Sexologies (2010) 19, 814

ORIGINAL ARTICLE
Female orgasm: Myths, facts and controversies

M.-H. Colson (MD)

1
Institut de mdecine sexuelle, 22, cours Pierre-Puget, 13006 Marseille, France
Available online 6 January 2010
KEYWORDS
Female sexuality;
Female orgasm;
Feminism;
G-spot;
Sexual myths
Summary In this article, we propose a review of data from scientic, anatomic, physiological
and clinical literature, combined with sociological and historic data, with a view to providing a
holistic picture of our knowledge of the subject. We will particularly focus on the growth of our
scientic knowledge and how it is structured, in parallel to the changes that have taken place in
cultural and historic factors related to our representations of the female orgasm. Controversies
on the subject of female sexuality and the nature of the female orgasm are still present today,
after mobilising feminists for more than half a century. You can almost follow the recent history
of women in the progression of heated debate that has taken place over nearly two centuries
about the nature of the female climax; vaginal or clitoridian. After the domination of vaginal
orgasm at the end of the 19th century and early into the 20th, the supremacy of the clitoris
became the cornerstone of feminist struggles; the symbol of social and sexual emancipation for
women in the second half of the 20th century. There are still many areas of the female orgasm
that are unclear today, in particular the existence of the G-Spot and female ejaculation, which
since the 1980s have been a topic of much fervent debate in the media, rendering an objective
scientic assessment of the relevant facts very difcult. More recent studies, using modern
means of investigation have revealed, in opposition to the classic dichotomy between vaginal
and clitoridian orgasm, the concept of clitoral complex and integrated and functional entity
at the origin of female pleasure linking the clitoris, the vulva, the vagina, the uterus and the
anus, opening up new prospects for understanding the female orgasm.
2009 Elsevier Masson SAS. All rights reserved.
Introduction
Womens sexuality has always been a problem for men. For
a long time it was considered a worrisome matter, and as
DOI of original article:10.1016/j.sexol.2009.11.003.

galement en version franc aise dans ce numro : Colson M.-H.

Lorgasme des femmes, mythes, ds et controverses.
E-mail addresses: marie.helene@colson.fr,
marie-helene.colson@univmed.fr.
1
Director of DIU Sexology program at Marseille Faculty of
Medicine, France.
such was repressed, but since Freud in the 19th century, it
is considered to be something incomprehensible and myste-
rious, a dark continent escaping all logic, as was the case
for women themselves, it appeared.
Whereas the male orgasm has never really given any
cause for controversy or debate, the female orgasmhas been
the subject of permanent questioning since the middle of
the 19th century. You can almost follow the recent history
of women in the heated debate that has taken place over
nearly two centuries on the nature of their orgasm, vagi-
nal or clitoridian. The subject was rst a cause for endless
controversy related to hysteria, then became the focus of
protest by feminist movements, before nally directing its
1158-1360/$ see front matter 2009 Elsevier Masson SAS. All rights reserved.
doi:10.1016/j.sexol.2009.11.004
Female orgasm: Myths, facts and controversies 9
attention more recently to the question of the Grfenberg
spot (G-spot).
Many myths and misconceptions continue today, despite
recent scientic discoveries. Beyond all the preconceived
ideas, loud statements made in the media and social prej-
udice, how far have we come today in terms of validated
knowledge and established facts concerning the female
orgasm?
History of Western women and their orgasms
Todays women are not afraid to proclaim their right to have
an orgasm, even making it an obligation for some, but they
were not the rst. There was even a time in the past when
the female orgasm did not pose any problems whatsoever.
There was no distinction or judgment made between the cli-
toridian or vaginal orgasm for those who had discovered they
could climax, and for the masses who had not, they did not
worry about something they did not even know existed. For
many years, the female orgasm was even thought to facili-
tate conception, since it was formalised in the Hippocratic
Corpus. This could explain why it is tolerated or even rec-
ommended by the three main religions, but of course, only
in wedlock.
In the 17th century, progress made in scientic knowl-
edge showed that women could conceive without having an
orgasm. From that point on, hot debate began about the
utility of the female orgasm, andwhy not? the poten-
tial harm it could cause: if it does not facilitate conception,
perhaps it hampers it? In 1875, the Dutch biologist Edouard
Van Beneden, who discovered meiosis and described the bio-
logical mechanism of fertilization, was unable to identify a
role for the clitoris, nor for female orgasm, which were thus
declared to be of no utility.
