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SexuS Journal www.sexusjournal.com │ Spring-2017 │Volume: 02 │Issue: 04 │Pages: 117-145
◦◦◦ Sayin HÜ. Female Orgasmic Consciousness ◦◦◦ ISSN 2536-5185 (web) ISSN 2536-5169 (print)
Spring-2017 Issue: 04; June 30th, 2017
Sexual Physiology ● Sexual Health ● ESR

ISSN 2536-5185 (web)
Research & Review
ISSN 2536-5169 (print)
SAYIN HÜ Female Orgasmic Consciousness: New Horizons
SexuS Journal 2 (4): 117-145, 2017, JUNE
Female Orgasmic Consciousness:

New Horizons
H. Ümit Sayin
Abstract: Although there are many forms of female orgasms described in the literature, there are still debates
about the female orgasmic response and no unified theory to explain those orgasmic reflexes and sexual responses have
been proposed. Also, there are inconsistent reports and comments about the ‘vaginal versus clitoral orgasm controversy’.
Recently, a novel form of female orgasms has been coined as “Expanded Sexual Response” (ESR), and defined as: “being
able to attain long lasting and/or prolonged and/or multiple and/or sustained orgasms and/or status orgasmus that
lasted longer and more intense than the classical orgasm patterns defined in the literature”. Expanded orgasms induce a
different state of consciousness, or “orgasmic consciousness”, whereas many forms of altered states of consciousness
(ASC) can be observed. There are lots of reports, coming from the data accumulated during last decades on the female
orgasm and orgasmic consciousness, which confirms the fact that “clitoral and vaginal orgasms are two separate enti-
ties”, while their unification may induce a stronger and intense form of female orgasm, coined as “blended orgasm”. As
we have hypothesized in our other publications, at least six orgasmic reflex pathways may take part in the development
of single or multiple clitoral, vaginal, blended orgasms, and expanded, enhanced, prolonged ESR orgasms. Pudental,
pelvic, hypogastric and vagus nerves play major roles in the development of single or ESR orgasms, as well as at least two
oxytocin pathways may contribute to it. In blended, ESR orgasms and/or status orgasmus, more than one ‘orgasm reflex
arch pathway’ may trigger the orgasm at the same time, while other pathways play a supplementary role. We have
investigated the ESR phenomenon using a specific ESR-Scale in a series of surveys among ESR-women, compared to the
control groups and defined the main characteristics of ESR phenomenon in the human female. ESR women seem to have
higher libido, higher masturbation frequency, more erotic fantasies, stronger and more intense, prolonged orgasms or
expanded orgasms (EO); while they experience multiple clitoral, vaginal and blended orgasms separately, as well as status
orgasmus. Also ESR women are more aware of their bodies and their deep vaginal erogenous zones (DVZs), which com-
prises inner clitoris, G-Spot, A-Spot, O-Spot, PC-Muscles and Cervix. “Four nerve-six pathway theory of female orgasm”
and oxytocinergic system may seem to explain ESR phenomenon.
KEY WORDS: orgasmic consciousness, vaginal orgasm, clitoral orgasm, G-spot, A-spot, PC-muscles, blended orgasm, status
orgasmus, expanded orgasm, four nerve theory, expanded sexual response, ESR, , deep vaginal erogenous zone, DVZ
SexuS Journal ● 2017 ● 2 (4): 117-145
Introduction1 (Vatsyayana, 1883; Chang 1977, 1983;
Wu, 1996; Schwartz, 1999; Chia 2002, 2005;
Female orgasm and female orgasmic
Mumford, 2005; Michaels 2008). ). Eastern
‘peak experiences’ have been well documented
cultures had tried to discover the limits and
in in the ancient historical literature
extents of female orgasmic response for cen-
Corresponding Author: H. Ümit Sayin, M.D., PhD. turies (Wu, 1996; Chang, 1977, 1983). It was
Address: : Institute of Forensic Sciences, Istanbul University, Cer-
rahpaşa-Aksaray, Istanbul-Turkey Sigmund Freud who first pronounced the
Reprinted by the permission of NeuroQuantology Journal, Sultan Tarlaci and existence of different kinds of female or-
Ümit Sayin.
gasms; according to his theory, mature fe-
humitsayin@gmail.com www.humitsayin.com
male orgasms were “vaginal orgasms, that
A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 117

occurred during coitus; however, long ral pathways, while “the brain” and the
after his theories, Masters and Johnson’s psychology of the woman played the
clitoris oriented orgasm theory became major role. According to the novel ac-
valid and “clitoral orgasm theory” estab- cumulating data, glans clitoris was re-
lished the basis of sex therapy for dec- sponsible of the ‘clitoral orgasms’ via a
ades (Masters & Johnson, 1966, 1970, reflex pathway originating from pu-
1995). According to Masters and John- dental nerve and sacral plexus, while
son, clitoris was the main focus that other vaginal erogenous zones, coined as
triggered female orgasm, as they reject- “deep vaginal erogenous zones” (DVZ)
ed the ‘vaginal orgasm theory’ (Masters & were responsible of ‘vaginal orgasms’, via
Johnson, 1966), since vaginal orgasms other orgasm reflex pathways, such as
were not observed frequently in their pelvic nerve-sacral plexus, hypogastric
laboratory experiments; they explained nerve-pelvic plexus and vagus nerve-
vaginal orgasms as a variation of “clito- brain (Ladas, 1982; Komisaruk, 2003,
ral orgasms”, whereas glans clitoris was 2004, 2005, 2006; Sayin, 2010, 2011a-b-c,
the target of orgasmic response in both 2012a-b-c, 2013). Also the term of “blend-
forms of orgasms. Some surveys, pointed orgasm” had been defined by Ladas et
ed out that a “hypothetical vaginal oral. (Ladas, 1983) and Sayin et al. (Sayin,
gasm” existed in some women; according 1993, 2010, 2011c, 2012a-b). “Four nerve
to Hite Report (Hite, 1974) and Cosmo theory of female orgasmic response” was
Report (Wolfe, 1983) only one third of hypothesized to explain the mechanisms
American women were able to attain of single, multiple and extreme pro-
“vaginal orgasms”. longed orgasms or ESR in the human
female (Komisaruk, 2006; Sayin, 2011 c,
2012 a-b, 2013).
After the book “G-Spot” was pub-
lished in 1982, a new debate was started
about the “clitoral versus vaginal orgasms” Lately, a novel phenomenon was
which still continues (Ladas, 1982). La- defined and coined as “expanded orgasm”
das et al. hypothesized that vaginal or- (EO) and “expanded sexual response”
gasms originated by means of the stimu- (ESR) in a minority of women (Taylor,
lation of G-Spot via pelvic nerve, which 2000, 2002; Sayin, 2010, 2011c, 2012a).
was a rudimentary embryologic prostat- ESR was defined as, “being able to attain
ic structure in the frontal wall of vagina long lasting and/or prolonged and/or multi-
at the mid length of urethra (Ladas, ple and/or sustained orgasms and/or status
1982). Recently, other intra-vaginal ero- orgasmus that lasted longer and more in-
genous zones have been proposed to be tense than the classical orgasm patterns de-
discovered that may take part in the fined in the literature” (Sayin, 2010, 2011a-
mechanisms of female orgasms (Morris, b-c, 2012a, 2013). The duration of EO
2004; Sayin 2012 a-b-c). Also Komisaruk and ESR varied from woman to woman,
et al. and Sayin et al. (Komisaruk, 2006; lasting starting from a couple minutes to
Sayin, 2010, 2011 a-b-c, 2012 a-b-c) have hours (Schwartz, 1999; Taylor, 2000,
reported that female orgasm can be trig- 2002; Sayin, 2010, 2012a, 2013). In the
gered by means of the stimulation of literature, the highest number of or-
other erogenous zones via different neu- gasms in a woman recorded by Dr. Wil-
liam Hartman and Marilyn Fithian was  Neurohormonal reaction of smooth

