As a gynecologist specializing in female sexual dysfunction, discovering that National Orgasm Day is July 31 is news to me.

In recent years awareness of the inherent gender-based biases includes the pay gap, glass ceilings for working moms, the #MeToo and Times-up movements for sexual assault and harassment, and now the orgasm gap.

This movement began in 2005 in a conservative town Espertatina, in Brazil, in order to raise awareness of female sexual issues. Too many women don’t realize that they don’t have to grin and bear it or feign pleasure to achieve a speedy end to unfulfilling sexual encounters with their partners. Rather the movement sought to encourage women to demand pleasure when having sex and raise awareness of sexual education beyond abstinence and reproduction.

Studies demonstrate that the majority of women orgasm through clitoral stimulation, while only one-thirdorgasm through vaginal penetration.  Both the medical and non-medical communities recognize that the female counterpart to the penis, the clitoris, has the main function of serving as a pleasure organ. 

Vaginal penetration for a minority of cis women can also bring women to orgasm via the female prostate. Yes, there is a female prostate in the top wall of the vagina.    Some women even have uterine contractions and orgasms via the uterine cervix as well.

Knowledge of female anatomy is imperative and lacking both for women and men. Female organs are not the opposite of male, but more analogous. They are derived from the same embryonic tissue in utero.

In my field, I see women who have certain levels of distress related to failure to achieve orgasms. This is usually seen concomitantly with other areas of sexual dysfunction such as sexual pain, arousal or libido disorders.

Think about it this way, if the one food that gave you pleasure was ice cream and every time you were reaching for ice cream you hit your head against a cabinet door causing you pain, over time, you would lose the desire to have ice cream.

Last month in India, Durex, the number one producer of condoms internationally, launched a #cometogether campaign.  In an effort to bring light to a taboo topic that sexual relations should be pleasurable, equitable and consensual, and with 70 percent of women surveyed in India have stated they do not climax with every sexual encounter Durex launched a campaign targeting this topic.

One of the endemic issues that are seen within many conservative cultures, whether religiously based or socially based, is the concept of virginity of a female and how it is viewed. Virginity is a heteronormative social, religious, and cultural construct with no true scientific or medical merit.  For women, the hymen is the membrane that is linked to being a virgin and is often seen as a membrane of honor in these cultures. Though it covers the vaginal orifice it has no medical purpose.  It can be torn during physical activity such as cycling, horseback riding, or even tampon use. While it can also be torn in sexual intercourse, sometimes there will be bleeding. But a majority of the time there is no bleeding involved in its breakage. It is the cause of a lot of distress in conservative cultures and often is a reason many women do not seek gynecologic care.

In my practice, among my young religiously conservative women, the hymen and its potential breakage is a big deal. It sometimes precludes exams and diagnosis of conditions that get worse with time (endometriosis, abnormal bleeding,  pelvic floor dysfunction). In fact, the status of the hymen and its link with virginity has many women seeking surgical procedures to recreate it.

Hymenoplasty is an emerging cosmetic gynecologic surgery that is sought for the reconstruction of this membrane in order to become a virgin again or to prevent dishonoring the family if they have already had sex.  This leads to a moral and ethical dilemma for gynecologists around the world. Admittedly, based on my patient population, I have been asked many times to perform this surgical correction. In circumstances where I feel the patient’s life may be in danger and the patient is fully educated on this topic, I have performed this procedure.

Women need to know their bodies and how they function intimately. Sex education needs to be prioritized as we move past  National Orgasm Day to a daily acknowledgment of each of us as whole human beings.  

Sameena Rahman is a practicing gynecologist in Chicago,  Clinical Assistant Professor of OB/GYN  at Northwestern University Feinberg School of Medicine, and a Public Voices Fellow through the Op-Ed Project.​

Photo by: Jean Koulev

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