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What promise does marijuana have for women’s sexual pleasure?

The short answer: More than I thought. 

Many of the women I see in my office tell me about their therapeutic use of marijuana. They take it to lessen their body pain, to get to sleep and to feel less anxious. We list it in their chart on their list of medications.  When doing this I never thought to ask them about what it did for their sex lives. Not once. Not having used pot since we used to sneak it into the dorms, I didn’t know it did anything specific for sex. Sitting here compiling what I have learned this year I feel like a girl late to the party. There is more promise here than I ever expected.

The biggest piece to me is that THC, in some doses, can be a vasodilator. In the world of sexual medicine that is big news. The category of vasodilator includes Viagra, and Levitra.  It also includes the ‘scream creams’, which are topical arousal aids.   Getting more blood in the genitals is what those of us in sexual medicine want to see happen for women.  We want woman to have enough blood flow that she feels turned on and excited (and we want her to be turned on and excited enough that it triggers good blood flow).  The vascular areas around the clitoris, that encircle the urethra, and are adjacent to the legs of the clitoris are designed to engorge with blood. Dilating blood vessels is a very good thing for women and sex.

This vasodilation effect could explain why research shows that female orgasms can be more intense or prolonged with marijuana use. The most recent study, published in Journal of Sexual Medicine last year, was a survey done at an OB/GYN practice.  It was voluntarily completed by 373 women.  127 of those women reported having used cannabis before having sex.  Women who reported using marijuana regularly before sex had a 2.1 times higher odds of reporting satisfactory orgasms than those who didn’t use it regularly. That is big news from this botanical. 

There are multiple other studies on cannabis with reports of prolonged orgasm or more intense orgasm.  There are also reports of heightened skin sensations, increases in sexual desire, and reports of a slowing of the perception of time so that pleasure feels prolonged. Reduced desire is reported too, mostly linked with higher doses and heavier use. 

Each of our bodies has cannabinoid receptor sites spread throughout it. This was ‘discovered’ in the 1990’s when the first receptors CB1 and CB2 were identified.  Historically it has been very difficult to get a license to legally research our innate cannabinoid system or our body’s reaction to the cannabis that we ingest. This has made data limited. All the survey results noted above are based on individuals self-reporting.  This is valuable info, and it is not the same as giving a woman a certain amount of THC and/or CBD and documenting her experience and measuring her actual hormone or neurotransmitter levels. 

Animal studies have been done with precise amounts of drugs, and changes in behavior and the physiology has been recorded. In these studies scientists have discovered what many humans have personally experienced for years — that the cannabis we smoke or ingest, interacts with our hormones and our neurotransmitters. 

One sex positive finding from the animal studies is that intermittent or light use of cannabis can cause the release of dopamine, the feel good neurotransmitter, aka the neurotransmitter of pleasure.  This finding, like the vasodilation finding, hits at the heart of drugs currently used in sexual medicine to optimize sexual experiences.  Wellbutrin, an antidepressant which increases dopamine, has been prescribed for years to augment sexual satisfaction.  This drug is used either alone or is prescribed to counterbalance the unfriendly sexual side effects that can come with raised serotonin levels from SSRI anti-depressants. And ADDYI, the first ever libido drug for women approved in 2015 works in part because it raises dopamine levels.  

The endocannabinoids (cannabinoids we naturally produce in our body) also interact with our hormones (testosterone, estrogen and progesterone), as well as our neurotransmitters. Receptor sites for this innate ECS (Endocannabinoid system) are widespread and include our central nervous system.

Of the 80 different compounds in the cannabis plant THC and CBD are the two well-known ones and they are the most researched overall.  In terms of sexual effects THC is more researched than CBD.  Other cannabinoids, CBDA, THCA, CBN, CBDV… are mysteries yet to be investigated. 

Cannabinodiol, the compound in cannabis called CBD, has promise for the anxious woman, or the woman with too many things on her plate. Women I see often have too much going on in their lives and no true down time.  They juggle roles and tasks from sunup until they hit the bed– where their pillow often looks better than their partner.  Small daily deadlines have been shown to be as detrimental to a woman’s arousal and orgasm capacities as major stresses such as a death or divorce. For many females it is go go go day after day. CBD products may be one of many answers to help her let go of her day and yield to receiving pleasure in the bedroom. 