reported to be 134 per hour (Sayin, 2010, muscle organs and contraction of homo-
2012a). logues of ejaculatory muscles (Campell
and Peterson, 1953).
Although defined recently, ESR and  Spastic vaginal contractions occur-
EO were not new phenomenon, but ring at highest tension levels (Glann and
peak experiences of female orgasmic Kaplan, 1968).
consciousness defined by different cul-  Reflexive sensory-motor response
tures centuries ago (Chang 1977, 1983; involving genitopelvic contractions
Wu, 1996; Schwartz, 1999; Chia 2002, (Kaplan, 1974).
 Reflexive sensory-motor response to
2005), while ESR may induce altered
sexual stimulation (Kline-Graber and
states of consciousness (ASC) and peak
Graber, 1975).
experiences in some women (Taylor,  Release of vaso-concentration and
2000, 2002; King, 2010; Sayin 2010, 2011c, myotonia from sexual stimulation (Mas-
2012a, 2013). ters & Johnson, 1966).
 Altered states of consciousness (Da-
vidson and Davidson, 1980).
This article briefly discusses some  Involuntary reflex action accompa-
novel findings, hypotheses and theories nied by uterine / vaginal contractions
on the mechanisms of female orgasms, (Reubens, 1982).
ESR and peak experiences of conscious-  Psychic phenomenon, a sensation
ness occurring during the enhanced and (cerebral neuronal discharge) elicited by
prolonged female orgasms. the accumulative effect on certain brain
structures of appropriate stimuli origi-
nated in the peripheral erogenous zones
The Nature of Female Orgasm (Alzate, 1985).
 Complex experiences of genital
Female orgasm is a neuro- changes, changes in skeletal muscle
psychological response and peak experi- tone/semi-voluntary movements, cardio-
ence that results from the accumulated vascular / respiratory changes (Bancroft,
sexual tension, sexual stimulation, 1989).
 Sudden, intense sensation just prior
arousal and internal sexual build up,
to genitopelvic contractions (Hite, 1976).
which is accompanied by neural and
 Acme of sexual pleasure with
psychological discharge. As Masters & rhythmic convulsions of the body of per-
Johnson, Hartman & Fithian investigat- ineal/reproductive organs, cardiovascular
ed in the laboratory conditions, female and respiratory changes, release of sexual
orgasmic response is complemented by tension (Schiavi and Segraves, 1995).
the contraction of some voluntary and  Orgastic potency; capacity to sur-
involuntary musculature, such as vulva, render to flow of biological energy; ca-
vagina, uterus, pelvic floor muscles pacity to discharge the dammed-up sexu-
(PFM), some of body muscles (leg, ab- al excitation through involuntary, pleas-
urable convulsions of the body (Reich,
domen, pelvic muscles etc.) (Masters &
1973).
Johnson, 1966; Sayin 2010, 2012a).
When we look at the nature of female
orgasm, although there are similar pat-
Some researchers have described terns to male orgasm, it seems to be very
female orgasm as (from, Mah & Binik, different than male ejaculation depend-
2001): ing upon the woman experiencing it. In
a classical single female orgasm, there
seems to be different patterns contrib- books and articles (Rhodes, 1991;

uting the bodily changes: Schwartz 1999; Bodansky, 2000; Taylor
 Whole body changes: tachycardia, ele- 2000, 2002; Komisaruk, 2006; Sayin 2010,
vated blood pressure, hyperventilation, 2011a-c, 2012a, 2013; Deadone, 2011). We
sweating, extension of some muscle have defined status orgasmus as (Sayin,
groups (e.g. legs and feet), muscle ten-
2010, 2011c, 2012a-b, 2013);
sion, ‘sex flush’, vasodilatation at the cu-
taneous arterioles and increased venous Status orgasmus is the continuous form of
blood pounding etc. blended orgasms and/or clitoral/vaginal
 Genito-Pelvic changes: erection of clit- orgasms that last for starting from 1 mi-
oral complex and glans clitoris, enlarge- nute to 10-15 minutes (or more). During
ment of G-Spot area and urethral sponge, status orgasmus a continuous orgasmic
lubrication, involuntary contraction of state is experienced and very few women
vagina, uterus and cervix, voluntary- are believed to achieve status orgasmus
involuntary contraction of pelvic floor state. Status orgasmus can be seen in vagi-
muscles (PC-muscles), involuntary con- nal and clitoral orgasms, however mostly
traction of anal sphincter etc. it is seen as an expanded/extended form
 Psychological changes: Relief of ten- of blended orgasms, in which both clito-
sion, discharge feeling, decrease of anxie- ral and vaginal orgasm reflexes are trig-
ty, happiness, euphoria, relaxation, ful- gered at the same time. Similar orgasmic
fillment, subjective feeling of getting rid states and full body orgasms are also de-
of electrical and muscle tension, altered fined in Tantric literature. The duration
states of consciousness (ASC) etc. may change from woman to woman. Sta-
tus orgasmus was first defined by Masters
& Johnson as lasting for 43 seconds in a
As measured by Masters & Johnson, woman in 1966. Today it is estimated that
the contraction duration of genito-pelvic status orgasmus continues for 1 to 2
minutes, while it may last for 10 to 15
area occurs at 0.8 second intervals (Mas-
minutes, a prolonged and extended or-
ters & Johnson, 1966). Although males
gasmic state which ends by a giant or-
have a refractory period after one or-
gasm (Big-O) that gives a great relief and
gasm, or ejaculation, to become erect satisfaction at the end. In most of the sta-
again, it has been well documented that tus orgasmus experiences there is usually
females have the capacity to continue a refractory period of 10 to 15 minutes.
having multiple climaxes if they are The number of minor orgasms in a status
stimulated continuously and properly orgasmus may exceed from 5-10 to 20-30
(Schwartz 1999; Bodansky, 2000; Taylor (some women claim that this quantity
2000; Komisaruk, 2006; Sayin 2010, goes up to around 50). In status orgasmus
it is thought that any combination of pu-
2012a, 2013). As described by Masters &
dental, pelvic, hypogastric and vagal
Johnson, some women can attain an or-
nerves mediate the triggering mechanism
gasmic state which may last for 43 sec-
at the same time.
onds, coined as status orgasmus (Masters
& Johnson, 1966). In some women who
have developed ESR; EO, multiple or- As a novel phenomenon “ESR or-
gasms and status orgasmus can vary in gasms and EO” seem to be different in
duration and in number of minor or- many ways from the classical single
gasms they contain in the train of or- orgasms, as defined by Masters & John-
gasmic pattern. Lately, such prolonged son and Kaplan (See Fig-1; Masters &
orgasms and the methods how to attain Johnson, 1966; Kaplan, 1981; Rhodes,
them have been published in many 1991; Schwartz, 1999; Taylor, 2000, 2002;
Diadone, 2011; Sayin, 2010, 2011c, contains nearly 8000 nerve endings, can
2012a-b, 2013): trigger an orgasm when stimulated
 The duration of single orgasms in manually
the orgasmic train may increase.
 The duration of the whole orgasmic
experience may increase, such as lasting
for tens of minutes to a couple of hours.
 The intensity of the individual mi-
nor orgasms generally increases along
with the length of the orgasmic train.
 The number of minor orgasms in
the orgasmic train may be beyond the
normal and average orgasmic pattern,
such as exceeding 20-30 orgasms in tens of
minutes.
 The pleasure taken and sexual relief
is reported to be much more compared to
single or a couple of multiple orgasms.
 Without a refractory period, a new
orgasmic state commences after each or-
gasm, without passing to a resolution
phase, while orgasmic consciousness
state is maintained for a long time (e.g.
from a couple of minutes to tens of
minutes or hours)
 Although there may be some forms
of ASCs in some single orgasms of some
women, most of the ESR and EO or- Figure-1: Top: Classical female orgasm pattern,
gasms are accompanied with ASCs, defined in the classical medical literature, Bottom:
whereas time perception, space-time Enhanced and expanded orgasm pattern in ESR
and EO, as defined in various resources recently.
continuum may be altered deeply. We
had reported 72 different states of mind
in our former publication (Sayin, 2011c). by friction, vibration, cunnilingus, or
 As reported by many ESR women, indirect penile trust stimulation in most
ESR orgasms seem to have anxiolytic, an- of the women (Masters & Johnson, 1966;
ti-depressant, euphoric, myorelaxant, sedat- Kline-Graber, 1975; Kaplan, 1981). Or-
ing, analgesic, acute and short acting hal- gasms attained through clitoral stimula-
lucinogenic effects which made us to
tion have been reported to be more lo-
adopt a humorous novel slogan: “Don’t
calized, sharp, bursting, short lasting,
use drugs! Use Expanded Orgasms!”
(Sayin 2011c; Sayin 2012a-d).
superficial, confined only to the pubic
area; while ‘coital vaginal orgasms’ have
been described as more diffuse, “whole
body”, radiating, psychologically more
Clitoral versus Vaginal
satisfying, lasting longer, having more
Orgasms tendency to turn into multiple orgasms
(Fisher, 1973; Hite, 1976; Kline-Graber,
Clitoral stimulation is the main 1975; Mah, 2001; Komisaruk, 2006;
source of sensory input for triggering a Sayin, 1993, 2010, 2012a, 2013).
female orgasm; glans clitoris, which

