American Medical Association Family Medical Guide - American Medical Association [239]
Orgasm
Orgasm is the climax stage of the sexual response cycle and usually lasts only a few seconds. During orgasm, heart rate, breathing, and blood pressure reach their highest levels. The skin may become flushed or appear to have a rash. In women, the muscles in the vagina contract rhythmically, producing pleasurable sensations. The uterus also contracts during orgasm. Women are capable of having multiple orgasms.
What Happens During Orgasm?
Orgasm can be defined as a peak of pressure in the blood vessels and tissues of the genitals that is characterized by pleasurable muscle contractions in the genitals and over the entire body.
When a woman reaches orgasm, the muscles in the lower third of the vagina contract repeatedly, while those in the upper third expand. The uterus also contracts during orgasm. To achieve orgasm, a woman must get sufficient stimulation at the base of her clitoris, but only 20 to 30 percent of all women are able to reach orgasm during intercourse with penetration of the penis alone. For a woman, having an orgasm during intercourse depends on the anatomy of both partners and the activity they engage in. Some couples fit together and move in a way that stimulates the clitoris; others do not. If you are a woman who has difficulty having an orgasm during intercourse, ask your partner to stimulate your clitoris with a finger, the mouth, or a vibrator beforehand so you can be sufficiently aroused. You can also try different positions to see if they are more stimulating, or masturbate during penetration. Many women can achieve orgasm more easily when they are on top.
When a man becomes sexually aroused, his brain sends signals to relax the muscles in his penis so blood can rush in and fill the penis sufficiently to produce an erection. Just before orgasm, the muscles around the base of the penis contract to help eject semen from the penis. After these pleasurable muscle contractions, he enters a period of relaxation in which he cannot respond to sexual stimulation.
The male orgasm occurs in two parts. First, semen collects in the urethra and the man feels that orgasm is inevitable. Then the penis contracts and expels the semen. Each ejaculation contains from 300 million to 500 million sperm, but only a few hundred will reach the woman’s fallopian tubes.
Resolution
During the resolution stage, the heightened state of arousal reverts to normal. The sex organs return to their normal size. Breathing, heart rate, and blood pressure decrease to their normal levels. This process usually takes longer for women, and women can be stimulated to reach another orgasm during this stage. Men go through a refractory period during which they cannot have another orgasm until a certain amount of time has passed. This refractory period can last from minutes to hours depending on the man’s age and physical condition.
Sexual Orientation
Sexual orientation is a term that refers to a person’s emotional, romantic, and sexual attraction to a person of a particular gender. People who are attracted to members of the opposite sex are called heterosexual, while those who are attracted to people of the same sex are called homosexual, gay (men and women), or lesbian (women). Some people are attracted to both men and women; they are called bisexual. It is difficult to determine the exact number of people in the United States who identify themselves as homosexual or bisexual.
Bisexuality and Homosexuality
The factors that influence a person’s sexual orientation are not completely understood, but they appear to encompass a complex combination of biological, psychological, and social influences. What is clear is that sexual orientation is not a lifestyle choice that can easily be changed. Most people discover at a very early age—in childhood or adolescence—before they have had any sexual experiences, that they are attracted to people of a certain gender.
To avoid the social stigma sometimes attached to being