For many women, sex is a chore. During sex, they are mere spectators and the euphoria that they so desperately want - and which their partners seem to experience effortlessly - is for them an elusive dream.

But they genuinely want to please their partners; they were told that true sexual satisfaction is only achieved when you have an orgasm and many men voice profound disappointment when their partners fail to 'come'. So, to placate men, they fake it!

What is an orgasm?

An orgasm, also called climax, apoplexy, coming and le petit mort (the little death), is derived from the Ancient Greek orgasmos, 'to swell with moisture'.

It is the conclusion of the plateau phase of the sexual response cycle, and may be experienced by both males and females. Orgasm is characterised by intense physical pleasure, controlled by the involuntary, or autonomic, nervous system.

Orgasm and sexual satisfaction

In 1990, Kaye Wellings et al, in a study called The National Survey of Sexual Attitudes and Lifestyles using a random sample of 20,000 British people aged 16 to 59, revealed:

48.75 per cent of men agree that orgasm is necessary for male sexual satisfaction.

43.3 per cent of women agree that orgasm is necessary for male sexual satisfaction.

37.45 per cent of men agree sex cannot be readily satisfying for women without orgasm.

28.0 per cent of women agree that sex without orgasm is not readily satisfying for them.

In 1994, Edward O. Laumann et al, in another paper titled The Social Organisation of Sexuality, revealed:

75 per cent of men in partnerships always have an orgasm with their partners.

28.65 per cent of women always have an orgasm with their partners.

Men's estimate of how their partners orgasm was 15 per cent higher than the real figures.

Many other studies have shown that only about 30 per cent of women regularly reach orgasm by penile-vaginal intercourse alone. It is obvious that there is a large pool of frustrated women out there and many men are unaware how unfulfilled their partners are.

When a woman has difficulty reaching an orgasm, it is called anorgasmia, frigidity, or female orgasmic dysfunction.

There are four types:

Primary orgasm has never been achieved.

Secondary orgasm has been achieved in the past.

Absolute orgasm impossible in all situations.

Situational orgasm impossible only in certain situations.

Factors of Frigidity

Anorgasmia can result from stress, anxiety, depression, fatigue, worry, guilt, fear of painful intercourse, fear of pregnancy and STIs, the undesirability of a partner, the undesirability of a setting, the use of alcohol, prescription or illicit drugs and unresolved resentment.

Overcoming anorgasmia

Let us now explore some possible solutions:

Improve communication: It is important that you learn to communicate your feelings and also to communicate how you like your body to be touched. Be frank. Do you prefer oral or manual stimulation, rather than penile thrusting? Then tell him!

Change sex positions

We recommend the female-above position for penile-vaginal intercourse, as it may allow for greater stimulation of the clitoris by the penis or symphysis pubis, or both, and it allows the woman better control of movement.

Try bridging: If, for example, you are readily orgasmic with manual stimulation but not with penile-vaginal thrusting, combine those two regularly until your body has learned to associate high levels of excitement and orgasm with penile-vaginal thrusting alone.

Use marital aids: Sex toys can be an easy way to achieve your first orgasm; you can also integrate it into lovemaking. However, don't rely on it indefinitely because it might decrease your ability to fantasise and cause jealousy or resentment from your partner if he is unable to satisfy you without a toy.

Masturbation

Try solo sex: Learn how to give yourself an orgasm through masturbation. Include healthy fantasies with your masturbatory therapy. Masturbating helps you to learn just exactly which pressures and rhythms you need in order to bring you to orgasm.

Indulge in sensate focus: Sensate focus is designed to increase communication between partners. Each person gets the opportunity to slowly explore a partner's body, listening to his or her preferences.

Practise pelvic exercises:

Tighten your legs and thighs to increase myotonia (muscle tension) which aids in triggering orgasm and do regular Kegel's exercises.

Help your partner last longer by using premature ejaculatory therapy if needed, such as the 'squeeze-release and stop-go' techniques.

Sex therapy is useful for those women who have severe anorgasmia and major psychological issues.

The problem with faking it is that your partner will never find out how to really please you, since you have deluded him into thinking that he is a superb lover. Faking ensures that sex is all about orgasm, rather than intimacy, and could seriously undermine your relationship. So stop faking it and experience the true joys of sex.

Physical signs of orgasm

An astute man can detect if an orgasm is real by looking for the following signs:

In women, an orgasm is preceded by erection of the clitoris and increased vaginal lubrication. As a woman nears orgasm, the clitoral glans moves inward under the clitoral hood, and the labia minora (inner lips) become darker.

Rhythmic muscle contractions occur in the outer third of the vagina, the uterus and anus. The first muscle contractions are the most intense, and occur at a rate of about one per second. As the orgasm continues, the contractions become less intense and occur at a more random rate. A mild orgasm may have three to five contractions, an intense orgasm 10-15.

A sex flush - a reddening of the skin over much of the body due to increased blood flow to the skin - is usually seen.

Some women will emit or spray some fluid from their urethra during orgasm. This is often called female ejaculation.

A woman's facial expression may indicate that she is in pain when she is having a pleasurable orgasm.

At the peak of orgasm, the entire body may become momentarily rigid.

Orgasms are often associated with other involuntary actions, including muscular spasms in other areas of the body and vocalisations (the emission of erotic sounds).

After orgasm, the clitoris re-emerges from under the clitoral hood, and returns to its normal size, typically within 10 minutes.

After climax, her breast and nipples are very sensitive to touch.

The final orgasm is usually followed by heavy breathing, rapid heartbeat and sweating.

Dr Alverston Bailey is a medical doctor and immediate past president of the Medical Association of Jamaica. Send comments and questions to editor@ gleanerjm.com, or fax 922-6223.