Is Your Pelvic Floor Affecting Your Orgasms? 5 Simple Steps That Will Change Your (Sex) Life

Talking about orgasms (yep!…we’re gettin’ right into it, friend) miiiiiiiiight not be what initially brings women into my pelvic health clinic, but as I ask questions and my patients get comfortable, the conversation inevitably ends up [there] more often than not. Curiosity combined with confidence is empowering women now more than ever to stop faking it and expect & experience amazing, mind-blowing, let’s-do-that-again kinda sex, and I’m here to tell ya ^^that^^ can be your reality too.

Unfortunately, the narrative that a man “finishing” is the focus of sex, combined with a historically male-dominated medical field, has placed the female orgasm at the bottom of the bedroom’s totem pole. Women have been left settling for mediocre intimacy and accepting the story that “most women just can’t climax” for centuries if not since the beginning of time, and I’m beyond ready for the pendulum to swing. While great sex doesn’t necessarily *have* to involve an orgasm (more on that later), I want it to be an option that you can achieve whenever & wherever & however your heart desires.

Recent research found that only 18% of women orgasm from intercourse alone and almost 40% require clitoral stimulation to make the magic happen. And if you’re doin’ the math, that means nearly half of the female population doesn’t orgasm at all. But “common” does not mean “normal” when it comes to incontinence, constipation, back pain, or diabetes, so why should this be any different!?

While orgasms certainly have a physical, mental, and emotional component, I as a pelvic rehab therapist believe the easiest, most effective place to improve a woman’s likelihood of achieving orgasm is in how the body feels and functions…specifically the pelvic floor. Because the average woman has some level of pelvic floor dysfunction in the form of muscle weakness and/or tightness, it’s no surprise that anorgasmia (delayed, infrequent, absent, or less-intense orgasms) is equally just as common.

In the name of no such thing as taboo topics or TMI, I’m about to share EVERYTHING I know about the female orgasm…because someone’s gotta do it and life’s too short not to have great sex. With a little more knowledge about how the pelvic floor works and a few step-by-step instructions from yours truly (plus some helpful free guides along the way *wink wink*) I believe every woman can have better control over her body, see improvement in pleasure, and ultimately experience a better time in the bedroom.

The anatomy of an orgasm

Let’s start with a little anatomy lesson, shall we? Because once you become a student of your own body, the easier it is to understand & appreciate & support it. The pelvic floor is a complex area including multiple systems with various functions (think bladder, bowel, sexual, reproductive, etc.), but there’s no need to be overwhelmed. All you need is a basic awareness of the “what” and “when” and “why” behind the female orgasm to move forward, and I’m giving you the TL;DR-style bullet points worth knowing here.

There are three layers of muscle that make up the female pelvic floor. Nearly all of the muscles in the first layer attach at the clitoris and contribute to orgasm.
During arousal, the first pelvic floor muscle layer facilitates blood flow to the clitoris and labia and lubrication to the vulvar glands. The vaginal wall lengthens by about one centimeter and the uterus rises by over two centimeters. The pelvic floor muscles and organs need to be relaxed and mobile for this to happen.
Repetitive clitoral nerve stimulation causes involuntary, maximal, repetitive, and rhythmic muscle contraction of the first pelvic floor layer and pleasure can be enhanced by engaging the third pelvic floor layer. Pelvic floor muscle endurance, coordination, and strength are required for this to take place.

“Soooooo is it normal if…?”

Before I share my tips for improving the likelihood and satisfaction of an orgasm, we’ve gotta establish what’s “normal” – because pornography, romance novels, and even good ol’ girl talk can create excessive standards and a false sense of reality. We have enough stress on us from society, social media, and self-induced perfectionism (*raises hand*), the last thing we need is pressure on our pleasure. When you know what’s really realistic, you can stop comparing and start…ummmmm…cumming.

WHAT ARE THE TYPES OF ORGASMS?