Not getting turned on in bed for many women is a disappointing and frustrating experience. 

We need many diverse approaches to changing that fact. I could go on and on about why I think it is vital that we do that for her health and the health of the world. And we want to be intelligent about how we do change it. There are a lot of interesting positives here about cannabis and sex and they do not wipe out the potential negatives. 

Marijuana use has known sinkholes. Concerns about its use are real. The serious concerns come mostly with its overuse.  You probably know these already: Marijuana is dangerous to the forming brain of the teenager and young adult.  There can be brain changes and loss of IQ points that do not reverse.  It can be harmful to the pregnant and breastfeeding woman and baby. You want to keep cannabis away from these groups.  

 Heavy use can affect you sexually in ways you won’t like, for instance it can lower your dopamine levels, decrease your sexual desire, and mute your overall personal motivation. Being constantly stoned can decrease your emotional connection with everyone including your partner. It can slow down your physical movements and coordination, creating accidents.  Marijuana is substantially less dangerous than alcohol and it is still dangerous to be high and drive.  

My friend calls the last two paragraphs my CYA section, and in a sense she is right. I don’t want you to get in any trouble when you experiment.  I want you to talk to those who have experience using, and to remember that there is more THC in the strains out there than there was in the 80’s. Three wise friends of mine have separately ended up in our local ER after using. 

Their stories are funny now, my husband and I roared with them in the retelling. Yet when it was happening our friends were highly uncomfortable and frightened and one felt terribly embarrassed. 

So far our FDA has approved four drugs made from the cannabis plant. Three are synthetically made drugs for the nausea related to chemotherapy, and for neuropathic pain, and in 2018 they approved one RX from naturally extracted cannabis for seizures.  More approved drugs are on the way, and I expect later in the pipeline some will be specific for female sexuality.

Right now, available for use, there are prepackaged OTC products, like AROUSE. These specify the amount of THC and CBD. These are vaping products designed for sexual pleasure.  They are not FDA approved. Your neighborhood dispensary may have a wide variety of other similar products.  

I find it wryly amusing that this botanical we snuck around smoking actually matches up with a system we already had in our body.  And the purpose of this innate system is thought to promote homeostasis, i.e. internal balance.  How wrong can that be? It brings up the question of what else we don’t know about the internal workings of our bodies and what we don’t know yet about the cannabis plant.

I want you to be safe, and I also want you to have the best time possible.  

So be smart and have fun exploring your erotic options. There is a lot of treasure (and pleasure) to be found in doing so.  

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For those of you interested in more detail re research here are two links. 

This link is to a review article from the Journal of Sexual Medicine listing all the qualified research on marijuana use and female sexual health.  There are 12 human studies and 8 animal studies, with a summary of each study.  Link:

This link is to an FDA teleconference.  Our FDA is, and I quote, “actively exploring potential regulatory pathways for the lawful marketing of appropriate cannabis products.” On November 19, 2020 the FDA convened experts to discuss effects of marijuana use on women as differentiated from the effects on men.  The Conference title: “CBD and other Cannabinoids:  Sex and Gender differences in Use and Responses”.  This link gives you an overview of what the FDA botanical review team is up to. It includes national and international experts and the FDA’s Directors.  The keynote speaker is on from minute 11 to minute 27.  After that there are multiple experts speaking that include research on pain, anxiety, pregnancy, breast feeding and more. The entire conference is five hours long. I was impressed by their commitment to cannabis research. 

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Sex Doesn’t Have to be Painful

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“Treat Your Vaginal Dryness Early” are the words I would put on large billboards along I-5 and along other major highways in the US. I want to get the word out to women sooner about this common problem. Many women I see have waited months or years to seek treatment, and I cringe at the number of nights they have been in pain. Or the number of nights they are ambivalent about having sex as they face the no win choice of either “sex with pain” or “no sex”.

