Friday January 20 2012
The G-spot is a source of mystery for some and a source of joy for others
“The elusive female G-spot may not actually exist,” The Daily Telegraph has today reported. The news, which was also covered by the Daily Mail, has generated a flurry of rather graphic reader comments, including debates on where exactly the erogenous zone might be (some readers have even suggested using satnav).
The news is based on a review of previous research intended to help determine whether women truly do have a ‘G-spot’ that can help them to orgasm when stimulated. Most women asked during previous studies said they believed it existed, and that they thought it was a highly sensitive area around halfway up the front side of the vaginal wall.
Interestingly, anatomical studies and lab analyses of tissue samples were inconsistent, with some suggesting this area had a separate nerve supply to the clitoris and vagina. Others concluded that there was no evidence of a distinct structure in the area that causes a vaginal orgasm when directly stimulated.
Although the study found no clear evidence that the G-spot exists, it has generated lots of debate across the internet, with many vehemently disagreeing with the finding. These opposing views raise the interesting point that just because you cannot find something, it doesn’t mean it’s not there. However, the dedicated lead researcher seems open to the G-spot’s existence and said the principle ‘was worth further investigation’.
Where did the story come from?
The study was carried out by researchers from Rambam Healthcare Campus, Haifa, Israel, and Yale-New Haven Hospital in the US. No sources of external funding were reported. The study was published in the peer-reviewed Journal of Sexual Medicine.
News coverage reflected the findings of this narrative review.
What kind of research was this?
This was a narrative review that searched the PubMed database for any medical literature about the G-spot in order to understand whether it is a distinct, identifiable part of a woman’s anatomy. The theory that women have an area of high sensitivity in the front wall of the vagina was first described by German gynaecologist Ernst Gräfenberg in 1950, though historic tests have speculated on the issue since the 11th century.
Although its existence has not been proven, Gräfenberg described its location as being close to the bladder and urethra, about halfway between the pelvic bone and the cervix.
A systematic review is the best way of indentifying all published articles relevant to a particular topic. This review did carry out a systematic search but did not appear to apply any strict criteria for deciding which studies were suitable for inclusion. Clear, predefined inclusion criteria are usually part of a good systematic review of evidence.
The difficulty with reviewing a topic such as the existence of the G-spot is that much of the literature is likely to be anecdotal and opinion-based, which prevents firm conclusions from being made. However, researching the topic in other ways could also prove problematic. For example, it is not possible to assess a biological question such as this in a clinical trial.
To truly settle the question would probably require biological evidence to show whether or not there is an area in the front wall of the vagina that has a different anatomical structure and nerve network that could result in heightened sensation.
This review’s literature search was limited to one medical database, so there is the possibility that relevant articles may have been missed.
What did the research involve?
A search of the PubMed database was carried for articles published 1950-2011 using the terms:
- Gräfenberg spot
- vaginal innervation
- female orgasm
- female erogenous zone
- female ejaculation
The search included clinical trials, meeting abstracts, case reports and review articles that were written in English and published in a peer-reviewed journal. Studies were included if they were deemed to be 'appropriate', but this was not defined further. After excluding non-English articles and those that did not focus on female sexuality, they reviewed 96 studies in total, almost half of which were identified using the search term ‘female orgasm’. Of these, studies were included if they were deemed to be 'appropriate', but this was not defined further.
They included 55 of these studies in their review: 29 surveys and observational studies, eight radiographic analyses, seven pathological analyses (lab studies of tissue samples), five biochemical analyses and six previous narrative reviews. From their retrieved articles, the researchers authored a narrative discussion on the findings.
What were the basic results?
Overall, the surveys included in the review found that a majority of women believe a G-spot actually exists, although not all of the women who believed in it were able to locate it. One questionnaire on sexuality was mailed to a random sample of 2,350 women (response rate of 55%), and the majority of respondents (84%) ‘believed that a highly sensitive area exists in the vagina’.
The review also included results from studies in paid volunteers who self-applied manual stimulation to both vaginal walls. All participants reported erotic sensitivity located on either the back (87%) or front (74%) vaginal wall. Similar rates would not be expected if the G-spot lies on the front wall. Of those reporting sensitivity, 89% had an orgasmic response to stimulation of these zones.
Biological analyses have identified anatomical structures called Skene’s glands in the area where the G-spot is thought to lie. These glands are known to secrete various amounts of fluid during sexual stimulation and, according to some reports, lead to ’ejaculation’ during orgasm. Other studies have shown that the behaviour of these glands may be comparable to the prostate of prepubescent males, and that the fluid released may have similar biochemical make-up to prostate fluid. Surveys of women have found that the majority of those that report having a G-spot also report having some sort of fluid ejaculation in response to orgasm.
Another possible explanation for the heightened sensitivity of the anterior vaginal wall may be its proximity to the tissue around the urethra, and the clitoris in particular (that is, mechanical pressure on the anterior vaginal wall could actually be indirectly stimulating clitoral structures). However, other MRI imaging has suggested that the networks of sensory nerves connected to the clitoris, vagina and cervix – although overlapping – are, in fact, separate.
Some laboratory assessments of tissue samples have also demonstrated that the anterior vaginal wall is more densely packed with nerves compared with the posterior wall. However, other radiological and laboratory studies have given conflicting results, and it has not been possible to find evidence of a distinct structure, other than the clitoris, that can produce a vaginal orgasm when directly stimulated.
Finally, the researchers discuss the media and its impact on sexuality, describing the conflict between the scientific challenge of verifying the existence of G-spot and the 'socially driven desire' for it to exist.
How did the researchers interpret the results?
The researchers conclude that, ‘objective measures have failed to provide strong and consistent evidence for the existence of an anatomical site that could be related to the famed G-spot’. However, surveys and anecdotal testimonials suggest that many women believe in the existence of a highly sensitive area in the front vaginal wall.
This narrative review searched for medical literature that might verify whether the G-spot actually exists. Overall, it found that results have been conflicting: in surveys many women believe in the existence of a highly sensitive area of the vaginal wall, which related to the experience of orgasm and fluid ejaculation in some.
Other radiological studies and lab analyses of tissue samples have demonstrated separate nerve supply to the clitoris and vagina, with some suggesting a dense network of nerves within the front vaginal wall where the G-spot is meant to be situated. However, other studies conclude that it is not possible to find evidence of a distinct structure, other than the clitoris, whose direct stimulation leads to vaginal orgasm.
With a topic such as this, where much of the published literature will be anecdotal and self-reported, it is difficult to draw firm conclusions. This particular review was also limited because it searched only one medical database, and there is the possibility that other relevant literature is out there for consideration. It is not possible to assess a biological question such as this in a clinical trial, although it is likely to need firm biological evidence to confirm the existence and nature of the G-spot.
For now, the existence of the G-spot still seems to be the subject of much debate.