The female orgasm It has always been surrounded by beliefs and myths that today are definitively denied. At this point there is no doubt that orgasm, both for men and women, fulfills a psychological and physiological function at the same time. There is also no discussion that women have the right to feel sexual pleasure.
For this reason, experts in sexual medicine and sexologists must spread certainties about the biological basis of the female orgasm to all women, not hypotheses or personal opinions.
The “vaginal orgasm” does not exist
A clear example is found in the term “vaginal orgasm” or “vaginally activated orgasm”. Both are often used to refer to the climax obtained during vaginal penetration, without direct stimulation of the external clitoris.
But the truth is that the vaginal orgasm has no scientific basis, since it is an insensitive organ. In fact, it does not have any anatomical structure that can cause an orgasm. Evidence of this phenomenon is that in women with vaginal agenesis (congenital absence of the vagina), the sexual responses of the artificial vagina are identical to those of the normal vagina.
What does happen both in women with a normal vagina and with an artificial vagina is that During orgasm, the perineal muscles contract.. Recurrent contractions of different perineal muscles have been identified in all women. Especially of the bulbocavernosus and ischiocavernosus muscles.
Both muscles run on both sides of the vulva (in the space delimited by the genital lips). During sexual arousal (and clitoral erection) they contract involuntarily and continuously, favoring arousal and causing female ejaculation.
At the same time, sexual disturbances are associated with urinary tract symptoms. More than 40% of women with recurrent urinary tract infections, incontinence or urethral prolapse experience a deterioration in their sexual life. This is because urogenital disturbances often cause low libido, vaginal dryness, and decreased rate and intensity of orgasms.
All these factors are part of the vicious circle of structural and emotional alteration that prevents the development of a full sexual life.
What does the pelvic floor have to do with orgasms?
Hypotonia or weakness of the pelvic floor and urinary incontinence can directly interfere with sexual relations. Occasionally, urine leakage can occur during penetration, during orgasm, or both. The displacement of the vagina (and the muscles that surround it) during penetration makes it easier for urine to leak. In these cases, it is logical to expect that, after exercising (appropriately scheduled) the pelvic floor, the symptoms of these women will improve.
In fact, the pelvic floor muscles they are directly responsible for the amount and intensity of sensations that a woman feels during sexual intercourse. As well as the intensity of the grip or pressure that your partner feels during penetration.
The rhythmic contractions of the pelvic floor contribute to arousal and the ability of many women to reach orgasm. Pelvic floor exercise programs improve muscle tone and circulation to the pelvic organs. This is especially important for the smaller muscles of the pelvic floor, which are the responsible for fattening and erecting the clitoris when women are excited.
Consequently, maintaining the perineal muscles in healthy conditions of strength, resistance and elasticity favors the development of satisfactory sexual relations. For example, with the well-known kegel exercises it is possible to train and strengthen the perineal muscles (including the ischiocavernosus and bulbocavernosus muscles). In fact, these exercises have been shown to be a highly effective preventative treatment for vaginismus.
Physiotherapy and sexual health
This is just a simple example of how physiotherapy is helpful in treating and preventing sexual dysfunction. Although beneficial effects of the application of perineal massage, the application of gentle electrical stimuli, the use of instruments such as Chinese balls… have also been demonstrated.
As community health professionals, physiotherapists participate in the education of healthy habits and the promotion of well-being. Since sexual health is an integral component of general well-being, physiotherapists at different levels of care have an important role in the prevention and treatment of sexual dysfunctions.
But it is necessary to make an effort dissemination and normalization of this problem. Starting with the general population, given that due to embarrassment and discomfort due to the intimate nature of the problem, patients may not volunteer information about sexual function to their referring health providers.
As for the health professionals, it is up to the professionals to be aware of the importance and seriousness of sexual alterations and to ask the pertinent questions of patients with clinical symptoms compatible with possible sexual involvement.
In addition, clinicians must also provide a safe and open environment in which patients can feel comfortable discussing their sexual relationships.
Raquel Leiros Rodriguez. Assistant Professor Doctor in Physiotherapy, University of León.
This article was originally published on The Conversation.