 

 

Treating women’s dryness early would reduce that personal pain and burning during and after sex, and it would do so much to maintain the closeness in marriages — the closeness that can wobble when this happens. So don’t wait. There is no reason to wait. Vaginal dryness, particularly menopausal vaginal dryness, is progressive. The earlier you treat it the better.

Treating dryness early would not only reduce sexual pain for women, it would also improve the capacity for arousal and the quality of the orgasms of millions of American women. On top of that it would add quality to the sexual experience of the women’s partners. As far as what it would do for relationships, well that is a lot. When a partner isn’t available for sex there is confusion, distress and sometimes a misinterpretation of the source of the problem. Treating dryness early would make this relationship chaos less.

Vaginal dryness occurs in more than 50% of women experiencing menopause. It also occurs in young women. Usually these young women are on hormonal contraceptives like the birth control pill, hormonal IUDs, and implants, or they have a hormone condition called PCOS (Polycystic Ovarian Syndrome). Significant sexual pain occurs in 10% of young women who go on the pill because of vaginal changes that occur from taking the pill. This intimate pain is quite a negative introduction to the new world of sexuality for these young women.

Whether vaginal dryness is due to the pill or menopause or other conditions, it is quickly and easily treated. Don’t wait. The symptoms of pain with intercourse or the feeling like you have a rug burn after sex, will resolve in six to eight weeks. And the treatment is safe. It doesn’t increase your risk of getting breast or endometrial cancer (links to the research on safety are included later in article).

There are multiple treatments for dryness, and there are a few new ones. Intra-vaginal DHEA is one that I reviewed in the last newsletter. More new treatments, including laser therapy, are gathering data now. Low dose minimally absorbed estradiol is still the go-to treatment for dryness. Below is the handout I give to women when prescribing this medication.

USING LOW DOSE MINIMALLY ABSORBED VAGINAL ESTRADIOL

You have been prescribed a vaginal estrogen preparation to use topically.

This prescription is to treat vaginal dryness related to loss of estrogen, or for some women it is to replace estrogen when “crowded out” by naturally higher levels of testosterone.

This is a prescription that you pick up at the pharmacy.

This medication is a low dose hormone prescription. It is different than a lubricant, and different than a vaginal moisturizer. You can think of it like a conditioner.

You do not use it before sexual activity.

The hormonal changes that occur to the vagina also affect the tissue around the opening of the vagina and the urethra (the tube that creates the passage where urine leaves your body). When a topical estrogen cream is prescribed, often the instructions are to take ½ the dose and apply around the opening of the vagina and the labia (lips) including the clitoris and clitoral hood. The other half of the medication goes into the vagina using the applicator from the pharmacy. You also can use your fingers to insert the cream internally.

If you are beginning the prescription, you will often be advised to use it daily for a week, then reducing to twice a week. It takes six to eight weeks for the tissue to get back to the thickness it had been before the hormonal change. When your symptoms are gone, you can reduce the prescription to once a week. If symptoms reoccur you can then increase again to twice a week. If you have been using it for 8 weeks and you still have dryness or pain, come back in — something else may be going on besides vaginal dryness.

Prescriptions for inside the vagina are also written for rings (Estring: this is a ring that is placed inside the vagina and releases low dose estrogen for three months) or suppositories (Vagifem or custom compounded suppositories). These methods deliver estrogen to the vagina internally. Often when a woman uses rings or suppositories internally she will still benefit from some estrogen cream applied externally around the opening of the vagina where more pressure occurs particularly with thrusting.

Compounded vaginal estrogens can be made in creams without parabens and propylene glycol and other chemicals that irritate when cracks or fissures are present, or when there is skin sensitivity. There are bio-identical options for both compounded and non-compounded prescriptions.

Vaginal Estrogens have not been shown to cause an increased risk of breast or endometrial cancer, or any other cancer. See the 2016 American College Of Gynecology guidelines here for women who have had Breast Cancer, and their use of estrogen, click here to visit.

The use of low dose vaginal estrogen and risk of stroke continues to be under study, and so far the Estring, and low dose topical creams show no increase in blood clots, click here to visit.