Singer gives another typology of fe- a separate “vaginal orgasm”:

male orgasm (Singer, 1973): 1) Vulva
orgasm: identified by orgasmic platform
contractions and induced by coital or
non-coital activity. 2) Uterine orgasm:
identified by some physiological param-
eters such as apnea and lack of orgas-
mic-platform contractions and induced
by cervical stimulation from deep coital
trusting. 3) Blended: Having the elements
of both, unified. Ladas et al. also men-
tioned about blended type of orgasms
(Ladas, 1982). Ladas hypothesized that
G-Spot was responsible for the trigger-
ing mechanisms of vaginal orgasms,
while vaginal orgasms were mediated
through a reflex arch through sacral
plexus via pelvic nerve; clitoral orgasms
were also mediated through a similar
pathway via pudental nerve. According
to the hypothesis defended in the book
“G-Spot”, blended orgasms were the
unifying of two types of orgasms, vulva-
uterine orgasms, which were mediated Figure-2: Deep Clitoral Structures and the Inner
through pudental, pelvic and hypogastric Clitoral Complex (left). Glans clitoris is innervated
by pudental nerve, while other structures are
nerves (Ladas, 2005-1982). innervated by both pudental and pelvic nerves
(right). (Taken and modified from www.the-
clitoris.com last access; June 2010)
Our extensive survey results on fe-
male sexuality (Kadınca Report-1993;
Hülya Report-2003; İstanbul Report-
2013, which is still continuing) among 1) The clitoral hood cannot move di-
nearly 2500 women since 1991, have rectly enough to stimulate the glans
pointed out that, clitoral orgasms and during coitus. If some deep erectile
vaginal orgasms are definitely two dis- structures of clitoris, such as bulbus
tinct phenomenon (Kocatürk, 2012; or crus, are stimulated as well, this
Sayin, 2010, 2011d, 2012a). sensory input will not be carried by
pudental nerve, because most of the
deep structures of clitoral complex
Masters & Johnson argue about the are innervated by pelvic nerve, which
possibility of indirect clitoral stimulation may cause another type of “clitoris-
during coitus, thus according to them, pelvic orgasm”, which is not exactly
the hood of clitoris inducing a friction to the same as “glans-pudental nerve or-
the glans builds up an indirect clitoral gasm”.
orgasm. The literature and our studies
have enough data to dispute such a phe-
nomenon. Let’s clear out the existence of 2) Most of the descriptions of each
type of orgasms in the literature 5) Our preliminary studies by means

are very different in terms of their of the electrical and vibration
physiological, neuropharmacolog- stimulation of DVZ seem to trigger
ical and psychological effects orgasm patterns alone, without the
(Campell, 1953; Fisher, 1973-77; stimulation of glans clitoris (un-
Hite, 1976; Taylor, 2000, 2002; La- published data). Similar interest-
das, 1981; Komisaruk, 2006; King, ing data comes out of the research
2010; Sayin, 1993, 2010, 2012a). For group of Komisaruk; stimulation
instance, orgasms triggered by coi- of cervix alone induced orgasmic
tus induce 4 times fold prolactin behavior in women who were
release in the female brain com- hemiplegic, having no connection
pared to manual clitoral orgasms, of nervous input from glans via
which is proposed to be a measure pudental nerve and from vagina
of satiety (Brody, 2006). via pelvic nerve (Komisaruk, 2003,
2004, 2005, 2006); this is also a
proof that orgasm reflexes can be
3) It has been reported that the wom- triggered from the brain without
en who are aware of their G-Spots the existence of input through
and who have responding- glans clitoris.
pleasurable G-Spots, are more like-
ly to attain ‘coital vaginal orgasms’ 6) In some women, undergone clitor-
(Ladas, 1981; Sayin, 2010, 2012a-c; idectomy, some coital orgasms
Hooper, 2008) have been reported (Sayin, 2010;
Escapa, 1989), which shows that
4) There appears to be other deep vag- without the existence of glans clit-
inal erogenous zones (DVZs) in some oris, orgasms may build up by
sexually hyper active and respon- some other mechanisms, while in-
sive women, other than clitoris ner clitoral complex may have
and G-Spot, as reported recently some contributions to those kind
(see figure-5 and below; Morris, of orgasms, however they are un-
2004; Sayin, 2012a-b-c). Those likely to trigger an orgasm by the
zones are more prominent in the stimulation of bulbus or crus of
women with ESR and high sexual clitoris alone; there should be oth-
responsiveness, compared to none- er triggering neural pathways and
ESR (NESR) women or average mechanisms that play major roles
women. Nearly 99 % of ESR wom- in the development of “orgasms
en were able to attain vaginal- without clitoris”.
coital orgasms (Sayin 2011b, 2012a-
b-c). Those areas are innervated by 7) After the definition of novel “four
pelvic nerve and partially by hypo- nerve and six pathway theory of fe-
gastric nerve, similar to G-Spot, male orgasm” (see below), it was
which induce a separate orgasm realized that at least six different
reflex arch pathway; thus a very pathway-mediated orgasm reflex
different physiological orgasmic arches, some of which may con-
response builds up. tribute to build up “vaginal or-
gasms” originating from direct

stimulation of DVZs, may exist! stimulation unit) may induce simi-

(Komisaruk, 2006; Sayin, 2011c, lar vaginal orgasms (unpublished
2012a-b) data).
8) Our preliminary research and oth- 9) Recently, “Brain Orgasms” without
er accumulating data also showed the stimulation of any genital ero-
that some specifically designed genous zones have been reported
electronic dildo shaped vibrators (Komisaruk, 2005, 2006; Sayin,
that have a rotational and vibrat- 2012a-b). If brain orgasms can
ing property at the tip may induce exist, than we should investigate
orgasms of vaginal origin (un- many other pathway systems and
published data), which may also mechanisms, such as the “oxytocin
show that stimulation of PC- pathway”, other than focusing
muscles, O-Spot, A-Spot and Cer- only on the ‘glans clitoris’!
vix may trigger vaginal orgasms in
some women. Near to these find-
ings, electrical stimulation of cer-
vix and DVZs by a TENS unit
(trans-cutaneous-electrical-nerve-
Figure 3. The venous network system surrounding the clitoral structures is depicted. Urethral sponge, deep clitoral structures,
G-Spot are interconnected. Glans clitoris is innervated by pudental nerve, while most of these structures and G-Spot are inner-
vated by pelvic nerve and some portions partially by pudental nerve. (Taken and modified from www.the-clitoris.com,

Figure 4. A) The venous blood supply of bulbus part of clitoral complex is depicted. B-C) The stimulation of urethral sponge and
G-Spot area and the female ejaculation, which is observed in a minority of women, is shown. (Taken and modified from
www.the-clitoris.com last access; December, 2011).
If there are separate vaginal orgasms Sayin, 2011a-b-c, 2012a-b-c-d, 2013; Koca-
mediated by some different neural path- türk, 2012)
ways other than ‘clitoral orgasm pathway
Recently, other erogenous zones in the
and arch’, and then there should be “blend-
deep structures of pelvic area and vagina
ed orgasms”, as well, which may occur
have been described (Morris, 2004; Sayin,
when both of those pathways that mediate
2011c, 2012a-b-c, 2013). We have investi-
clitoral and vaginal orgasms are activated
gated the possible existence of such areas
at the same time. Our survey data on fe-
in our surveys and other research projects;
male sexuality and our researches and
we have come across the description of
surveys on ESR, have revealed that such
such sensitive areas that may contribute to
stronger, longer, more intense orgasm pat-
the development of female orgasm in
terns also exist, as first described by Singer
some women (Sayin, 2011c, 2012a-b-c,
and Ladas (Singer, 1973; Ladas, 1982;
2013). The descriptions of DVZs and oc-
currence frequency of the awareness of

DVZs in some women, particularly with
ESR (ESR women N=35; None-ESR Con-
trol women N= 163; total group N=198),
were as follows (See Figure 5):
 G-SPOT (Grafenberg’s Spot): The lo-
calization of G-spot is at the anterior
vaginal wall, 2.5-4 cm inside, under
the mid uretral length. In our series
63 out of 198 women (31.8 %) admit-
ted to be aware of their G-Spots. 55
of them (27.7 %) were positive that
they had experienced G-Spot or- Figure 5. Deep Vaginal Erogenous Zones (DVZs)
gasms. 25 of these women (45.4 %) include G-Spot, inner clitoral structures of the clitoral
complex, A-Spot, O-Spot, Cervix, Pelvic Floor Muscles
were ESR-women.
(PC-Muscle), which have been proposed to be func-
tional in some of the ESR-high orgasmic women to
 A-SPOT: A-Spot is at the anterior trigger different forms of orgasm patterns. The fre-
quencies of occurrences of these areas have not yet
wall of vagina, 2-3.5 cm below ante-
been investigated extensively and in detail. The areas
rior fornix, under the bladder. 21 with stars are likely to trigger orgasms in a small
women (10.6 %) admitted to be group of women. U-Spot, although proposed by
Morris in 2004, have not yet been identified in the
aware of such an erogenous zone. 13 literature and in our surveys. It has been reported
of them (61.9 %) were ESR-women. that female orgasms can be mediated and triggered
 O-SPOT: O-Spot is between the by various forms of stimulation of glans clitoris, inner
clitoris of clitoral complex, G-Spot, A-Spot, O-Spot,
posterior vaginal wall and the rec- Anus, Cervix, PFM, Nipples, Ear Lobes, and the brain.
tum, 2-4 cm below posterior fornix.
16 women (8 %) replied that they
have a sensitive area at this part of
their genitalia. 12 of them (75 %)
were ESR-women.
 U-SPOT: U-Spot was hypothesized
to exist at the area of the urethral
opening by Morris (Morris, 2004).
No U-Spot has been detected in the
survey.
 Cervix: Cervix is the collum (neck)
Figure 6. The investigation of DVZs among 198 wom-
of uterus. 15 women (7.5 %) replied en along with the survey research on ESR. The survey
that their cervix was sensitive and questionnaire had detailed descriptions and schemat-
might have triggered an orgasm. 9 of ic figures of DVZs. The total number of 198 also in-
cludes 35 ESR women. As seen on the plot the fre-
them (60 %) were ESR-women. quency of the occurrence of DVZs’ awareness was
 Pelvic Floor Muscles (PFM-PC- much higher in women with ESR, who attained vagi-
nal orgasms in nearly 99 %. Some women admitted
Muscles): PFM are the muscle net-
that they experienced orgasms through the stimula-
work between pubis and coccyx. 24 tion of G-Spot, A-Spot, O-Spot, Anus, PFM, Cervix,
women (12.1 %) told that activation Nipples, however no one had a memory of pleasure
or orgasm from the stimulation of the coordinates of
of PFM was effective for the devel- an area that coincided ‘the hypothetical U-Spot’, as
opment of an orgasm. 12 of them (50 described by Morris in 2004.
%) were ESR women.

