Based on objective hormonal changes, these authors confirm that in this case, the woman was able to put herself into a relatively continuous orgasmic state after years of yoga and tantric training

A Case of Female Orgasm Without Genital Stimulation. James G. Pfaus, Karolin Tsarski. Sexual Medicine, Volume 10, Issue 2, April 2022, 100496. https://doi.org/10.1016/j.esxm.2022.100496

Introduction: Orgasm is a complex, multimodal reflex induced typically by genital stimulation. Genitally stimulated orgasms (GSOs) activate excitatory neurochemical pathways in the brain and spinal cord that ultimately stimulate sympathetic outflow and the inhibition of parasympathetic spinal circuits in the lower lumbar cord. However, some women claim to have orgasms spontaneously without genital stimulation.

Aims: To report the case of a 33-year-old woman who developed the ability to attain and control the duration of a subjective orgasmic state without genital stimulation after tantric training.

Methods: Blood was taken at weekly intervals before, during, and after spontaneously-induced orgasms that lasted 5 or 10 minutes, or after a 10-minutes period of book reading. Plasma was analyzed using ELISA for luteinizing hormone, follicle stimulating hormone, free testosterone, and prolactin. The woman also provided subjective scores for different types of orgasms using the Mah and Binik (2002) Orgasm Rating Scale (ORS).

Results: Prolactin levels post orgasm increased by 25% and 48%, respectively, after the 5- or 10-minutes non-genitally stimulated orgasm (NGSO), and were still elevated from baseline 30 minutes after orgasm. No changes were observed in FSH or free testosterone. The pattern of sensory, affective, and evaluative orgasm ratings after a 10-minutes NGSO was similar to orgasms induced by clitoral or anal stimulation. Book reading did not result in any change in prolactin.

Conclusion: Prolactin surges after orgasm are an objective marker of orgasm quality. The increase in prolactin after her NGSOs indicate that they induce the same physiological changes as GSOs and result from “top-down” processing in the brain.

Key Words: Spontaneous OrgasmHormoneProlactinOrgasm Rating Scale

DISCUSSION

Leeners et al6 proposed using the post-orgasmic prolactin surge as an objective marker of orgasm quality, given that the surge levels followed a lawful increase in women that experienced 1 or 2 orgasms during partnered intercourse, and whose subjective rating of the orgasm quality also increased progressively from 1 to 2 orgasms. Moreover, the surge is not likely to be affected by movement artifacts during orgasm. A similar increase in prolactin was observed from the 5-minutes to 10-minutes NGSO in the present case study. In fact, the prolactin surge following the 10-minutes NGSO was in the range reported by Leeners et al after 2 orgasms from partnered intercourse.

The increase in luteinizing hormone during the 5-minutes NGSO was unexpected. Compared to her other pre baseline levels, the pre level before the 5-minutes orgasm was elevated, suggesting that she was in or around the ovulatory stage of her menstrual cycle. Indeed, as mentioned above, her pre levels of prolactin were increased before the 10-minutes orgasm condition a week later, suggesting that she was in her luteal phase at that time. Estradiol levels peak and fall before ovulation, which precedes the rise in progesterone secreted from the corpora lutea. During this time the ovaries release a pulse of testosterone27 which, combined with the genomic and non-genomic effects of the previous estradiol peak, increases women's responsivity to sex-related cues and their sexual desire.18,28, 29, 30 An increase in luteinizing hormone-stimulated by orgasm during this phase could also enhance pregnancy, suggesting that female orgasm may have a reproductive function during this phase of the cycle.

Finally, yoga and tantra meditation training is reported to enhance sexual arousal, desire, and orgasm in both women31,32 and men,33 and can facilitate sexual satisfaction overall34 and intimacy in couple-based sex therapy.35 Brotto and colleagues have refined this into a mindfulness-based approach to treat sexual arousal, desire, and pain disorders in women.36, 37, 38 Such training may well sensitize spinal and brain circuits for sexual climax and orgasm4,39 which should also feed forward to enhance neural mechanisms of sexual arousal and desire.18

CONCLUSIONS

The ability to be orgasmic sensitizes with sexual experience throughout the lifespan. Although orgasms are typically activated by genital stimulation in a “bottom-up” fashion, it is clear that they can be induced without genital stimulation in a “top-down” fashion that reflects both sensory and motor memory and may be activated by dreams, fantasy, and erotic imagery, especially in women. The woman examined in the present case study was able to put herself into a relatively continuous orgasmic state after years of yoga and tantric training. The increase in prolactin observed in the present study was an objective response to orgasm and followed a lawful pattern of doubling as the time spent in orgasm doubled, similar to the results of a prior study in which women had 1 or 2 orgasms during partnered sex.14 These data suggest strongly that NGSOs are not “faked” or partial orgasms, but rather reflect a top-down induction of a real subjective orgasmic state that includes objective hormonal changes.