These discoveries fuelled the extensive debate on hyste-
ria, which was of particular interest in medical spheres at
the end of the 19th century. Quite a mysterious disease, that
seemed to only affect women, due to no specic anatomi-
cal lesion, as shown under hypnosis by Jean-Martin Charcot
(1882). There were several hypotheses regarding the origin
of hysteria. Some thought its seat to be in the uterus; for oth-
ers its origin was clearly the clitoris, this organ for which no
utility had been found. In 1865, Isaac Backer Brown, Chair-
man of the highly respectable British Medical Society,
had no hesitation in recommending its excision as treatment
for hysteria, epilepsy, homosexuality and other forms of
female folly, and excision was practised for this purpose
until the rst decades of the 20th century.
Other medical schools were in favour of stimulating the
clitoris for the same indication, and the end of the 19th
century and the beginning of the 20th saw the unprece-
dented medical usage of vibrators, which were the very
rst objects to be electried, just after the light-bulb, the
sewing machine and the toaster, as can be seen today in the
Minneapolis Electricity Museum.
The dark continent
The end of the 19th century also saw the advent of the rst
scientic theory on sexuality. Sigmund Freud and psycho-
analysis had a lengthy and profound effect on the medical
and scientic beliefs of our era, but also on our concep-
tions of the female orgasm. For Freud, the construction of
sexuality in women was formed around frustration at their
absence of penis. According to Freud, the clitoris was a
miniature penis, an amputated sexual organ that little
girls used as a form of compensation, waiting to discover one
day their true sexuality, revealed by male penetration of the
omnipotent phallus: the vagina has value only as a recep-
tacle for the penis as Freud stated in his Three essays on
the theory of sexuality (Freud, 1905). According to Freud,
it was only later in life, after renouncing her clitoridian
orgasm as infantile and immature, that a woman could reach
adult sexuality, by nally obtaining a vaginal orgasm. Women
who did not have vaginal orgasms were frigid (Bonierbale,
2000). Women must change their directive sexual zone
and move their sexual centre of gravity from the clitoris to
the vagina in order to prove their sexual maturity, and hence
their femininity.
Not everyone agreed with the Master in his vision of
the female orgasm. Mlanie Klein, Ernst Jones, and Karen
Horney who, well before her book on female psychology,
reproached his androcentric vision of femininity and the
female orgasm (Horney, 1942). Willhelm Reich, as early as
1927 in his function of orgasm, developed a surprisingly
modern conception of orgasm and the sexual function; for
him they are a pair and not an opposition: the womans part
is equally important as the mans.
Female sexuality nevertheless remained obscure and
unfathomable for many years. For those trying to under-
stand it on the basis of male sexuality. Helene Deutsch, a
psychiatrist and feminist activist in the USA stated in 1945
that a real woman (i.e. not frigid), has managed to estab-
lish the maternal function of the vagina and abandoned the
demands of the clitoris, showing the dominant school of
thought regarding female orgasms, perfectly summarized
in Moores treaty (Moore, 1964), which was accepted as
an authority for many years on the subject of sexuality:
a frigid woman is a woman who does not have vaginal
orgasms.
In the 1960s, whilst the duality between vaginal and
clitoridian orgasm had been clearly established, the dark
continent seemed to be getting ever more mysterious, and
the French psychoanalyst Jacques Lacan said, summarizing
what everyone thought: the nature of the vaginal orgasm
is keeping its inviolate secret (Lacan, 1964).
The rst scientic surveys into female sexuality
At about the same time, female sexuality was not only of
interest to psychoanalysts. It came to the fore, making the
headlines in the major American magazines when Alfred
Kinsey published two important epidemiological studies into
sexuality, including one on women in 1953, highlighting the
role of the clitoridian orgasm in female sexual pleasure. He
also showed the importance of female masturbation, passed
over in silence until then, and most importantly, that women
considered as frigid could reach orgasm as quickly as any
man by masturbating.
In 1966, William Howell Masters, a gynaecologist, and his
partner Virginia Eshelman Johnson, a midwife, convinced
by their experience of some 10,000 orgasms observed with
10 M.-H. Colson
694 subjects, ranging from teenagers to the age of 70 for
women, and 80 for men, defended their idea that there
is only one type of orgasm which starts in the clitoris and
then extends to the vagina (Masters and Johnson, 1966).
