What Do Women Want?: Adventures in the Science of Female Desire - Daniel Bergner (2013)

Chapter 8. Four Orgasms

Shanti, a former model who’d just turned fifty, took off her black boots, her black wrist bands, and her blue, red, and yellow Tantra Warrior choker. She slid off her dress, slid off everything, then arranged her body under a sheet and her blond head in the mouth of an fMRI cylinder. This was in Newark, in a Rutgers University lab with a wide glass pane dividing a pair of rooms. The giant cylinder was on one side of the window, and Barry Komisaruk, a Rutgers neuroscientist, and Nan Wise, a sex therapist and a doctoral candidate in his program, were on the other. They watched Shanti get settled.

Over the next hour, she would masturbate in various ways. She would use her finger on the external part of her clitoris. She would use a dildo to stimulate her G-spot and her cervix. Clitoral, G-spot, cervical—with Shanti and their other subjects, the scientists were trying to get clear and distinct pictures of the brain regions that burst into activity during three different types of climaxes. Komisaruk, a cheerful man in his late sixties with a horseshoe of curly gray hair, designed and made the translucent streamlined dildos himself to facilitate internal stimulation while avoiding contact with the clitoral exterior. He bought plastic rods, heated them at home in his oven, and bent them to his specifications.

Tantra Warrior was Shanti’s self-created profession. She’d once been on the cover of Elle; now she made her living around Manhattan and the resort towns of Long Island, imparting erotic wisdom at soirees held by the erotically foiled, the erotically seeking. Komisaruk and Wise needed subjects like her who had no problem masturbating in public and amid the fMRI machine’s bleating and clanging.

“When you’re about to have an orgasm,” Wise told Shanti through an intercom, “just raise your hand.”

Shanti started on her clitoris under the sheet. Komisaruk, in khakis and a light blue button-down shirt, and Wise, in a crisp black skirt and silk blouse, were joined now by Wen-Ching Liu, a Chinese physicist and expert at interpreting neural imagery, in a white lab coat. They alternately glanced through the window and stared at a monitor on their own side of the glass, watching a map of Shanti’s brain light up in constellated dots.

Komisaruk’s decades of orgasmic research had begun with his wife’s final stages of fatal breast cancer. They’d met at a summer colony when he was fifteen and she was two years younger. They’d gone steady right away and married five years later. At twenty-nine, she was diagnosed. She had just given birth to their second child. The metastases were swift and filled her with fluid and put her in such excruciating pain that she tore out her IV tubes and crawled across the hospital floor, trying somehow to escape her agony. “And I’m standing there like a dummy,” he remembered, “unable to do anything.”

His work at the time involved studying how sexual stimulation blocked pain in female rats, a tunnel of research that he’d branched onto after following a grand ambition, since college, to seek out the neurological underpinnings of consciousness. Watching his wife on her hands and knees, “I said to myself, I’ve got to do something useful.” He would devote himself more thoroughly, he vowed, to understanding pain and figuring out whether sex might hold a natural analgesic. Could he distill an organic pain blocker to rescue sufferers like her? Along the way, after his wife died, his explorations with rats drew the attention of Beverly Whipple, nurse and sexologist and author of the early-eighties bestseller The G-spot and Other Discoveries About Human Sexuality. While he went on hunting for an analgesic on his own, he teamed with Whipple on experiments dealing with nerve tracks and women’s varied climaxes, and that had led him here.

“Now we’re getting it!” he exclaimed, eyes on the screen while Shanti worked. The clusters of dots were growing more dense.

“Wow!” Wise let out. “It’s a Christmas tree!”

“She’s moving fast,” he noted, lifting his eyes fleetingly from screen to subject.

“For a Tantra girl,” Wise said.

Shanti was imagining, she recounted later, “My lover touching me; him showing someone else how to touch me; lots of people watching; a line of guys waiting to stroke me, to lick me; then a cute, butchy girl putting her hand up my skirt.”

“She’s getting close,” Komisaruk said. “That’s the insula!”

Shanti raised her free hand.

“It’s popcorn brain!” Wise said, inspired by the points of light.

But Shanti’s session, it turned out, wasn’t a great success. There had been some miscommunication, it seemed, when she’d been signed up as a subject. Erotic guru though she was, she told me afterward that she didn’t think she’d ever had, in her life, a G-spot orgasm, and she knew she’d never had a cervical one. Her efforts with Komisaruk’s homemade dildo didn’t produce the data he was hoping for.

