The elusive orgasm has remained something of a mystery - until now

Published on Sunday 7 February 2010 10:36

IN THE decades since Mick Jagger spoke up for a generation that wasn't getting any satisfaction, we've undergone a sexual revolution that has seen us embrace the contraceptive pill, abortion on demand, the morning after pill and the ubiquitous presence of sex shops on our high streets.

Nowadays it's as easy to pop in to Ann Summers to pick up one of the best-selling Rampant Rabbits as it is to drop into Sainsbury's for a bag of carrots, and we don't even blink when Michael Douglas happily comments that he keeps up with decades-younger Catherine Zeta-Jones by dropping a Viagra or two.

Of course, we would do the same, wouldn't we? And when the female version of the little blue helpers comes on the market, women won't think twice about badgering GPs for a prescription.

We've done internet dating, one-night stands, no-strings sex. Post-Sex and the City, post-Viagra, can there really be anyone who isn't enjoying a satisfying sex life? Aren't we having way more sex and many more orgasms, multiple and mutual, these days?

It would seem not, according to Sara Nasserzadeh, the psychosexual therapist and author who, along with three colleagues, has written The Orgasm Answer Guide. The book covers all aspects of orgasms, from how they happen to what to do when they don't.

• Everything you want to know about orgasm but are afraid to ask

Aiming to answer 80 of the most common questions they hear in their clinics and in the field, the authors also provide simple scientific explanations to help us – in the words of Mr Lurve himself, the legendary mattress-bouncing Barry White – "qualify to satisfy".

How can you tell if your partner is faking? Do orgasms stop at a certain age? How do you know if you're having an orgasm? These are apparently some of the typical questions.

"These are the questions I hear all the time in my practice," says Nasserzadeh, who is not only a world-renowned sexologist, but also an award-winning radio host and producer for the BBC World Service radio programme The Whispers, which deals with sexual health issues.

Really? Surely in this day and age people know if they're having an orgasm or not. "Women come and see me and say, 'I don't know if what I'm having is an orgasm or what it should feel like.' They're not sure. There are a lot of misconceptions out there about sex," she says.

"We hear about it all the time in the media, but that's for entertainment and we're not provided with accurate or practical information. Television shows women hanging from chandeliers and having multiple orgasms, but that's not real life.

So I got together with Barry Komisaruk, Carlos Beyer Flores and Beverly Whipple, all of them experts in the field, in order to give people answers. We wrote down the most common questions and wound up with around 100, then crossed out the ones that overlapped. So they're all based on clinical experience."

But does the world really need yet another book on orgasms? Yes, yes, yes, as Sally said to Harry in that famous diner scene, and Nasserzadeh and her colleagues are in wholehearted agreement.

Presented in a question- and-answer format, The Orgasm Answer Guide covers everything you could want to know about orgasms but were afraid to ask, from how post-operative transsexuals climax to whether women ejaculate.

"Nothing was too shocking to leave out," says Nasserzadeh. "Nothing shocks me, nothing surprises me. I'm fascinated by people, so everything interests me. I'm also fascinated by shades of culture and how people can pick and choose the parts they want, and the similarities between different cultures."

"We hope that if people have more information they enjoy sex more and will have more satisfying sex," says Nasserzadeh.

In writing a book about the orgasm, she and her co-authors focus on women's orgasms more than men's because women are more likely to experience problems.

For men, physiologically, it's much more straightforward and their sexual health problems are much more likely to be in the areas of erectile disfunction and premature ejaculation, which will be the focus of her next book on the common sexual problems she addresses in her practice.

"For men and women it's different. It's a very low percentage of men that don't orgasm compared with women and we understand the whole process of what happens with them physically, whereas for women it's much more complicated. The equivalent of orgasmic disfunction for women is delayed ejaculation for men and I see men who suffer from this and erectile disfunction."

"I recently had a 60-year old male, who had chain smoked since he was 18 and now had a problem getting erections. It was a situation where I had to say to him, 'You had a good run and I'm afraid there's no way back.' They should put on the packet too: Smoking kills, but it also kills your sex life.

People might take more notice. In my practice people who come to see me and say I can't have an orgasm or I don't know if what I'm having is an orgasm or what it should feel like are women. Ejaculation and orgasm usually happens simultaneously with men."

One of the problems identified by the therapist and her colleagues is that all of the hue and cry about sex means we think what is natural should, well, come naturally.

But for so many of us that's just not the case. "The problem is people have such high expectations that they're setting themselves up for failure, and it can cause a lot of stress. But all orgasms are different – nobody can say, 'Mine is better or more intense than yours.' We are giving people permission to be comfortable with what they're doing," she says.

So what's the latest in the world of orgasm research? Back in the 1960s, US researchers William Masters and Virginia Johnson gave us the classic linear model of arousal, orgasm and then back to normal. Helen Kaplan added desire in the 1970s and 1980s, and Beverly Whipple and colleagues went on to suggest that sexual response in women is more circular.

