Freudian BS in a Legit, Peer-Reviewed Journal: A Journal Article I Read

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Welcome back to 'A Journal Article I Read,' a series where I summarize a lady-gasm related journal article in a way that is hopefully both comprehensive and also not too long. You can find a list of all the journal articles in this series HERE.

Here is what I'll be summarizing today.

A woman's history of vaginal orgasm is discernible from her walk.
Nicholas A1, Brody S, de Sutter P, de Carufel F.
J Sex Med. 2008 Sep;5(9):2119-24.

The BS intent of this article - a background from me
This is a unique summary for me because I have a lot to say about not only this article, but also about the author of this article and the background of why this article exists. Spoiler alert: I'm pretty darn disappointed with the amount of bias, the direct link to Freudian BS, the incorrect assumptions about scientific understanding of vaginal orgasm, and the experimental design. 

Let me begin with the quickest summary of my discontent that I can conjure up.
 Freud thought the vaginal orgasm was the only mature way for a woman to orgasm and that ability to orgasm from clitoral stimulation only was a sign of immaturity. He just made that shit up. Like if I just decided to say that for men, orgasm from penile stimulation was infantile, and to gain full maturity a man must be able to orgasm from anal intercourse...and people believed me and acted like it made sense.

Anyway, it was not backed up by reality or scientific investigation and it still isn't. In fact, there actually is still not any physical evidence at all in scientific literature that women can orgasm through vaginal stimulation alone. This is after decades of research into female orgasm - which does btw clearly back up the knowledge that women can and do orgasm from outer clitoral/vulva stimulation just as men do from penile stimulation. Clitorally stimulated orgasms have been observed and physically verified numerous times. Just like penile orgasms, it is fairly clear in scientific literature how they can happen, what happens in the body when they do, and to some extent who can have them...i.e. any intact healthy body is capable of a penile or clitorally (really anything around that tissue even if it's somewhere in between a clit and a penis) stimulated orgasm. Female orgasm is not mysterious or confusing, but vaginal orgasm is because as much as it's discussed, researched, and advised about, scientists have not yet found physical evidence that orgasms can happen though stimulation inside the vagina without additional external genital stimulation.

So, to be real clear, when a person (and believe you me a shit ton of these people are scientists in peer reviewed journals*) speaks about the vaginal orgasm, about what women and/or their bodies are like who have them, about their health benefits, about what they look like in the brain, these people are, if you will, talking out of their ass. If they make no mention that orgasms caused by stimulation inside the vagina, with no additional outer vulva/clitoral stimulation, have never been physically verified, then they are not speaking, and may not even understand, the whole story. We don't actually know if these orgasms can happen. We don't know what is actually happening in the body when the women who say they have vaginal orgasms are experiencing what they call vaginal orgasms. So please tell me how we can make distinctions between women who do and do not have them?

NO RESEARCH ARTICLE YOU'VE EVER READ OR HEARD OF THAT TELLS YOU ABOUT A DIFFERENCE IN WOMEN WHO ORGASM VAGINALLY VS. THOSE WHO CAN'T IS ACTUALLY ABLE TO BACK UP THE CLAIM BECAUSE THEY DO NOT KNOW FOR SURE THAT THE WOMEN WHO CLAIM TO ORGASM VAGINALLY ACTUALLY ARE PHYSICALLY DOING THAT. #RealTalk ya'll. Feel free to go through the existing research yourself. If you find something that proves that wrong. I would LOVE to see it.

So...what exactly pisses me off so much
Incorrectly going about a study as if vaginal orgasms (orgasms caused by stimulation inside the vag only w/ no additional outer stimulation) are a scientifically understood and verified phenomenon is sadly pretty normal for female orgasm studies in peer reviewed journals. Me critiquing that uninformed assumption in these journal summaries is par for the course, so that's not what I'm most worried about in this one. I'm worried about the Freud-was-right-vaginal-orgasms-are-the-only-mature-sexual-climax-a-woman-can-have-and-clitoral-orgasms-make-women-less-mentally-and-physically-healthy agenda this article and this author seem to have. Because I do feel like there is evidence for this kind of agenda.

A little history of clit hate
Freud made that shit up about vaginal orgasm in his whole psychoanalysis deal. Wilhelm Reich was a student of Freud. Alexander Lowen was a student of Reich. All of them had similar feelings about the supremacy of the vaginal orgasm. Reich combined elements of the body into psychoanalysis and Lowen updated Reich's philosophy. It's called bioenergetic analysis. A main tenet of which is "blocks to emotional expression and wellness are revealed and expressed in the body as chronic muscle tensions which are often subconscious. The blocks are treated by combining bioenergetically designed physical exercises, affective expressions and palpation of the muscular tensions." - from Wikipedia.

