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But the ascendancy in the late twentieth century of the clitoris as the real site of female sexual pleasure has not resulted in the female orgasm becoming as one-dimensional as the male's in women's view. If women's experience of orgasm could be neatly encapsulated, it would be that all orgasms are ultimately
centred
on the clitoris, but that they can start in a host of places within the ‘orgasmic crescent'. The G-spot, the bean-shaped mass of sensitive tissue found in some women between the back of the pubic bone and the top of the cervix, and which in many is the focal point of sexual arousal, is just one of the these orgasmic centres. (The link between the G-spot and orgasm is far from clear; but it certainly seems to work extremely well for millions of women.)

A 1972 article in the
Journal of Sex Research
identified three
fairly distinct forms of human female orgasm – vulval, uterine and ‘blended'. The vulval orgasm is what we know better as the clitoral orgasm, characterised chiefly by involuntary contractions of the PC muscle; the uterine orgasm is the result of stimulation deeper inside the vagina; the blended orgasm is the deeply satisfying combination the two.

This natural facility of women for a kind of multimedia sexual pleasure, which can only be assumed to have been the case for all humankind's existence, has led over the millennia to understandable confusion on behalf of ‘consumers' of sex, both female and male. While our prehistoric ancestors must surely have chanced upon the many and varied forms of female sexual gratification, they are unlikely to have tried to rationalise or tabulate them.

Successive cultures, however, did just that, and never more so than in our own scientific age, in which researchers, aware that there is more than just the clitoris involved (and that anyway the clitoris does not respond especially well to stimulation immediately after orgasm), have adopted an alphabet soup approach to mapping the alternative female pleasure points necessary for the three to five climaxes the average woman needs to be sexually satiated; first came recognition of the G-spot, then the U-spot – the sensitive opening to the urethra; and then the X-spot on the cervix (‘Better than the G-spot and easier to find,' according to the slogan of its ‘discoverer', Chicago sexologist Debbie Tideman). And Barbara Keesling has found an interesting nearby area in the upper rear of the vagina known as the cul-de-sac or fornix. ‘Incredible' orgasmic sensations, she reported in
Psychology Today
magazine in 1999, can be achieved by a phenomenon called ‘tenting', in which, when a woman becomes highly aroused, muscles and ligaments surrounding the uterus lift it up to allow penetration into the small space
behind
the cervix. Keesling has also found that stimulation of the PC muscle surrounding the opening of the vagina is successful in enhancing orgasm.

Three major points about the basic and unchanging sexual Nature of the female human animal can be drawn from the discoveries of successive generations of sex researchers in different times and cultures.

The first is that the clitoris is not simply a female penis. As Germaine Greer has written: ‘If we localise female response in the clitoris we impose upon women the same limitation of sex which has stunted the male's response.' Not only are there plenty of other orgasmically sensitive areas, both below the waist and elsewhere, but sexual enjoyment for women is even more of a generalised, ‘whole person', psychological experience, that, most crucially, continues after the last muscular spasm of orgasm. As Dr Greer puts it again: ‘The male sexual ideal of virility without languor or amorousness is profoundly desolating; when the release is expressed in mechanical term it is sought mechanically. Sex becomes masturbation in the vagina.'

The second is that the complex and time-consuming nature of women's orgasm (as opposed to the user friendliness of the male) is not a design flaw, or some psychological quirk of fickleness or awkwardness. There is an underlying logic behind it all. Mary Jane Sherfey's view is that the female need for long, drawn-out foreplay and psychological scene-setting is biological, that nature, not culture, has determined that women must be gently, sensitively and lovingly led by the hand towards sexual intercourse. Since women do not have an oestrous cycle, this psychiatrist contends, they need caressing and encouragement to stimulate the blood flow to the pelvis they need for their reproductive system to gear up to best advantage. (There are other, parallel rationales to be discussed later for the strength, length and power of the female orgasm, as distinct from its typical starting difficulties.)