Good news gals…us ladies have a leg up in this department because, compared to the guys, we actually have more anatomical opportunities to orgasm. While science states some locations are easier to achieve than others, I believe if you have these body parts (check!) knowledge of the female anatomy (check!), and the tips below (check!), you also have the ability to achieve orgasm in all of the following areas with a little practice & persistence & patience.

Clitoris – Clitoral stimulation results in an orgasm via rhythmic contraction of the pelvic floor muscles. With about 10,000 nerve fibers innervating the clitoris, it’s no wonder that this is where the average woman has the easiest time climaxing.
Vagina –The peri-urethral female prostate (aka the “G-spot”) sits in the front of the vaginal wall behind the clitoris, pubic bone, and bladder. Pressure on this tissue through vaginal penetration arouses the clitoris and causes rhythmic contraction of the pelvic floor muscles and ultimately an orgasm.
Cervix/Uterus – Deep vaginal penetration can place pressure on the cervix, which simultaneously activates the vaginal wall and clitoris. This results in an orgasm via rhythmic contraction of the pelvic floor muscles.
Blended – Just like it sounds, you can stimulate more than one of these areas at a time.

In case you didn’t catch it…while there are multiple potential places to initiate an orgasm, clitoral stimulation (from the outside or inside) is what ultimately triggers the pelvic floor muscles to maximally contract and end in an orgasm. Instead of thinking of each of these structures as separate entities, consider all of the above a network of organs and nerves and muscles working together with one goal in mind. While each structure can produce a slightly different sensation, an orgasm is an orgasm in the end.

HOW LONG DOES IT TAKE TO ORGASM?

It wasn’t until 2003 (!!!!!) that a group of experts agreed on a definition for the female orgasm as “a variable transient peak sensation of intense pleasure creating an altered state of consciousness…usually accompanied by involuntary, rhythmic contractions of the pelvic musculature”. Since then, it seems like research on the subject has finally increased #praise. A study in 2020 with over 600 participants from twenty countries concluded it takes the average woman around 14 minutes to orgasm – six to eight minutes with clitoral stimulation and typically longer during penetrative intercourse.

CAN WOMEN CLIMAX MORE THAN ONCE?

There are four phases in the female sexual response cycle – excitement, plateau, orgasm, and resolution – and in the end its all about blood flow and muscle contractions. If you can 1) achieve clitoral engorgement through pelvic floor relaxation during excitement, then 2) keep blood there through plateau with muscle engagement, and 3) maximally contract those muscles with orgasm, then you can 4) repeat to your heart’s content. With body awareness and pelvic floor muscle control, women can cycle between plateau and orgasm multiple times before resolution occurs.

DO HORMONES MATTER?

While hormones have EV-ERY-THING to do with libido, they really don’t dictate your ability to orgasm. If you’ve read through any of the info above, you now know orgasms are purely blood flow, nerve stimulation, and muscle contraction (and this is why I can’t help but believe achieving “the big O” is available to just about everyone). Sure, healthy hormones & relationships & mental and emotional wellbeing are necessary to help get you there, but once you’re [there]…have confidence in your body’s ability to make it happen and get excited about it.

A pelvic rehab therapist’s guide to orgasms

Drumroll please…the moment you’ve been waiting for is here! Because once you know a little more about the physical process of an orgasm and what the female body is capable of (not surprisingly the most magical things), the actual “how to” makes so much more sense. Per usual, I want this to be your one stop shop for actionable, achievable advice & real results, so I’m sharing it alllllllllllllll. Here’s how I recommend moving forward for the most success –

Read through each of the steps below to get a full view of the plan.
Start with step one, dive in deep, and commit to completing it before moving on. Repeat with each step.
Save this post somewhere safe so you can keep coming back and progressing through the process.
If at any point you get stuck, a personalized virtual consult may be just what you need to see success. I’m here and happy to help you work towards your pelvic health goals!

