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ORIGINAL RESEARCH—PSYCHOLOGY
More Frequent Vaginal Orgasm Is Associated with Experiencing
Greater Excitement from Deep Vaginal Stimulation
Stuart Brody, PhD,* Katerina Klapilova, PhD,†and Lucie Krejcˇová, MSc†
*School of Social Sciences, University of the West of Scotland, Paisley, UK; †Department of General Anthropology,
Faculty of Humanities, Charles University, Prague, Czech Republic
DOI: 10.1111/jsm.12153
ABSTRACT
Introduction. Research indicated that: (i) vaginal orgasm (induced by penile–vaginal intercourse [PVI] without
concurrent clitoral masturbation) consistency (vaginal orgasm consistency [VOC]; percentage of PVI occasions
resulting in vaginal orgasm) is associated with mental attention to vaginal sensations during PVI, preference for a
longer penis, and indices of psychological and physiological functioning, and (ii) clitoral, distal vaginal, and deep
vaginal/cervical stimulation project via different peripheral nerves to different brain regions.
Aims. The aim of this study is to examine the association of VOC with: (i) sexual arousability perceived from deep
vaginal stimulation (compared with middle and shallow vaginal stimulation and clitoral stimulation), and (ii) whether
vaginal stimulation was present during the woman’s first masturbation.
Methods. A sample of 75 Czech women (aged 18–36), provided details of recent VOC, site of genital stimulation
during first masturbation, and their recent sexual arousability from the four genital sites.
Main Outcome Measures. The association of VOC with: (i) sexual arousability perceived from the four genital sites
and (ii) involvement of vaginal stimulation in first-ever masturbation.
Results. VOC was associated with greater sexual arousability from deep vaginal stimulation but not with sexual
arousability from other genital sites. VOC was also associated with women’s first masturbation incorporating (or
being exclusively) vaginal stimulation.
Conclusions. The findings suggest (i) stimulating the vagina during early life masturbation might indicate individual
readiness for developing greater vaginal responsiveness, leading to adult greater VOC, and (ii) current sensitivity of
deep vaginal and cervical regions is associated with VOC, which might be due to some combination of different
neurophysiological projections of the deep regions and their greater responsiveness to penile stimulation. Brody S,
Klapilova K, and Krejcˇ ová L. More frequent vaginal orgasm is associated with experiencing greater excite-
ment from deep vaginal stimulation. J Sex Med 2013;10:1730–1736.
Key Words. Sexual Intercourse; Vagina; Vaginal Orgasm; Masturbation; Early Sexual Experience
Introduction
Recent research has shown that stimulation
of the clitoris, distal vagina, and proximal
vagina/cervix is conveyed through different
peripheral nerves (deep vaginocervical stimulation
activates the vagus nerve, among others) and acti-
vate different regions of the somatosensory cortex
of the brain [1,2]. The orgasms induced by clitoral
stimulation and by penile–vaginal intercourse
(PVI) differ in important ways [3–5], including
indices of psychological and physical health, and
sexual function and relationship satisfaction being
associated specifically with PVI [3,6,7]. Notably,
greater likelihood of orgasm from PVI, or more
specifically vaginal orgasm (orgasm elicited solely
by penile–vaginal stimulation without clitoral
masturbation; measured in research studies either
dichotomously as ever having a vaginal orgasm,
or dimensionally as vaginal orgasm consistency
1730
J Sex Med 2013;10:1730–1736 © 2013 International Society for Sexual Medicine
[VOC], the percentage of PVI occasions result-
ing in vaginal orgasm) is associated with physi-
ological and self-perceived sexual functioning
within women. Differences have been observed
for measures including: greater tactile sensitivity
[8], higher heart rate variability (an index of
parasympathetic tone relevant to emotional func-
tion, attention, and life expectancy) [9], greater
concordance of vaginal and subjective indices of
sexual arousal [10,11], less functional pelvic mus-
culoskeletal blockage [12], lower likelihood of
developing female sexual arousal disorder [13],
greater satisfaction with sex life and other aspects
of life [14–16], emotional regulation [8,17,18], and
intimate relationship function [7,19].