Most of the ESR women admitted that spondents admitted to have G-Spots;
they may have such erogenous zones, however, 50 % of these women were able
which may take part in the development to describe the exact coordinates of G-
of an orgasm, other than glans clitoris. In Spot, while 35 % described it deep inside,
our preliminary study in 198 women, 15 % located it elsewhere
some of the ‘DVZ spots’ were identified by (http://www.orgasmsurvey.co.uk/pressrelease.htm).
ESR (N=35) and NESR women (N=163) This study also confirms our hypothesis
(Sayin, 2012a-b-c). on DVZ, since 35 % of the 72 % of the
study group (1260 women out of 5000
women), reveal that they have sensitive
The Arguments and Discussions zones deep inside the vagina, assuming
about G-Spot that DVZ was G-Spot, since they did not
have any idea about the sensitivity of A-
The G-Spot was first described by a
Spot, O-Spot, Cervix and PFM.
Dutch physician Regnier de Graaf in 1672
and then by Ernst Grafenberg in 1950, as
an erogenous zone on the anterior wall of Today there are still arguments about
vagina that expels urethral ejaculate dur- whether the G-Spot exists or not, however,
ing an intense orgasm (Ladas, 1982; Mah, many studies and surveys showed that,
2001). Glandular structures, Skene’s para- although the frequency alters, from 35-40
urethral glands, have been proposed to % to 50-60 % of the female population con-
homologous to male prostate that stayed firm to have G-Spots and accept the con-
atrophic and rudimentary during the tributions of G-Spot to the development of
course of embryological development female orgasm, particularly during vagi-
(Addegio, 1981; Belzer, 1981; Perry, 1981; nal orgasms.
Ladas, 1982; Zaviacic, 1985, 1993, 1998).
Many reports and surveys and laboratory
observations revealed that 40 % to 66 % of Expanded Prolonged Orgasms
the subjects reported a sensitive and (EO) and Expanded Sexual
pleasurable area around 11:00-1:00 (clock- Response (ESR)
wise) position of the anterior wall of vagi-
na at the mid-length of urethra (see Figure ESR is a recently defined phenomenon
5) (Perry, 1981; Ladas, 1982; Davidson, (Rhodes, 1991; Taylor, 2000, 2002; Arma-
1989; Weijmar Schultz, 1989; Komisaruk, gan, 2012; Sayin, 2011a-c, 2012a-b, 2013).
2006; Sayin, 2010, 2012a-b-c, 2013). The As ESR was defined above, the main hy-
laboratory studies of Addegio et al. and pothesis in ESR studies was, “Sexual re-
Zaviacic et al. also showed that biochemi- sponse, orgasmic consciousness and experience
cal analysis of female ejaculate revealed and orgasmic pleasure can be enhanced, pro-
that the ejaculate was different than that of longed, and expanded in the human female”.
urine and female ejaculate had some simi- Although a small proportion of women
lar components of prostate secretion has attained or can attain ESR today, ESR
(Addegio, 1981; Zaviacic, 1985, 1988, 1995, is a learned phenomenon that can be de-
1998; Ladas, 1982; Sayin, 2010, 2012a). veloped in many women by training and
education. To determine the main parame-
Recently, another internet survey ters and mechanisms of ESR, we have in-
among 5000 women in England (2011), vestigated the main characteristics of
showed that nearly 72 % of the corre- women who have developed ESR (Taylor,
2000, 2002; Armagan, 2012; Sayin, 2011a-b, Our preliminary findings of ESR re-
2012a-b-c, 2013): search, which is still continuing, were pre-
1) The ESR women experienced vaginal, clit-
sented in NACS-2011 (Oslo-Norway),
oral and blended orgasms, as described by Ladas
IASR-2012 (Lisbon-Portugal) and NACS-
et al. (Ladas, 1982; Taylor, 2000, 2002; Ar-
magan, 2012; Sayin 2010, 2011a-b-c, 2012-a- 2012 (Helsinki-Finland) Meetings. As a
b-c-d). summary, some of the presented data
2) The ESR women experienced multiple or- which support above ten characteristics of
gasms in most of their sexual activities. ESR women were as follows (Sayin,
(Schwartz, 1999; Taylor, 2000, 2002; Mam- 2012b):
furd, 2005; Armagan, 2012; Sayin 2010,
2011a-b-c, 2012-a-b-c-d) Novel Explanations of Neuro-
3) The ESR women were able to attain long
anatomical, Neurological and Neuro-
lasting and/or prolonged and/or multiple and/or
sustained orgasms and/or status orgasmus that
pharmacological Mechanisms of Single
lasted longer than the classical single orgasm Vaginal and Clitoral Orgasms, Multi-
and/or multiple orgasm patterns defined in the ple Orgasms and ESR Orgasms
literature. (Schwartz, 1999; Taylor, 2000,
2002; Sayin, 1993, 2010, 2011a-b-c, 2012a-b- To explain the enhanced and expanded
c-d) forms of female orgasmic consciousness,
4) The ESR women claimed to have strong we had hypothesized the “Four Nerve and
pelvic floor muscles (PFM) compared to NESR
Six Pathway Theory of Female Orgasm” in
women. (Ladas, 1981; Britten, 1983; Sayin,
our former publications (Sayin, 2011c,
2010, 2011b, 2012a-b)
5) The libido of ESR women was very high 2012a-b-f). There is a lot of data which
compared to NESR women. (Armagan, 2012; confirms that four separate nerves carry
Sayin, 2012a-b) sensory inputs from the “orgasming zones”
6) ESR women described a phenomenon of female genitalia or body; these are pu-
called G-Spot orgasms. (Ladas, 1982; Taylor, dental, pelvic, hypogastric and vagus nerves
2000, 2002; Armagan, 2012; Sayin, 2010, (Ladas, 1982; Komisaruk, 2003, 2004, 2005,
2011b, 2012a-b-c) 2006; Sayin, 2011c, 2012a-b, 2013). The fol-
7) ESR women described sensitive erogenous lowing are the possible pathways that car-
zones in their genitalia other than clitoris.
ry sensory input to somato sensory, frontal
(Morris, 2004; Armagan, 2012; Sayin, 2012a-
and prefrontal cortices and the limbic sys-
b-c)
8) ESR women masturbated more frequently tem, and contribute to the formation of an
compared to NESR women. (Armagan, 2012; “orgasm reflex” (Figure 10); some of those
Sayin, 2012a-e) loci directly trigger a female orgasm, some
9) ESR women had erotic fantasies more fre- of them may have contributions in terms
quently than the NESR women. (Armagan, of sensory input. Also there are two other
2012; Sayin, 2012a-e) oxytocinergic pathways which contribute
10) ESR women admitted to have a form of to the formation of an orgasm of any kind
altered states of consciousness during some of (Sayin, 2011c, 2012a-f)
their prolonged orgasms and/or status orgasmus
(Taylor, 2000, 2002; Mah, 2001, 2002, 2005;
King, 2010; Sayin, 2011c; Sayin,2012a-d).

Figure 7. Partial preliminary data of ESR study, which is still continuing. A) ESR scores were directly proportional with the strength
of PFM (PC-Muscles) (r=0.782, N= 94); a specially designed Kegel Perineometer, of which monometer could measure pressures up to
25, 40 and 60 milibars, was used in the study. Note that, the women who got scores above 100, were accepted as ESR-women, out of
the course and statistics of the study. The women who trained PC-Muscles may become multi-orgasmic, vaginally orgasmic and train-
ing of PC-Muscles is an important factor in the development of ESR. B) Masturbation frequency is also correlated with ESR scores
(r=0.895, N=94). ESR women masturbated more frequently compared to NESR-women. C) Orgasm intensity measures were also
directly proportional with ESR scores. The ESR women experienced more intense, prolonged, long lasting and strong orgasms com-
pared to NESR women (r=0.857, N= 94).
Figure 8. A) Comparison of ESR scores of ESR and NESR women. The ESR cut off line was between 90-100. We
have accepted women with scores over 100, as ESR-women. B) Libido of ESR (N=35) women was much higher
compared to NESR women (N=59).

