Exploring the Perceived Inequity of Female vs. Male Orgasm - Obstetrics and Gynecology

Dr. Chen Fuhao reply Obstetrics and Gynecology

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Dear netizens: This question should ideally be directed to a urologist.
However, since you are inquiring online, I will do my best to provide you with information based on my medical knowledge and some articles.
Both men and women have sexual desire, which is an instinct for procreation.
Generally, sexual desire can be divided into sexual urges and reproductive urges.
Male sexual behavior is related to male hormones, as previously mentioned.
For instance, administering male hormones to castrated individuals or eunuchs can lead to increased sexual desire and erections, and occasionally ejaculation or nocturnal emissions.
Moreover, their mental state may become more active.
These hormones enhance sexual arousal but do not affect all forms of sexual excitement.
In summary, many individuals who have experienced sexual activity can still engage in intercourse after castration.
Additionally, elderly men lacking sexual hormones may still have sexual desire.
Unfortunately, individuals with spinal cord injuries who cannot achieve erections or ejaculation may also experience sexual desire.
Conversely, systemic diseases such as nephritis and obesity can lead to a loss of sexual desire.
Both physical health and mental state significantly influence the intensity of sexual desire.
Therefore, if one is physically and mentally healthy, well-nourished, and has robust hormone secretion, sexual desire will naturally increase.
The intensity of sexual desire does not have a fixed standard; the frequency and duration of sexual intercourse vary based on factors such as race, age, physical condition, and habits, making it difficult to compare with others.
According to surveys on sexual frequency, the number of times and duration varies from person to person, and there is no definitive conclusion on what constitutes a normal frequency or duration.
The most important aspect is whether one can provide a satisfying experience for their partner.
As with female orgasm, male orgasm can also be discussed in terms of physiological, psychological, and social aspects.

From a physiological perspective, male orgasm can be divided into two phases.
The first phase involves the contraction of the epididymis, vas deferens, and prostate, which expels semen into the prostatic urethra.
At this point, the male feels that ejaculation is inevitable (ejaculatory inevitability), marking the ejaculation phase.
The second phase involves the relaxation of the external sphincter muscle, allowing semen to enter the penile urethra, followed by contractions of the penis and pelvic floor muscles, which expel the semen.
The initial ejaculation can reach a distance of thirty to sixty centimeters if not obstructed within the vagina.
In older adults, the distance gradually decreases, along with the intensity and speed of ejaculation.
Similar to the one-third contraction of the vagina during female orgasm, the local contractions during male orgasm occur at intervals of 0.8 seconds.
However, like females, after three or four contractions, the intervals gradually lengthen.
Typically, males under thirty can respond to sexual stimulation and ejaculate again in a short time, although the volume of semen decreases with each ejaculation.
Older males experience a longer refractory period and cannot achieve erection again quickly, a phenomenon not seen in females, who can immediately respond to sexual stimulation and experience multiple orgasms.

Some believe that ejaculation may be harmful, but all scientific studies indicate no evidence that ejaculation adversely affects the body.
Psychologically, during the first phase of male orgasm, men feel an inevitable urge to ejaculate as semen enters the prostatic urethra.
Approximately two to six seconds later, ejaculation occurs, entering the second phase of orgasm, which can be divided into two sub-phases: the first phase is the sensation of contraction, and the second phase is the experience of semen volume, which corresponds to the third phase of female orgasm.
Interestingly, in the research by Masters and Johnson, women experiencing multiple orgasms often find subsequent orgasms more pleasurable and satisfying than the first; however, men who ejaculate consecutively in a short time usually find the first ejaculation the most pleasurable.
This seems to be due to the release of stored semen during the first ejaculation, which also alleviates sexual tension, while subsequent ejaculations lack the same necessity for release.

