How do women really know if they are having an orgasm?

Dr Nicole Prause is challenging bias against sexual research to unravel apparent discrepancies between physical signs and what women said they experienced

In the nascent field of orgasm research, much of the data relies on subjects self-reporting, and in men, theres some pretty clear physiological feedback in the form of ejaculation.

But how do women know for sure if they are climaxing? What if the sensation they have associated with climax is actually one of the the early foothills of arousal? And how does a woman know if she has had an orgasm?

Neuroscientist Dr Nicole Prause set out to answer these questions by studying orgasms in her private laboratory. Through better understanding of what happens in the body and the brain during arousal and orgasm, she hopes to develop devices that can increase sex drive without the need for drugs.

Understanding orgasm begins with a butt plug. Prause uses the pressure-sensitive anal gauge to detect the contractions typically associated with orgasm in both men and women. Combined with EEG, which measures brain activity, this allows for a more accurate picture of a womans arousal and orgasm.

Dr Nicole Prause has founded Liberos to study brain stimulation and desire. Photograph: Olivia Solon

When Prause began studying women in this way she noticed something surprising. Many of the women who reported having an orgasm were not having any of the physical signs the contractions of an orgasm.

Its not clear why that is, but it is clear that we dont know an awful lot about orgasms and sexuality. We dont think they are faking, she said. My sense is that some women dont know what an orgasm is. There are lots of pleasure peaks that happen during intercourse. If you havent had contractions you may not know theres something different.

Prause, an ultramarathon runner and keen motorcyclist in her free time, started her career at the Kinsey Institute in Indiana, where she was awarded a doctorate in 2007. Studying the sexual effects of a menopause drug, she first became aware of the prejudice against the scientific study of sexuality in the US.

When her high-profile research examining porn addiction found the condition didnt fit the same neurological patterns as nicotine, cocaine or gambling, it was an unpopular conclusion among people who believe they do have a porn addiction.

The evolution of design of the anal pressure gauge used in Nicole Prauses lab to detect orgasmic contractions. Photograph: Olivia Solon

People started posting stories online that I had falsified my data and I received all kinds of sexist attacks, she said. Soon anonymous emails of complaint were turning up at the office of the president of UCLA, where she worked from 2012 to 2014, demanding that Prause be fired.

Does orgasm benefit mental health?

Prause pushed on with her research, but repeatedly came up against challenges when seeking approval for studies involving orgasms. I tried to do a study of orgasms while at UCLA to pilot a depression intervention. UCLA rejected it after a seven-month review, she said. The ethics board told her that to proceed, she would need to remove the orgasm component rendering the study pointless.

Undeterred, Prause left to set up her sexual biotech company Liberos, in Hollywood, Los Angeles, in 2015. The company has been working on a number of studies, including one exploring the benefits and effectiveness of orgasmic meditation, working with specialist company OneTaste.

Part of the slow sex movement, the practice involves a woman having her clitoris stimulated by a partner often a stranger for 15 minutes. This orgasm state is different, claims OneTastes website. It is goalless, intuitive, and dynamic. It flows all over the place with no set direction. It may include climax, or it may not. In Orgasm 2.0, we learn to listen to what our body wants instead of what we think we should want.

Prause wants to determine whether arousal has any wider benefits for mental health. The folks that practice this claim it helps with stress and improves your ability to deal with emotional situations even though as a scientist it seems pretty explicitly sexual to me, she said.

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