And then, too, he may have been overly optimistic in aiming to distinguish climaxes through brain imaging. In the months that followed, he didn’t manage it, even once he had a set of subjects more versatile than Shanti. The needed machinery probably didn’t exist yet, something he seemed both to have known and not let himself know as he leaped with scientific exuberance into the study. Brain regions could be glimpsed but not the terrain within and not the way those areas interacted. And the identifiable regions were broad, immeasurably complex. The insula—whose illumination had made Komisaruk’s voice spring upward—was a neurological territory of pain as well as pleasure. When all his subjects had been through the experiment, Komisaruk could point to distinct spots in the brain that jolt into action with a touch of the clitoral exterior, the vaginal walls, or the cervix, but this was a long, long way from being able to separate out the almost infinitely intricate systems of ecstasy—systems encompassing much of the brain, from front to mid to back, from the prefrontal cortex to the hypothalamus to the cerebellum—in a trio of orgasms.

And that was assuming that the three different kinds of climax were a reality, that G-spot and cervical orgasms weren’t a figment of popular suggestion and personal imagination. About the culmination of women’s desire there was a swirl of uncertainty and a tangle of angry scientific and political debate, and it was all a reminder that in the twenty-first century it wasn’t only the psychological questions of female eros that were unresolved but something seemingly much more basic: the mechanical workings of women’s genitalia.

The array of plausible orgasms was a reminder, too, of Tiresias, who lived for seven years as a woman and informed Zeus and Hera that women are given the greater part of ecstasy.

The story behind Komisaruk’s experiment traced back to Freud. The father of psychoanalysis, who made eros the essential substance of our psyches, decreed that stimulation of the external clitoris—he had no knowledge of the bulbs and wings—was like “pine shavings” compared to the vaginal “hard wood fire.” A woman who relied on the clitoris for her orgasms was stymied, locked in an immature sexuality, thwarted physically and psychologically. Erotic womanhood was marked by orgasms through vaginal intercourse.

But Freud was hazy about one thing, a physiological problem that still bedevils the research of sexologists. He didn’t deal with the dilemma that intercourse sometimes grazes, pulls, or puts pressure on the clitoris. Did he mean that mature, womanly climaxes were solely internal or was this external tugging and pressing acceptable?

It is impossible to know how many women attempted to train themselves to meet Freud’s orgasmic standard, and which interpretation they took as the goal, but Marie Bonaparte—the same French psychoanalyst to whom Freud posed his question, “What does a woman want?”—was tormented by Freud’s edict. Driven by her inability to climax through intercourse, and, it seems, interpreting the edict the second way, in the nineteen twenties she enlisted physicians to measure the distance between the tip of the clitoris—the glans—and the upper edge of the vaginal opening in their patients. She and the doctors collected, too, reports of the women’s ecstasies. Then Bonaparte scrutinized the evidence. She concluded that her personal failure was due to the three centimeters that divided her key parts. Two and a half centimeters, she determined from her data, was the threshold; less than that and a woman stood a good chance of reaching bliss from a man’s thrusting.

Next, Bonaparte consulted a Viennese surgeon. She had her clitoral ligaments snipped, her clitoral glans moved. Though the organ’s nerves survived, the operation didn’t achieve her orgasmic longings. Nor did a second try. She saw herself as doomed to what she termed “frigidity.” But she kept on with her research, zeroing in on African women whose clitorises had been ritually cut, excised. Because of the loss of clitoral sensation, she asked, “Are African women more frequently, and better, vaginalized than their European sisters?” As a start toward interviewing subjects and finding out, she befriended Jomo Kenyatta, who was soon to lead Kenyans in rebellion against British rule, a war of liberation waged partly to preserve the Kenyan custom of clitoridectomy.