In addition to the indices of physiological and
perceived sexual functioning present within
women, there is increasing evidence that VOC is
associated with several characteristics of men with
whom women are more likely to have vaginal
orgasm. For example, the men tend to manifest
greater duration and quality of erection [20–22], a
longer penis [22,23], and indices of greater attrac-
tiveness and masculinity [24–26].
The association between penis size and VOC,
together with female preference for longer penises
was confirmed in cross-cultural samples [22,23],
and it is consistent with theories of the possible
adaptive function of vaginal orgasm. Penis size was
found to be positively associated with health-
related cues in men including height, slimness, and
overall physical attractiveness or to 2D:4D digit
ratio indicating a higher level of prenatal testoster-
one exposure (see [23]). Therefore, vaginal orgasm
was proposed as an adaptive mechanism that could
lead to greater reinforcement for PVI with men of
higher quality [23]. Greater sexual responsiveness
in deep vaginal and cervical areas could thus lead
to more frequent PVI and pair-bond quality in
contrast with responsiveness of other vaginal sites
and the area of the clitoris. However, the associa-
tion of VOC and excitability of specific vaginal
regions has not been directly examined. In the
present study, we focus on this topic and examine
whether women’s greater VOC was associated
with greater excitability from deep vaginal stimu-
lation (but not associated with excitability from
clitoral stimulation and with no explicit hypoth-
eses regarding excitability from stimulation of the
vaginal entrance or middle vagina).
Developmental and psychological aspects also
should be considered. Vaginal responsiveness
could be expected to vary across time and age,
owing to many factors including accumulation of
greater sexual experience and positive condition-
ing of vaginal sexual reactions. For example,
greater VOC was found to be associated with
women having been educated in their youth that
the vagina is a source of female orgasm, and those
currently focusing greater mental attention on
vaginal sensations during PVI [22].
Therefore, we also examined whether greater
VOC was associated with having incorporated
vaginal stimulation in the woman’s first masturba-
tion (for those women who ever masturbated) to
explore the role of incorporating the vagina and
thus the potential for sensitization of vaginal areas
in the prediction of VOC.
Materials and Methods
The study was conducted in accordance with
the principles of the Helsinki Declaration and
approved by the Institutional Review Board of
Faculty of Sciences, Charles University, Prague.
Female participants were recruited via adver-
tisements on the web pages of the university, which
invited women to participate in a study of women’s
sexuality (the present study is one component of an
ongoing research program). The recruitment cri-
teria included: age 18–35 years, with no physical
disabilities and no hormonal, fertility or sexologi-
cal issues. Participants were paid the equivalent of
2 euros to complete the questionnaires. A total of
78 women volunteered for the study. However,
three of them chose not to complete the question-
naires and were thus excluded from the analyses. A
sample size of 75 has over 80% statistical power
[27] to detect a correlation of 0.37 (the medium to
large effect size correlation obtained between
VOC and a personality trait reported in a Journal of
Sexual Medicine study; [17]).
The written questions included items on VOC:
“Have you had a vaginal orgasm (orgasm pro-
duced solely from movements of the penis in your
vagina, without any additional stimulation such as
fingers for the orgasm after foreplay)?”; response
options were: 1 =never, 2 =ever but less than
25% of PVI occasions, 3 =25% to 50%, 4 =50%
to 75%, and 5 =75% to 100%), age, sexual arous-
ability (rated on a visual analog scale from
1=low/none to 7 =very high; the scale was
inspired by a scale developed by Kratochvíl [28])
from deep vaginal stimulation, middle vaginal
stimulation, shallow vaginal stimulation (vaginal
entrance), and clitoral stimulation (a diagram was
provided to indicate the regions), and whether
their lifetime first masturbation involved only
Deep Vaginal Excitement 1731
J Sex Med 2013;10:1730–1736
clitoral stimulation, only vaginal opening stimula-
tion, only deep vaginal stimulation, or both clito-
ral and vaginal stimulations (nine women who
reported never masturbating were excluded from
the masturbation analyses).