Another difference in the sexual psychology of both genders is that women can interrupt their orgasm due to external or psychological factors, whereas men cannot stop the two phases of ejaculation once the contractions of the reproductive organs begin, regardless of external or psychological influences.
From a social perspective, literature discusses fewer social factors related to male orgasm.
This is partly because ejaculation is a necessary aspect of the male lifecycle, and cultural pressures often focus on other sexual functions, such as the ability to achieve and maintain an erection to satisfy a partner's orgasm.
In other words, concerns about male sexual dysfunction, particularly erectile dysfunction and premature ejaculation, are more prevalent than issues related to incomplete ejaculation or delayed ejaculation, which contrasts with female concerns.
For women, most do not face difficulties in engaging in sexual activity since they do not require an erect penis; their primary concerns are achieving orgasm and fully enjoying sexual pleasure.

In understanding the differences and similarities in sexual responses between genders, we can see that both male and female sexual responses share many commonalities.
This is because, during the embryonic stage, male and female genitalia are homologous and structurally similar before being influenced by male hormones (androgens).
However, there are notable differences, particularly in the phases of excitement and plateau.
During this phase, men are more vulnerable than women; the mechanisms of engorgement and erection in men are more complex than those of engorgement and lubrication in women.
Men must achieve and maintain an erection for a period to engage in sexual activity, leading to common issues such as erectile dysfunction and premature ejaculation, while women rarely experience isolated difficulties with engorgement and lubrication.

In terms of orgasm, men experience ejaculation and a refractory period, which women do not.
However, women's orgasms can be easily suppressed by various factors, making it difficult for them to achieve or causing them to stop at any time, leading to common difficulties in achieving orgasm for women, while men rarely experience ejaculatory dysfunction.
Therefore, in terms of orgasm, women are more vulnerable (Kaplan, 1974).
Both genders' sexual desires are influenced by male hormones and psychological factors, with male hormone levels being significantly higher in men than in women.
Psychological and cultural factors have a more substantial impact on female sexual desire than on male sexual desire.
Thus, we can say that male sexual needs are more physiologically driven, especially in younger men, although they are not entirely unaffected by psychological factors.
In contrast, female sexual needs fluctuate more than those of males (Kaplan, 1974; Bancroft, 1989).

While orgasm is not the only opportunity for sexual pleasure, it undeniably plays an important role.
If a woman in a long-term sexual relationship consistently fails to achieve orgasm and remains in the plateau phase while her partner has ejaculated, it can lead to psychological dissatisfaction.
Over time, due to pelvic congestion, she may also experience pelvic congestion syndrome, resulting in lower abdominal pain and discomfort during intercourse.
Therefore, enhancing female arousal during sexual activity to facilitate orgasm and delaying and reducing male arousal to prevent premature ejaculation can help both genders reach a state of physiological and psychological ecstasy.
This understanding is crucial for young couples to learn quickly after starting their married life.
Understanding the similarities and differences in sexual responses between genders greatly aids in navigating sexual activity and enhances the quality of sexual relationships.

Modern life is complex and stressful, leading to widespread anxiety and difficulty achieving satisfying sexual experiences.
Any psychological factors can lead to erectile dysfunction.
Systemic diseases such as nephritis and diabetes can also cause erectile dysfunction.
Additionally, surgeries for rectal or bladder tumors may lead to erectile dysfunction, particularly impotence.
Treatment for erectile dysfunction includes psychological therapy and surgical options.
Couples should seek advice from specialized doctors together!
Frequency of Intercourse by Age:
Age Frequency/Month (Times)
Laborers:
20 years 13.1
30 years 8.2
40 years 5.4
50 years 4.0
Mental Workers:
20 years 17.8
30 years 12.4
40 years 5.4
50 years 5.7
60 years 3.7
70 years 1.9
Duration of Intercourse by Age:
Age Duration/Session (Minutes)
20 years 7.8~8.6
30 years 10.6~11.1
40 years 12.5~14.3
50 years 14.2~15.0
60 years 8.1
70 years 5.5

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Reply Date: 2003/02/24