The female orgasm continues to be the subject of intense scientific debate. Doctors puzzle over the different means by which women can achieve orgasm, and the things that can prevent orgasm in women.
When women do achieve orgasm, "There are changes throughout the whole body, a head-to-toe kind of experience," says Sandra Leiblum, PhD, a sex therapist and director of psychological services at the New Jersey Center for Sexual Wellness in Bedminster.
How Women Achieve Orgasm
Women achieve orgasm through a four-step process first described by sex researchers William Masters and Virginia Johnson decades ago:
  1. Excitement. The woman initiates or agrees to sex, and as it commences she finds herself focusing mainly on sexual stimuli. Blood begins to engorge the clitoris, vagina, and nipples, and creates a full body sexual blush. Heart rate and blood pressure increases.
  2. Plateau. Sexual tension builds as a precursor to orgasm. The outer one-third of the vagina becomes particularly engorged with blood, creating what researchers refer to as "the orgasmic platform." Focus on sexual stimuli drowns out all other sensations. Heart rate, blood pressure, and respiration continue to increase.
  3. Orgasm. A series of rhythmic contractions occur in the uterus, vagina, and pelvic floor muscles. The sexual tension caused by lovemaking releases, and muscles throughout the body may contract. A feeling of warmth usually emanates from the pelvis and spreads throughout the entire body.
  4. Resolution. The body relaxes, with blood flowing away from the engorged sexual organs. Heart rate, blood pressure, and respiration return to normal.