Q: I have read in magazines about G-spot orgasms and clitoral orgasms. What is the difference? And do all women have a G-spot?

Dr. Thomas Stuttaford

A: Occasionally, learned neurophysiologists publish research papers that they hope will lay to rest once and for all some of the myths surrounding the supposed G-spot and female ejaculation. These two possible aspects of the female orgasmic response are said by some to be linked, whereas most medical scientists doubt their very existence.

Dr Ernst Gräfenberg and his wife, also a doctor, were responsible for the G-spot’s fame. It was named after him in 1944 following his well-publicised research with a very small group of women, who were not randomly selected. Another factor that casts doubt on the research was that there was no control monitoring. But since the publication of the Gräfenberg s’ results, the myth of the importance of the G-spot has been perpetuated.

Women don’t ejaculate in the same way as men. There is evidence of a vestigial prostate in women but it has no function, is minute and doesn’t ejaculate. Women produce lubrication in variable quantities from several different sources, including the vaginal walls and glands around the entrance of the urethra and the vagina. Occasionally, the small glands around the entrance to the urethra produce lubrication so abundantly that this could be mistaken for ejaculation.

According to the latest research, so-called female ejaculation is in fact spurting incontinence. Many women are frequently minimally incontinent either at penetration or during orgasm. The constitution of the so-called ejaculate has been carefully analysed as to the proportion that could be uriniferous, and that that could have come from the paraurethral glands and has some similarities to prostatic fluid.

Many writers of sex books suggest that the G-spot is a small, hyper-sensitive area of the vagina about three quarters of the way up the anterior (towards the front) vaginal wall.

Anatomists have studied the anterior vaginal wall with great care, including microscopic studies. These have not shown that any patch of the wall is especially well supplied with nerve endings.

The clitoris is the most sexually sensitive part of the genitalia, its erectile tissue extends back an inch and a half as the bulb beneath the inside of the vulva to the vaginal orifice. The lower portion of the vagina, the area between the anus and the vagina (perineum) and the perianal area are also highly sensitive.

Conversely, the upper portion of the vagina, in which the G-spot is said to be located, is relatively poorly supplied by nerves and so is relatively insensitive. Physiologists suggest that stimulating the upper third of the anterior vaginal wall, relatively insensitive as it is, is most likely to cause a rhythmical pulling of the covering of the clitoris over its surface. This produces an orgasm. The same principle applies to sex involving penile penetration. Theoretically, there is therefore no difference between clitoral and vaginal orgasms.

When there is a difference in the orgasmic response it is probably related to other factors in female arousal. Some women need direct clitoral stimulation for orgasm, others, far fewer, only after penile penetration. The difference is probably related to psychology rather than female anatomy and is dependent on such varied factors as mutual sense of closeness and lust, or feelings of guilt, anxiety or anger.