Bonaparte seems to have abandoned her African project without gathering much evidence either way, and by midcentury, scientific doctrine started to shift. Kinsey, from his interviews with thousands of women, and Masters and Johnson, from watching women having sex and masturbating in their lab, doubted the existence of the internal orgasm. Then, in 1970, feminist writer Susan Lydon published a clitoral manifesto. Men had forever “defined feminine sexuality in a way as favorable to themselves as possible. If a woman’s pleasure was obtained through the vagina, then she was totally dependent on the man’s erect penis . . . she would achieve her satisfaction only as a concomitant of man’s seeking his.” She proclaimed, “The definition of normal sexuality as vaginal, in other words, was a part of keeping women down, of making them sexually, as well as economically, socially, and politically subservient.” But with the proper exaltation of the clitoris, “woman at long last will be able to take the first step toward her emancipation, to define and enjoy the forms of her own sexuality.”

And soon the manifesto seeped into sexology. A kind of clitoral absolutism took hold. With her bestseller of the seventies, The Hite Report on Female Sexuality, researcher Shere Hite commanded an audience of tens of millions. She announced that the clitoris was the only locus of women’s ecstasy. Whether from tongue or finger or the tuggings of intercourse, the external organ was where climax happened.

The absolute became accepted truth, imbued in popular consciousness. But in 1982, Beverly Whipple, Komisaruk’s eventual collaborator, published her book on the G-spot. There was, she and her co-authors maintained, an area along the interior of the vagina’s front wall that could bring on astonishing orgasms. She first hit on this phenomenon while working as a nurse with patients having bladder trouble. The zone could be elusive, she cautioned, and could be trickier to locate in some women than others. Sometimes G-spot climaxes produced ejaculations—not urine, she clarified, but a fluid that “resembles fat-free milk and has a sweet taste.” She named the magical bit of anatomy after a German gynecologist, Ernst Grafenberg, whose forgotten writing from decades earlier, she discovered, had noted the same territory.

Grafenberg wasn’t the first to have found it. A seventeenth-century Dutch scientist had documented the same region. But it was Whipple who brought it to prominence. Her book was translated into nineteen languages and set off an international firestorm. Critics railed that her research was anecdotal, flimsy, that she was sending women on an impossible hunt within the vaginal canal, a quixotic journey in search of superior, grail-like pleasure, that she was reviving oppressive Freudian ideals, that she was elevating patriarchal sex. The G-spot, her opposition insisted, was a fraud.

And nowadays, despite all the powers of contemporary science, the seemingly straightforward anatomical question, is there a G-spot? remains unanswered. The doubters view the phenomenon as a kind of psychosomatic bliss. They raise evidence like a study done recently by British researchers who sent out a questionnaire to thousands of pairs of female twins, identical and fraternal. If the G-spot exists, the scientists proposed, if it is a zone of actual flesh rather than an article of trumped-up faith, then identical twins, whose anatomies are nearly perfect copies of each other, will be far more likely than fraternal pairs to agree that they have one. The twin experiment had a classic structure, one that’s been used repeatedly to separate the genetic from the learned, the objective from the subjective, in domains other than sex. And when the responses came back, the rate of positive answers was the same among the two groups. “What an Anti-Climax: G-spot Is a Myth,” the Sunday Times of London declaimed. Women were now saved, one of the researchers said, from reaching for an orgasmic fiction and gaining only feelings of inadequacy.

But Whipple and Komisaruk, meanwhile, together and on their own, have accumulated data that leads to a different conclusion, with some of their evidence arriving through the orgasms of paraplegic women. In female rats and female humans, they’ve established that four nerve paths carry signals from the genitals to the brain. Two of these channels course straight up the spinal cord. But a third, the hypogastric tract, does an end-around; it doesn’t join the spine till well above the pelvis, at about the level of a person’s belly button. And a fourth, the vagus, whose name in Latin means “wandering,” makes its wending way to the brain without relying on the spine at all.

Komisaruk and Whipple have shown the orgasmic importance of this multipronged map by working with women with severe spinal cord injuries, who, theoretically, shouldn’t be able to feel what’s going on below their waists. Their genitals should be insensate. And under examination in the lab, the paraplegics’ clitoral glans have indeed proven dead. But the interior front wall of their vaginas and their cervixes have been plenty sensitive. As they masturbated by stimulating the wall or the cervix, the subjects reported having orgasms. The scientists validated their claims by gauging their sense of pain, taking their pulse, and measuring the dilation of their pupils. Sexology had already verified such readings as markers of climax: pain vanishes, pulse races, pupils widen. Whipple, sitting beside the masturbating women, collected the data, using a calibrated finger pricker and a pupillometer. And she and Komisaruk published papers arguing that the vagus and, in some cases, the hypogastric tracts were escorting the vagina’s ecstatic messages around the point of spinal damage, while the signals of the clitoral exterior, by contrast, depended on the lower spine and were cut off. This, they reasoned, demonstrated that vaginal orgasms were real and distinct, that they weren’t merely due to oblique pulling and pressing on the external clitoris. And, they explained, the two circuitous tracts, the hypogastric and the vagus, were why healthy women described vaginal climaxes as feeling different from the external, the clitoral, as feeling “deeper,” more “throbbing,” “stronger.” Somehow the less linear, more sinuous and imbedded nerve paths created these sensations.

