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.

Distorted View of Women's Bodies

I am both a very visual and very sexual person. Consequently, I enjoy watching porn on occasion. Let's face it, porn is visually stimulating, erotic, and allows a person to expand their fantasy life. But I am conscious of the importance of balance in using these images for our health and well-being.

We already know that viewing porn on a regular basis changes our ideas of what we consider attractive. We adjust our view of what we consider acceptable or desirable to match what is put out there by the media - in this case, porn. We also tend to place value in the images we see when they are reinforced by being presented as exciting, desirable, and sexy. This is accomplished by the immediately aroused response seen in porn actors. I'm not saying that some of them are not enjoying their work, but at the end of the day, they are actors playing a fictional role.

It's interesting to see how porn is shaping the view of what we consider attractive or sexy. First, let's consider breasts. If you look at a comparison of Playboy centerfolds from the 1960's to now, you see a large difference not only in size, but in the shape of breasts as well. Whereas years ago it was very common to see teardrop-shaped breasts, nowadays, breasts are usually very round and seem to defy gravity. It's obvious that very round breasts look more like a pregnant woman's breast - full of milk and ready to lactate. But they also may be an indicator of sexual excitement, since breasts can increase in volume from 25 - 30% when a woman gets aroused. It also seems that surgically enhanced breasts take more of the shape that natural breasts do when a woman is laying on her back - not an uncommon position for sex. Certainly, there are some beautiful surgically enhanced breasts out there. But our society's expectation of these as the standard is what seems dangerous. In some South American countries women can even have their government-sponsored health care pay for elective breasts implants (not related to mastectomy or an accident). This is how important it has become in our culture.

If we continue our travels a little southwards (on the female figure), we notice there have been major changes in the landscaping. Where there used to be anywhere from a full bush to a neatly trimmed little patch, now it's much more common to find the absence of bush altogether. This works very well for porn if you don't want anything obstructing your camera shot. It probably makes clean up after the money shot a bit easier as well. But pubic hair has always been one of the physical characteristics that distinguishes women from girls. So where is society going with this? How did completely shaved become the norm?

Perhaps the most disturbing trend, however, is the desire for some women to "beautify" their labia by surgical reduction. Could porn also be promoting labiaplasty? This procedure involves removing a triangle-shaped wedge from the middle of the labia, then pulling the rest together and suturing it up. (Imagine a pie slice coming out from the middle of a half-circle). This creates smaller, tighter labia. And since the edges of the labia minora are usually darker than the rest, the removal of a large part of this edge results in the appearance of lighter-colored labia. In order to create a uniform, more natural look, surgeons will often also remove part of the clitoral hood when performing a labiaplasty. The surgeons who perform labiaplasty suggest that women who have large or uneven labia should feel embarrassed with a sexual partner and that the surgery would correct this. Perhaps an understanding of what genitals actually look like would correct this without the risk of side effects from surgery. If women are comparing themselves to women they see in porn movies and skin mags, they are not getting a real view of what average and normal are. Instead, I hear of 16 year-old girls already thinking that they are "not normal" and need to "get fixed" because they think their labia are too big.

My question is how far are we going to go? Is it porn driving this distorted view of women's bodies that society seems to be adopting? How are "Hollywood" plastic surgeons contributing to this by referring to their procedures as "the Barbie" (disturbing). We are not far from that plasticine figure that has exaggerated proportions and shape, and most notably has the absence of pubic hair or defined genitals. How distorted will we allow our vision of natural and beautiful to become?

Wide-eyed

There have been a multitude of articles and advertising in the media stating that women prefer to experience a wider penis over a longer penis. And this is truly the case. When surveyed, 90% of women stated that width was more important to their sexual satisfaction than was length. It seems that in publishing their research, Masters and Johnson did not consider certain factors when they said that penis size has no real physiological effect on a woman's sexual pleasure and satisfaction. In order to understand a little more what they may have been missing, it's important to think about the anatomy.

First, let's talk about the clitoris. Most people are familiar with the little pink pearl that sits at the top of the labia. It is extremely sensitive and is covered by a little hood of skin that is actually where the top of the labia come together. But there is much more to the clitoris than just what you can see and feel. The entire clitoris is shaped like a capital A (without the bar in the middle). It's legs (crurae) extend down and under the pubic bone, and it also has extensions that follow along each side of the vaginal opening, called the vestibular bulbs. The entire clitoris is made up of spongy tissue that fills with blood when a woman gets aroused.

When a man has a wider penis, there is more pressure put on the vestibular bulbs which gives a pleasurable feeling of fullness at the vaginal opening. Some researchers have commented that this feeling of fullness is both physically and psychologically pleasing. Also, with a wider penis, there is more tension on the labia, which in turn causes more tugging and movement at the hood covering the clitoris. This adds stimulation to the clitoris in addition to the surrounding tissues. The entire vulva, including the labia, clitoris, and the lower 1/3 of the vagina is innervated by the Pudendal nerve. The more surface area you have contact with at any one time, the more you have exciting signals travelling up through that nerve. There may be some element to the stretch of the PC muscle at the vaginal opening that adds to the pleasure - also transmitted via the Pudendal nerve. Remember, this nerve covers the whole area including below the vaginal opening and the anus. This also benefits from a little tension from a wider penis going through the lips and vaginal opening.

Now, an average erect penis is about 10cm in circumference (that's about 4 inches around for those of us not on the metric system). So all of you who are wondering how you measure up, we'll wait while you take out the tape measure.....Ok. Now there are different techniques to give a woman the feeling of a wider penis. One such technique is to have a slight circular motion as you thrust. In this way, the shaft of the penis pushes more against the sides of the vaginal opening, giving the woman that extra pressure and tension. This can also be done by choosing an angle of entry that allows you to put more pressure on the fourchette below the vaginal opening where the labia end in a little "v." This works to also tug the labia a little more and stretch the PC muscle. And still others are much more imaginative, finding ways to work in extra fingers or using penile sleeves. So that's the skinny on width. No comment on bumpy penises.