Stuart motha-fuckin' Brody
Let me also point out that this is an article by a man named Stuart Brody, who is an absolutely prolific writer of scholarly, peer reviewed research articles jocking hard on vaginal orgasms, penile-vaginal intercourse, and even barebacking. He's not the lead author in this particular one, but I see him as a constant player in Freudian BS studies, so I'm picking on him. Please see a list of some of his articles at the bottom of this post - and it's just a few. This dude really cranks these out. But seriously, just take a minute to check out the names of these articles. I think it will help orient you.

The premise of the article
Anyway, Brody was an author on a previous article that claims to show that women who orgasm vaginally use less immature defense mechanisms. Since one must find some type of measurable aspect of maturity in order to prove someone (non-vaginally orgasming women, perhaps?) immature, that study uses a series of self-report questionnaires about personality and psychological defense mechanisms against a questionnaire about their sex lives...and voila, proof that non-vaginally orgasming women are less mature. And do be sure, Brody cites that study several times to back up a variety of statements he makes in his article I will be summarizing below.

This, I would argue, is the first backbone intent in the article I will be summarizing below: Freud/Reich/Lowen were actually right about vaginal orgasms reflecting female maturity! The second backbone intent takes it all a bit further to prove, as Lowen's bioenergetic analysis would tell us, a mental problem (immaturity) manifests itself in us as a physical problem...often tension or 'muscle blocks.'

So, put those together, and we get why the fuck someone (Brody) would even care to study whether a woman's history of vaginal orgasm is discernible from her walk...because immature clitorally orgasming women probably have tension and muscle blocks, and they won't have that swaaang in their walk like the mature vaginal orgasmers...and this article will prove this and Freud and bioenergetics were right all along!!!!!!


What annoys me? Let me count the things.

1. So, the premise here in itself is annoying to me. Freud just made shit up. Just. made. shit. up. There's been decades since then that have shown us he was pretty off base - particularly about female orgasm. Why are people still acting like what he says is worth further scientific investigation?
2. The fact that in this study, and in every other study, Brody and his cohorts assume vaginal orgasms are a verified and scientifically understood entity and that the women in their studies who say they orgasm vaginally are actually orgasming vaginally shows ignorance of the existing scientific data and bad experimental design - and is annoying to me. 
3. That this study bases its data on how some 'experts' visually rate women's body movement instead of using technology to actually take measurements of things like women's hip rotation is lazy and possibly extremely biased - and is also annoying to me. 
4. Maybe the most annoying thing is that this shit is somehow legitimate lady-gasm science. This article's in a respected peer reviewed journal - a lot of his studies are. Brody is legit. He doesn't seem to be an outcast from the mainstream lady-gasm researchers (although he does have critics- thank you Prause and others, he's still getting his work into mainstream journals). He teams up occasionally with some of the most well known scientists in female orgasm research (Komisaruk for example) and gets included in major journal expert reviews on the topic of vaginal orgasm. This article has also been referenced a fair amount in pop culture. It was even used in a quite popular book Vagina by Naomi Wolfe to emphasize the importance of and help prove the existence of vaginal orgasms.  

More proof of Lowen/Bioenergetic asshole-ery
Before we begin the summary, I'd first like to show you I'm not completely making assumptions about how deep into the vaginal-orgasms-are-real-things-and-also-the-best-things agenda this article, this author, and Lowen/bioenergetics has. Below is a quote from a book written by Lowen (the father of Bioenergetic Analysis). This book is cited in this here article I am about to summarize. I repeat. This is not from this Brody article, but from a book that is referenced in this Brody article.

Most men feel that the need to bring a woman to climax through clitoral stimulation is a burden. If it is done before intercourse but after the man is excited and ready to penetrate, it imposes a restraint upon his natural desire for closeness and intimacy. Not only does he lose some of his excitation through this delay, but the subsequent act of coitus is deprived of its mutual quality. Clitoral stimulation during the act of intercourse may help the woman to reach a climax but it distracts the man from the perception of his genital sensation and greatly interferes with the pelvic movements upon which his own feeling of satisfaction depends. The need to bring a woman to climax through clitoral stimulation after the act of intercourse has been completed and the man has reached his climax is burdensome since it prevents him from enjoying the relaxation and peace which are the rewards of sexuality. Most men to whom I have spoken who engage in this practice resented it.    

