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Orgasm in the female is marked by simultaneous rhythmic muscular contractions of the uterus, the outer third of the vagina (the orgasmic platform), and the anal sphincter. The first few contractions are intense and close together (at 0.8 second intervals). As orgasm continues, the contractions diminish in force and duration and occur at less regular intervals. A mild orgasm may have only three to five contractions, while an intense orgasm may have ten to fifteen.
Orgasm is a total body response, not just a pelvic event. Brain wave patterns show distinctive changes during orgasm and muscles in many different body regions contract during this phase of sexual response. In addition, the sex flush achieves its greatest intensity and its widest distribution at the time of orgasm.
Women often describe the sensations of an orgasm as beginning with a momentary sense of suspension, quickly followed by an intensely pleasurable feeling that usually begins at the clitoris and rapidly spreads throughout the pelvis. The physical sensations of the genitals are often described as warm, electric, or tingly, and these usually spread through the body. Finally, most women feel muscle contractions in their vagina or lower pelvis, often described as "pelvic throbbing."
Despite a popular misconception, most women do not ejaculate during orgasm. The erroneous belief that women ejaculate probably stems from descriptions in erotic novels of fluid gushing from the vagina as a woman writhes and moans at the peak moment of sexual passion. Such descriptions are not particularly accurate.
Recently, however, it has been suggested that a somewhat different form of female ejaculation occurs. Various workers have claimed that some women expel semen-like fluid from the urethra at the time of orgasm. It has been theorized that this fluid may come from a "female prostate," rudimentary glands (Skene's glands) around the urethra near the neck of the bladder that derive embryologically from the same tissues that develop into the prostate gland in males. In fact, some suggest that this "female prostate" is the anatomical site of the "G spot," but this idea — although stirring considerable controversy and conjecture — has not yet been proven scientifically. And, while a report on one woman with this ejaculation-like phenomenon indicated that the fluid was not urine, another more detailed study of six other women who "ejaculated" showed that the fluid they expelled was indistinguishable from urine.
Further confusion in this area is caused by uncertainty over the number of women who have this ejaculation-like response. Perry and Whipple, who have been among the most vociferous self-proclaimed "experts" on this subject, initially claimed that "perhaps 10 percent of females" had this response, but later reported that they were finding "closer to 40 percent" of women "had ever experienced" female ejaculation. In our own studies, a survey of approximately 300 women aged eighteen to forty revealed only fourteen who claimed to note any gushing or expulsion of fluid at orgasm. This observation is certainly more in keeping with our experience with well over a thousand women in our sex therapy program, where there have been only a handful of reports of fluid "ejaculated" by women with orgasm. However, we have observed several cases of women who expelled a type of fluid that was not urine.
Although it is clear that at least some women experience this ejaculation-like reponse, it should be realized that a number of these cases represent a condition called urinary stress incontinence in which urine is expelled from the urethra due to physical straining such as occurs with coughing, sneezing, or sexual arousal. Since this condition is usually correctable either by the use of Kegel exercises or minor surgery, medical evaluation is warranted if a woman is bothered by such a response.

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