Figure 9. A) ESR women were more multi-orgasmic compared to NESR women. Multiple orgasm sub-
scores of ESR women (N=35) were more than twice that of NESR women (N=59). B) Masturbation frequ-
ency sub-scores of ESR women (N=35) was nearly twice that of NESR women (N=59). ESR women mas-
turbated more frequently than the control NESR women.
Enlarged Version of Figure-5

If a single “orgasm reflex pathway”, cral plexus (+ partially Pelvic plexus)

while some other pathways having some BRAIN  Vaginal orgasm, or contrib-
involvement, as well, operated during the utes to Vaginal orgasm or ESR orgasm
development of an orgasm; a single clito-  Cervix  Partially Pelvic N. +
ral, vaginal or brain orgasm may occur. If Mostly Hypogastric N.  Pelvic Plexus
many (more than one) “orgasm reflex path- (+ partially sacral plexus) BRAIN 
ways” and a combination of the following Vaginal orgasm, or contributes to Vag-
pathways are involved in the formation of inal orgasm or ESR orgasm
an orgasm, then an EO or “ESR orgasm”  Cervix  Vagus N.  BRAIN 
may develop and orgasms may become Vaginal orgasm, or contributes to Vag-
more intense, multiple and prolonged. inal orgasm, or ESR orgasm
This is a learned and maturing phenome-  Uterus  Hypogastric N. + Vagus
non, which can be developed and im- N.  Pelvic Plexus + BRAIN  con-
proved by training and education, as tributes to Vaginal orgasm or ESR or-
many ancient Tantrists had done centuries gasm
ago (Mamford, 2005; Carellas, 2007; Sayin,  Anus + Rectum  Infra Anal N. +
2012a). Pudental N. + Pelvic N. + Anal sphinc-
 Glans clitoris  Pudental N.  ter nerves  Sacral Plexus  (BRAIN)
Sacral plexus  BRAIN  Clitoral or-  Anal orgasm (O-Spot stimulation
gasm contributes to anal orgasms)
 Parts of clitoral complex (crus,  Nipples  Intercostal N. 
body, bulbus etc)  Pudental N.  Sa- Pituitary  Oxytocin Pathway 
cral plexus  BRAIN  Clitoral or- BRAINNipple orgasm; or contributes
gasm or Vaginal orgasm, or contributes to Clitoral orgasm, Vaginal orgasm or
 Parts of clitoral complex (crus, ESR orgasm
body, bulbus etc) Pelvic N.  Sacral
plexus  BRAIN  Vaginal orgasm, BRAIN-imagination-fantasy-sexual
or contributes images  Pituitary  Oxytocin Pathway
 G-Spot  Pelvic N.  Sacral  BRAIN Brain orgasm or contributes
plexus  BRAIN  Vaginal orgasm; to all kind of orgasms
and ejaculation in some women
 Various vaginal stimulation during If there are six orgasmic pathways to
coitus  Pelvic N.  Sacral plexus  trigger an orgasm, then female orgasm can
BRAIN  Vaginal orgasm be triggered in 63 ways; among them, 57
 A-Spot  Pelvic N. (possibly par- of them would be blended or ESR or-
tially hypogastric N.)  Sacral plexus gasms. If the above 14 loci take part in the
(+ partially Pelvic plexus)  BRAIN  development of an orgasm, then there are
Vaginal orgasm, or contributes to Vag- (214 -1 = 16283) combinations or possibili-
inal orgasm or ESR orgasm ties of factors, that supply complementary
 O-Spot  Pelvic N. (possibly par- orgasmic input into the brain. This theory
tially hypogastric N.) Sacral plexus (+ may explain why female orgasms are so
partially Pelvic plexus)  BRAIN  diverse, and why it is very difficult to un-
contributes to Vaginal orgasm, Anal derstand and explain the patterns of fe-
orgasm or ESR orgasm male orgasms.
 PFM (PC-Muscle)  Pelvic N.
(possibly partially hypogastric N.) Sa-

Figure 10. Four Nerve Six Pathway Theory of Female Orgasm. At least six pathway-orgasmic reflex arch systems work dur-
ing the development of female orgasms. Pudental, Pelvic, Hypogastric, intercostal and Vagus nerves constitute the main nerve
network system. Also there are at least two Oxytocin pathway systems, whereas Oxytocin works as a neurotransmitter and as a
hormone, separately. During expanded orgasms and ESR orgasms, more than one ‘orgasm reflex arch pathway’ is activated and
trigger an expanded orgasm, while many others contribute to the formation of an EO or ESR orgasms.
According to this theory, during the er, other loci and pathway systems may
development of a particular type of or- also carry supplementary pleasure input
gasm, the other pathways or loci may into the pleasure centers of the brain and
supply additional sensory input and the neocortex. In expanded orgasms or
pleasure information into the brain until ESR orgasms, more pleasure input is car-
an orgasm reflex is triggered. For the de- ried through many loci and many path-
velopment of clitoral orgasms, for in- way systems, such that at least two or
stance, the triggering locus is glans clitoris more, orgasm reflex pathways are activat-
and the main reflex arch is pudental nerve- ed at the same time, while many other loci
sacral plexus orgasm reflex arch, whereas the and pathways carry lots of supplementary
orgasm trigger command is given by the information into the brain, such that or-
neocortex and limbic system. During the gasmic response is stronger, more intense,
development of a clitoral orgasm, howev- prolonged and more pleasurable, lasting

for from a couple of minutes to tens of ened sensations; increased energy; tempo-
minutes, or even hours (Rhodes, 1991; rary pain relief; energy expanding out of
Schwartz, 1999; Bodansky, 2000; Taylor, body; deep relaxing abdominal breathing;
2000, 2002; Zdrok, 2004; Sayin, 2010, 2012a, increased clarity and creativity; acceptance
2013). This is just like the “opening of the of the self and others; extra sensory per-
doors of perception”, namely “opening of the ception; ecstasy; mystical experience; di-
doors of the orgasmic perception and orgasmic vine feelings; increased awareness of the
consciousness”. In ESR orgasms, the intensi- body; mind connection and integration;
ty, duration and pleasure increases by psycho-spiritual birth and death experi-
time and by the course of orgasmic train, ence; loss of illusion of spatial separation;
as described by many women; for in- loss of spatial dimensions, loss of sense of
stance, the fifteenth orgasm is much more time; personal boundaries dissolving and
intense and prolonged than the fifth or- merging with the divine; cosmic emptiness
gasm, once the orgasmic train commences and void; sharing with the partner; com-
and continues, as depicted in the plot in passion; sense of fulfillment etc. (Taylor,
Figure 1-B. Many women have described 2000). In our study, which is still continu-
transcendental, mystical, ASC experiences ing, we have identified 85 psychological
during an EO or ESR orgasm, which is a effects during intense and prolonged or-
proof that ESR orgasms are novel doors gasms, as we have reported before (Sayin,
opening to another “orgasmic conscious- 2011c, 2012a-d, 2013; See Table-1). In our
ness”, which lasts for a very long time, study we also separated single orgasms
compared to classical single orgasms rec- from, prolonged-multiple-intense ESR
orded in the literature (Taylor, 2000, 2002; orgasms; evaluating them as two separate
Sayin, 1993, 2010, 2012a, 2013). entities. Although in classical single or-
gasms, there are sometimes sharp psycho-
logical changes and ASCs; we have come
Discussion to the conclusion that most of piercing
Orgasmic Consciousness psychological shifts of the mood and most
of the ASCs occur during intense and pro-
Female orgasm has been defined as a longed ESR orgasms. The main mecha-
form of ASC by many researchers (Fisher, nism of such alterations of mood can only
1973; Davidson, 1980; Taylor, 2000, 2002; be explained by the “ecstatic activation” of
Mah, 2002, 2005; King, 2010; Sukel, 2011; various centers of the brain and release of
Sayin, 2010, 2011c, 2012a-b, 2013). King, many neurotransmitters in various parts
Mah & Binik categorized subjective feel- of the brain during intense and prolonged
ings of female orgasms in 10 dimensions orgasms; such as endogenous opiates, do-
as building sensations, flooding sensa- pamine, serotonin, oxytocin, norepineph-
tions, flushing sensations, shooting sensa- rine, glutamate, and prolactin. It is, al-
tions, throbbing sensations, general ready, reported that during a single or-
spasms, pleasurable satisfaction, relaxa- gasm developing by masturbation or by
tion, emotional intimacy, and ecstasy intercourse, dopamine (Stahl, 2001; Kruger,
(King, 2010). Taylor classified her cases 2006; Passie, 2005; Brown, 2007), prolactin
into four dimensions as physical, mental, (Kruger, 2002, 2005; Passie, 2005;), oxytocin
emotional and spiritual. Taylor’s cases de- (Stahl, 2001; Argiolas, 2003; Passie, 2005;
scribed a deep experience of ASC such as, Krüger, 2006), melanocortin (Brown, 2007),
more pleasure; deep relaxation; height- serotonin (Stahl, 2001; Brown, 2007) norepi-