I do not mean to condemn the practice of clitoral stimulation if a woman finds that this is the way she can obtain a sexual release. Above all she should not feel guilty about using this procedure. However, I advice my patients against this practice since it focuses feelings on the clitoris and prevents the vaginal response. It is not a fully satisfactory experience and cannot be considered the equivalent of a vaginal orgasm.  

-Lowen, A. Love and Orgasm: A Revolutionary Guide to Sexual Fulfillment. New York, Collier Books, 1975. pp.216-217.

THE ARTICLE SUMMARY
So, that's the point from which I'm starting this summary, but I'd like to let you see for yourself. I will summarize below as straightforward as I can - just as I always try to do, and I will only add in my thoughts or opinions in the me brackets "[Me:]" So, please enjoy,

Summary quick-style
This article is actually quite simple. 16 women take a survey with a question about how often they reach vaginal orgasm. 8 said they vaginally orgasm always or usually and another 8 say they vaginally orgasm rarely or never. The ladies then meet the researchers outside and walk for 100 meters while thinking of something nice, and another 100 meters while thinking of a man they are interested in romantically. They are taped from a distance doing this, and then 4 people, "two appropriately trained (in Functional-Sexological therapy) professors of sexology...and two female research assistants" watch the tapes and come to a consensus on whether or not each woman has had vaginal orgasms or not. "The basis for judgment was a global impression of the woman's free, fluid, energetic, sensual manner of walking (with an emphasis on energy flow through the rotation of the pelvis and the spine)."

The raters made a correct assessment for 6 of the 7 women who claimed vaginal orgasm and 7 of the 9 women who claimed not to have vaginal orgasms.

Introduction
I'm going to go over some main points the authors put forth in the introduction with a quick discussion of the studies they cited to support their statements;

This article begins with, "A growing corpus of empirical research has clarified that orgasm triggered by stimulation of the vagina and cervix differs physiologically from climax induced by clitoral stimulation." This is backed up by citations for 2 Komisaruk studies about women with spinal cord injuries having 'cervical orgasms' that are facilitated by the vagus and not the pudendal nerve and also by Brody's own studies about vaginal orgasms being associated with less use of immature psychological defense mechanisms and about there being more prolactin hormone releases after p-in-v intercourse vs. after masturbation.
[Me: Not one of these studies actually verifies that the women who claim vaginal orgasm are having an orgasm, so they're, let's say, not all that convincing. Also, the 'cervical orgasms' in the Komisaruk studies are not only never physically verified as orgasms, but furthermore they are strangely 'achieved' by a method of cervical stimulation that is not something one could do at home or even with a penis during intercourse. These Komisaruk studies referenced here are cited in pretty much any study talking about vaginal orgasms, but are rarely cited, in my opinion, in a way that could actually back up what the authors presume to back up. I detail the main Komisaruk study HERE].

"At a more speculative, theoretical level, the idea that chronic muscle blocks (or excessive muscle flaccidity) impair sexual function by impairing feeling, sexual motility (and perhaps being a tangible representation of corresponding  psychological blocks), and the discharge of sexual tension has it's roots in a theory developed by Reich [11]. His student Lowen [12,13] developed that theory (and safely distanced it from one of Reich's less well reasoned theories later in his life) and the corresponding psychotherapeutic approach of  bioenergetics, which sought to integrate psychoanalytic psychotherapy approaches with direct liberation of chronic muscle blocks. Other body therapies focus more exclusively on the muscle blocks alone. These body therapies and the underlying theory have rarely been subject to empirical evaluation."
[Me: The citations [11-13] are Reich and Lowen's philosophical work including the book by Lowen that I quoted above.].

"However, one study of men found that the Rolfing method of tissue manipulation led to both a decrease in standing pelvic tilt angle and an increase in cardiac vagus nerve tone associated with improved parasympathetic function [14]." [Me: Maybe check out the Wikipedia on Rolfing HERE] There is then a quick discussion of a few more studies, including one that these authors admit does not have clear controls, that relate physical therapy to improved sexuality. The articles cited in this section are pictured below.

"Observation of the characteristics of a person's walk can convey diagnostic information beyond the obvious musculoskeletal an neurological disorders" It goes on to point towards a few studies (pictures below) that illustrate the point.

The Introduction ends with: "The primary hypothesis in the present study is that clinical sexologists appropriately trained in the relationship between personality, sexology, and body movement will be able to differentiate between women with and without a history of vaginal orgasm purely on the basis of observing the women walking. As an exploratory measure, there is also an examination of the association of vaginal orgasm history with specified components of the walk (described below)."