Pearson correlations were conducted between
VOC, age, and sexual arousability during stimula-
tion of clitoris, shallow vagina, middle vagina, deep
vagina/cervix. In addition, a multiple regression
(backward elimination method) was conducted
with the dependent variable of VOC and candidate
predictor variables of age, and sexual arousability
at each of the four genital sites. Analysis of cova-
riance (ancova) was conducted with VOC as the
dependent variable, and whether the vagina was
stimulated during first masturbation as the inde-
pendent variable (the various combinations involv-
ing vaginal stimulation were collapsed, due to
small cell sizes; see below for details) and age as a
covariate. SPSS for Windows version 13.0 (SPSS
Inc., Chicago, IL, USA) was used for analyses.
Results
Table 1 provides a summary of age and sexual
experience-related variables. All participants were
university students, Czech or Slovak citizens
(studying and living in Prague at the time of the
study), and 65.3% were living in a long-term rela-
tionship. The results exclude the two women who
never had PVI. The VOC distribution was: never:
31%; 1–24% of PVI occasions: 29%; 25–50% of
PVI occasions: 18%; 51–75% of PVI occasions:
14%; and 76–100% of PVI occasions: 8%. Seventy
of the women had experience with masturbation. At
first masturbation, 61.5% stimulated only their cli-
toris, 3.8% stimulated only their vaginal opening,
3.8% stimulated deep in their vagina, and 9%
stimulated both their clitoris and vagina.
Table 2 presents the bivariate associations
between VOC, age, and sexual arousability during
stimulation of clitoris, shallow vagina, middle
vagina, and deep vagina/cervix. VOC was signifi-
cantly associated only with sexual arousability
during stimulation of the deep vagina (deep
vaginal sexual arousability was also associated with
sexual arousability at the other vaginal sites but not
the clitoris). Sexual arousability during stimulation
of the shallow vagina was associated with sexual
arousability during stimulation of the three other
genital sites, and sexual arousability during stimu-
lation of the middle vagina was associated with the
other vaginal sites but not the clitoris (there was a
trend toward association with age as well).
A multiple regression (backward elimination
method) was also conducted with the dependent
variable of VOC and candidate predictor variables
of age, and sexual arousability at each of the four
genital sites. Again, only sexual arousability during
stimulation of the deep vagina was associated with
VOC (beta =0.354, P=0.002).
In the ancova examining the association of
VOC with whether genital site stimulated during
lifetime first masturbation included the vagina
(with the covariate of age), there was a significant
Table 1 Sample characteristics
N Mean SD
Age 75 22.8 3.7
Age at first masturbation 66 12.3 3.9
Age at first intercourse (range: 14–22) 73 16.8 1.7
Number of sexual partners (range: 1–100) 73 6.7 12.6
Sexual arousability during stimulation of
clitoris
73 5.64 1.87
Sexual arousability during stimulation of
shallow vagina
73 4.67 1.77
Sexual arousability during stimulation of
middle vagina
73 4.21 1.41
Sexual arousability during stimulation of
deep vagina
73 4.52 1.72
Table 2 Bivariate associations between vaginal orgasm consistency (VOC), age, and sexual arousability (SA) perceived
during stimulation of clitoris, shallow vagina, middle vagina, and deep vagina/cervix
SA in shallow
vagina
SA in middle
vagina
SA in deep
vagina
SA in
clitoris Age
VOC r 0.130 0.115 0.354 -0.082 0.168
p 0.277 0.336 0.002 0.492 0.159
SA in shallow vagina r — 0.365 0.298 0.245 -0.072
p— 0.001 0.011 0.037 0.544
SA in middle vagina r — 0.235 0.054 0.228
p—0.046 0.649 0.053
SA in deep vagina r — 0.170 0.003
p — 0.151 0.982
SA in clitoris r — -0.079
p — 0.507
Note: VOC =vaginal orgasm consistency; SA =sexual arousability perceived during stimulation of specified genital site; r =bivariate correlation coefficient;
p=level of statistical significance; all significant results (P<0.05) are in bold