THE BOTTOM LINE: Don’t put up with dryness or sexual pain from dryness. Find out the cause and treat it until it is gone. There are many resources to help you be successful with this safe treatment, so if your provider doesn’t ask you, then you ask them for treatment.

Click here to read my article about why there is no better time in history to be a post-menopausal woman who wants to have a great sex life.

 

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How to Keep the Bedroom Alive and Interesting for Both of You

These tips for increasing pleasure are from a handout given out at a recent couples workshop. Read through the list together as it can start an intimate conversation or even a more interesting engagement.

1. Experiment together with different touches, different times and new places to have sex and observe how excited you are. Track what positions, what touches, or what words arouse you. You can write them down. These things make up your arousal pattern, and you want to know what these things are and do them. Ask your partner for them. Don’t stop experimenting until you know what works to get you excited. Having you be aroused in the bedroom is at the heart of having it be special.

2. Sexual arousal is unique in that it takes simultaneous relaxing and excitement. The psyche wants to be relaxed so the body will allow excitement/tension to build. That tension and excitement is a good thing. Arousal is a YES to PLEASURE. Let yourself FEEL pleasure.

3. You have “gates” that arousal triggers have to get past to start the cascade of arousal. Stimulating multiple sensory channels at once increases the chance the gates will open. Physically stimulating the body in two or three places, and using your voice in intimate erotic talk at the same time does this. Adding music and aromatherapy uses even two more channels. In the most delightful sense you want to overwhelm those gates.

4. Be curious about your partner and what makes his/her pulse faster. You are in bed with someone who is different than you. His/her likes, body and attention patterns are different than yours. So is his/her arousal pattern. You can figure it out if you pay attention to what works. Track what works.

5. For women: Own your femininity and make it more real and visible to yourself and your partner. Appreciate that this is what you are sharing, it is not just your body, it is your aesthetic, your motion, your essence.

6. For men: If your woman has a busy mind and is distracted it is OK for you to say to her: “I want all of you here with me. What do I have to do to get all of you here with me?” Then listen closely to her answer and don’t try to add more pressure to the moment. Don’t problem solve. Listen as attentively as you can. If she gets emotional, you stay steady.

7. For men: Use your attention as the powerful agent it is. Get skilled in your use of it and then let your woman bask in it. Your daily attention feeds her as a vital nutrient to her well-being, as well as it can be an erotic additive to sexual moments.

8. For men: When you have positive thoughts about your partner, e.g. the way she looks, the way she feels when she is close to you, how you enjoy watching her move…Say those thoughts OUTLOUD. Verbalize those thoughts. Multiple times per day is not too much.

9. For women: When you dress up, or put on lipstick, or show some cleavage, or wiggle in front of him: LET HIM KNOW YOU ARE DOING IT TO GET HIS ATTENTION. OWN THAT YOU WANT HIS ATTENTION. Keep your dynamic as a couple alive and interesting.

10. For women: Make something happen sexually because you can. Do it because you have that power and can celebrate that power. You don’t have to wait till your body tells you to have sex, and you don’t have to wait for him to start something. You can make something happen anytime.

11. Break the “every time” bedroom habits that you have around sex even if they “work”. Doing new things increases your pleasure and raises the excitement and neurotransmitter levels.

12. Make the bedroom furnishings align with HER (your) sensuality. The colors and fabrics used should be the ones that make you feel the most sensuality and sexually alive. The bedroom creates a physical space that represents how you value your sexual connection. Make yours great.

Click here to read my blog post about how to add femininity into your sexual chemistry.

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A Focus on Your Arousal

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When women get in bed with their mates and start touch that leads to sex, they are often not yet physically turned on. They may be starting at a zero level of sexual arousal — or a two or three — out of ten. Their partner may already be at 7 or 8 or higher. The arousal level that would be exciting enough to lead them to an interesting experience or an orgasm would be a nine or a ten. That is a big jump, and it is a jump that can stall out. Finding out how to increase one’s arousal is a process of discovery. Most women I talk to who have low levels of arousal have not spent the time needed to explore what brings them pleasure. They have not discovered what actually works for them. Or, in some cases, they used to know, but their bodies have changed, and they have not re-explored.