[Me: The introduction of a scientific article, in my opinion, is meant for a few things. It orients the reader to the history of research on the subject thus far. It also sorta justifies why this the experiment being undertaken is a worthwhile experiment and what the outcome of this experiment might mean to the science of this subject. So in many ways, the introduction is an incredibly important thing to read because it gives you a look into the authors' mind. It exposes biases that aren't usually discussed as biases.]

[Me cont: So, to put this in perspective, let me piece together what the authors of this article are trying to do here. They are linking together 1. the Freudian/Reich/Lowen assumption that vaginal orgasm are better for women in the mind, body, and soul. 2. The idea in bioenergetics that psychological/emotional problems manifest themselves in the body, i.e. 'chronic muscle blocks' and 'excessive muscle flaccidity'  and 3. that if a woman were to have these psychological/emotional problems manifest in their body, one might be able to see it in her movement. So, in essence, the authors are going from the hypothesis that vaginally orgasming women are mentally/emotionally/physically  healthier people who will express that health in their energetic movement. Women who do not orgasm vaginally are less mentally/emotionally/physically who will express that unhealthiness in their bad, unenergetic movement.]


Materials and Methods

• Female psychology students in Belgium were asked (by a female researcher) to answer a preliminary questionnaire on sexual behavior.
• Of the women who did the questionnaire and who indicated their willingness to be contacted further, 10 were chosen who responded that they 'always"'or 'often' had vaginal orgasms (vaginally orgasmic) and 10 were chosen who responded that they 'rarely' or 'never' had vaginal orgasms (vaginally anorgasmic). Vaginal orgasms being defined as "triggered solely by penile-vaginal penetration." [Me: Are women who 'rarely' have vaginal orgasms the same as women who 'never' have them? I mean, I'm obviously skeptical of all these answers, given that their ability to have vaginal orgasms is not physically verified (and vaginal orgasms themselves have never been physically verified), but even if one believed these women's answers to be completely true, wouldn't one wonder if they were grouped incorrectly? Maybe women who 'rarely' have them are physically capable of vaginal orgasm and the 'nevers' are not. So grouping them together would confuse the results. The authors don't discuss this as a possible problem. Experimental design, people.]
• The women also reported their ability to have clitorally stimulated orgasms on the questionnaire
• After anonymity and confidentiality were assured, the women were given a complete description of the study although participants "were blind to the experimental hypothesis." Written informed consent was obtained, and they were scheduled individually to meet the researchers in a public place
• 4 participants (3 vaginally orgasmic and 1 vaginally anorgasmic) did not show up, making 16 total participants.
• Participants were asked to walk 100 meters while "thinking pleasant thoughts of being on a vacation beach" and then another 100 meters while "being in the same local but with in the company of a man for whom they had thoughts of love."
• These walks were filmed at a distance and the videotapes were then rated by "two appropriately trained (in Functional-Sexological therapy) professors of sexology...and two female research assistants." 
• "The raters conferred and agreed on a vaginal orgasm status for each woman."  [Me: Why did they confer? Why not let them all rate separately and see if they match each other and match the women's self reports? Did they try it that way first but found it made the results messy as hell, so they had them confer and luckily got better, more positive results? It makes me wonder.]
• "The basis for judgment was a global impression of the woman's free, fluid, energetic, sensual manner of walking (with an emphasis on energy flow through the rotation of the pelvis and the spine)."
• The researchers all also rated each woman's walk (from 0-10) for the extent of their: hip adduction, hip rotation, stride length, arm movement, and fluidity of movement. [Me: this was made in 2008. It was very possible at that time to use video of women walking to not just visually rate these things, but to do actual objective measurements of things like stride length and arm movement. Since the authors are trying to create evidence that the psychological problems from not orgasming vaginally can literally manifest physically as muscle tension and 'blocks' that make the women walk less 'fluidly,' you would think it useful to show that there are real objectively measured limitations in these non-vaginally orgasming women's movement. Yet, all the ratings on the movements are just, like, the rater's opinions, man. I mean, I'd at least like to see the authors acknowledge their choice and give a quick explanation for why they chose to have only subjective ratings of these women's movements. And, in case you are wondering if 2008 was too early for people to be thinking about the technology to do objective measuring from video and the pros and cons of rating movement that way, you're wrong. Here's a 2007 textbook dedicated to analyzing human movement patterns in relation to sports biomechanics.]
• "An additional derived variable reflecting the movement of the leg through the back (sum of ratings of stride length and vertebral rotation) was calculated."
• The correlation between women's reported experience of vaginal orgasm and the researchers' guesses of vaginal orgasm was examined using "chi-square and Fisher's exact tests (a similar analysis was performed for clitoral orgasm history)" 
• The associations between the researchers ratings of the individual components of a woman's walk and her history of vaginal orgasm were examined.