nephrine (Stahl 2001) and endogenous opioid was 16. Her score from ESR-Scale was
peptides (Argiolas, 2003) are released and 132/150 (in 2011). She says that she has been
involved in the mechanisms of altered hypersexual since she was 26. She adds that
“orgasmic consciousness”. Acute dopamine, she has been practicing Kegel Exercises since
she was 26. She has not been diagnosed for
the pleasure neurotransmitter, release is a
any psychiatric disorder:
‘satisfaction and bliss’ factor during the fe-
male orgasms (Stahl, 2001; Komisaruk, During my orgasms I depart from every-
2006; Brown, 2007). For such an alteration, thing around, it is a total depersonalization. I
involvement of more than one orgasmic just feel myself, I even forget myself. Only my
reflex pathway can be one of the mecha- voice and screams stay. In status orgasmus,
nisms, whereas the physiological changes which are my best to be satisfied, the pleasure
during a female orgasm is doubled or tri- increases gradually, I am totally isolated from
pled, by the stimulation and activation of my environment. Only I hear the animal voice
coming from my throat, my short moans turn
many reflex centers. “Four nerve and six
out to be incredible screams. I feel it on my
pathway theory of female orgasm” seems to
stomach, first some tingling, then the contrac-
be a better model to explain the sharp
tions follow each other. It is a total altered state
changes of the consciousness, while oxyto- of consciousness. My vision darkens; I see
cinergic pathways play a major role. We flashes of colors or light. During minor or-
have also investigated the acute behavioral gasms I feel funny contractions, like a game.
effects of intranasal oxytocin spray (10 IU) The minor orgasms or contractions starting
in a group of women, compared with the from my vagina and pubis circulate through
placebo: our results were confirming this my stomach, where I can feel the real center of
hypothesis, because intranasal oxytocin the orgasmic volcano. Once status orgasmus
starts, it is like a hurricane taking me away
(1o IU), alone, induced ASC-like symp-
from my body and I fly, these minor orgasms
toms in 9 women (30.7 %); subjective feel-
each lasting for nearly 10 to 20 seconds, build
ing of analgesia in 9 women (30.7 %); hap-
up into a continuous tetanic fit, while I some-
piness, calmness, serenity, euphoria in 15 times can’t hear my screams, I am lost in the
women (57.6 %) and sexual arousal in 10 first few minutes. These contractions continue
women (38.4 %) out of 26, within 10 for 10-20 minutes especially when my partner
minutes after administration. There were is doing oral sex (cunnilingus) on me. He con-
no such effects after the placebo, which tinuously stimulates my clitoris by his tongue
was administered to the same person ei- so talented that one orgasm finishes, other
ther before or after oxytocin administra- begins. During a status I feel that I am travel-
ing the world, as if I have an astral body, I go
tion in a double blind fashion (Sayin,
to unknown gardens, waterfalls, meadows.
2012g ).
During intercourse orgasms I feel an unbeliev-
able unification and merging, and dissolving
A sample description of an ESR or-
into each other. I also had status orgasmus dur-
gasm we have recorded in our surveys ing intercourses. If my partner continues inter-
may clarify and visualize the “orgasmic course for 1-3 hours, it is easy to attain pro-
consciousness” of a woman (Sayin, 2010): longed orgasms. My brain melts, I realize that I
J. K. is a medical doctor. She is 36 years old. am an animal; I hear my animal voices coming
She had her first sexual intercourse at the from my throat which make me more excited.
age of 16, she had her first vaginal orgasm Vaginal orgasms are sometimes better than
at the age of 24, when also she discovered clitoral. While we also apply a message vibra-
her G-Spot. She started to have expanded tor during the intercourse, I easily go into the
orgasms and status orgasmus at the age of status orgasmus which lasts for ten minutes to
28. She had nearly 40-50 partners since she half an hour, while I experience nearly 50-60

minor orgasms. During orgasms I laugh, cry, minutes to 10-15 minutes or more, they
moan, make very loud noises (always I am had had 20 to 30 minor orgasms in a train
afraid that neighbors may hear me!) my body of multiple orgasms during the “orgasmic
arches, I am in full extension, it is sometimes consciousness” (Sayin, 2012a, 2013). These
not certain whether I having pain or pleasure.
figures are beyond the published limits
Fantasies whispered to my ear make me crazy
and the normal recorded physiology of the
during these orgasms. Even a word may start
another minor orgasm. It could be anything, female orgasm; however it is a fact to be
wild or soft; I want to become an animal, re- investigated and explained by neurosci-
turn to my archetype body whatever it had ence. According to ‘Cosmo Report’ among
been. When I contract, I feel like an animal, as 10 000 American women, 14.8 % of women
if it comes from my collective sub conscious- could attain only one orgasm, 65.9 % could
ness. I feel the penis like a hot, burning sword have 2 to 5 orgasms, 13.4 % could reach to
that brands me. Makes my pelvis hotter and 6 to 10 orgasms, while only 5.9 % could
hotter, it steams out, and then comes a huge
attain 11 or more orgasms during one love
contraction, following another. Status orgasmus
making session (Wolfe, 1982). Our surveys
is very satisfactory for me, compared to other
point out that 2.1 % (Kadınca Report, 1993;
orgasms, like the ones due to the clitoral or
vaginal stimulation alone. I feel so dizzy and N=1534), 4.7 % (Hülya Report, 2003;
my brain is so high and turning around that I N=706) and 4.3 % (Istanbul Report, 2013,
believe it would be very hard for me walk on a continuing; present N= 470) of Turkish
straight line, I would fall. I love to lose myself women can attain more than 11 orgasms
in my own brain chemistry. I would not be during a love making session (Sayin, 2010,
satisfied if I did not experience status, because 2011d, 2013). Thus, in different cultures we
clitoral or vaginal minor orgasms are so low have substantial data which confirms the
for me. They don’t make me as high as the
existence of a group of nearly 4-5 % of
status orgasmus does. I don’t have any refracto-
women who can attain more than 11 (up
ry period for attaining vaginal or clitoral or-
to 20 or more) orgasms in a couple of
gasms. One may come after another without
building into a status orgasmus. But for the hours. Depending on the data from many
status, which comes with a BIG-O at the end, other worldwide surveys made us to work
there is always a refractory period of 15-20 on a mathematical model to make an as-
minutes (truncated)… sumption that a proportion of 10 to 15 %
of women can attain ESR orgasms by
training and education, while an average
Expanded Orgasms and ESR of 1-3 % are, most probably, experiencing
the extreme “orgasmic consciousness” men-
Taylor has reported that the expanded tioned above, at present (Sayin, 2012a-b,
orgasm (EO) or ESR orgasm duration was 2013).
0.2 to 60 minutes in 22 female subjects (a
total of 44 subjects or 22 couples), while
the average EO duration was 7.2 hours
(Taylor, 2000). Although Taylor’s data
seems to be difficult to believe and we
have never come across such extreme cas-
es; in our study, the women who experi-
enced ESR orgasms proclaimed that dur-
ing a status orgasmus or prolonged ESR
orgasm, which lasted from a couple of

Table 1. Psychological Effects and ASCs Induced by Enhanced, Expanded and ESR Orgasms
30) Feeling of fulfilling, achieving
1) Pulsating feeling 59) Feeling wild, becoming wild
something
31) Losing oneself
2) Throbbing feeling 60) Feeling animal, animalism
32) Exploding 61) Seeing different colors
3) Tickling
33) Volcano 62) Seeing flaring of lights
4) Warm, warmth feeling
34) Ecstatic 63) White or colored flashes
5) Hot, very hot feeling
35) Unify, Unified feeling
6) Physical warmth 64) Seeing different geometrical objects
36) Unifying with the partner
7) Spiritual warmth 65) Feeling the body and mind extraordinary
37) Extreme feelings of love and
8) Exciting 66) Travelling to different lands, e.g. evergreens,
bursts of love to the partner
forest, waterfalls, gardens etc
38) Attachment to the partner
9) Pleasurable 67) Voyage to unknown places
39) Cessation of time, time stops
10) Quivering 68) Finding one’s self in different lands, e.g. ever-
greens, forest, waterfalls, gardens etc.
40) Distortion in space-time contin-
11) Shuddering 69) Dissolving into the partner
uum
41) Flowing feeling 70) Unifying with environment and universe
12) Earth quake feeling
42) Flooding feeling 71) De ja vu
13) Flushing
43) Absorbed feeling
14) Euphoric 72) Unreal feeling
44) Immersing feeling
15) Uncontrolled feeling 73) Surreal feeling
45) Swelling feeling
16) Elevation of mood 74) Opening into a surreal universe
46) Dissolve feeling
17) Elated, being high 75) Seeing Cartoon characters, short cartoon movie
47) Crying 76) Blissful feeling
18) Rapturous
48) Giggling, laughter 77) Mystical experience
19) Losing oneself
49) Rising, going up 78) Cessation of breathing, not to be able to breath
20) Intense LOVE
for a long time
50) Out of body experience 79) Resolving of pain (Analgesic Effect)
21) Extreme excitement
51) Fly, flying
22) Close to herself, environment) 80) Subsiding and decreasing of depression (Anti-
Depressant Effect)
23) Close to the partner 52) Astral voyage 81) Release from anxiety, decreasing of existing
anxiety (Anxiolytic Effect)
24) Peaceful 53) Death feeling 82) Increase of enthusiasm and creativeness
25) Spurting feeling 54) Near death experience 83) Feeling of relaxing of muscles, decreasing ten-
sion in muscles (Myo-relaxant Effect)
55) Spreading feeling 84) Soothing and sedating effect; release from
26)Relaxing
tensions and stress (Sedating Effect)
56) Depersonalization 85) Happiness during and after orgasm, Feeling
27) Feeling of being totally filled
extremely content (Anti-depressant effect)
28) Peacefully relaxing 57) Losing the soul feeling
29) Soothing 58) Soul outside

