Orgasm

Orgasms involve a complex interaction between the brain and sexual organs.  Orgasm is defined as a peak, intense pleasure and sensation that creates altered consciousness and occurs with physical changes. During arousal, contraction of sexual organs and the urethral bulb increase pressure and when pressure reaches a certain point, orgasm occurs with a release pressure at the end of the urethra.  Orgasm can be generated without input from genitals or without ejaculation! Patients with a spinal cord injury or patients that have undergone a prostatectomy (surgical removal of the  are still able to orgasm. 

Orgasm is associated with hyperventilation or increased breathing, increased heart rate, and increased blood pressure. To give you an idea, at rest, we take about 10-12 breaths per minute while during orgasm, breathing can increase to 40 breaths/min. Orgasm occurs when there is a release of pressure with simultaneous powerful and pleasurable contractions of the pelvic floor muscles including the rectal sphincters that is often associated with facial expressions. After an orgasm, there is a release of and increased levels of the hormones prolactin and oxytocin.

Studies have used positron emission tomography to measure changes in blood flow in the brain to identify which areas of the brain are active during orgasm.  Various parts of the brain had increased activity during orgasm while others were less active.

Orgasms can vary in intensity if stimulation is provided via penile stimulation or prostatic massage and stimulation.

Water symbolic of orgasm.

The quality of the pelvic floor muscles can impact the quality of orgasm due to the intense and rhythmic contraction of these muscles. Therefore, if the pelvic floor muscles are too weak or if they are too active (think too tight or have trigger points) then they cannot contract well, leading to erectile dysfunction, inability to orgasm, or possible pain during or post orgasm due to muscle spasm.  Oftentimes, if patients experience pain with or after orgasm other pelvic floor symptoms may be present such as leakage after urinating, incomplete bladder emptying, or constipation.  While those with a vagina may experience pelvic floor dysfunction in pain with intercourse, those with a penis may have pelvic floor dysfunction present as difficulty with orgasm, erectile dysfunction, or pain/ discomfort with orgasm.  Pelvic health PT in addition to guidance and treatment with your urologist and/or primary care physician can help relieve symptoms associated with orgasm or erection.

If this post speaks to you or if you are experiencing any of these symptoms, please reach out here and schedule a phone consultation or initial evaluation to address the underlying factors.

The pelvic floor muscles overlay the bulb and roots of the penis and form a hammock at the bottom of the pelvis. When these muscles contract during orgams they provide an intense and pleasureable experience. These muscles can also be contracted and relaxed voluntarily and with verbal and tactile training and cues. Therefore, premature ejaculation, difficulty achieving orgasm, and/or erectile dysfunction are linked the the integrity and functioning of these muscles.

References

Alwaal A, Breyer BN, Lue TF. Normal male sexual function: emphasis on orgasm and ejaculation. Fertil Steril. 2015;104(5):1051-1060. doi:10.1016/j.fertnstert.2015.08.033