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Women who experience vaginal (rather than clitoral) orgasm have "greater satisfaction with their sex life, mental health, relationships with both partners and friends, and life in general," according to a new study that is stirring longstanding anxieties about the nature of the female orgasm.

And women could have more of them if they received better sex education in their youth, were more focused in bed, and in some cases, had lovers with bigger penises, according to the report.

The study, conducted by Stuart Brody, psychology professor at University of the West of Scotland, and co-author Petr Weiss, asked 917 Czech women to recollect their experiences with vaginal orgasm.

The findings, which will appear in an upcoming issue of The Journal of Sexual Medicine, have provoked controversy among sex researchers.

Unlike the large-scale studies performed by researchers such as Alfred Kinsey, Masters and Johnson and Shere Hite - which concluded that most women cannot climax without clitoral stimulation - this study found that just 21.9 per cent of the Czech participants could not achieve vaginal orgasm. (The researchers defined it as "orgasm produced simply from movements of the penis in your vagina, without any additional stimulation such as fingers for the orgasm after foreplay.") More controversially, in their discussion the authors accuse feminists of pushing "clitorocentric" sex ed and denying the existence of the vaginal orgasm. It's a denial that has divided the sexes by fragmenting lovers' intimacy, and compromised women's psychological and sexual health in the process, they say.

"Educators, practitioners, feminists and others who are interested in the goal of elevating women (as opposed to diminishing men), would be supportive of vaginal orgasm as an aspect of women's psychosexual health," Prof. Brody wrote in an e-mail.

Sexologists have reacted strongly to the study, with one critic accusing the authors of "clitoral envy" in an Australian Broadcasting Corporation Science Online article published earlier this month.

"It's not a new phenomena that most female orgasms are triggered by clitoral stimulation. Women's studies professors didn't invent that," said Alexander McKay, Toronto-based research co-ordinator of Sex Information and Education Council of Canada.

Mr. McKay and other critics have accused the researchers of holding antiquated - and potentially destructive - Freudian views. Freud contended that the clitoral orgasm was adolescent, while the vaginal orgasm was psychologically mature - the one women have with men after reaching puberty.

"To suggest that a vaginally induced orgasm is somehow superior from a mental-health perspective certainly seems to harken back to the ideas of Freud," Mr. McKay said.

The views can be damaging to a woman's confidence, said Lori Brotto, assistant professor in the department of obstetrics and gynecology at the University of British Columbia.

"By stating that you should be reaching orgasm through vaginal stimulation, it leads to a pathologizing of probably the vast majority of women who don't reach orgasm in that way. That has clinical implications for diagnosing an orgasm disorder, it has relational implications, it has psychological implications for the woman herself," said Prof. Brotto, who is also director of the school's Sexual Health Laboratory.

But just as his critics have questioned his motivations, Prof. Brody questions what he views as the clitoris-biased sex ed movement: "What is the effect of telling women that they cannot feel a penis in their vagina, or at least not saliently enough to orgasm from it?" he asked in an e-mail.

Toronto-based certified sex educator Cory Silverberg countered that Prof. Brody is "mischaracterizing" people in his field: "Sex educators don't go out there and say, 'The clitoris, the clitoris, the clitoris.' We talk about the clitoris mostly because nobody knows about it, and everyone knows about the vagina."

Despite the authors' assertion that women have been "inculcated" to believe vaginal orgasms don't exist, experts say it's the opposite: pop culture often depicts women climaxing upon penetration.

"When you read a romance novel, inevitably when it comes to the sex scene, when the guy's rock-hard python enters her steaming love lava or whatever, she instantaneously orgasms," said Trina Read, a Calgary-based author and sex coach.

Dr. Read said the men and women she counsels are often insecure about vaginal orgasm, namely why can't they give or get one, and what might be wrong with them.

The study's findings about penis size could stir unnecessary insecurity in men as well. The researchers told the Czech women to assume that the average erect penis is the length of a 200 Crown banknote (14.5-centimetres long). A third admitted a bigger penis helped them orgasm vaginally, but two thirds said size made little difference.

Still, many of the critics agree with Prof. Brody's prescription that women could benefit from being more aware of vaginal sensations during sex.

"Most of us, when we have sex, are so pre-occupied with other thoughts: the work we have to do, or the kids hearing us in the next room, or thoughts about whether your partner finds you attractive, or even pornography. It's hard for us to really tune into our bodies. This is one major cause of sexual dissatisfaction," Mr. Silverberg said.

Prof. Brotto said awareness-based approaches are making headway in the treatment groups she runs at UBC's sexual-health lab.

"[They're]showing a lot of promise: treatments that teach women how to be present, mindfulness-based approaches."

"But again," she added, "that's not specific to vaginal orgasm. We find that you to teach any woman to attend to her sensations and she'll report better sexual functioning."

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