Why the intensity of female orgasms depends on the pelvic floor

The female orgasm has always been surrounded by beliefs that are now definitively demystified.

At this point, there is no doubt that orgasm, for both men and women, fulfills both a psychological and a physiological function.

There is also no argument that women have the right to experience sexual pleasure.

Therefore, specialists in sexual medicine and sexologists must disseminate certainties about the biological basis of female orgasm for all women, not hypotheses or personal opinions.

The ‘vaginal orgasm’ does not exist

A clear example is found in the term “vaginal orgasm” or “orgasm activated via the vagina”. Both are often used to refer to the climax achieved during vaginal penetration without direct stimulation of the external clitoris.

But the truth is that vaginal orgasm has no scientific basis, as it is a very sensitive organ.

In fact, it has no anatomical structure that can trigger an orgasm.

Evidence of this phenomenon is that in women with vaginal agenesis (congenital absence of the vagina) the sexual responses of the artificial vagina are identical to those of the normal vagina.

What happens in both women with a normal vagina and an artificial vagina is that the perineal (pelvic floor) muscles contract during orgasm.

In all women, recurrent contractions of different muscles in the perineal region were identified. Especially the bulbocavernosus and ischiocavernosus muscles.

Both muscles extend on either side of the vulva (in the space bounded by the labia).

During sexual arousal (and clitoral erection), they contract involuntarily and continuously, favoring arousal and causing female ejaculation.

At the same time, sexual disorders are associated with urinary tract symptoms.

More than 40% of women with recurrent urinary tract infections, incontinence or urethral prolapse experience a deterioration in their sex life.

This is because urogenital changes often cause low libido, vaginal dryness, and a decrease in the rate and intensity of orgasms.

All these factors are part of the vicious cycle of structural and emotional alteration that prevents the development of a full sex life.

What does the pelvic floor have to do with orgasms?

Pelvic floor hypotonia or weakness and urinary incontinence can directly interfere with sexual intercourse.

Sometimes, urine leakage may occur during penetration, during orgasm, or both.

The movement of the vagina (and the muscles that surround it) during penetration facilitates the loss of urine.

In these cases, it is logical to expect that after (properly programmed) pelvic floor exercise, these women’s symptoms will improve.

In fact, the pelvic floor muscles are directly responsible for the amount and intensity of sensations a woman feels during intercourse.

As well as the intensity of the grip or pressure your partner feels during penetration.

The rhythmic contractions of the pelvic floor contribute to the arousal and ability of many women to reach orgasm.

Pelvic floor exercise programs improve muscle tone and circulation in Organs pelvic organs.

This is especially important for the smaller pelvic floor muscles, which are responsible for swelling and lifting the clitoris when women are aroused.

Consequently, the maintenance of the perineal musculature in healthy conditions of strength, resistance and elasticity favors the development of satisfactory sexual relations.

For example, with the well-known Kegel exercises it is possible to train and strengthen the perineal muscles (including the ischiocavernosus and bulbocavernosus muscles).

In fact, these exercises have been shown to be a highly effective preventative treatment for vaginismus.

Physiotherapy and sexual health

This is just a simple example of how physical therapy is helpful in treating and preventing sexual dysfunction.

Although beneficial effects have also been demonstrated from performing perineal massage, applying gentle electrical stimuli, using instruments such as Chinese balls…

As collective health professionals, physical therapists participate in the education of healthy habits and the promotion of well-being.

Since sexual health is an integral part of general well-being, physical therapists at different levels of care play an important role in the prevention and treatment of sexual dysfunction.

But an effort must be made to spread and normalize this issue.

Starting with the general population, given that, due to the embarrassment and discomfort resulting from the intimate nature of the problem, patients may not spontaneously provide information about their sexual function to health professionals.

As for health professionals, it is important to be aware of the importance and severity of sexual changes and to ask pertinent questions to patients with clinical conditions compatible with possible sexual impairment.

In addition, healthcare providers should also provide a safe and open environment in which patients can feel comfortable talking about their sexual relationships.

*Raquel Leirós Rodríguez is an assistant professor and PhD in Physiotherapy at the University of León, Spain.

This article was originally published on the academic news site The Conversation and republished here under a Creative Commons license. Read the original version here (in Spanish).