Hapless lovers are not the only ones who get lost down there: even sexologists can't agree on what's what, and where, among women's female parts.
At least, that's according to a father-daughter team of researchers in Italy, Drs Vincenzo and Giulia Puppo.
Female erectile organs
In a new review October 6 in Clinical Anatomy, Vincenzo, of the Italian Centre of Sexology in Bologna, and Giulia, a biologist at the University of Florence, point out some problems with some of newer anatomical and physiological terms researchers have been using since the mid-1990s.
The G-spot? Out. Vaginal orgasm? Out. Female penis? In. It's the best way to refer to female erectile organs, according to the Puppos.
Sexological and sexual medicine textbooks today often neglect the embryology, anatomy and physiology of the female erectile organs, Vincenzo said.
He and his co-author cite dozens of such publications by other researchers, largely from within the last 15 years, pointing out the use of terms like "inner clitoris" that are, admittedly, not very well defined in those papers.
"The internal clitoris does not exist, the entire clitoris is an external organ," Vincenzo said. It is composed of an externally visible glans and body, like the male penis, and of roots, which are hidden, he said.
But to back their assertions regarding the correct terminology to use, the Puppos employ no actual subjects or data and instead use 12 diagrams, 11 of which come from their own previous publications (the 12th is from Wikipedia).
What sexologists sometimes refer to as "clitoral bulbs" should in fact be called "vestibular bulbs", and the areas that are stimulated and become erect during sex should not be called the "clitoral complex" but instead the "female penis", they write.
That won't be useful information for most women, who don't typically meet up for coffee to chat about anatomical terminology. But some other assertions could make a difference.
Phase out G-spot term
For one thing, the authors insist that researchers stop using the term G-spot for a spongy area of the front vaginal wall anecdotally linked to orgasm, because it has no basis in science.
We should phase out that term if possible, agreed Dr. Amichai Kilchevsky, a urologist at the Yale School of Medicine in New Haven.
"I don't think very many scientists or urologists would argue that there is an actual G-spot," he told Reuters Health. "I don't think it does any favours to women to refer to it as one spot, it's probably a system of vascular structures that are all kind of interplaying."
It is wrong to say there is one specific location called the G-spot, that, when stimulated, leads to orgasm for every woman, he said.
Is the vagina involved in orgasm?
But the Puppos go one step further, arguing that the vagina is never involved in orgasm since it is not part of what they call the "female penis".
As a consequence, they say, the term "vaginal orgasm" should be thrown out. Orgasm is only possible by stimulation of the clitoris, they write. Using the catchall term "female orgasm" will include both actual clitoral orgasms and the vaginal orgasms women may think they are having because they have been misled by the media.
Other experts disagree.
"Puppo is ignorant of, or dismisses, published evidence showing that applying mild pressure to the clitoris, vagina, or cervix activates distinctly different regions of the sensory cortex," said Barry R. Komisaruk, a distinguished professor of psychology at Rutgers University in Newark, New Jersey.
Women with spinal injuries who have no sensation of the clitoris can still feel sensation in the vagina and cervix, Komisaruk told Reuters Health in email.
The Puppos dispute peer-reviewed, published evidence without performing research to test or refute that evidence, he said.
"Obviously women do have vaginal orgasms," Kilchevsky said. "I don't think the media or anyone else is leading females into believing they are experiencing something they are not."
The Puppos emphasize that perpetuating the myth of the G-spot or vaginal orgasm is unfair to women who may try to find or achieve them and feel "less-than" because they cannot.
But they also state that since the vaginal orgasm, according to their argument, does not exist, the duration of penile-vaginal intercourse is not important for a woman's orgasm. Every woman is able to achieve a clitoral orgasm "if the clitoris is simply stimulated with a finger," they write.
The Puppos arguments for a more anatomically accurate terminology are mostly sound, but will probably not be widely adopted, and the semantic argument is mostly relevant for researchers, Kilchevsky said. "If those are the terms he feels are appropriate, more power to him," he said.
Clitoris: "Female penis"
Anatomical structures which were once named for their appearance are today named for their function, Komisaruk said. (Puppo) is simply replacing conceptual terms sexologists already accept, like "clitoral complex",' with his own conceptual term "female penis", he said.
"I absolutely see no reason to begin using the phrase "female penis" and am pretty certain most American women and men would agree," given that men interested in women don't want to talk about stimulating their partner's penis, nor do most women want to think of themselves as having a penis, said Debra Herbenick, an associate research scientist at Indiana University Bloomington School of Public Health.
"We also have no evidence that all women can or do experience orgasm from any kind of stimulation, including direct clitoral stimulation," she told Reuters Health by email. "Yes, most women can and do experience orgasm but most sexuality researchers and educators recognize the enormous variety of turn-ons, forms of physical stimulation, and types of sexual pleasure and orgasm that are an important part of women's sexual experiences."
The reality is there are multiple ways for women to have an orgasm and to say that the cause is always the same is not accurate, Kilchevsky said. "I think every woman should embrace what they feel works for them," which won't be the same for the billions of women on the planet, he said.
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