STEP 1: DITCH PELVIC PAIN WITH SEX

Ok, ok…I realize this is easier said than done, but if sex is painful for whatever reason, you’re a lot less likely to want to participate in it, let alone orgasm during it. From endometriosis to postpartum healing, fibroids, vulva & vaginal dryness, and general pelvic floor muscle tightness, there are so many things that can cause sex to hurt, but there are answers to all of the above (girl scout’s honor) and it’s NOT have a glass of wine beforehand. I believe in my bones that sex does not have to be painful, and therefore have already written multiple articles on this topic. Dig deeper into one (or more) of the following blog posts for the answers you’ve been lookin’ for.

PS – If you don’t have pain with sex, you just skip right on down to step two, girlfriend. And if you do, learning to relax your pelvic floor is my number one strategy for relieving pelvic pain, so don’t hesitate to pop down there next while you’re here as well.

STEP TWO: LEARN TO RELAX (YOUR PELVIC FLOOR)

While “just relax” is one of the worst piece of advice to give just about anyone at almost any time, releasing…resetting…relaxing the pelvic floor muscles is step one to achieving an orgasm (remember that whole circulation & lubrication & vagina mobilization piece for arousal!?). Pelvic floor muscle tightness is theeeeee primary cause for pelvic pain and dysfunction – aka pain with sex & difficulty with orgasm, among every other pelvic floor problem you can think of – and learning to decrease muscle tension, both in your everyday and the heat of the moment, is your ticket to pelvic floor control, coordination…and better orgasms.

The posts above are my top resources for learning to relax the pelvic floor, but if you want a condensed version with all my top tips right in one place, this free guide is *everything* you need. Inside you’ll find exercises for posture, breath, and stretching, along with my favorite, most effect technique called the “let it go”. Here’s what using it during sex to achieve an orgasm looks like –

1. During the arousal stage, momentarily pause your brain to bring your attention to your pelvic floor muscles.

2. Perform a mini kegel to turn on your muscles (just enough to feel it) to send a message to your brain that says “focus here!!!”.

3. From there, simply let the contraction go and feel your muscles soften into a more relaxed position.

4. Repeat as necessary until you reach the climax phase where the muscles naturally, maximally contract. Purposefully relaxing them again after is your ticket to experiencing multiple orgasms.

5. PS – If you don’t feel your pelvic floor naturally contracting, this is a sign that your pelvic floor muscles are “too tense” or “stuck tight” and you need to keep working on pelvic floor relaxing outside of the bedroom.

Even though an orgasm is ultimately just a series of muscle contractions and cutting to kegels might make more sense, do not (I mean it…DO NOT) skip to strengthening your pelvic floor without learning & practicing & perfecting how to relax it first, in and out of the bedroom. This skill is the missing piece to most if not all pelvic floor problems, so start and stay with these strategies before moving on to step three.

STEP 3: IMPROVE PELVIC FLOOR STRENGTH & ENDURANCE

Once you know how to relax your pelvic floor muscles enough to promote the physiological events in the arousal phase, it’s time to support the plateau and orgasm phases with strengthening. The pelvic floor needs to have enough power and endurance to tip the orgasm scale, and kegels (or pelvic floor muscle contractions) are the best way to get there. This free guide has just about all the kegel information you’ll inside, including how & when & where to do them to improve your general pelvic floor strength, but here’s how to use them during sex to achieve an orgasm –

1. Clitoral, vulvar, or vaginal tingling/throbbing/pulsing are signs of adequate blood flow and nerve stimulation for arousal.

2. As you begin to feel your pelvic floor muscles naturally engage on their own, essentially contracting to nod the clitoris, begin performing kegels (and making sure to relax your muscles after each contraction) to create more momentum for an orgasm to occur.

3. Experiment with quick, repetitive kegels, longer muscle holds, or a mix of both…whatever works for you! No matter what you fancy, always make sure to fully relax your pelvic floor muscles after each contraction.

