Conceptualizing the G-Spot

What is a spot? The dictionary says that a spot is a small area different from the main area of which it is a part. Not a big deal really. But leave it to us humans to make things complicated. Whenever we are told that there is something bigger and better, we must have it, do it, own it. The G-Spot is no exception. Once we learn that there may be a G-Spot, we go hunting for it, trying to push on it, stroke it, finger it, rearrange our positions so we can hit it. We want to get enough credits to win the G-Spot Merit Badge. At least this is the way that I see a lot of people approaching sexuality. To all of you who may fall into this category, I say "Would you cut it out? It's very annoying and it takes the sensuality out of sex, and instead makes it a treasure hunt or a competition." So let's see how we can break out of this idea of the G-Spot as a discrete structure and see the G-Spot as part of a much larger picture.

Whenever I talk to patients about the G-Spot, I invite them to think of it conceptually instead of a discrete anatomical structure. I would like to describe to you how I understand it so that you can getter a better understanding as well. This requires that we think about the anatomy of the area in a 3-D way. If you would like to see a straight-forward, 2-D, cross-section diagram of the female anatomy, you can find one here (very high school biology). Let me describe how I conceptualize the G-Spot.

First to consider is that the female urethra has spongy erectile tissue surrounding it which has been known by different names from Skene's glands, to paraurethral glands, and even called the female prostate. You can get a 3-D image of this by imagining that you are holding a cup in front of you with both hands. The cup represents the urethra going from the bladder above and opening below between the labia minora. Your hands represent the erectile tissue (obviously not the exact shape or thickness), and the space between your arms represents the vagina. Imagine that the area of your thumbs is down towards the opening of the vagina. In our makeshift model, if something were to reach up between your arms and push on the area of your thumbs, it would be pressing onto the erectile tissue from inside the vagina. The erectile tissue actually fills the space between the wall of the vagina and the urethra, so although the erectile tissue is not in the vagina, you can stimulate it by pressure from inside the vagina.

Interestingly, scientists have found that this area of the vagina next to the erectile tissue has the greatest number of nerve endings of the entire vagina. There is a mix of different nerve endings, but a very large percentage of them are from the Pudendal nerve that also gets sensation from the labia, the PC muscle, the anus, and the clitoris. So when this area is stimulated, it adds to any other stimulation a woman may be receiving at the same time in any of those other areas. It is this area precisely that is also known as the G-Spot.

When a women begins to get sexually aroused, there is increased blood flow to the area which can fill up the erectile tissue. This expands the erectile tissue and can push the area of the G-Spot further into the vagina. Women have reported that when they have been aroused for awhile, this area of the G-Spot becomes more noticeable in the vagina and feels good with stimulation. If a woman is not yet aroused, the erectile tissue is not filled with blood and pressure on the area of the G-Spot can be uncomfortable, give a sensation of having to pee, or can even be painful for other women. This explains why the G-Spot tends to feels better after some time of sexual stimulation and excitation, but not necessarily before.

So I do believe the G-Spot does exist. If we can conceptualize this 3-D view of the G-Spot, it helps us understand where it is located, and also helps us better understand how it functions and responds to sexual arousal and stimulation. It is not to be seen as an independent structure by itself, but instead an area of anatomical opportunity for pleasure.

New G-spot Study - Deconstructed

Do you think that you have a G-spot? No? Oh well, I guess then it doesn't really exist!

If the above sounds like a big leap in logic to you, then you are not alone. There has been so much buzz lately about the new study put out recently by researchers at King's College London that I just had to check it out. After reading through their article in the recent edition of the Journal of Sexual Medicine, I was very disturbed by the liberties they took in their assumptions. Because of this, I wanted to deconstruct their study here for you and give you the real story.

First of all, this study was not based on anatomical study, physiological tests, or histological or biochemical examination. This study was a survey study, which means they only asked women questions. They focused on twins - identical (monozygotic - MZ) and fraternal (dizygotic - DZ) to see if they would give similar responses to the question "Do you believe you have a so called G-spot, a small area the size of a 20p coin on the front wall of your vagina that is sensitive to deep pressure?" Since they found that about half of the time, twins gave the same answer (either "yes" or "no") and about half of the time, twins gave different answers, they concluded that there was no genetic base for self-reporting having a G-spot. (So far, so good.)

But they took this way too far when they stated that: "This supports the argument that a self-reported G-spot -- the popular conception of the G-spot -- does not appear to exist." They go on to say: "Our main conclusion is that there is no genetic basis to the self-reported G-spot, suggesting that the G-spot is rather a perception caused by non-physiological factors that can cause a heightened sexual sensation." This means that they are suggesting that just because twins can't agree on their opinion of whether they have a G-spot or not, that if we think we have one, it must just be in our minds. They also self-proclaim their study to be a "substantial contribution to the current debate on the existence of the G-spot." I agree that it is contributing to debate, but not to scientific evidence.

I think it is incorrect and irresponsible to suggest that the G-spot is "a perception caused by non-physiological factors" when there were no physiological studies done. Their goal was not to actually see if the G-spot exists, but to see if women perceive themselves to have one. They then use twins, falsely concluding that if both individuals in a set of twins report the same perception, that it has a genetic basis. But awareness does not equal existence. Many people are not aware of their Ligament of Treitz, but this does not mean they don't have one. They cannot scientifically make the jump from a self-report study to physical and anatomical evidence. That is not how science works.

They also go on to make some very silly conclusions about G-spots and orgasms. They expect that "if there was a G-spot, then it is reasonable to expect that women reporting one would have a higher rate of orgasm through penetration." How is it that they came to this assumption? This would mean that simply having vaginal penetration would automatically stimulate the G-spot enough for women to have an orgasm each time. But are they not aware that certain positions and angles are more conducive to stimulation of the G-spot than others? Maybe these women are not having sex in those positions or at those angles? Maybe they just have more orgasms from clitoral stimulation? There's nothing wrong about these differences.

They also happened to notice that some women who reported not having a G-spot still had vaginal orgasms. Because of this, they state that this "provides legitimate grounds to further question its existence." They completely ignore the fact that women can have vaginal orgasms by stimulation of the cervix via the hypogastric and pelvic nerves. That doesn't mean they don't have a G-spot. They may just be having vaginal orgasms with deeper penetration instead of with G-spot stimulation. C'mon people! Be real! (real scientists, that is!)

The Times Online (UK) wrote "Andrea Burri, who led the research, said she was anxious to remove feelings of “inadequacy or underachievement” that might affect women who feared they lacked a G-spot. “It is rather irresponsible to claim the existence of an entity that has never really been proven and pressurise women — and men, too,” she said. " Was she approaching this with a bias? This quote suggests that she fashioned a study and presented her results to confirm her directive, rather than draw logical and appropriate conclusions from her data. Unfortunately (for her, but not for us), her study does not disprove the existence of the G-spot.

Although I believe that trying to reduce women's anxiety (and men's too) about sexual performance and adequacy is an important goal, making these sweeping assumptions without physical evidence is not the way to do it. Instead, I believe that the way to reduce people's anxiety about sex is proper sex education, access to information, open-mindedness, and acceptance of the great variety of experiences that exists. These will do much more to advance our knowledge and our experience of sex, which has come a long way - but still has far to go.

There are some reasonable statements in their paper, such as "...it might be that objective measurement of anatomical variability is the only valid way to assess the actual existence of a G-spot." and that "Future studies investigating the G-spot should focus on anatomical assessment methods...." So I stick by my statement that they should stop asking so many questions and actually stick their fingers into women's vaginas if they really want to look for a G-spot. Otherwise, don't bother me with your questions.