For them, female orgasm is caused by a single neurophys-
iological axis. But does that mean the end of the dark
continent and the duality between the clitoridian orgasm
and the vaginal orgasm?
Probably not, as in the following years, another report,
written by Shere Hite, added to the debate, this time assert-
ing the supremacy of the clitoridian orgasm. In the same
way as Kinsey and Masters and Johnson, Shere Hite made
the headlines of Time Magazine in 1987 for her two reports,
one published in 1976 and the other in 1987, in which she
defends the opposite theory to Freud, with gures to prove
it, based on a survey conducted on 1844 American women.
According to her, the only true female orgasm is clitoridian
(Hite, 1976).
From Freuds miniature penis to the triumphant
clitoris of the feminists
The second part of the 19th century saw women committed
to a long feminist struggle for recognition of their civil rights.
The following century saw them in a ght for recognition of
their right to have control over their own bodies. It was no
longer just a question of their identity as individuals, but
of their identity as women (Colson, 2007). They still had to
decriminalize abortion, have it recognized as a principle and
obtain acceptance for contraception. The work of Kinsey
and Shere Hite arrived at the perfect time to help them,
by reinforcing the idea of female specicities, so radically
different from men.
For the feminists, women were not simply castrated men,
and the clitoris was not just an atrophied penis that is only of
interest to little girls, but rather the living evidence of their
adult sexuality. Women in the 20th century wanted an end
to sexuality under the diktat of men. Totally at odds with
Freuds phallocentric vision, their struggle for equality of
the sexes requires recognition of their own specic orgasm,
clitoridian orgasm, and the rehabilitation of the clitoris as
an organ belonging to them alone, denigrated for too long
by Freud and the psychoanalysts.
It took about 20 years for the hostilities against men
to become a little less virulent and for women to allow
themselves to start seeing their vagina as a pleasure zone
too. In the 1990s, the feminist struggle changed somewhat.
Less aggressive, it focused less on defending womens rights
and more on helping them to nd their identity in terms
of female specicities that are theirs alone. Such was the
context within which American sexologists rediscovered the
vagina as a zone of female pleasure, as much as the clitoris.
The G-spot is the support for a new feminism, but without
dispersing the mystery of female sexuality. The extensive
debate in the media and the fashion phenomena that it has
created today, far from appeasing it, has strengthened the
controversy about the duality of female orgasm. New mis-
conceptions, based on other representations have appeared
about the G-spot, new symbol of female sexuality, still very
different fromthat of men, but escaping their understanding
and knowledge as much as ever.
The G-Spot: a new mystery in female
sexuality?
A father, a mother and a godfather
The G-spot has been known and used from time immemorial,
mentioned in tantric texts with the name Kanda, and in
the Taoist tradition as the black pearl of eroticism. In
the Western world, its paternity is attributed to a gynae-
cologist from Berlin who took refuge in New York during the
Second World War, Ernst Grfenberg. In an article written
in 1950, he described a zone located on the front part of
the vagina, close to the urethra, which he thinks plays a
determining role in reaching vaginal orgasm for women dur-
ing vaginal intercourse (Grfenberg, 1950). He states that
he has observed anorgasmy in many women after hysterec-
tomy associated with a vaginal impairment affecting this
zone in particular and therefore concluded that it plays an
important role in triggering vaginal orgasm.
But the G-Spot has also a mother; Beverley Whipple, who
in the 1980s set off all the media attention we know today.
In 1982, she published a book for the general public, with
John Perry and Alice Kahn Ladas called The G-Spot and Other
Recent Discoveries about Human Sexuality (Ladas et al.,
1982), which was the starting point of the long exchange
of ideas and controversies that is still very much alive and
kicking today.
The G-Spot also has a godfather; Addiego gave it its name
in 1981, paying tribute to Grfenberg, and perhaps also to
Reinier De Graaf, a Dutch physician and anatomist who made
key discoveries in reproductive biology in the 17th century.
He described the presence of glandular tissue around the
urethra that releases a slimy liquid and makes a woman
more desirable by its acrid and salty odour (De Graaf,
1672).