Results

• "The hypothesis was supported, because the trained sexologists were able to infer vaginal orgasm history on the basis of watching the women's walk."
• "Reported clitoral orgasm ability was unrelated to both rated vaginal orgasm ability and to reported vaginal ability."
• The only statistically significant correlation found between history of vaginal orgasm and any of the ratings of individual components of the women's walks were from the data points made from the sum of stride length and vertebral rotation. [Me: it seems a little fishy to me that this combination was the only element of the researchers' individual movement ratings to show correlation with the women's reported vag-gasm history. What actual meaning does that combo number have in the end? Clearly none of the straight-forward movement ratings such as stride length or hip rotation correlated, and it makes me wonder if that lack of correlation led them to start combining the ratings in every possible way until they found one that happened to have a statistical correlation with the vaginal orgasm self-reports. They call it exploratory, so I imagine this is close to the case. that kind of thing is probably not an uncommon practice and not really unethical or wrong, but it sure seems like it's sort of a disingenuous way to make a study show more positive results. To their credit I will say that when they spoke of this correlation in the Discussion section. They said "However, the exploratory nature of the secondary finding implies that less emphasis be placed upon it pending appropriate replication."  So, I think even the researchers don't place much meaning on this combo rating of stride length and vertebral rotation.]
• "Age was unrelated to the sexual variables."

Discussion

• "Appropriately trained sexologists were able to infer vaginal orgasm history on the basis of watching women walk. The sexologists made global inferences about the women's vaginal orgasm history based on the extent to which the women had a fluid, sensual, energetic, free gait. The ratings were unrelated to the women's reports of clitoral orgasm with a partner, and clitoral orgasm was unrelated to vaginal orgasm."
• 6 women who claimed to be vaginal orgasmers were rated correctly, and 1 was rated incorrectly.
• 7 women who claimed not to be vaginal orgasmers were rated correctly and 2 were rated incorrectly.

• "Although the couple of incorrect diagnoses could simply be that, it is also possible that in the case of the two false positives, it might be that the women have the capacity for vaginal orgasm, but have not yet had sufficient experience or met a man of sufficient quality to induce vaginal orgasm." [Me: I'm assuming the 2 women who were rated incorrectly as vaginally orgasming are not ones who marked themselves as 'rarely' vaginally orgasming (since clearly they DO have a capacity for it), because if that were the case, I feel REAL confident the authors would have been real quick to tell us that and make their results look even better.]
• The study goes on to say that these women who were pinned by the researchers as vaginal orgasmers but were not, may not have a man with a '"penis of sufficient length to produce cervical buffeting" or that isn't able to keep his erection (either because of erectile dysfunction of premature ejaculation) long enough. They also note the there are studies saying women are most likely to have vaginal orgasms with men who have signs of greater fitness - like attractiveness. [Me: Can I just quickly mention that 'buffeting' can be defined as 'to strike against forcefully and especially repeatedly; batter.' So cervical buffeting with a big ol' dick sounds to me not like a good way to bring about lady-gasms as these researchers seem to say it is, but like a terribly painful sexual encounter akin to a really long and brutal gynecological exam. This banging the cervix for orgasm thing seems kinda out of touch with reality to me, and it's also not backed up in scientific literature, and contrary to what this article would have one believe, it's certainly not backed by the Komisaruk article they cite here. They cite the same Komisaruk article they cite and I discuss in the Introduction that finds women with spinal cord injuries can orgasm from cervical stimulation, but the conclusion is a stretch of the evidence at best (I detail it here). And seriously, this study does not include buffeting the cervix. It actually uses a make-shift thing that does not actually touch the cervix but creates a suctiony stimulation at the cervix, so even if this study did find that orgasms were created from this stimulation (which it doesn't in any verified physical way), it would not be something that could be replicated by ramming a big dick into a woman's cervix. This is the only study I know of (and there are no others referenced) that can support the idea of women needing cervical stimulation or  'buffeting' to orgasm... and it's not a great one.]
• They point out that "as in any correlational study, a universe of possible unmeasured forces could play a role in the observed findings." They mention that maybe some anatomical features could predispose women to less readiness for vaginal orgasm, and specifically use a recent study correlating more distance between the vagina and urethra to women who claim vaginal orgasm [Me: you can see more on that study HERE. Surprise surprise, there are no actual vaginal orgasms verified in this research, so one should be skeptical of its conclusions] "such characteristics might conceivably influence both vaginal orgasm and pelvic movement directly, whether they are a true precursor of vagina orgasm, or develop as a consequence of developing vaginal orgasm." 
• They also mention that it might be that women who orgasm vaginally might feel more confident or comfortable or have a better relationship and it shows in their walk. [Me: Ooooorrrrrr...maybe being vaginally orgasmic is a thing women covet because of how much women in movies and porn and books are able to do so, and how much it seems that men like it (remember: stimulating the clit is pretty inconvenient and men resent doing it according to Lowen up there), so after saying they can do that on a survey, those women feel all good about themselves, but the women who just had to admit that they are lame and can't orgasm vaginally on a survey feel, well, lame. Ooooooorrrrr...there were only 16 women in the study, and the raters only got about 82% right, so it might be the luck of the draw and their walks are not really different between groups at all.]
• They point out this was a small convenience sample of volunteers so that may "limit the generalizability of these results to older women and to the wider community"
• "The present finding of vaginal orgasm being associated with a more fluid, sensual, energetic, free, unblocked gait adds to the empirical research findings of penis-vaginal orgasm history being specifically associated with the indices of women's better psychological and interpersonal function." 
• They mention that a recent study [their own previous study] associated women who could orgasm vaginally with having less use of immature psychological defense mechanisms - and say that "Two of the specific immature defense mechanisms (somatization and dissociation) that differentiated vaginally orgasmic and vaginally anorgasmic women might be related to aspects of the present finding. Dissociation involves disconnection of the usually integrated psychological (including sensory-motor) functions of the self, and somatizations involves converting psychological problems into physical complaints and impairments." 