"Then, in 2005, Rosemary Basson said it's even more complicated than that, because in the middle a child might wake up and interrupt you, but then you can go back and start again, so in fact we're all over the place. For men it's much simpler.

"The other controversial area is whether orgasms are clitoral or vaginal. Some people believe an orgasm is an orgasm, why make it complicated? But it's not. They are different, and people need to know that."

Born in Tehran, 33-year-old Nasserzadeh left Iran to train in psychosexual therapy in England, doing postgraduate studies in London for six years, and has worked in 14 countries around the world.

She has been married for ten years to her doctor husband and nowadays practices in New York, the sexual playground of Carrie Bradshaw and her permissive pals and a city where the women are among the most sexually liberated in the world.

Thus Nasserzadeh has a foot in both camps: in the Middle East and in Manhattan. She's au fait with both Islam and 'Wham bam, thank you ma'am', and is uniquely placed to comment on how the earth moves, whether you're to the east or west of Greenwich Mean Time.

"In the Middle East, the poems in Persian or Arabic are all about love, tenderness and sexual relationships, and in everyday life when women get together they have jokes about it and most of them are dirty.

But as soon as it gets serious and it's a problem, they don't discuss it. In northern America, sex is everywhere. Everyone talks about it in a provocative, teasing way, and it is used to sell shampoo and ice-cream, but mothers and daughters don't talk about it there either. People everywhere need more information and practical advice on their sex lives," she says.

While we might think of Islamic cultures as the more conservative when it comes to sexual matters, Nasserzadeh is keen to point out that there are equally conservative forces at large in the US, where some Christian fundamentalists can be every bit as reactionary as their Islamic counterparts.

"There are even those who argue that women shouldn't be having orgasms at all," she says. "Dr Elisabeth A Lloyd, in The Case of the Female Orgasm: Bias in the Science of Evolution, said biologically women shouldn't have an orgasm at all as it's not part of sex, which is for the purpose of getting pregnant."

In Lloyd's 2005 book, she argues that the male orgasm actually serves an evolutionary purpose – in that it makes men want to have sex often, which makes it more likely that they will produce offspring. But there is no similar impetus for women, three quarters of whom apparently don't climax during sexual intercourse, therefore the female orgasm is merely the icing on the cake – a pointless, though pleasurable accident of nature, rather like the male nipple.

Handing out advice is easy enough if you're in the UK or the US but when Nasserzadeh was first qualified, she held sexual health classes for women in Iran. There she had to separate the married and unmarried participants. The sessions were also monitored by an Islamic regulatory body, which sent along representatives to make sure they were in accordance with the country's religious teachings. "I had no wish to push young women to be sexually active, just to make sure they had information," she says.

"In Islamic countries, women are increasingly trying to get themselves educated – and, in fact, Islam says the woman should be satisfied first. There are quotations from Mohammed about how to romance a woman, setting the scene with candles and washing first, not just going to the bit you want," she says. "But it's a conservative culture and there are not many studies to go on. That's why the book is based on our experience and interaction with people we work with, many of whom are from that culture."

According to Nasserzadeh, women everywhere have expectations that sex should be pleasurable for both them and men. "We've had decades of feminism and pharmaceutical advances so there's really no excuse any more. Women, especially in urban areas, see orgasm as a right. You can see a social evolution of women claiming more from their sexuality. Just as they expect the same salaries and social rights, what's wrong with them expecting to enjoy it and have orgasms?"

Not only do both sexes see orgasm as a right, there's also an increasing trend for seeking to heighten a woman's enjoyment of sex with injections of fillers into the G-spot to increase sensitivity. Initially an American phenomenon, the procedure is now available in the UK, with Beyond MediSpa at London's Harvey Nichols offering such a treatment.

I ask Nasserzadeh whether she is familiar with the practice. "Oh yes, G-spot parties are big in California. Women invite each other over and the doctor comes and inserts collagen into the G-spot area so it's engorged and they have more stimulation. But I really think we are derailing ourselves from the whole concept of self if we do that. We have all of the necessary equipment already. You see it with men who have surgery to enlarge their penis.

They are never happy afterwards. They want it even bigger, or something else altered. Then, when everything goes wrong, they end up in my clinic. Too much intervention leaves people dissatisfied and disappointed.

"What's important is that you're satisfied and happy, whether or not you have an orgasm. We shouldn't concentrate on the goal of achieving orgasm, but on having a pleasurable sexual experience. That's the key to a successful sex life. We can't tell people to expect to have an orgasm or how many, but we can say they should expect sex to be pleasurable." r

The Orgasm Answer Guide, by Barry Komisaruk, Beverly Whipple, Sara Nasserzadeh and Carlos Beyer Flores (10, The Johns Hopkins University Press) is published on 5 March

&#149 This article was first published in Scotland on Sunday on 07 February 2010