A spot that changes with the wind: mythology
versus scientic observation
A small spot or a large zone, it is said by some to be located
close to the urethral sphincter, for others it is by the peri-
urethral glands or Skenes glands, of variable anatomy from
one woman to another, and according to some authors, the
female equivalent of the prostate gland in men. For others,
the G-Spot corresponds to the region of Halbans fascia, the
space between the trigone of the bladder and the anterior
part of the vaginal wall. Filled with mesenchymal lamina, it
is a bro-elastic sheet made up of collagen, elastic and mus-
cular bres with a rich blood and nerve supply with Krause
bodies or pseudo-corpuscular nerve endings. On stimulation
this space is said to become vasocongested and creates an
erotic pleasurable response. For Grfenberg, who in fact
never specied a precise spot in his article of 1950, the
whole of the urethral tract is hypersensitive to stimulation
by an intravaginal nger or the penis. For others such as
Alzate (1985), the whole of the anterior wall of the vagina
is involved.
The contours of the G-spot seem difcult to pinpoint,
and their mystery is often lost in the meanders of miscon-
ceptions and new myths about female sexuality. A large part
Female orgasm: Myths, facts and controversies 11
of the difculty in dening and locating the G-spot resides in
the scientic inadequacy of the founding texts, which gave
it existence in the rst place. Grfenbergs publication in
1950 offers none of the characteristics demanded today by
evidence-based medicine.
The following studies, whose main characteristic was that
they created a lot of noise in the media, involve only a
small number of patients, and are based on a level of evi-
dence manifestly insufcient. The 1981 study by Addiego
et al. concerned one case alone. The book by Alice Ladas
and Beverley Whipple published in 1982 (Ladas et al., 1982)
refers more to anecdotes and stories than scientic facts.
Goldbergs 1983 study concerned 11 women, of which only
four stated they could reach orgasm by stimulation of the G-
Spot. As far as methodology is concerned, the study speaks
of some exotic sexological two-handed palpation tech-
nique used to locate the G-Spot, and seems more than
dubious (Goldberg et al., 1983). In addition, all these studies
were conducted by the same team, and extensively chal-
lenged in 2001 by Hines and by Pauls et al. (2006) who, in
his anatomic study of 2006 concerning 110 vaginal biopsies,
did not nd any specic neurological characteristic in terms
of what is being described as the G-Spot.
Small spot or large zone?
Outside of all the media debate, there does nevertheless
seem to be an area of the vagina where elective stimu-
lation can lead to orgasm. The whole anterior wall of the
vagina, due to its proximity with the urethra and the clitoris
(Nicholas et al., 2008), Halbans fascia, with a rich blood
and nerve supply, is seen in studies with better levels of
evidence (Ingelman-Sundberg, 1997), as a large structure
playing the role of an active organ, used to transmit arousal
to the clitoris by stretching the ligaments that are inside
it, with the to-and-fro movements during intercourse. This
would appear to be conrmed in more recent studies using
ultrasound techniques, evidencing that the sensitivity of this
specic zone could be explained by the fact that the cav-
ernous bodies of the clitoris can descend to rest against the
lower part of the anterior wall of the vagina during a reex or
voluntary contraction of the anus elevator muscles (Foldes
and Buisson, 2009). The high sensitivity of the zone around
what is described as the G-Spot is, therefore, thought to be
related to its amplication caused by the protrusion of the
corpus cavernosa of the clitoris swelling and descending to
rest against it during the to-and-fro movements.
For Hines (2001), if the G-Spot exists, it cannot be
reduced simply to the periurethral glandular tissue (Skenes
glands). Neither can the extreme sensitivity of this zone be
due only to its amplication during the to-and-fro move-
ments, which bring it into contact with the corpus cavernosa
of the clitoris. There must also be some sort of neurologi-
cal transmission, strengthening the idea of neurovascular
unity involved in vaginal orgasm. The data provided by
Krantz (1959), although now quite old, or the more recent
ndings of Hilliges et al. (1995), appear to conrm this, evi-
dencing the extensive innervation of the anterior part of
the vagina, much more so that the rest of the vagina, but
without being able to prove the existence of a G-Spot per
se.
A functional anatomical unit
What was baptised the G-Spot in 1981 does therefore
seem to exist as a specic zone of sensitivity, but more in
terms of an anatomic and functional unit, as was evidenced
by Helen OConnell (OConnell et al., 1998, 2005, 2008;
Ortigue et al., 2007), and where vasomotor pressure is being
exerted as shown by Imbimbo et al. (2003), interacting with
neuromuscular phenomena, already described by Shak in
2000.
