We start with a frustrating reality: 70% of OB-GYNs never ask patients about orgasm. And when women finally get the courage to bring it up themselves, the answer is usually "I'm so sorry, this just happens when you age."

I ask Dr. Streicher to break down what an orgasm actually is and why arousal has to happen first. We discuss the different types of orgasms clitoral, cervical, and the controversial G-spot. Dr. Streicher shares the fascinating Maria Bonaparte research from the 1920s that discovered the 2.5 centimeter rule and why anatomical distance matters for orgasm during intercourse.

We dive into primary versus acquired orgasmic dysfunction. For women who've never had an orgasm, nine out of ten times they just need education and a map to their clitoris. For women who used to have orgasms and can't anymore, SSRIs are often the culprit not hormones. We discuss solutions including Viagra, topical sildenafil, CBD, and why local estrogen on the clitoris matters.

Dr. Streicher walks me through the history of vibrators and why they become necessary as women age and nerve endings become less sensitive. We talk about how to bring up using a vibrator with a partner and why it's a tool to make something possible, not just a toy for fun.

We also discuss the FDA's removal of the box warning from local vaginal estrogen and what that means for women who were told they couldn't use it.

Highlights

The tiny nerve endings in the clitoris that respond to soft touch degenerate the most with age, while thicker ones that respond to vibration stay intact longer.
The cervix has nerve endings that go to a different part of the spinal cord, which is why some women with spinal cord injuries can still have cervical orgasms.
About 30% of women who develop orgasmic dysfunction from SSRIs will see improvement if they wait it out.
There's no expiration date on local vaginal estrogen you can start using it at 99 years old,
Only 7% of women consistently reach orgasm from intercourse alone without additional clitoral stimulation.

If you're experiencing difficulty with orgasm or sexual function, don't accept "this just happens with age" as an answer. There are real solutions available, from addressing SSRI side effects to using local estrogen to exploring vibrators as medical tools.

Talk to your provider about what's actually happening. If they don't have answers, find someone who specializes in sexual medicine.

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GSM Collective

The GSM Collective - Chicago Boutique concierge gynecology practice Led by Dr. Sameena Rahman, specialist in sexual medicine & menopause Unrushed appointments in a beautiful, private setting Personalized care for women's health, hormones, and pelvic floor issues Multiple membership options available Ready for personalized women's healthcare? Visit our Chicago office today.

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