A few years ago a 33-year-old woman introduced herself in an evening class I taught by saying she was there to find out if she could have sex that was something in-between the sex she was currently having with her husband, and the sex in the erotic novel, 50 Shades of Grey. Peals of laughter emerged from all corners of the room as the women in the class could relate. Women want to be highly aroused, and yet they don’t know what to do. They hope their partner can figure it out for them, they hope it will be more exciting this time, yet they don’t have a map to make it so. 

In my view the sex in 50 Shades of Grey is remarkable not for its S and M components but because it displays the benefits of having sex with someone who is well trained in sexual arousal. The level of training in and attention to arousal is the standout element in this book. The sex in 50 Shades of Grey did not just happen. It was sex with someone who had spent hours paying attention to what is sexually arousing to another person. Christian Grey had invested time, attention, and thousands of dollars on his sexual education. He had practiced and experimented for hundreds of hours the best way to move a woman from a zero to a ten. He learned to identify increases in her heart rate, to know which pressure of touch got her there faster, to hear which moans indicated she was near her edge. If the arousal level in your sex life does not match 50 Shades of Grey, don’t be down on yourself or your partner. Don’t think you should already know. If you’re like most of the people who come to see me, neither you nor your partner has had a single class in sexual arousal. You have not had the hours of one-on-one mentoring with uninterrupted focus and no expense spared that the fictitious Christian Grey had.

Most women piece together their education in sexual arousal with the bits and pieces they have stumbled upon from direct experience, or as interpreted through girlfriends, the movies, TV, Cosmopolitan Magazine, and maybe a sister. They hope their partner has had a better education, but this is unlikely.

As interested as men are in getting their women excited and pleasing them, and they are interested in doing that, few are well informed about how to do it. Most likely your partner has had little useful education about sexual pleasure. High school sex education classes cover anatomy and physiology, pregnancy, and sexually transmitted diseases. These classes focus on real problems and risks involved with sexual activity, but they do not educate at all on how to create a good experience or peak of pleasure. Your partner’s information about your pleasure most likely is collected from bits too, e.g. his friends, TV pornography, or other things he has read on the internet, as well as what he has found to work in the past.

Your arousal is at the heart of enjoying sex and central to both you and your partner’s satisfaction. Your arousal is a very good thing. The more you are aroused, the more excited you will feel, and the more likely you are to orgasm. Finding out what kind of stimulation gets you going is the missing information. 

The first thing to know as you explore what takes you from a zero to a ten is that no two women are alike. You have your own personal arousal triggers. The ideas you see in the movies, or hear from a girlfriend may or may not work for you. Experiment. Find out what makes you tingly or hot and what makes you wet.

What works for you sexually is not something you get to choose — it is something you get to discover. You can’t decide to be aroused by something, you get to try it and see if it actually works.

Be yourself, relax your mind, and feel your reactions. Feel them, don’t think about them, feel them. It can be fun. Perhaps a light touch to the side of your ribs is deliciously arousing to you. Or maybe you prefer being lifted strongly into the bed by your partner and aggressively mounted. Or a tender personal, erotic dialogue in your ear during intercourse may be what works to get you going. Is it roses? It is his sexual advances? Is it when he does something on the edge? What gets you sexually excited? Do you want touch on the sides of your external clitoris, sweeping in and barely touching, or do you want pressure from the top down?

Does romance arouse you? If so, don’t judge it; work with it. Read romance novels. Watch movies with swashbuckling heroes or heroines that are swept away by love. Ask your partner to up his romantic moves. Ask to be surprised with flowers, or to have your bed littered with rose petals and an enormous number of candles lit around the room, or dine first by candlelight as a prelude. Perhaps you’d like to role-play with him. He gets to be the Texas Ranger, and you are the irresistible damsel in distress, or vice versa. As you experiment you may be surprised by what excites you. Make note of it. You may not choose to do everything that you find excites you. Some things may not be safe or desirable. You will want to do some of them.