1732 Brody et al.
J Sex Med 2013;10:1730–1736
overall effect of genital site: F(1, 56) =12.5,
P=0.001, partial eta squared =0.183. The stimu-
lation of clitoris only group (mean 2.1, standard
deviation [SD] 1.2; see Methods for the coding of
the ranges of VOC) had significantly less VOC
than the women with a history of vaginal stimula-
tion (mean 3.6, SD 1.4) at first masturbation. Age
was not a significant covariate. Seventeen partici-
pants left the item on genital site stimulated during
lifetime first masturbation blank, which included
those women who reported never masturbating, as
well as others who might have simply not recalled
the details of their first masturbation.
On an exploratory basis, a multiple regression
was conducted with VOC as the dependent variable
and the independent variables (backward exclusion
method) of age, age at first masturbation, age at first
PVI, sexual arousability at each of the genital sites,
and whether first masturbation included the vagina.
VOC was independently associated (multiple
R=0.61) with inclusion of the vagina at first mas-
turbation (beta =0.41, P=0.001), current deep
vaginal arousability (beta =0.28, P=0.02), and
younger age at first PVI (beta =-0.265, P=0.03).
An additional exploratory analysis examined
the association of genital site at first masturbation
with current sensitivity at the genital sites and
found that only current deep vaginal sensitivity
was significantly [F(1,57) =9.5, P=0.003; partial
eta squared =0.143] related to genital site at first
masturbation (women who stimulated their deep
vagina at first masturbation orgasm have greater
current deep vaginal sensitivity than women
who stimulated only their clitoris at first mastur-
bation orgasm; other comparisons were not
significant).
The final exploratory analysis examined the
association between lifetime number of inter-
course partners and VOC and arousability at the
genital sites. There were no significant correla-
tions with number of partners (all P>0.05). A
log10 transformation [29] of number of partners
correlated significantly only with arousability in
the middle vagina (r=0.25, P<0.05), but this
correlation became nonsignificant when age was
statistically controlled.
Discussion
In both bivariate and multivariate analyses, VOC
was associated with greater perceived sexual arous-
ability during stimulation of the deep vagina but
not with greater sexual arousability at the other
vaginal sites nor at the clitoris. This finding is
consistent with earlier findings that women who
are more likely to have vaginal orgasm have a pref-
erence for a longer penis [22,23] that might more
effectively provide deep vaginal and cervical stimu-
lation, and thus stimulate additional nerves to
those stimulated by middle or shallow vaginal
stimulation, let alone only superficial clitoral
stimulation [2,4]). In an interesting ultrasound
investigation of one couple having PVI in one
position, Buisson et al. [30] found that penile
stimulation of the vagina led to stimulating struc-
tures that could indirectly stimulate areas con-
nected to the clitoris, and in a related study,
ultrasound indicated that perineal contractions
and finger stimulation of the vagina can lead to
clitoral movement [31]. Gravina et al. found that
vaginally orgasmic women had a thicker ure-
throvaginal space, suggesting that more innervated
tissue in the vagina could result in greater likeli-
hood of vaginal orgasm [32]. However at the ulti-
mate level of the brain, Komisaruk et al. [2]
provided clear evidence that in addition to a region
of overlap, different brain regions are activated by
stimulation of clitoris, vagina, and cervix. Our
results indicate that (i) there are differences in
current VOC between women as a function of first
masturbation being at clitoral vs. deep vaginal
sites; and (ii) current VOC being significantly
associated only with sexual arousability perceived
during stimulation of the deep vagina (not with
arousability perceived at the other sites including
the clitoris). Our results also indicate that deep
vaginal sexual arousability is associated with sexual
arousability at the other vaginal sites, but not the
clitoris (implying differential activation). These
results are consistent with the brain imaging dif-
ferences noted by Komisaruk et al. [2], as well as
clinical differences between vaginal orgasm and
clitoral orgasm [4,8,9,17,19,33]. Our finding that
sexual arousability during stimulation of the
shallow vagina was associated with sexual arous-
ability during stimulation of the three other
genital sites is consistent with the findings of
Komisaruk et al. [2] but also not inconsistent with
the finding of Buisson et al. [30,31] because of the
correlation we observed between shallow vaginal
and clitoral arousability. However, as noted, VOC
was not associated with either clitoral or shallow
vaginal arousability.
