This monthly column is (primarily) focused on women's health issues and concerns, but our resident lesbian doc Inna can accommodate questions about anything womyn under the sun.  Please send your questions and requests for featured topics to indigophilippines@yahoo.com.

Slow Burn - The Female Sexual Response
by Gina S. Itchon MD, Indigo Corewomyn
August 2002

I. Is lesbian sexual savvy a myth?

As a community doctor, I have often been asked various questions about sex. Frankly, I am appalled at the lack of sex education and the level of sexual savvy among many Filipinos. Perhaps that explains why, in one sociological study done in Cagayan de Oro City in 2000, 85% of married women claim they do not derive enough pleasure from sex with their husbands.

I would like to think that among us lesbians, the percentage of sexual satisfaction is much higher. After all, we claim quite smugly that satisfying our partners during sex is a foregone conclusion.

However, I am seriously beginning to doubt this, because of the many questions I have been getting from fellow lesbians, primarily the younger ones who are in first-time relationships. Questions like: "How do I know that I have satisfied my girlfriend?" or "Why does it take so long for my girl to come? Am I doing the right things?" or even "How do I perform oral sex without getting suffocated?"

The fact that Filipino society still prefers to pretend that sex should not be discussed openly (even heterosexual sex) does not help at all. Many gays and lesbians in our country seem unwilling to openly seek information about their sexual orientation, and much more so with sex and same-sex practices. The Internet, as well as friends with the same sexual orientation, just about sums up the existing resources for lesbian sexual information (and misinformation) in the Philippines.

From the many interesting questions I have been asked by fellow lesbians, I have come to the conclusion that we have numerous misconceptions about sex in general, and about lesbian sex in particular. In part, this comes from the pattern of heterosexual sex which we all grew up with and which, to a certain extent, is more familiar to us.

I have therefore decided to write about the female sexual response for the August 2002 edition of Indigo Interactive. This is dedicated to all lesbians out there who may have questions about lesbian sex but were always afraid to ask.

II. Misconceptions

It is a common misconception that a woman can only be sexually satisfied and reach orgasm by penetration of the vagina. It may surprise many of us, but this is farthest from the truth. The female vagina, in fact, has very few nerve endings that it is almost not capable of feeling pleasurable sensations.

A woman's body has a multitude of erogenous zones. The more well-known areas are of course the breasts, particularly the nipples, the neck and the nape, the ears, the lips, and the clitoris, the most sensitive part of a woman's body in terms of sensation. Other areas, less well known, are the palms and fingertips, the soles of the feet, the inside of the elbows and knees, and the lower abdomen.

Since women do not have a penis, sex is of course, more creative (thank God!). Giving pleasure to our partners can be achieved by concentrating on the erogenous zones, and the imaginative use of the lips, tongue, and fingers.

But let's start first with a quick review of the "sexual response cycle".

III. The Sexual Response Cycle

The human sexual response is characteristically discussed scientifically as having four distinct phases. These are the phases of: a) desire; b) excitement and plateau; c) orgasm; and d) resolution. In females, this is what happens during the four phases:

The phase of desire, also called the appetitive phase, reflects motivations, drives, and personality. This phase is characterized by the desire to have sexual activity.

The excitement and plateau phase, brought on by psychological stimulation (presence of the sexual partner) or by physiological stimulation (kissing and caressing), or a combination of both, brings about a subjective sense of pleasure.

In women, this phase leads to nipple erection; clitoral erection, where the clitoris becomes hard and turgid; engorgement of the labia majora and minora. Continued stimulation leads to color changes in the external female genitalia including the vagina. From a pinkish color, the outer genitalia, particularly the labia minora, become a bright or deep red.

Sexual excitement is marked by the production of lubrication from the Bartholin's glands, the openings of which are located around the vagina. Voluntary contractions of large muscle groups occur, the heart rate and respiratory rates increase, and blood pressure rises. Female excitement plateaus during this phase, and depending on the woman, this phase may last from 30 seconds to several minutes.

The excitement and plateau phase in the female sexual response cycle is usually the longest. Length may vary from a few seconds to several minutes, depending on many factors such as mental and physical preparation (foreplay), level of excitement, hormonal levels (stage in the menstrual cycle), and of course, skill of the partner.

