According to Encyclopedia Britannica™, the orgasm is a physiological state of heightened sexual excitement and gratification that is followed by relaxation of sexual tensions and the body’s muscles. In the female, orgasm is marked by a feeling of sudden and intense pleasure, an abrupt increase in pulse rate and blood pressure, and spasms of the pelvic muscles that cause contractions of the lower vagina. In the male, orgasm is marked by contractions of the urethra and ejaculation.Many women of all ages come into the office and want to ask questions about orgasms. They think that they are not normal because they can only have an orgasm via clitoral stimulation. I tell them that not only is it normal, but as you get older, and especially after menopause, it takes longer to even achieve orgasm that way. After they get comfortable with the conversation, they sometimes admit that they have never really had an orgasm without clitoral stimulation. This is normal. There are many women who come in and admit that they are not sure that they have ever even had an orgasm. The first thing that a healthcare provider should do in this circumstance is make sure that the patient has not been sexually abused. There may be some underlying issue that makes them unable to “let go” enough to get to orgasm. I do make sure that they know their own anatomy. If you are not sure where your clitoris is, then ask your OB/GYN. I promise that he or she will not ridicule you or think badly of you if you do not know. We get this question all the time. There is no OB/GYN out there that will make you feel uncomfortable about this. If they do, then find another doctor. You can purchase books on how to give you pleasure, use a vibrator, and where to stimulate themselves.As far as getting your partner to bring you to orgasm, there are several points that I would like to make. Men and women both know that stimulation of the penis causes a man to have an orgasm. A woman knows that stimulation of the clitoris causes an orgasm. Somewhere along the way, we didn’t tell all men this important point. If a woman got into bed with her partner with the intention of making love and never touched the penis, never stimulated the penis, and never let the penis touch her, she can be pretty sure that he is not going to have an orgasm. So why do most women accept that their clitoris is not going to be stimulated? This is the number one complaint that I hear from women. Men may not really understand the role of the clitoris in a female orgasm, and women are embarrassed to tell them. The men realize on some level that the clitoris is used for self-stimulation (masturbation), but may not realize that it is the main way for a woman to have an orgasm whether she is alone or with him.