Watch erotic movies, or read erotic literature. There is a whole genre of material out there that is designed to turn you on — see if it does. In bed try a variety of touches and pressures, different positions, unique places and see how you respond.

When something works don’t keep it to yourself. With your words or your moans, let your partner know you are turned on. You can say: “More there,” “Yes!” “That’s it.” Be direct and positive. 

When things are not working, let him know too. If his hand is slightly off the right spot, move it. If the pressure is too strong, adjust your body or his.  Don’t do it as a frustrated woman, or a stern teacher, do it as a sexy female who is aroused and wanting to be more aroused. You are on the same team, working together to make sex exciting for both of you.

If you don’t know what touch or position you want, but you know what he or she is doing isn’t working, communicate your desire to experiment, “Let’s try here” or “Touch me here.” Take his hand and place it where you can explore. Move it in the rhythm that feels good to you. Small immediate sexy communications that disclose to your partner what is happening inside your body work to keep arousal building.

If squeezing your nipples is more arousing than kissing them, tell him to squeeze them. If you know the kind of passion in the kiss you want, show him. Kiss him the way you want to be kissed. Tell him in your aroused passionate (not angry or critical) voice that this is how you love to kiss.

For examples of women who have claimed their sexual selves enough to share the specifics of their own orgasms, go to www.OMGyes.com. The open talk on this site may reframe things for you and make it easier to disclose what you are experiencing.

Don’t take it personally if you have to tell him again the next time. Persist. When he sees what awakens when you get fully excited his memory will improve.

Be direct and positive. A man’s macho self can take it. They can take your honesty. They want you to be excited, so they are more open to change than you think. They don’t know what to do to get you excited, so tell them. 

If your partner is female, communicate with her in the language that would work for you, whether you are using the language of touch or words. Watch and listen to her responses closely, and adjust what you do. There are two arousal speeds in the bed, and you want both to be at a nine or a ten.

Remember, if you don’t know what works for you it does not mean there is anything wrong with you. Most likely you are sexually “normal”. You just never had the hours of education in arousal that Christian Grey had. You can start now. 

For more specifics on desire and arousal, click here to buy my book Fanning the Female Flame — How to Increase Your Sexual Desire without changing partners.

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Women and Sexual Desire: Adding clarity into this mystery

The women I see in my office express a yearning for a deep connection and a big love affair, for a mate that treasures them more than anyone else. They want this passion and excitement in their everyday lives. Preferably they want to have this with their current husband, or partner. They do not want to change husbands to get this, though they may if it seems impossible otherwise.

At the same time that they express this yearning for a deeper and more exciting connection, they speak very highly of their mate. Nine out of ten women who come to my office give high marks to their partners. They deeply love and respect the male or female partner in their lives. They comment on his/her patience, understanding, and willingness to try anything. They talk about kindness and support and goodness. They are attracted to their mate.

And then we come to SEX, the reason she made the appointment in the first place. She says, “Is there something wrong with me, or wrong with my hormones, that I am not interested anymore? Is there a reason I am not into it? Can I change anything? Do I have to accept this as my new normal? Can I get back to the way it used to feel?” Or if she has never been turned on, “Can I ever feel what I hear is possible? It is not him, it is me. I am just not that into it.”

Low desire is the number one complaint women have worldwide. Four out of ten women say they have low libido, and one of those four is distressed about it.

One way to talk about women’s sexual desire is to break it down and talk about the different types of desire. Spontaneous desire is the name we give to desire when a woman herself wants sex. She is interested, she is on the prowl, she is excited. She is not responding to her partner’s advances; instead she is the one initiating the contact, making that first wink. There is also receptive or responsive desire. This is when a woman responds with interest to her partner’s or husband’s approaches. Sex is not her idea. The idea is originating with her partner. He or she does the thing that gets her interested, whispers the personal sweet thighs into her ear, or draws her a bath and lights candles.