The third conclusion to be drawn from the mysteries of the female orgasm is balder and more disturbing to generations of men. It is, simply, that penile penetration is rarely involved other than in a peripheral role with the attainment of orgasm
for women. They may get plenty of psychological fulfilment
conducive
to orgasm from penetrative sex, but, according to every serious study and the vast majority of anecdotal evidence, it is downright unusual for a woman to reach orgasm solely through the friction of conventional sexual intercourse – even if she gets substantial pleasure from the feeling of penetration and simply having the man's erect penis inside her.

It is undeniable, meanwhile, even when ambiguities over anatomy and questions of copulatory etiquette and gender politics are factored out of the sexual equation, that not all women have orgasms. Statistics understandably vary, the matter of the female orgasm being more subjective than the binary certainties of the male, but the most comprehensive and methodically sound investigation into Americans' sexual practices ever conducted, the 1994 survey
Sex In America: A Definitive Survey
by members of the University of Chicago's National Opinion Research Center, confirmed that it is women who experience far greater problems of sexual satisfaction and interest than men. This study and others indicate that 40 or more per cent of women suffer from some type of sexual dysfunction. Most of these women are between the ages of 25–50.

Most women, it appears, can attain orgasm with clitoral stimulation, but only about 50 per cent of women who can orgasm ever
claim
they can reach climax during coitus. Around 10 per cent of women never achieve orgasm, whatever the situation or degree of stimulation. Women can be orgasmic throughout their lives, and 85 per cent retain sexual desire after the menopause, for once a woman learns how to reach orgasm, she rarely loses that capacity. However, sexual activity tends to decrease after the age of 60 because of lack of partners and untreated bodily changes such as atrophy of the vaginal mucosa.

A pooled global survey in 2001 of 27,500 men and women aged 40-80 in thirty countries,
Global Study of Sexual Attitudes and Behaviors
, carried out again by the University of Chicago
and funded by Pfizer, suggests that a third of all women at any one time (not just of the dysfunctional 43 per cent) lack any interest in sex, a third are unable to orgasm, a third have only occasional orgasms, 21 per cent do not find sex pleasurable, 20 per cent have trouble lubricating, and 14 per cent experience pain with intercourse.

Orgasmic disorder in women, it is generally accepted today, may be lifelong or acquired, general or situational. Because of the widely varying definitions of female orgasm – an orgasm can mean different things to different women – the diagnosis of sexual dysfunction in women is frequently problematic. The most clinical definition is that, with increased blood flow, the vagina and uterus contract and make orgasm impossible. But much of the female sexual anatomy even today remains unknown, particularly the nerves and blood vessels affecting sexual function. An even greater variety of causes can affect and nullify orgasm in women than in men.

Among the factors which can make orgasm difficult or impossible for women are medical diseases, minor ailments, depression, medications including antidepressants, stress, psychosocial difficulties such as financial, family or job problems, family illness or death, physical, sexual abuse or rape (currently or in the past), smoking, cycling (unlike horse riding, which can stimulate orgasm, bicycle seats can cause perineal pressure and reduced blood flow), anger, ignorance of genital anatomy and clitoral function and of arousal patterns and techniques, anxiety, association of sex with sinfulness and of sexual pleasure with generalised sense of guilt, more specific guilt (such as felt by a widow with a new partner or a woman engaged in an extra-marital affair), fear of intimacy, concern about reputation, fear of unwanted pregnancy, hormonal changes, mood disorder, fear of ‘letting go' and losing control, fatigue, time pressure, religious taboos, social restrictions, sexual identity conflicts, sexual inexperience, different sexual preferences from a partner and other conflicts, and poor sexual communication.

The Canadian QueenDom.com website revealed in a 1999 poll of an unusually large sample of 15,000 sexually active adults in the US, Canada and the UK, that the simple matter of self-consciousness inhibited orgasm in a large proportion of women and an equivalent or larger number of men, too. While 46 per cent of anorgasmic women blamed the problem on lack of confidence in their appearance, 70 per cent of men having trouble with orgasm admitted that the difficulty was that they get hung up about their looks when they have sex.