ESR and Deep Vaginal enon, Whipple et al. had observed, could
be a result of the analgesic effects of acute
Erogenous Zones
oxytocin and endorphin release, which is
secreted by the stimulation of clitoris, vag-
Our study on ESR points out that, for inal walls, cervix, uterus or DVZ, and
experiencing extreme orgasmic conscious- during a female orgasm, as we also have
ness, a woman; reported (Sayin, 2010, 2012a-g). Those
1-Should attain and experience multiple zones at the anterior and posterior walls of
clitoral, vaginal and blended orgasms sepa- vagina can be G-Spot, A-Spot, O-Spot, and
rately. probably cervix is included, while most of
2-Should use her PFM (PC-Muscles) dur- the women cannot pinpoint the sensation
ing sexual response and should possess devel- originating from deep vaginal structures
oped, powerful PFM. in correct coordinates. A proof for this
3-Should have a developed masturbation hypothesis came from a recent survey
pattern. among 5000 British women in England
4- Should have a developed “sexual-brain”. (2011), as mentioned above
5- Should be aware of her G-Spot and (http://www.orgasmsurvey.co.uk/pressrelease.htm),
DVZs, experiencing G-Spot or DVZ orgasms. 1260 women out of 5000 (25.2 %) de-
6-Should be using novelties, variations and scribed pleasurable zones at the vaginal
sex toys (e.g. various types of vibrators, vibes) walls as “G-Spot”, while they described the
to discover herself and to attain more pleasure coordinates of G-Spot incorrectly, since the
in her sexual life style (Sayin, 2012a-b, 2013). questionnaire did not have the choices of
other DVZ areas.
DVZ was first defined by the famous
British zoologist Desmond Morris (Morris,
2004); however, the pleasurable sensitivity Awareness of DVZs (G-Spot, inner
of anterior and posterior walls of vagina clitoris, A-Spot, O-Spot, Cervix, PFM) is
have been reported for a long time by very important for developing ESR, and
many researchers, since Sigmund Freud many ESR women are aware of those
(Reich, 1973; Singer, 1973; Fisher, 1972, pleasurable areas, as our surveys on ESR,
1973; Kaplan, 1981; Ladas, 1982; Britten, has found out (See figure-6; Sayin, 2012a-
1983; Whipple, 1988; Bancroft, 1989; Es- b-c). Our other research also revealed that
capa, 1989; Komisaruk, 2003, 2004, 2005, some areas in deep vagina were sensitive
2006; Zdrok, 2004; Carellas, 2007; Sayin, to high frequency vibration (80 Hz to 160
1993, 2010, 2011a-b-c, 2012a-b-c-e). Alt- Hz), which is not experienced by tradi-
hough the nervous innervations of pelvic tional vibrators, having a vibration fre-
nerve and hypogastric nerve in the walls of quency of nearly 40-60 Hz. and also, when
vagina are not well established anatomi- stimulated by galvanic current using a
cally and histologically, Whipple et al, TENS unit, these DVZ areas induced sex-
reported that self-stimulation of anterior ual pleasure and occasionally orgasm in
and posterior walls of vagina induced some women (unpublished data). We have
pleasure and analgesia, as much as the recently described a method to induce
stimulation of the clitoris (Whipple, 1988). prolonged blended orgasms in women
If there is pleasure and analgesia, then who have achieved the state of “orgasmic
there should be some zones innervated by consciousness” and ESR, which can be used
peripheric nerves that carry messages of in sex therapy (Sayin, 2012a, 2013).
pain, pressure, vibration etc. The phenom- A Special Method for Sex Therapy to Induce
Expanded ESR Orgasms in Women. Four orgasm was a taboo in many cultures. In
Spot Method: In the women who have de- England, during the Victorian Era, women
veloped ESR, an effective method is de- were prohibited to masturbate and to get
scribed to induce prolonged orgasms: pleasure from sex, while doctors made
Stimulation of G-spot (coitus, manual, elec-
them wear weird chastity belts at nights to
trical or vibe), Deep Vaginal Erogenous
prevent them from masturbation and sex-
Zones (DVZs) (coitus, vibe , electrical, or
manual), glans clitoris (cunnilingus, manu- ual pleasure, claiming that masturbation,
al, vibe, or electrical), clitoral complex (coi- pleasure and orgasm were harmful for the
tus, vibe, electrical, or manual), anus (coitus, good women’s psychology (Escapa, 1989;
vibe, or manual) , nipples (mostly manual, Sayin, 2010, 2012a). After the publications
labial or vibe) and the brain (fantasies, imag- of Havelock Ellis, Kraft Ebbing, Sigmund
es, thoughts, sexual pleasure objects, learned Freud, Van de Valde, Wilhelm Reich, Erich
sexual behavior patterns) at the same time, Fromm, Alfred Kinsey and Masters &
may start to induce blended orgasms in a
Johnson, female sexual pleasure, mastur-
minority of women after certain numbers
bation, and female orgasm were started to
of trials, by means of triggering more than
be accepted as normal and healthy physio-
one orgasm reflex pathways. The vibra-
tion frequency of effective vibes (vibrator logical entities. However, ancient cultures
dildos) differs from spot to spot (60-200 had investigated the limits and possibili-
Hz); also, vibe frequency may be variable ties of female pleasure and orgasm in the
in different women. For coitus, a male Far East (Chang 1977, 1983; Wu, 1996;
partner should be maintaining intercourse Schwartz, 1999; Chia 2002, 2005; Mamford,
for more than 30 minutes. For oral sex, a 2005; Michaels 2008; Sayin, 2012a); Tan-
continuous stimulation more than 20-30 trists and some Taoists had developed
minutes should be maintained. In Four
some unique and specific techniques to
Spot Method, male partner uses his left
enhance female pleasure and orgasm cen-
hand’s second and third fingers to stimu-
turies ago. Although defined in medical
late the G-Spot upward, fourth finger of
the left hand is used to stimulate anus. literature recently, those cultures were
The head is in between the legs of the aware of the ESR phenomenon; which
woman to perform cunnilingus, which means that we are re-discovering the ESR
should be continued for at least 30 to 40 in the West in this century! Even recently,
minutes, with up and down (sometimes the debate about the existence of G-Spot
left and right) continuous movements of has lasted for 30-40 years, while today
the tongue (1-3 Hz). The right hand there are still some physicians and re-
should be stimulating the left nipple of
searchers who do not believe that G-Spot
the women (Sayin, 2012a). Thus anus, G-
exists in some women. In this very con-
Spot, glans clitoris, nipples are stimulated
servative world, it is very difficult to es-
at the same time until she reaches a series
of orgasms, which may last for more than tablish some novel facts, even though they
2-15 minutes. In between these stimula- are reported by many researchers and sci-
tions, rotating probe and vibrating vibes entists; however, the only way to be aware
can be used to stimulate the DVZ. of those facts is to investigate and to con-
tinue doing research!
Why Should We Do Research on Some authors state that the re-

discovery and research of female orgasm
ESR Phenomenon?
is a revolutionary process in the new en-
lightenment age and is a litmus paper for
Only 130-140 years ago, a woman’s
being civilized (Tannahill, 1992;
questioning and mentioning about female
Muchembled, 2008). Investigating the ex- As a mathematical model, let’s as-