Spontaneous desire in women can happen for a variety of reasons. One pattern that gets a lot of floor time in my office is cyclical or biological desire. This is the most common description I hear from women of what desire means to them. If you are still menstruating this occurs mid-cycle for a few days when hormones peak at ovulation time, about day 14 of your cycle. Some women also report an increase in desire right before their period begins or a day into their periods. At this point in your menstrual cycle, the PMS time, estrogen and progesterone are actually at their lowest levels. Testosterone is the only hormone left standing. It gets to dominate the action for a day or two, or longer. This type of desire is hormonally driven by the hormones that drive your menstrual cycles. This cycling drives the acne and irritability before your period too.

The cyclical spontaneous desire that can occur mid-cycle, and maybe at the end of the cycle, is not there after menopause. It is also not there when you block ovulation with hormonal birth control. As you can see women are not simple around sex, and in their beauty and complexity there are many places to look for desire. Occasionally low desire is caused by one thing, like an interfering medication. Sometimes it is hormones, vaginal dryness or sexual pain. Most often it is a variety of obstacles, physical and non-physical.

An important thing to remember: A woman does not have to have a surge of hormonal desire to make something interesting happen in the bedroom. She can create something interesting any day just because she can. 

Click here to read my blog post about women and sexual arousal.

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A Body Designed for Sexual Pleasure

There is quite a lot to celebrate about the fame body and how it responds to and is geared for sexual pleasure. It is quite marvelous. When arousal is triggered, cascades of events occur. Neurotransmitters release from a woman’s brain and she gets a nice tingly feeling in her genital tissue. Her nipples become firm, and the clitoris gets erect. Her vulva swells and the labia change from flesh or pink color to a dusky rose or purple. She feels sexually excited. The vaginal walls get suddenly wet. Her clitoris and its two 5 to 7cm long internal legs and surrounding significant vascular tissue engorge with blood. Some muscles contract and heart rate increases. Breathing is fast. There is a sense of tension.

On the outside of a woman’s vulva, women and their partners can see the glans of the clitoris, that external bump of tissue. This glans has the most nerve endings of any place on her body. This is similar to the head of a man’s penis which is thought to be the most sensitive part of the penis with the highest concentration of nerve endings. Both these glans are very sensitive to touch and they can be extremely so. Yet they are not the whole story of arousal and orgasm. Obvious on the male, yet hidden on the female are the shaft and the two internal legs. The shaft and the legs, are what cause the organs, both the penis and the clitoris, to swell when arousal happens. They become erect. That internal swelling can be felt through the upper vaginal Wallin the area we know as the G-spot. When swelling is significant enough and those clitoral legs are impacted by the swelling that surrounds the urethra, an internal orgasm occurs, a vaginal orgasm. There is also an area of the vaginal wall that is deeper inside, referred to as the A-spot or the Deep spot. This spot is in front of the cervix, and when stimulated can lead to orgasm. This is mediated by a different nerve and women report that it feels different than an external orgasm.

The only function of the clitoris and its 8,000 nerve endings is for a woman to experience pleasure, sexual pleasure. The clitoris does not secrete substances or hormones, it does not contribute directly to reproduction or urination, it does not support other processes in her body. It is there for her pleasure.

On top of this awesome genitalia there are the many other erogenous zones in the female body. Her lips, her breasts, her nipples and the skin at the nape of her neck or inner thigh are territories of sensual delight to be explored. Skin can be wonderfully erotic and is packed with nerve endings. Light feathery touch can be scintillating, exploration can be done with your lips, tongue, fingers. There are 2,500 nerve endings per square centimeter in female fingertips, for example, and a lot can be communicated with touch intended to excite and arouse.

Look at the female body and you can appreciate that the physical groundwork for exquisite pleasure has been pre-established. Having this sensitive equipment does not mean women get easily aroused. Many don’t. One has to have one’s arousal triggered for this cascade of events to occur. What triggers arousal is the million dollar question. Arousal is not something you choose – it is something you discover. Arousal can start long before you get in the bedroom, or it can start in the bedroom. It can start with a look, a touch, a smell. If a woman’s arousal is heightened and sustained on enough of her multiple channels, her orgasm happens.

Click here to read my blog post about women and sexual arousal.

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