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A Brief Overview of Orgasms at Every Age, According to an OBGYN

As a gynecologist with more than 20 years’ experience in women’s health and sexual medicine, what better time to share some exciting information about the big O at every age than National Orgasm Day! 

Birth, Childhood & ‘The Little Death’

Did you know that a small but significant number of women experience orgasm with unmedicated childbirth? A 2013 French study by midwives reported that 0.3 percent of women experienced orgasm during natural childbirth delivery. Undoubtedly more were reluctant to report it. Granted, that is not a high number, but it points to the possibility that orgasm can be a result not of sexual contact but of an intense feeling of love and extreme physical stimulation, combined with incredible euphoric relief. This also points to the fact that intense orgasm does not always require a partner — just love, connection and euphoria.

As we progress into breastfeeding, it is quite common to experience intense sexual pleasure and even orgasm during breastfeeding due to the intense nipple stimulation and deeply loving close contact. 33-50 percent of breastfeeding women report experiencing this. The important thing to remember is that this sensation is natural and nothing to be ashamed of. It’s reflective of a deep physical stimulation and connection, which does not have to be sexual. 

Few people know that young girls are able to have intensely pleasurable orgasms at very young ages, perhaps even younger than two years old. While little boys are often known to enjoy “playing with themselves,” they are not able to reach orgasm until puberty, whereas girls are sometimes able to experience adult-quality orgasms well before puberty. Young girls are not infrequently seen “squeezing their legs” or enjoying activities such as climbing poles or ropes in order to enjoy this pleasurable sensation. The worst thing we could do is to shame our daughters and young girls by telling them that they are doing something wrong. Instead, we should suggest that this is a lovely private activity that should not be done in public, but to continue it in private without shame or fear of disapproval.

Communication & Minding the gap 

As we move into adulthood, close to 100 percent of young men and women experience their first orgasms through masturbation. While our culture seems to widely accept and applaud this behavior in boys, it’s important to recognize that girls are experiencing exactly the same feelings but may feel less accepted. If you have a teenage daughter, talk about the subject of orgasm as you would a sneeze or scratching an itch. It is a natural process, not to be feared or shamed, but to be explored alone so that when she is ready to enter the complex world of sexuality with a partner, she is confident in what feels good for her and is able to communicate it.

In adult relationships, female orgasm can become the source of both great joy and great suffering. It’s crucial to understand that men have no idea what feels good for women, and so they need to be told. They want to be told. For over 40 percent of women, vaginal intercourse does not lead to orgasm. For young inexperienced couples, if that is all that is on the menu, both members of the couple are likely to have sexual encounters that end in disappointment, shame, blame, and feelings of inadequacy. 

It is our responsibility as women to tell our partners, male or female, what we like (start with the positive — “I like it when you …”) and what you don’t like. Set clear boundaries around which sexual activities are acceptable to you and which are not. In a perfect world we would have that discussion before our first sexual encounter with a partner. In my research and the research of many others, resentment or unspoken anger is the #1 killer of libido and orgasm, as a result of unclear communication and a pattern of activities that we simply do not want and that cross our boundaries.

You may be your own best orgasm partner 

In my 2018 study for my book Sexually Woke the most reliable way for women to achieve orgasm was with a vibrator or toy, alone. In second place was manual stimulation, alone. Equally placed for #3 were oral sex and manual stimulation with a partner, and vaginal intercourse was in fourth place. This highlights the fact that we know exactly what we want, but we are not communicating it well to our partners. If all we needed was an orgasm, clearly we have that covered on our own. But my study and many others show that we crave intimate connection and orgasm with a partner — we are just not always sure how to get it.

As women, many of us have been conditioned not to speak up about what we want, but in the bedroom, challenge yourself to speak honestly about what feels good for you. I promise you, he/she wants that as much or more than you do!

Sex after menopause

As we age, particularly around and after the time of menopause, blood flow to the clitoris decreases and nerves become less sensitive. As a result, most women experience a decrease in libido and ability to orgasm as we approach menopause and after. Now that we are going to live perhaps half of our lives after menopause (without ovulation and the associated hormones) it’s important to realize that our bodies are changing, but sex can still remain as vibrant as ever, or even more.

 or women suffering from age-related decrease in orgasmic potential and sexual pleasure, a number of treatments are available to keep the vagina and clitoris young and vibrant. Hormone replacement (my preference is pellet therapy including low doses of testosterone), platelet rich plasma (from your own blood) injected into the clitoris and surrounding tissues (brand name O-shot), clitoral revascularization with the Cliovana outpatient therapy as well as many other outpatient procedures such as Thermiva to increase vaginal tightness can keep your orgasmic potential as good or better than ever.

The big finish

As I always say, doctors can do everything under the sun to optimize your hormones and your anatomy, but if your mind isn’t into it, you won’t want to have sex. For women, the primary source of our libido is from above the neck. So talking through any limiting beliefs that you hold about sex or your sexual potential with your partner or a therapist is often the most important element to get you back to your vibrant, orgasmic self.

Here’s your key takeaway for National Orgasm Day: Know yourself first. Spend time with yourself, getting to know what feels good and how to have an orgasm without the pressure of a partner. Let go of whatever shame and negative conditioning you have around this natural and beautiful experience that can lead to deep, loving connection.

Dr. Susan Hardwick-Smith is an award-winning Board Certified Obstetrics and Gynecology physician, author and life coach. She is the founder of Complete Midlife Wellness Center and is dedicated to empowering women to feel fully alive — sexually, relationally, and spiritually. Her first book Sexually Woke is available for pre-order on Amazon.

Sexually Woke: Awaken the Secrets to Our Best Sex Lives in Midlife and Beyond $22.00 on Amazon.com Buy now

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Before you go, check out our bucket list of 69 (nice!) sex positions to try before you die. And have fun! 

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