The results are consistent with an evolutionary
understanding of vaginal orgasm also being an
indicator of quality of the male partner, including
the hypothesis that vaginal orgasm evolved as part
of a female mate choice system favoring somewhat
Deep Vaginal Excitement 1733
J Sex Med 2013;10:1730–1736
larger than average penises [23,34]. This is a
special case of the concept that women’s orgasm
evolved as a mechanism for mate choice (for a
review of evidence of that general concept, see
[35]). Women who prefer longer penises are more
likely to have vaginal orgasms (but not clitoral
orgasms) [23], indicating an orgasm reward system
bound to the one reproductive sexual behavior per
se. Multiple studies found intimate relationship
quality and satisfaction to be associated with
vaginal orgasm [7,13–16,19,36]. Our present study
indicates that deeper vaginal stimulation (as would
more probably occur with a man with a longer
penis) is associated with greater VOC, so at least
one aspect of the higher quality concept is sup-
ported. Moreover, penis length appears to be
related to prenatal and postnatal testosterone
influences [37,38], among other fitness-related
indices [23]. Future empirical research might also
investigate the degree to which the trait preferred
by intersexual selection (e.g., human penis size)
can also be involved in male intrasexual competi-
tion, such as men attempting to ascertain women’s
PVI orgasm or men paying attention to size of
other men’s penises [39]. The associations noted
above between relationship quality and VOC
could be viewed in part as vaginal orgasm being a
genuine interpersonal sexual responsiveness con-
tributing to effective mate retention, and contrast
with women faking orgasm, which is associated
with women’s sexual dysfunction [40].
The finding that sexual arousability during
stimulation of the deep vagina was associated with
sexual arousability at the other vaginal sites, but
not the clitoris, adds to the aforementioned neu-
roanatomical and clinical evidence that vaginal and
clitoral stimulation, arousability, and orgasm
involve different processes.
The majority of women who ever masturbated
stimulated only their clitoris during their first
ever masturbation (the percentage was similar to
the percentage reported at recent masturbation in
a large study of Arab women [41]). Women who
incorporated vaginal stimulation in their first
masturbation (including those who stimulated
exclusively their vagina) had greater VOC as
adults than women who stimulated only their cli-
toris during their lifetime first masturbation. This
result might be due to a combination of several
factors dependent on individual development of
each woman, including: (i) already being aware of
the vagina as a source of female orgasm [22]; (ii)
not having an aversion to stimulation of the
vagina; and (iii) subsequent conditioning to
vaginal as opposed to only clitoral stimulation,
thereby enhancing attention to subsequent PVI
sensation. The latter aspect is consistent with
research that found that women who were edu-
cated in their youth that the vagina (as opposed to
only the clitoris) is a source of women’s orgasm
were more likely to have vaginal orgasm [22], and
the related finding that greater mental attention
by the woman to her vaginal sensations during
PVI is associated with greater VOC [22]. From a
practical point of view, educating young women
that the vagina is a source of women’s orgasm
might possibly improve their likelihood of devel-
oping vaginal sensitivity and attention to vaginal
sensation, possibly supporting intimate relation-
ship functioning.
