The Critical Fact About Female Orgasms That We Disregard

Few topics seem guaranteed to generate as much controversy, misunderstanding, and shame as the female orgasm. Surveys repeatedly suggest that orgasmic dysfunction is among the most reported sexual concerns for women. As a sex therapist, I discuss orgasms with my clients almost every day—heterosexual women think they should be orgasming more, or faster, or easier. Heterosexual men feel responsible for their partner’s sexual pleasure, believing that offering her bigger and better orgasms are part of his duty as a good lover. Debate about female orgasm even extends into the sexual medicine literature—is there a distinction between clitoral and vaginal orgasms? Are G-spot orgasms real? These questions and controversies are facilitated by the fact that the female orgasm is an extraordinarily complex phenomenon, with physiological, hormonal, emotional, interpersonal, and technical features. But one critical anatomical fact consistently remains outside of this discussion.

The clitoris is composed of erectile tissue – the same erectile tissue that forms a penis. But unlike the penis, most clitoral tissue is hidden under multiple layers of skin. Only the relatively tiny head of the clitoris is visible and directly accessible externally. So, the clitoris is much larger than it appears to the eye, although most of it cannot be directly accessed.

Contrast this to a penis. Penises are like clitorises, but located mostly on the outside of the body. Like the clitoris, penises have an internal aspect as well. But the internal aspect of a penis is much smaller than its visible, accessible aspects.

So, the same erectile tissue makes up the clitoris and the penis. For women, the erectile tissue is mostly tucked away inside her body, while for men, most of the erectile tissue is accessible outside his body. What’s missing, however, is a discussion of the implications of these anatomical realities on sexual sensitivity and orgasm. Simply put, covering up sensitive tissue with layers of skin impacts its sensitivity.

It can be more challenging for women to orgasm not because they are more neurotic, or less sexual, or socialized not to like sex—instead, it can be largely because most of their sensitive sexual tissue is concealed deep within the pelvis.

How this critical difference between male and female sexual physiology escapes our dialogue about orgasm has always been a mystery to me. When I explain this to my clients, I regularly see looks of shock, and then relief. Understanding this reality helps women feel more self-compassion for their orgasm struggles. Sometimes, this knowledge decreases a woman’s anxiety to such a degree that she can orgasm for the first time. Other women feel vindicated that they need more stimulation than their partners. They finally feel justified in taking more time to climax. It’s amazing to me how healing and de-shaming simple information can be.

This knowledge also helps to clarify why premature ejaculation (PE) is largely a male sexual dysfunction. If clitorises were as accessible as penises, women would struggle with PE, too. I suggest to my clients with PE to imagine how their urge to orgasm would change if they were wearing five condoms. And in fact, many men do wear condoms in an effort to last longer.

Of course, we know that there are many other variables that contribute to ease and intensity of orgasm. However, this simple fact seems at least as critical as any other consideration that we more commonly acknowledge.