The orgasm phase consists of a peaking of sexual pleasure, with the release of sexual tension. In women, orgasm is characterized by 3 to 15 involuntary contractions of the lower third of the vagina and by the strong, sustained contractions of the uterus, occurring at intervals of 0.8 seconds. Other manifestations include voluntary and involuntary movements of the large muscle groups, including facial grimacing and vocal manifestations. Blood pressure rises by 20 to 40 units, and heart rate increases up to 160 beats per minute. Orgasm lasts from 3 to 25 seconds and is associated with a slight clouding of consciousness.

Resolution consists of the disgorgement of blood from the external genitalia, which brings the body back to its resting state. If orgasm occurs, resolution is rapid and is characterized by a sense of well-being, general relaxation, and muscular relaxation.

If orgasm does not occur, resolution may take from 2 to 6 hours and may be associated with irritability and discomfort. The uterus, vagina, and other external organs remain engorged with blood, which produces a sensation of heaviness and discomfort in the pelvic area.

"Non-orgasm" not only produces pelvic discomfort. It also leads to irritability and bad temper. Woe unto you if you caused your partner non-orgasm!

Women have a very short refractory period (some women don't have it at all). This is the reason why a number of women are multi-orgasmic or capable of having one orgasm after another, ad infinitum, if sexual stimulation continues.

I have always compared a woman's sexual response to a "slow burn", as opposed to a "flash". The Tagalog term "ningas" also gives a very accurate picture also. 'Ningas' (to burn slowly) as opposed to "liyab" ( a sudden flash of fire). Sexual response in women is this: slow, indolent, smoldering heat.

IV. Tips and foolproof signs

As earlier described, female orgasm consists of rhythmic contractions of the vagina and the lower part of the uterus which are, of course, very pleasurable. Aside from these contractions, there is involuntary contraction of large muscle groups. Therefore, embraces become tighter and hands begin to grasp at anything. The nipples also become more erect, the clit becomes more tumescent (harder), and if one cares to look, the color of the external female genitalia become an even deeper red.

Orgasm is usually brought about by caressing the clitoris, either done through the use of the fingers or the mouth, usually in combination with digital penetration of the vagina. However, because the clit is so sensitive, many women cannot stand its direct manipulation - in which case, the tongue is better used because it is softer and gives a more subtle sense of pleasure.

Orgasm may occur with or without penetration of the vagina, but very rarely will a woman come without some sort of contact with the clit. Some practical tips though; be very gentle, use a light touch, caress the surrounding labia minora too which is very sensitive. If you are using your mouth, be careful not too use your teeth for obvious reasons, except when you're experienced enough to use your teeth for nipping lightly.

If you don't have that much experience, PRACTICE! Oral sex also requires a perfect coordination of mouth and tongue, fingers, and respiration. There are many techniques to achieve the coordination but let us reserve that for a later issue.

Just before orgasm, lubrication around the vagina increases in amount and a flush appears on the face and around the area of the neck and the upper chest, which lasts a few minutes after the orgasm. When a woman fakes an orgasm, she is only able to fake the voluntary actions. These are the tighter embraces, the facial grimace, the vocal manifestations. She will not be able to fake the involuntary physiological changes such as the erection of the nipples and the clit, the color change in the external genitalia, the increased vaginal lubrication and the facial flush. When these involuntary changes are present, you can be sure your partner has "arrived".

I have a foolproof way of telling if my partner had an orgasm or not; I use my nose. A woman who has just come will emit a faint, very sexy smell brought about by the release of pheromones, which only an honest-to-goodness orgasm will trigger. However, it takes practice and patience, not to say experience, to detect that subtle scent.

V. Know Your Partner

IN THE FINAL ANALYSIS, every woman is slightly different from each other. Female sexual response is of course different for each one of us. Whenever I'm asked by patients and friends about sexual matters, I always say these: a) know your partner's body very well, figure out what will send her to oblivion; b) if you don't know what she likes, ask; and c) talk less and do more.

Previous Articles
Looking Beyond Reproductive Health: An Issue for Women

Lesbians are Women too, Stupid!

The Author
Doc Inna is an out and proud practicing lesbian doctor (yes, practicing lesbian, and practicing doctor!) who is also an assistant professor at a medical school somewhere in the Southern part of the country.  Aside from her medical degree, she also has post-graduate degrees in Medical Science and Public Health.