejaculation, and orgasm, “ejaculation” is commonly used as an all-encompassing word for all three phases.4

People AFAB experience orgasm when there is vasocongestion (swelling) of the anterior of the vagina, known as the orgasmic platform, when aroused. This vasocongestion may not return to the baseline as quickly as it does in males. Some researchers state that female orgasm is an evolutionary process that helps to aid sperm retention. However, findings have shown that these physiological processes are less functional and more of a biological response. The physical stimulation of the clitoris is the primary origin of many female orgasms. It can be direct or indirect stimulation during sexual intercourse. In contrast, vaginal stimulation alone has been shown not to result in female orgasm. Many surveys involving sexually active people AFAB as respondents showed that a majority of them rated clitoral stimulation as essential to attain orgasm. Only 20 % of them stated that clitoral stimulation is not required. Another 12 % submit that the stimulation of the vagina alone is more essential to attain orgasm than clitoral stimulation.4

Human organisms are complex and involve different biological systems. There has been a higher focus on female orgasm which is essentially considered as a sexual response triggered by physiological structures. On the other hand, male orgasm is regarded as a marker for ejaculation.4


A common challenge among many people AMAB would be the fact that they attained ejaculations at times they did not want. People AFAB on the other hand tend to report an inability or difficulty in attaining orgasm at all! The phenomenon whereby people experience absent or impeded orgasmic response is known as anorgasmia. The prevalence of it was found to be between 10 % and 40 %. It is worthy of note that certain factors are to be put into consideration. This includes hormonal status, age, prior experience, stimulation or activity type, and the nature of the relationship.5

According to the International Society of Sexual Medicine, premature ejaculation, a major problem for many people AMAB at the orgasmic phase, can be characterised into 3 setups: cases where the man ejaculates too quickly (less than one minute), an inability of the male partner to delay the ejaculation process, and a total avoidance of intimacy due to a distressful feeling.5


Orgasm is a very important phenomenon in people’s sexual health. Studies show that people AFAB tend to experience orgasm at a much lower frequency after coitus compared to people AMAB. Most people AFAB do not even attain orgasm without clitoral stimulation.  Many people AFAB hardly experience orgasm with vaginal stimulation alone. For people AMAB, a very high percentage agree that they must attain orgasm for sexual satisfaction to take place. Interestingly, even though the ejaculation phase is considered the orgasm phase for people AMAB, some researchers insist it (ejaculation) is a separate phase that occurs separately from orgasm even though they usually occur simultaneously or closely to one another.


Orgasm is essential in sexual health. It is a biological response triggered by physiological factors that are altered during sexual stimulation, providing a feeling of satisfaction and well-being. People AMAB experience orgasm more frequently than people AFAB because women require direct or indirect clitoral stimulation, unlike people AMABwhose orgasm is broadly regarded as the point of ejaculation.


  1. Levin, Roy J. ‘An Orgasm Is… Who Defines What an Orgasm Is?’ Sexual and Relationship Therapy, vol. 19, no. 1, Feb. 2004, pp. 101–07. DOI.org (Crossref), https://doi.org/10.1080/14681990410001641663.
  2. Courtois, Frédérique, and Samantha Dubray. ‘The Neurophysiology of Orgasm’. Current Sexual Health Reports, vol. 6, no. 3, Sept. 2014, pp. 201–10. DOI.org (Crossref), https://doi.org/10.1007/s11930-014-0026-6.
  3. Komisaruk, Barry R., et al. The Science of Orgasm. Johns Hopkins University Press, 2006.
  4. Mah, Kenneth, and Yitzchak M. Binik. ‘The Nature of Human Orgasm: A Critical Review of Major Trends’. Clinical Psychology Review, vol. 21, no. 6, Aug. 2001, pp. 823–56. DOI.org (Crossref), https://doi.org/10.1016/S0272-7358(00)00069-6.
  5. Rowland, David L., and Tiffany N. Kolba. ‘Understanding Orgasmic Difficulty in Women’. The Journal of Sexual Medicine, vol. 13, no. 8, Aug. 2016, pp. 1246–54. DOI.org (Crossref), https://doi.org/10.1016/j.jsxm.2016.05.014.

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Olajide Otuyemi

BPharm, Olabisi Onabanjo University, Nigeria; MPH University of Ilorin, Nigeria; MSc. Drug discovery, development, and delivery, Liverpool John Moores University, UK

Olajide Otuyemi is an experienced pharmacist and public health specialist with years of experience and a proven track record in the pharmaceutical industry and global health. His knowledge and experience spans across research, pharmaceuticals, patient education, and public health initiatives. He is passionate about health education and empowering others to make informed decisions to support positive health outcomes. He hopes to continue making high-quality medical information accessible and available to all.

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