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Sexual Health Sexual Health Basics

Orgasm Q & A


Author:

Michael Yin, MD

New York Presbyterian Hospital - Columbia College of Physicians and Surgeons

Medically Reviewed On: March 31, 2006

What is an orgasm?

Orgasm is an emotional and physical experience that occurs during a normal sexual response cycle. During this cycle, pleasure peaks and is then accompanied by a sense of release from sexual tension. During orgasm, both men and women experience involuntary, rhythmic contractions of the pelvic muscles. The mind senses these contractions as pleasurable, but the intensity of these sensations differs from person to person. Each orgasm can also differ in intensity from one time to the next for the same person. For example, an orgasm could feel like warm, gentle throbbing in the genital area one night, and then tomorrow it could feel like an explosion that causes the whole body to become rigid and the mind to momentarily black out.

The four phases of sexual response are as follows: Arousal, Plateau, Orgasm, and Resolution. Arousal, or feeling "turned on," is a combination of mental arousal and physical changes, such as a racing heart, rapid breathing, flushing, increased sensitivity in the genital area, erection of the penis, and swelling and lubrication of the vagina. During the plateau phase, sexual and muscular tension intensifies. During orgasm, sexual pleasure peaks and sexual tension is released. The fourth stage is resolution, during which there is a gradual return of the body to its baseline state accompanied by a sense of warmth, pleasure, and relaxation. After orgasm and ejaculation, most males are unable to have another orgasm for a period of time. This refractory period depends on age (younger men can need only minutes to fully "recover" and older men may need an hour or more) and differs widely between men.

What is the difference between a male and female orgasm?

The most obvious difference in orgasms is that male orgasms are usually accompanied by the ejaculation of semen. Ejaculation involves the secretion of semen into the urethra (urinary tube) and a rhythmic contraction of pelvic muscles that forces the semen out of the urethra. In males, however, orgasms can occur with or without ejaculation. When men have orgasms without ejaculation, the pelvic muscles contract and you feel like you're having an orgasm, but the semen is prevented from being secreted into the urethra. Less commonly, the semen is pushed backward into the bladder during orgasm and appears as milky fluid that comes out during urination after sex. This is called retrograde ejaculation and happens occasionally when men try to prevent ejaculation during orgasm and is usually not a sign of a disorder. However, retrograde ejaculation does happen more frequently in people with diabetes or after surgery, causing damage to the nerves around the penis.

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