Intercourse isn't everything for most women, says study -- try 'outercourse'
by Ian Kerner, a licensed couples therapist, writer and contributor on the topic of sex for CNN.
Many of us equate "sex" with "intercourse" and use those words interchangeably. Yet highly satisfying sex doesn't have to be limited to penetration -- and doesn't even have to include it at all.
According to a recent study, many women report that they require clitoral stimulation to have an orgasm.
For the study, Debby Herbenick, director of the Center for Sexual Health Promotion at Indiana University and a research fellow and sexual health educator at the Kinsey Institute, and her colleagues assessed data from 1,055 women ages 18 to 94 who answered a detailed online survey about their sex lives. "Our purpose was to understand more about women's experiences with ... the kinds of touch they find pleasurable and how clitoral and vaginal stimulation contribute to their orgasms," she explained.
金赛研究所：由美国生物学家、昆虫学、动物学教授以及人类性科学研究专家阿尔弗莱德·查尔斯·金赛（Alfred Charles Kinsey，1894年6月23日－1956年8月25日）于1947年在印第安纳大学设立一所性学研究所，该研究所现在被称为金赛性、性别与生殖研究中心。金赛因其分别于1948年及1953年出版的《男性性行为》和《女性性行为》（统称金赛报告）而知名。金赛针对人类的性学研究让其成为性学这一领域的奠基者，他的研究不仅影响了美国，甚至影响了全世界的社会、文化价值。
In reading her results, I'm struck by the idea that the majority of women report that they often don't reach orgasm through intercourse alone. This flies in the face of the stereotype of intercourse as the be-all and end-all of sexual activity -- and suggests that couples should explore the whole range of pleasurable options for achieving climax. The study contained a few compelling findings worth enumerating.
Intercourse isn't everything
This study found that only about 18% of women reported being able to climax during intercourse from vaginal penetration alone. About 36% said they needed clitoral stimulation in order to orgasm during intercourse, and another 36% said it enhanced the experience. Yet, many women still fake orgasm during intercourse, according to therapist Laurie Mintz, author of the new book "Becoming Cliterate."
"The main reasons they give for faking is that they want to appear 'normal' and want to make their male partners feel good," she said.
"This is one of the saddest and most common problems I deal with in my clinical practice," added Anita Hoffer, a sexuality counselor and educator. "Women who either are uninformed or insecure and therefore easily intimidated by ignorant partners bear a great deal of shame and guilt at being unable to climax from intercourse alone. Many are greatly relieved when they learn that they are among the majority of women who engage in sexual intercourse."
Do some orgasms feel better than others? According to 78% of the survey respondents, the answer is yes. These so-called better orgasms aren't necessarily dependent on the length of an encounter. In fact, fewer than one in five women surveyed believed that longer sex contributed to better orgasms.
Instead, the most common contributors to orgasmic bliss included spending time to build arousal, having a partner who knows that they like, emotional intimacy and clitoral stimulation during intercourse, said Herbenick. "A woman's general mood and stress level -- including the degree to which she is able to mindfully immerse in the sexual encounter -- can have an impact on orgasm quality too," Mintz explained.
This term "outercourse" refers to sex that isn't intercourse and doesn't involve penetration. It can include kissing, touching, erotic massage and using sex toys, just to name a few options.
"When we equate intercourse and sex and call everything that comes before intercourse 'foreplay,' we are buying into the cultural script that sex should proceed as follows: foreplay (just enough to get her ready for intercourse), intercourse (during which both women and men orgasm), and game over," Mintz said. But sex doesn't have to involve intercourse at all. Even when it does, other forms of stimulation can add to the experience and may improve the odds of reaching orgasm.
Herbenick suggested that couples take a lesson from the early days of their relationship. "Sometimes, when people are first getting together, they spend time making out and touching each other's genitals long before they start having oral sex or intercourse with each other," she explained. "All too often, once oral sex and intercourse become part of their routine, the rest fades away -- which is too bad, considering how powerful genital touching can be."
Communication is key
The study found that 41% of women prefer just one style of touch. "This underscores how important it is to have conversations about sex and pleasure or even to show your partner what you like, since otherwise, the chances of just stumbling upon that one preference are pretty low," Herbenick said. "Couples should be having conversations about what they like, what they don't like, what feels good and leads to orgasm, as well as what feels good but doesn't necessarily lead to orgasm."
One good source of information about women's sexual pleasure that can help you get the conversation started is the website for OMGYES, which sponsored the study. The site, which states it's for 18-year-olds and older, contains a series of videos that demonstrate different types of touch that real women find pleasurable, including techniques labeled "edging," "layering" and "orbiting." There is a free preview but a cost to access all of them.
I've found this site very helpful to my female patients and their partners who want to learn more about female pleasure. "It tastefully and unselfconsciously names, describes and normalizes behaviors that are universal and, by example, invites the viewer to experiment and learn," Hoffer said. "As Leonore Tiefer (sex researcher, therapist and activist) has said, 'Sex is not a natural act,' and good lovemaking is an art that must be learned and practiced."
10 reasons to have sex
The health benefits of sex go way beyond the pleasures of orgasm. You get a health boost in all sorts of ways from fooling around, from lowering blood pressure to stress reduction.
Sex, especially orgasm, releases the bonding hormone oxytocin, which promotes a feeling of well-being and happiness. And you don't have to act like bunnies to get the benefit; a study of 30,000 Americans over four decades found that sex at least once a week was enough to make people happy.
Sex seems to be especially good for a woman's heart -- the physical one, that is. A recent study found that women who said they had frequent, extremely satisfying sex had a lower risk of hypertension, a common precursor to heart disease.
Regular, frequent sex may lower the risk of prostate cancer, according to research presented to the American Urological Association. A study of 32,000 men over 18 years found that men who ejaculate at least monthly may be less likely to be diagnosed with prostate cancer later in life.
You won't look like this without hitting the gym, of course, but sex is a form of exercise, burning about 150 calories an hour. Add it to the end of your workout as a reward with benefits.
Sex can lessen pain. Studies have found that even stimulation without orgasm can reduce menstrual cramps, chronic back and leg pain, even migraines. Something to think about the next time you consider saying "Not now, honey, I have a headache!"
Sex may help your memory, too. Men over 50 who had more sex were better at word recall and number sequencing, while older women improved only in word recall, according to a study published by Oxford University. Both did better than those who had less sex.
Sex lowers stress and anxiety by releasing all sorts of good-for-you hormones, and that can help ward off depression, too. Studies show that men and women who have intercourse with their partners have greater satisfaction with their mental health. Unfortunately, the benefits didn't extend to masturbation.
Good sex improves sleep, too. After orgasm, the hormones prolactin and serotonin are released, helping you feel relaxed and sleepy. Women (and some studies) argue that men receive the greater benefit.
In case you didn't know it, sex can also make a baby. And that can be good for you. Studies show that people with kids living at home tend to have more money and are more highly educated and in better health.