Dear Cumming,

Enough stimulation of or around the clitoris and (for some women) pressure on the cervix or other sensitive areas cause pelvic fullness and body tension to build up to a peak. Orgasm is the point at which all the tension is suddenly released in a series of involuntary and pleasurable muscular contractions that may be felt in the vagina, uterus, and/or rectum. (Note that some women do experience orgasms without contractions.)

The difference between a "clitoral" and a "vaginal" orgasm is where you are being stimulated to achieve orgasm, not where you feel the orgasm. That may clear up some of the confusion around your questions. The clitoris has a central role in elevating feelings of sexual tension. During sexual excitement, the clitoris swells and changes position. The blood vessels through the whole pelvic area also swell, causing engorgement and creating a feeling of fullness and sexual sensitivity. Your inner vaginal lips swell and change shape. Your vagina balloons upward, and your uterus shifts position.

You or your partner can stimulate your clitoris in a number of different ways — by rubbing, sucking, body pressure, using a vibrator. Although some women touch the glans of the clitoris to become aroused, for others it can be so sensitive that direct touching hurts, even with lubrication. Also, focusing directly on the clitoris for a long time may cause the pleasurable sensations to disappear. Your clitoris can also be stimulated during sexual intercourse, most often with the woman on top — this happens when the clitoris is rubbed against the man's pubic bone. It can also be achieved when the man is on top if the man positions himself high enough so that his pubic bone presses against his partner's clitoral area. You or your partner can also stimulate your clitoris with fingers during intercourse to help bring you to orgasm.

For some women, the outer third of their vagina is also very sensitive. When stimulated during intercourse or other vaginal penetration, these women can orgasm. This would be what you referred to as a vaginal orgasm — without clitoral stimulation. Sigmund Freud made a pronouncement that the "mature" woman has orgasms only when her vagina, but not her clitoris, is stimulated. This, of course, made the man's penis central to a woman's sexual satisfaction. In reality, orgasms are a very individualistic thing — there is no one correct pattern of sexual response. Whatever works, feels good, and makes you feel more alive and connected with your partner are what count.

Alice

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