Other very recent studies also using ultrasound seem
to have revealed anatomic differences in the vaginal wall,
which would seem to be thinner in women who have dif-
culty in experiencing vaginal orgasms (Gravina et al., 2008),
but without being able to determine a precise spot, but
rather a broad zone of the anterior vaginal wall. In one
of their many studies using positron emission and nuclear
magnetic resonance, Whipple and Komisaruk formulated the
idea that by stimulating this specic zone, the pain percep-
tion threshold could be increased, and appeared to play a
signicant analgesic role related to the release of endor-
phins during childbirth (Whipple and Komisaruk, 1988).
Modern concepts
Current conceptual models of the female orgasm would,
therefore, appear quite different from the traditional dual-
ity between vaginal and clitoridian orgasm, and be moving
more towards the broader concept of a single anatomo-
physiological unit comprising the clitoris, connected to the
anterior vaginal wall during the to-and-fro movements that
enable it to swell, and the ligaments inside it (Ingelman-
Sundberg, 1997; Foldes and Buisson, 2007, 2009). The
presence of pseudo-cavernous erectile tissue inside the
mucosa of the anterior wall of the vagina was evidenced
in 2002 in 89% of women in a series of 14 autopsies (DAmati
et al., 2002), and would appear to conrm this hypothesis.
The female orgasm, regardless of its point of origin could
be expressed by the simultaneous participation of all these
structures.
The female brain, hormones and orgasm
Without going into too much detail on the central or hor-
monal aspects of orgasm, we need to bear in mind their
major role, which closely conditions the functioning of the
external genital organs with differences that that have been
recently evidenced between female and male orgasms.
Whereas a womans initial orgasm is always triggered by
arousal of the external genital organs (Mah and Binik, 2001),
it has been extensively shown that other erogenous zones
can frequently be involved in triggering subsequent ones.
Whipple and Komisaruk have even evidenced the ability of
the cortical structures to reorganise the erogenous zones in
paraplegic women (Komisaruk et al., 1997) after spinal cord
injuries.
The involvement of the subcortical structures and the
limbic system would seem, particularly for women, to mean
that orgasm is a subconscious reex process, underpinned
by an affective and emotional experience, which gains in
strength according to the menstrual cycle and the hormonal
12 M.-H. Colson
status (Gizewski et al., 2006). We have better understand-
ing of the prefrontal cortex since the work of Tiihonen in
1994 showed its role of cognitive modulation enabling or pre-
venting the dissemination of arousal and progression of the
orgasm. Without its green light, it is impossible to climax.
The role of oxytocin also seems to be highly dependent
on the specic features of the female orgasm. Its impor-
tance in women was recognised a long time ago, but more
recent research has also shown that oxytocin is released
in large quantities during orgasm, and that the quantity
released determines the intensity of the orgasm (Meston and
Frohlich, 2000). It is released in huge quantities during fore-
play, caresses or massages (Moberg, 1990), and its secretion
increases during kissing, loving thoughts and even on hearing
the sound of the loved-ones voice (Light et al., 2005). We
have recently learned that oxytocin also plays a decisive role
in monogamy in rats (Bielsky and Young, 2004), and studies
by Helene Fisher showed us some 10 years ago already how
important it was in attachment.
Other recent studies have reinforced the idea of the key
role of the emotions, loving feelings and attachment in the
female orgasm, for instance Ortigue et al. (2007), who sug-
gest that the quality and intensity of the female orgasm
depends on the amount of loving emotion she feels and are
underpinned by activation of the left anterior part of the
insula.
The new challenges for female sexuality
today: loving your vagina, but not because of
men
Articles published over the past two years seem to mark
a watershed in the new, more subtle representations of
female orgasm in the way we understand it. Vaginal orgasm
seems today to be portrayed as the only orgasm able to
ensure good sexual health and a better quality sex-life,
or even quality of life altogether (Brody and Costa, 2009).
Women who are not able to obtain vaginal orgasm and have
difculty with orgasm are sometimes seen as being emo-
tionally unstable, not open to new experiences, introverted
(Harris et al., 2008). For others, absence of vaginal orgasm,
as back in Freuds days, appeared highly correlated with
immature defence mechanisms (Brody and Costa, 2008). A
very recent British study of 2035 women attempted to estab-
lish a correlation between a very low emotional intelligence
score and the inability to reach orgasm (Burri et al., 2009).