4. PS – if you feel like you’re on the verge of an orgasm but just. can’t. get. there., or you achieve them but they’re not as strong or exciting as you want them to be, those are signs of pelvic floor weakness, and working on your strength outside of the bedroom is your next best step.

STEP 4: GET TO KNOW YOUR BODY & PRACTICE, PRACTICE, PRACTICE

Orgasming requires pelvic floor strength, endurance, coordination, and control, and is therefore a skillset you have to exercise regularly and practice with repetition. Each time you attempt it, by yourself or with someone else, use that opportunity to tune into your body and really feel what it’s doing, to learn what you like (and don’t), to be proud of taking your pleasure into your own hands, and empowered by what your body can do. It can take a little time to get [there], but I encourage you to enjoy the process with patience & persistence, kindness & compassion.

STEP 5: COMMUNICATE YOUR NEEDS

There’s a saying that “communication is lubrication”, and if you desire to orgasm with a partner, then you MUST talk about it regularly before, during, and after sex – what you’re trying from the steps above, what you do and don’t like, constructive feedback, etc. It honestly may be worth having your significant other read this blog post as a way to start the conversation and get on the same page. I don’t know a single person who would turn down “hey babe, can we try something new tonight”…do you!? While all the information above is lovely, it simply won’t work if you’re not in it together.

Your mental & emotional health matter too

The brain is the largest sex organ, and while as a pelvic floor physical therapist the musculoskeletal component of an orgasm is my bread and butter (and what I’m primarily sharing here), where you are mentally and emotionally with your body, your partner, and the acts of sex themselves play an equally important role. If you don’t feel safe, if there isn’t an atmosphere of trust and respect, or if a traumatic past still lives in your body, your pelvic floor muscles are a lot less likely to function properly and therefore an orgasm less probable.

This side of sex is not my specialty, so if this speaks so you and you have an opportunity to see or learn from a specialist regarding the above, I highly recommend it. Sex therapists and mental health providers are highly trained yet under-utilized caregivers that can make a big difference in this area. Or if you’d rather try a DIY approach first, the following blog post includes my favorite books on the subject and this podcast episode by Gabby Bernstein is a must-listen.

PS – Pleasure doesn’t always mean orgasms

Yes, this post is all about orgasms, and I firmly believe they are physically available to every woman with the tips above. But at the end of the day…you get to define and decide what pleasure is. Maaaaaybe read that again if you need to!? Achieving how you want to ~feel~ physically, mentally, and emotionally with Intimacy and/or sex and/or intercourse should be your only goal, and whether you “finish” or not only matters if it matters to YOU. There are a million ways to check the pleasure box, and orgasms make a million and one.

If you’re still reading, then I have a message for you

As I was growing up, talking about sex was shameful. And never ever did someone tell me it was supposed to be pleasurable, let alone how to make that happen. If you’re somewhere in a similar boat, then oooooooh girl, the fact that you’re still reading this means you’re brave & open & committed & proactive and…well…I love to see it! While my job title is a pelvic rehab therapist, I’m ultimately in the business of taking the “too much” out of TMI, and breaking down orgasms like ^^this^^ is proudly my life’s work.

Even if you aren’t to the point of talking about orgasms like you chat about the weather (no shame, sister, it took me a long time too), I’m hopeful that you’re inspired to share this post with your significant other, to send it to a friend, or even save it for your daughter someday. And if something just doesn’t make sense or you’re feeling stuck, remember that this is a worthy & worthwhile topic for a virtual pelvic health consult (…we’d likely get to this subject anyway) and you can book an appointment with me here.

– Amanda

Disclaimer: The content provided here does not constitute medical advice, nor is it a substitute for personalized healthcare. I’m a doctor, but I’m not your doctor. If you have concerns about a medical condition, diagnosis, or treatment, you should consult with a licensed healthcare professional.