What is the G-spot? Does it really exist?

The Grafenberg spot[1], more familiarly known and referred to as the G-spot, is named after the Berlin-based gynecologist Ernst Grafenberg, who first published an article in the International Journal of Sexology in 1950 titled "The Role of Urethra in Female Orgasm." In this article, Grafenberg proposes that the clitoris is not the sole anatomic structure responsible for female sexual arousal, lending a concrete anatomic structure to the theories of vaginal orgasm. In his gynecologic examination of women, Grafenberg reported the discovery that "an erotic zone . . . could be demonstrated on the anterior wall of the vagina along the course of the urethra." The G-spot was subsequently popularized by Ladas, Whipple, and Perry with the publication of their ground-breaking book on female sexuality, The G-Spot and Other Recent Discoveries About Human Sexuality, and it has become known as an erogenous zone that, when stimulated, leads to high levels of sexual arousal and powerful orgasms.

Because the initial evidence for the existence of the G-spot was based almost exclusively on anecdotal evidence, several scientific investigators in the mid- to late 1980s sought to more rigorously and methodically evaluate the subject matter. Hoch and associates studied vaginal erotic sensitivity in 56 women by a sexologic examination of the vagina tissues. The female subjects in this study were selected from a group of 59 couples who were experiencing sexual complaints related to anorgasmia[2], or the inability to achieve orgasm. Sexologic examination included a detailed gynecologic and physical examination involving digital exploration of the vaginal walls by a trained healthcare provider while the patient was asked to take note of the variations in sensation throughout different locations within the vagina. Rather than finding one single erogenous spot, Hoch and associates concluded that the entire anterior vaginal wall was erotically sensitive in most female subjects.

Many researchers believe that the G-spot is not a specific discrete structure, but rather a collection of erogenous zones primarily located on the upper anterior wall as well as in the lower posterior vaginal wall. This is an area inside the vagina that is extremely sensitive to deep pressure. Davidson and colleagues anonymously questioned 2350 professional women about their personal perception of their own sexual anatomy. Of the 1245 women who responded, 84.3% believed that an exceptionally powerful and sensitive area existed within the vagina. The perceived areas of location were varied among the respondents, however, including anterior vaginal wall (55.1%), posterior vaginal wall (7.3%), upper vagina (46.1%), and lower vagina (21.5%).

Female Ejaculation

Many sexual healthcare providers believe that when properly stimulated, the G-spot can swell and lead to orgasm in many women. At the time of orgasm, many ejaculate through the urethra some liquid that is chemically similar to male ejaculate but that contains no sperm.

Approximately 10-40% of women ejaculate, and the quantity may be from a sprinkle to a gush, drops to tablespoons; most women may exude rather than spurt fluid. The fluid or ejaculate is from the urethra and occurs during orgasm. It is often ignored by obstetricians and gynecologists, and many women confuse this with urination. The link between the G-spot and female ejaculation[3] originates from Grafenberg's original paper that noted the possible existence of such a phenomenon in response to female sexual arousal and orgasm. Chemical analysis of female ejaculate was shown to have higher levels of prostatic acid phosphatase than preorgasmic urine samples as well as significantly lower urea and creatinine levels.

What is G-spot enhancement or amplification?

G-spot amplification (GSA) is a novel method of augmenting the G-spot using cosmetic tissue filler such as human-engineered collagen or hyaluronic acid (Restylane). The premise of these interventions is that the injection enlarges the G-spot, making it easier to locate and henceforth stimulate. The cosmetic procedure has been touted as a method for enhancing female arousal and female subjective experience of orgasm. Centers offering this procedure claim that one intervention may last approximately 3 to 6 months. It is not covered by insurance and is extremely costly. Patients must also sign extensive consent forms.

As of yet, there have been no randomized, controlled studies on efficacy, safety, or side effect profile for this cosmetic procedure. There exists much controversy as to whether or not cosmetic procedures should be done based upon patient autonomy to improve and/or enhance sexual function. Caution should be exercised before considering this procedure. It is best to seek out a professional sexual medicine specialist for a comprehensive history and physical examination prior to considering this operation.

  • [1] An area of increased erotic sensitivity on or deep in the front of the vagina. It is located on the anterior surface of the vaginal vault. Stimulation in some women provides intense sexual pleasure.
  • [2] Difficulty experiencing or the inability to experience orgasm; in women it is often referred to as female orgasmic disorder.
  • [3] Expulsion from the urethra in women of about 3 to 5 milliliters of fluid different in chemical composition from urine.
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