Current representations of the modern woman, likely to
be more active and dominant, seem to be supported by
the image of a resolutely vaginal orgasm, where the man
is no longer the exclusive dispenser of orgasm, but the
potential partner in obtaining pleasure seen as the right
to assert individual identity. It is common today or even
trendy to proclaim that one uses sex-toys to prove
an active sex-life, and this is said to promote good sexual
health (Herbenick et al., 2009).
What about men?
Men do not seem really reassured by their idea of this new
femininity apparently eager for increased sexual perfor-
mance. They feel obliged to ensure that their erection is
hard enough and durable enough to ensure long-lasting
penile intercourse, without being really able to earn extra
marks for foreplay, their hopes on this subject dashed
by a recent publication, which insists upon the fact that
long-lasting penile intercourse is more likely to give a
woman sexual satisfaction than extended foreplay (Weiss
and Brody, 2009).
They can nevertheless avoid the worst, since it is now
said to be possible to identify vaginal women from the way
they walk, since their gait is conditioned by their abdominal-
pelvic muscles, according to some authors (Nicholas et al.,
2008). And for those unlucky enough to have an undiscerning
eye for gait, the thickness of the anterior vaginal wall, mea-
sured using ultrasound, seems able to provide an indication
of the ability of a woman to reach vaginal orgasm (Gravina
et al., 2008).
The idea of there being one functional and anatomi-
cal unit comprising the vulva, the clitoris, the vagina, the
urethra and the anus will perhaps open the door to dissi-
pating one of the mysteries of female sexuality which has
always been deeply troubling to men; women who simulate
orgasms. This is what a team of researchers claims, saying
that anal contractions, measured in terms of variations in
rectal pressure, could be an excellent marker of objective
orgasm (Kortekaas et al., 2008).
As far as the clitoris is concerned, its function is still
a mystery today and since Elisabeth Lloyd conrmed its
absence of involvement in reproduction. Perhaps the one
closest to the truth was the biologist and philosopher
Stephen Jay Gould, when he stated that the clitoris is no
more than a lucky stroke of fate that nature forgot to
deactivate.
Womens orgasms will most probably continue to follow
the evolution of the human race, complicating it endlessly,
and never ceasing to surprise us. In China, where women are
only allowed to have one child, women report more frequent
and more intense orgasms with rich men. Perhaps we are
seeing the arrival of new and original selection criteria to
guarantee the best chances for the future of these highly
regarded children (Pollet and Nettle, 2009).
Conclusion: towards reconciliation
Today we are at last starting to see the end of the rampant
phallocentrism that prevailed until the second half of the
20th century, but also of the militant feminismthat occupied
the second part of that same century. It is nally possible to
take a calmer, more objective look at the specicities of the
female orgasm.
The conjunction of recent scientic discoveries, made
possible by a change in ideas and representations of the
image of women in our society will slowly but surely coax
the dark continent to give away some of its secrets, but
without ever revealing itself entirely.
Scientic studies with satisfactory levels of evidence
clearly show that there is a specic periurethral area of
the vagina located on its anterior wall, richly innervated,
and communicating dynamically with the clitoris that rests
against it during the to-and-fro movements of sexual inter-
course. This zone is thought to be the origin of an orgasm
Female orgasm: Myths, facts and controversies 13
that is triggered during the intra-vaginal movements, but
that also involves the clitoris.
One can only deplore the media attention of the 1980s,
which was at play during the political upheaval of the major
feminist movements, principally in North America, and
which was responsible for many pseudo-medical excesses
and feelings of failure on the part of a multitude of women.
Using shamefully incomplete scientic data, the media pub-
licity was in fact responsible for creating a great many sexual
difculties, by broadcasting the idea that a woman could not
truly be a woman until she had found her G-Spot, making this
a kind of gold standard of womanhood.
More reasonably, current studies would appear to be
going in the same direction as Masters and Johnson who
already in the 1960s were suggesting the idea of one
orgasm produced from many erogenous zones, but using the
same neurological channels, reconciling the clitoris with the
vagina, and women with themselves.
More generally speaking, this functional unity would
appear to work in close correlation with the emotions, rep-
resentations and motivational circuits, and take us in the
direction of a greater affective involvement for women than
for men, with the female orgasm much more closely related
to attachment, underpinned by the major role played by
oxytocin.
Conicts of interest
The author is, or has been, speaker and/or consultant of
Bayer Schering, Boehringer, Ipsen, Jansen Cilag, Johnson
Johnson, Lilly SA, Pzer, Procter Gamble, Prostrakan,
Takeda.
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