But even for those who dismiss evidence like the twin study and who trust the lessons of the paralyzed and the truth of the internal orgasm, a primary mystery clouds everything. What is the exact anatomical origin, or blend of physiological sources, for this variety of bliss? Is the G-spot a spot or a diffuse and even slightly morphing province? Is it an entity of the vaginal wall itself or is it more about what lies behind the wall, the nerve-dense clitoral extensions, the wings, charted in the late nineties? If it’s about those extensions, and the stimulation they might receive through the wall during intercourse, are vaginal orgasms clitoral after all? Or is Komisaruk right in deducing, from his data with paraplegics, that this probably can’t be the case, because in these paralyzed women the nerve tracts from the extensions would be severed just like the paths from the glans?

And how should anyone grapple with understanding the mechanics and nerve routes of the proposed third type of rapture, the cervical climax, a late addition to the orgasm debate—and one with a possible reproductive relevance? As with rats, stimulation of a woman’s cervix facilitates a hormonal release that can, to an unknown degree, aid the fertilized egg. But finding out, scientifically, whether women can actually have a cervical climax may be impossible. It’s difficult to imagine how the experience could be isolated, difficult to imagine the dildo, kitchen-made or otherwise molded, that could completely bypass stimulation of the walls and touch only the back of the canal.

Setting themselves to unclouding the G-spot if not the cervical uncertainties, two French doctors lately positioned a woman, who said that she had vaginal orgasms, in gynecological stirrups. They had her lover slide himself inside her, and they put a sonogram’s scanner on her pelvis. This vision of intercourse revealed that a pair of the clitoris’ underlying projections might be the solution to the G-spot puzzle. These projections embrace the spongy, nerve-lush lining of the urethra. And on the sonogram, when the penis struck a particular zone on the front wall, the extensions were stirred into a scissoring motion, massaging the urethral lining. This, one new theory went, stoked the lining into an overload of neural activity—and the woman into climax. So the spot was the source of the scissoring, and the ultimate origin of the orgasm was the urethra’s cushiony outer layer.

Komisaruk and Whipple have released a guide for the general reader: “If one or two fingers are inserted into the vagina, with the palm up, using a come here motion,” the zone can be found. “Women have reported that they have difficulty locating and stimulating their G-spot by themselves (except with a dildo, a G-spot vibrator, or similar device), but they have no difficulty identifying the erotic sensation when the area is stimulated by a partner. To stimulate the G-spot during vaginal intercourse, the best positions are the woman on top or rear entry. The orgasm resulting from stimulation of the G-spot is felt deep inside the body.”

None of the efforts on either side has put an end to the vaginal versus external disputes. Nothing seems likely to. About half of all women believe they have a G-spot; half think they don’t. But Komisaruk and Whipple, using their finger pricker and pupillometer, have verified something that transcends anatomy, something that hasn’t brought much doubt: there are women who can think themselves to orgasm with no touching whatsoever. For reasons unclear, it’s a capacity much more common in women than in men. In Komisaruk’s and Whipple’s lab, imagining lovers or, for some, passages of music, women have sent themselves into ecstasy.

One afternoon I watched as Wise, Komisaruk’s associate on the fMRI study, lay back in the cylinder and demonstrated. It was all about breathing, she told me before she went into the machine, and about the strength of the pelvis and about “knowing how to circulate the energy.” She kept her preferred fantasies to herself.

I asked if it was truly an orgasm.

“There are all kinds of sneezes,” she said, “but there’s no question it’s a sneeze.”

Now she was motionless under the sheet. On the screen, the constellations of dots were getting thicker and thicker, more crazed. Five minutes and nineteen seconds after she began, she raised her hand.