Grunting, groaning and facial grimacing during the latter stages of sex (the critical endgame known colloquially by some, because of the facial expressions involved, as ‘the vinegar strokes') can make us feel embarrassed and fail to orgasm –
61
per cent of women and 72 of men feel they ‘lose the plot' when they start becoming too demonstrative, the figures showed. Equally, if a partner seems to be thinking about work or football scores during sex, the chance of orgasm for many vanishes. Anger with a partner over some unresolved emotional issue was shown to be a reliable showstopper, as was the wrong kind of physical assertiveness. Here, however, the statistics are a little double-edged: 60 per cent of women and 52 percent of men explained that when orgasm eludes them, it is because their partner is too rough; conversely 50 per cent of women and 63 per cent of men said that it happens because their partner is not rough enough!

New sexual dysfunctions are regularly identified. According to recent work by Jim Pfaus, who studies the neurobiology of sexual behaviour at Concordia University in Montreal, for instance, some women confuse what is called sympathetic arousal, as evidenced by increased heart rate, clammy hands, nerves and so on, with fear. As Pfaus explains: ‘That makes them want to get out of the situation. Psychotherapy is a common treatment for the condition, although if anxiety is a factor, patients may also be prescribed Valium. But then Valium can actually delay orgasm.'

Cultural differences, especially male machismo, also come
into play in anorgasmia. In a 1985 survey, 60 per cent of working-class women and 50 per cent of professional women in Puerto Rico admitted to faking orgasm to avoid a vanity-fuelled interrogation from their male partner. In South Africa, the Sexual Dysfunction Clinic at Johannesburg Hospital has treated black men worried about their inability to sustain an erection for an unrealistic length of time, or to have sex up to four to five times a night. In Brazil, where sexual expectations are generally perceived as high, poor female field workers treated for anorgasmia in 1990 were found to have neither expectations nor a scintilla of sexual knowledge. Over a third of the women were unaware that the sexual act was normal in marriage, although they knew that prostitutes and other ‘bad men and women' engaged in
sacanagem
(‘the world of erotic experience'). They were under the impression that all sex was immoral and indecent and that their husbands were insane for desiring sex.

The caveat mentioned earlier, that orgasm can mean different things to different women, deserves more than cursory attention. There is, by some accounts, a significant phenomenon among women of mis-perceived orgasmic dysfunction. This may well spring from the reluctance among many women, open as they are to frank discussions with their peers about sensitive topics, to talk as openly about their experiences and expectations of orgasm.

A urologist, J.G. Bohlen, working in the early 1980s, made the remarkable finding that there was minimal correlation between the perception of orgasm by women and physiological signs of it as measured in the laboratory. Some women he monitored said they had experienced orgasm when no muscle contractions had occurred. Other sex researchers have also reported that, in tests, some women can have what they are satisfied is an orgasm while lying perfectly still and without contractions.

Conversely, Hartman and Fithian monitored a group of 20 female therapy clients who claimed thev were not orgasmic.
Three-quarters, however, were found to be undergoing the classic physiological responses associated with orgasm. Once the women had these changes highlighted for them, all but one were able to identify it for themselves as an orgasm the next time they were monitored. Significantly, many of the subjects had read up widely on orgasm, but decided what they had did not seem to feel what it was supposed to be like. It is as if the modern mythology and cult of orgasm has placed the sensation on such a pedestal – created such an aspirational ‘super-brand' of it – that women perfectly capable of orgasm refuse to believe they are having a legitimate one and must instead be experiencing an inferior imitation brand. Either that, or they simply discover that, for their taste, orgasm simply is not all it is cracked up to be.

The judgement that a woman is anorgasmic – and the above strongly suggests that, at some level, it
is
a judgement – is also subject to the cultural wind blowing at any particular time in history. One early male sex researcher, E. Elkan, argued in 1948, in an attempt to place female orgasm in an evolutionary context, that ‘fixing' mechanisms such as hooks and barbs have evolved in lower species such as snakes to allow the male time to inseminate the female. In species where males do not have such capture mechanisms, there are behavioural immobilising mechanisms such as skeletal contractions to ensure insemination. Elkan went on to argue that since orgasm is not one of these mechanisms and therefore does not occur in animals, women should regard orgasm as a gift and not part of their due. An anorgasmic woman, therefore, should be no more worried about it than if she were unable play the piano.