Orgasm Q & A

By: Michael Yin, MD

• What is an Orgasm?
• What is the Difference Between a Male and Female Orgasm?
• What is the Fluid on the Tip of His Penis Before he Ejaculates (Comes)?
• How Long Does Sperm Live After Ejaculation?
• Can a Guy Hold His "Come" Inside During Sex, or is an Orgasm Uncontrollable?

What is an orgasm?

Orgasm is an emotional and physical experience that occurs during a normal sexual response cycle. During this cycle, pleasure peaks and is then accompanied by a sense of release from sexual tension. During orgasm, both men and women experience involuntary, rhythmic contractions of the pelvic muscles. The mind senses these contractions as pleasurable, but the intensity of these sensations differs from person to person. Each orgasm can also differ in intensity from one time to the next for the same person. For example, an orgasm could feel like warm, gentle throbbing in the genital area one night, and then tomorrow it could feel like an explosion that causes the whole body to become rigid and the mind to momentarily black out.

The four phases of sexual response are as follows: Arousal, Plateau, Orgasm, and Resolution. Arousal, or feeling "turned on," is a combination of mental arousal and physical changes, such as a racing heart, rapid breathing, flushing, increased sensitivity in the genital area, erection of the penis, and swelling and lubrication of the vagina. During the plateau phase, sexual and muscular tension intensifies. During orgasm, sexual pleasure peaks and sexual tension is released. The fourth stage is resolution, during which there is a gradual return of the body to its baseline state accompanied by a sense of warmth, pleasure, and relaxation. After orgasm and ejaculation, most males are unable to have another orgasm for a period of time. This refractory period depends on age (younger men can need only minutes to fully "recover" and older men may need an hour or more) and differs widely between men.

What is the difference between a male and female orgasm?

The most obvious difference in orgasms is that male orgasms are usually accompanied by the ejaculation of semen. Ejaculation involves the secretion of semen into the urethra (urinary tube) and a rhythmic contraction of pelvic muscles that forces the semen out of the urethra. In males, however, orgasms can occur with or without ejaculation. When men have orgasms without ejaculation, the pelvic muscles contract and you feel like you're having an orgasm, but the semen is prevented from being secreted into the urethra. Less commonly, the semen is pushed backward into the bladder during orgasm and appears as milky fluid that comes out during urination after sex. This is called retrograde ejaculation and happens occasionally when men try to prevent ejaculation during orgasm and is usually not a sign of a disorder. However, retrograde ejaculation does happen more frequently in people with diabetes or after surgery, causing damage to the nerves around the penis.

During orgasm for a female, the rhythmic contractions take place within the pelvic muscles as well as the walls of the vagina. In most women, there is no fluid ejaculated, but they often experience vaginal wetness when they are sexually aroused. Another difference between male and female orgasm is that women do not experience a refractory period and may have multiple orgasms with continued or additional stimulation.

What is the fluid on the tip of his penis before he ejaculates (comes)?

The pre-ejaculatory fluid or pre-come is a clear fluid that is secreted from the Cowper's glands (bulbourethral glands), which are two pea-sized glands near the prostate gland. This fluid's primary purpose is to serve as a lubricant during sexual intercourse. Not everyone produces pre-ejaculatory fluid, however. If you don't produce this fluid, it doesn't necessarily mean there won't be adequate lubrication during intercourse. Although Cowper's glands do not contain sperm, pre-ejaculatory fluid may contain some sperm, which have mixed in from the secretions pooled within the inner urethra. Therefore, there is always the risk of getting pregnant from pre-come, which can be prevented by the proper use of condoms and other forms of contraception.

Howw long does sperm live after ejaculation?

Although sperm can live for many weeks while in the testicle, sperm remains capable of fertilization only 24 to 48 hours after ejaculation. The woman's egg can probably only be fertilized for 12 to 48 hours after ovulation.

People often use this information to determine when it is least possible to get pregnant with unprotected sex. These methods are called the rhythm methods of contraception. Rhythm methods are not reliable methods of contraception. Pregnancy rates in some field studies using these types of methods were as high as 20 percent. Furthermore, they do not prevent the transmission of STDs such as HIV.

Can a guy hold his "come" inside during sex, or is an orgasm uncontrollable?

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Male sexuality is extremely variable. Most men ejaculate within two minutes of penetration during sexual intercourse, then lose their erection and experience a refractory period. Some men can prevent ejaculation and experience multiple orgasms without ejaculation and without losing their erection. Although most men who experience multiple orgasms develop that ability naturally, some men are able to develop it with training. This is accomplished by a combination of interrupting sexual intercourse before a point when ejaculation is inevitable, deep breathing to reduce the building excitement, and contraction of pelvic muscle to inhibit the secretion of semen. A helpful guide on this matter is one called "The Multi-Orgasmic Man," and a guide for a wide range of questions on human sexuality is "The Kinsey Institute New Report on Sex."

Next: How the Off-Beat Guy Always Gets the Girl

Last reviewed: 10/05

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