tents and limits of female climax, sexual sume that the amount of erogenous infor-
peak experiences and “orgasmic conscious- mation input to trigger an orgasm in the
ness” is not for only the benefit of the brain is 106 bytes (Figure 11). In either clit-
women, but particularly for the men, also! oral, vaginal or blended orgasms, the ero-
Discovery of the mechanisms of the nor- genous input information into the brain is
mal sexual physiology, as well as the ex- shared by many components, e.g. brain’s
tents and limits of it, can be utilized for a perception, input from glans clitoris, love
better sexual life and happiness of women making, other erogenous zones, psycho-
and men in the 21st Century; while, many logical sexual molds, fantasies, sexual
sexual disorders can be treated in a better pleasure objects etc. If the erogenous input
context. ESR is a learned phenomenon and information overflows a certain amount of
many women and men can learn how to input, e.g. exceeds 106 bytes of infor-
attain it by training and education. mation, that is needed to trigger an or-
gasmic reflex arch at one of the orgasm
Four Nerve and Six Pathway centers of the spinal cord or the brain, then
the brain gives the order to trigger an or-
Theory of Female Orgasm:
gasm. In this model the sensory and psy-
A Unified Theory? chological input serve as positive infor-
mation in favor of orgasm, while psycho-
Glans clitoris is an orgasm triggering logical inhibitions, learned psychological
locus for many women (Masters & John- taboos, obstacles and clogs, may play an
son, 1966; Kaplan, 1981). However, it is not anti-orgasmic role against orgasm, attenu-
easy to talk the same way about the other ating the effects of the sensory erogenous
erogenous zones for the majority of wom- input information in the dynamics of inner
en. Fifty to sixty percent of women in psychology and subconsciousness; name-
many cultures are not aware of their G- ly, the brain can learn orgasming, as well
Spots, and nearly two third of the female as un-orgasming, or psychologically clog-
population cannot experience vaginal or- ging pleasure or orgasms, which may lead
gasms (Hite, 1976; Wolfe, 1982; Sayin, to sexual function disorders, such as anor-
2010, 2011b, 2012a); the awareness of other gasmia, hyposexuality and vaginismus.
recently proposed DVZs is much less.
DVZs, in average women may contribute
to the building up of an orgasm by means A schematic model is described in the
of supplying additional and supplemen- drawings of Figure-11, to symbolize this
tary erogenous information input into the complementary sharing. All the process is
brain, however, the sensory input from the “a learned reflexive behavior”. In clitoral or-
DVZs in ESR women, is much more and gasms, glans clitoris plays the major role,
enhanced, even to trigger an orgasm from while the stimulation of the clitoris may or
each DVZ, e.g. triggering an orgasm from may not be sufficient to trigger an orgasm
the stimulation of G-Spot, A-Spot, Cervix, which is learned during the growth of the
PFM etc. alone, while they may only serve women by trial and error, since glans clito-
as a complimentary erogenous zone in the ris is outside the body and reachable.
development of an orgasm in the rest of Sometimes stimulation of glans clitoris is
the women. not sufficient and other erogenous sensory
input information may be needed, which

can be supplied by other components of (e.g. fantasies, variations, novelties etc.). In

four nerve and six pathway system (e.g. ESR women, the learned orgasmic reflex
additional oxytocin release, by means of pathways are enhanced and increased; e.g.
sucking or stimulating the nipples) or fan- ESR women can attain orgasms by means
tasies and particular erotic thoughts. of the stimulation of glans clitoris, coitus,
sole stimulation of DVZs or by contracting
PFM (PC-Muscles) etc. So four nerve-six
In vaginal orgasms, there may be more pathway theory is more likely to explain
components to trigger an orgasm, such as, ESR phenomenon. In ESR women the fol-
DVZ areas or other psychological input lowing pathways may induce orgasms
from the brain itself. In average women separately, while they may only play as a
(NESR-women), such extra informational contributing and complementary role in
input can be supplied from many other NESR women to build up an orgasm. Do-
pathways cited in this article, particularly paminergic, oxytocinergic, serotoninergic,
orgasmic four nerve-six pathway system. glutamatergic, endogenous opioid systems
In ESR women, all the components in four also play an auxiliary role in the develop-
nerve-six pathway system is enhanced and ment of orgasms through these pathways:
carry more sensory sexual information
1-Glans clitoris-Pudental nerve-sacral
input, and probably the number of sexual
components are increased too, which is plexus
observed in our surveys such as that the 2-Coitus-DVZs-Pelvic nerve-sacral plex-
fantasy, masturbation, sexual image, libido us
patterns are enhanced and expanded in 3-Coitus-DVZs-cervix-Hypogastric
ESR women. Thus, ESR women have nerve-pelvic plexus
learned more orgasm inducing pathways
to be sufficient to trigger an orgasm alone 4-Coitus-DVZs-uterus-cervix-Vagus
(e.g. to become orgasmic through the acti- nerve-brain
vation of each pathway alone). Hence, ESR 5-Nipples-intercostal nerves (particu-
orgasms are enhanced and prolonged, larly T-4) -pituitary-oxytocin pathway
since they carry more sexual erogenous (oxytocin as a hormone)
information input from more than one 6-Brain-fantasies-sexual images-sexual
orgasm inducing pathway into “a more psychology-frontal, somatosensory,
sexually excitable brain and psychological sys- prefrontal cortices-limbic system- hy-
tem”. However, in NESR women only one pothalamus-pituitary-oxytocin pathway
systematic orgasmic pathway works, and (oxytocin as a neurotransmitter).
that is, most of the time, the clitoral or-
gasm pathway through pudental nerve, the “Four nerve and six pathway theory of
other orgasm inducing pathways in NESR female orgasm” seems to explain some of
women only function as complementary, the characteristics of ESR. ESR is a novel
and supply additional sensual information phenomenon to be investigated by neuro-
to facilitate the building up of an orgasm science in 21st Century, since many women
through one pathway, e.g. clitoral-pudental- can have a better quality of sex life, pleas-
sacral plexus orgasm pathway. The brain ure and orgasms, after certain training, if
and the body of ESR women function in a the basic mechanisms of ESR are discov-
more sophisticated and evolved fashion, ered. More detailed research should be
while many novel components to the four carried for the investigation of ESR, EO
nerve-six pathway system may be added and female orgasm, as well as the neuro-

physiology and neuroanatomy of female

sexual response to grant a more healthy
and pleasurable life to both women and
men.
Figure 11. Hypothetical Informatics Model for the Formation of Clitoral and Vaginal Orgasms in Four Nerve and Six
Pathway Theory. The psychological sexual sensory input that leads up to the development of an orgasm reflex is shared by many
components, while psychological inhibitions, taboos play an inhibiting role of the orgasmic input, as anti-orgasmic. All the process
is a learned reflexive behavior. A schematic model is described in the drawings, to symbolize this complementary sharing. The
sensory input information is carried by action potentials from the receptors of genital organs, body and the brain itself as erotic
and orgasm inducing/triggering sensations, such as pleasure, pressure, heat, vibration, touch, pain and erotic thoughts etc. being
transformed into sensual information (e.g. information in bytes at pleasure centers, limbic system and the neocortex).
A) In clitoral orgasms, glans clitoris plays the major role, while the stimulation of clitoris may or may not be sufficient to trigger an
orgasm. Other erogenous sensory input information may be needed, which can be supplied by other components of four nerve and
six pathway system (e.g. additional oxytocin release

B) In vaginal orgasms, there may be more components to trigger an orgasm, such as, DVZ areas or other psychological input from
the brain itself. In average women (NESR-women), such extra information input can be supplied from many other pathways cited in
this article, particularly orgasmic four nerve-six pathway system. In ESR women, all the components in four nerve-six pathway
system are enhanced and carry more sensory sexual information input, and probably the number of sexual components are in-
creased too; and ESR women have learned more orgasm inducing pathways to be sufficient to trigger an orgasm alone, e.g. to
become orgasmic through the activation of solely each pathway. Hence, ESR orgasms are enhanced and prolonged, since they carry
more sexual erogenous input information from more than one orgasm inducing pathway, while in NESR women only one system-
atic orgasmic pathway works, and that is the clitoral orgasm pathway through pudental nerve, the other orgasm inducing pathways
in NESR women only function as complementary, and supply additional information to facilitate the building of an orgasm through
one pathway, e.g. clitoral-pudental-sacral plexus orgasm pathway. Note that the constituents given by geometrical shapes at the
left side of the two figures are only for schematic purposes, there are of course more components, not only the ones that are
shown.

pirical analysis. J Sex & Marital Ther 1989;

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SAYIN FemaleOrgasmicConsciousness Spring 2017 V02 No 04

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SAYIN-Female Orgasmic Consciousness-Spring-2017-V02-No-04

Article · June 2017

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Spring-2017 Issue: 04; June 30th, 2017

Sexual Physiology ● Sexual Health ● ESR

Female Orgasmic Consciousness:

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 117

liam Hartman and Marilyn Fithian was  Neurohormonal reaction of smooth

seems to be different patterns contrib- books and articles (Rhodes, 1991;

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 121

Singer gives another typology of fe- a separate “vaginal orgasm”:

type of orgasms in the literature 5) Our preliminary studies by means

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 123

stimulation of DVZs, may exist! stimulation unit) may induce simi-

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 124

currence frequency of the awareness of

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 126

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 128

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 129

Enlarged Version of Figure-5

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 130

If a single “orgasm reflex pathway”, cral plexus (+ partially Pelvic plexus)

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 131

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 132

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 133

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 134

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 135

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 136

Why Should We Do Research on Some authors state that the re-

Muchembled, 2008). Investigating the ex- As a mathematical model, let’s as-

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 139

can be supplied by other components of (e.g. fantasies, variations, novelties etc.). In

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 140

physiology and neuroanatomy of female

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 141

A Multidisciplinary Journal Published Quarterly by CİSEATED-ASEHERT ● www.ciseated.org ● www.sexusjournal.com ● 142

pirical analysis. J Sex & Marital Ther 1989;

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