Conclusion
The authors say that even with the small sample, the results are consistent with both theory [Me: made-up Freudian and neo-freudian theory?] and previous empirical findings about vaginally orgasming women having better psychological function. [Me: Let it be known the 'previous empirical findings' they cited were all Brody's own previous studies - 4 of them were cited]
They also say the present findings provide some potential support for "theoretical assumptions of a link between muscle blocks and impairment of sexual and character function" [Me: this is cited with 3 works by the neo-Freudians Lowen and Reich - including the book by Lowen that I quote above.]
The authors also say the findings are "consistent with the possible utility of incorporating training in movement, breathing and muscle patterns into the treatment of sexual dysfunctions"

Appendix
*I want to give Dr. Nicole Prause a shout out for being a scientist in the lady-gasm field who speaks out in direct ways against those non-sense assumptions about vaginal orgasm. I talk more about here HERE.]

More Articles By Stuart Brody!
Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis. Brody S1, Weiss P.
J Sex Med. 2010 Aug;7(8):2774-81.

Slimmer women's waist is associated with better erectile function in men independent of age. Brody S1, Weiss P. Arch Sex Behav. 2013 Oct;42(7):1191-8.

Women's partnered orgasm consistency is associated with greater duration of penile-vaginal intercourse but not of foreplay. Weiss P1, Brody S. J Sex Med. 2009 Jan;6(1):135-41.

Simultaneous penile-vaginal intercourse orgasm is associated with satisfaction (sexual, life, partnership, and mental health). Brody S1, Weiss P. J Sex Med. 2011 Mar;8(3):734-41.

Condom use for penile-vaginal intercourse is associated with immature psychological defense mechanisms. Costa RM1, Brody S. J Sex Med. 2008 Nov;5(11):2522-32.

Immature defense mechanisms are associated with lesser vaginal orgasm consistency and greater alcohol consumption before sex. J Sex Med. 2010 Feb;7(2 Pt 1):775-86.

Vaginal orgasm is more prevalent among women with a prominent tubercle of the upper lip. Brody S1, Costa RM. J Sex Med. 2011 Oct;8(10):2793-9.

Greater tactile sensitivity and less use of immature psychological defense mechanisms predict women's penile-vaginal intercourse orgasm. Brody S1, Houde S, Hess U. J Sex Med. 2010 Sep;7(9):3057-65.

Vaginal orgasm is associated with less use of immature psychological defense mechanisms.Brody S1, Costa RM. J Sex Med. 2008 May;5(5):1167-76.