Clitoral orgasms not associated with mental health issues after all

A new study confirms Freud was wrong, but many women might be too: there’s still no evidence for clitoral and vaginal orgasms being different.

Sigmund Freud renounced clitoral orgasms as infantile and immature. According to his “Three essays on the theory of sexuality’’ adult female sexuality could only be achieved by vaginal climax. Scientists, however, have found no evidence for two physiologically different types of orgasm. Nevertheless, Freud’s idea still persists in some circles, but a new study refutes it. We speak with one of the authors, Nicole Prause, a neuroscientist who founded Liberos, a research firm that studies sexual desire and function.

ResearchGate: What led you to study the connection between the source of orgasm and mental health in women?

Nicole Prause: A series of published studies made the shocking claim that women who reached orgasm by clitoral stimulation were mentally unfit in a variety of ways. They were shocking because we know that a majority of women report using clitoral stimulation to help themselves experience orgasm, so these studies were pathologizing a majority of women. We strongly doubted the veracity of these publications.

RG: Who associated clitoral orgasms with psychiatric disorders – and why?

Prause: Stuart Brody and Miguel Costa had published a series of studies based on Freudian theory suggesting that clitoral orgasms were associated with "immature psychological defense mechanisms", poorer relationship quality, and poorer "psychological function". Many scientists were quite surprised by this series of studies, because none of us could replicate their findings and the theory, we thought, had long been debunked.

RG: How did you study the connection between “type” of orgasm and mental health?

Prause: We brought a large group of women (N=88) in to the laboratory to complete a series of questionnaires, including common tests on depression and anxiety. They also completed a computer task. The computer task, commonly called a “self-regulation” task, included a series of short (20 s) neutral and sexual films. Before each sexual film, the women were asked to watch the sex film as they usually would, try to decrease their sexual arousal, or try to increase their sexual arousal. Women who had recently used clitoral stimulation to experience orgasm also reported experiencing more sexual arousal to watching the erotic films. They were also better at increasing their sexual arousal than women who had recently experienced orgasm through vaginal stimulation. Put another way, women favoring clitoral stimulation seemed more responsive to sexual films and were better able to ramp up their sexual feelings when instructed.

Earlier research has also shown no evidence for a scientific difference between clitoral and vaginal orgasms. This, by definition, rules out Freudian views of the clitoral climax being associated with inferior mental health. If anything, in this study we show that women who perceive their clitoris as the primary source of orgasm have a higher sexual drive.

What is the difference between clitoral and vaginal orgasms, and is the distinction that easy?

Prause: The clitoris and vagina can be distinguished in the somatosensory cortex, or the motor homunculus on the outside top part of the brain. Some people misinterpreted this as evidence that these areas can independently generate orgasm. There is not actually any evidence that can occur. Further, vaginal intercourse always displaces the clitoral (its legs extend down towards the vaginal opening), so it is impossible to make this distinction when penetrative intercourse is involved for vaginal orgasms.

RG: What kind of orgasms did your participants report having?

Prause: Our participants did endorse having one "type" (vaginal or clitoral) of orgasm when we pressed them, which I think is a fascinating testimony to how well a physiological myth has been perpetuated in popular culture. The great majority of the women did report that both vaginal and the clitoral stimulation were involved in their orgasm experience. In this sense, their experience does follow the physiological difficulty in distinguishing orgasm "types".

RG: Did you find any connection between the source of orgasm and mental health?

Prause: This is the first time orgasm source has actually been used to examine differences in well-validated measures of depression and anxiety in a well-powered sample, and we found no evidence for a link with mental health.

RG: What has the feedback to this study been like?

Prause: The study has been very well-received by our scientific colleagues, who also have not been able to replicate the findings this one group was proliferating in the literature. The article has just appeared publicly, so it is not yet clear what the public reception will be. I hope that this study will give women great confidence to not worry about their orgasm source: Just enjoy!

Feature image: Juan Barahona via flickr