However, an additional exploratory analysis
found that there were independent contribu-
tions to the statistical prediction of VOC from
incorporation of the vagina into lifetime first
masturbation (for the women who had ever mas-
turbated), younger age at first PVI, and current
greater deep vaginal (but not shallow or middle
vaginal or clitoral) arousability. This (as well as
the other additional exploratory analysis that
found that women who stimulated their deep
vagina at first masturbation have greater current
deep vaginal sensitivity than women who stimu-
lated only their clitoris at first masturbation) sug-
gests that some of the variance in deep vaginal
sensitivity (and thus in VOC) might be due to
prenatal factors [33] (which might involve many
possible pathways, including possibly tactile sen-
sitivity thresholds that are related to PVI orgasm
but not to clitoral orgasm [8]). This could also
support sensitive women being more ready to
have the advantage of reinforcing repeated copu-
lation with favored males. Greater PVI frequency
might also enhance vaginal sensitivity (via positive
learning/conditioning or via learning to pay more
attention to the sensation from the vagina), and
thus might augment the potential to have vaginal
orgasm.
A shortcoming of the study is that it used a
convenience sample of relatively modest size, as
opposed to a large nationally representative sample.
Future studies would optimally use large nationally
representative samples [22,42], which would also
allow for investigation of the possible role of a
stable relationship in these aspects of sexual behav-
ior. Future research might also include collection of
hormonal and biochemical profile data on the par-
ticipants and perhaps query women’s recollections
of their motivations for choice of genital sites at
1734 Brody et al.
J Sex Med 2013;10:1730–1736
their first-ever masturbation (if any). The arous-
ability of various areas of the vagina can be exam-
ined in more detail; for example, the nominal
“G-spot” [43] might be found between the shallow
and middle vaginal regions, so future research
might examine this issue. Our use of ranges for
VOC (rather than a continuous measure) likely led
to an underestimate of the observed associations.
It would be also worthwhile to compare self-
perceived sexual arousability of different vaginal
sites with psychophysiological measures of vaginal
site sensitivity (using appropriate methods based on
pressure rather than superficial stroking) and to
examine effects of differing penis lengths and girths
on women’s VOC [23].
Conclusions
The findings suggest that incorporating the vagina
during early masturbation might indicate indi-
vidual readiness for developing greater vaginal
responsiveness, leading to adult greater VOC. The
findings also suggest that current sensitivity and
responsiveness of the cervix and deep vaginal
regions is associated with greater VOC, which
might be due to (at least in part) the different
neurophysiological projections of those regions in
comparison with other genital areas. Therefore,
this study contributes to the growing evidence for
vaginal and clitoral orgasm having different physi-
ological and psychological aspects and ultimate
functions. Finally, it points to the need to make
young women aware of the vagina being a source
of women’s orgasm and of the added value of the
perception of the deep vaginal and cervical sensa-
tion during PVI.
Acknowledgments
This publication was supported by the Ministry of Edu-
cation, Youth and Sports—Institutional Support for
Long-term Development of Research Organizations—
Charles University, Faculty of Humanities (Charles
Univ, Fac Human 2013), the grant SVV-2013-267 702
and Charles University Research Centre (UNCE
204004).
Corresponding Author: Stuart Brody, PhD, School of
Social Sciences, University of the West of Scotland,
Paisley PA1 2BE, UK. Tel: +44 1418494020; Fax: +44-
141-8483891; E-mail: stuartbrody@hotmail.com
Conflict of Interest: The author(s) report no conflicts of
interest.
Statement of Authorship
Category 1
(a) Conception and Design
Stuart Brody; Katerina Klapilova; Lucie Krejcˇ ová
(b) Acquisition of Data
Katerina Klapilova; Lucie Krejcˇ ová
(c) Analysis and Interpretation of Data
Stuart Brody; Katerina Klapilova; Lucie Krejcˇ ová
Category 2
(a) Drafting the Article
Stuart Brody
(b) Revising It for Intellectual Content
Stuart Brody; Katerina Klapilova; Lucie Krejcˇ ová
Category 3
(a) Final Approval of the Completed Article
Stuart Brody; Katerina Klapilova; Lucie Krejcˇ ová
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