Orgasm without Genital Stimulation: Is It Real?

In my quest to find out, whether my self-induced whole-body orgasms could also be considered “real” scientifically, I set on a mini-experiment. The results were significant enough to be presented at the International Academy of Sex Research annual conference in Mexico City. Below is the write-up of the presentation which was done with great support from one of the most recognized experts in this field Dr Jim Pfaus.

See also the article published in the Journal of Sexual Medicine 

A case study of female orgasm without genital stimulation: Is it real?

Karolin Tsarski1 & James G. Pfaus2

1Essence Feminine, Tallinn, Estonia

2Centro de Investigaciones Cerebrales, Universidad Veracruzana, Xalapa, VER, México


Orgasm is a complex, multimodal reflex induced typically by genital stimulation. Such stimulation activates excitatory neurochemical pathways in the brain and spinal cord that ultimately stimulate sympathetic outflow and the inhibition of parasympathetic spinal circuits in the lower lumbar cord. In women, this can be achieved by stimulation of the external and internal clitoris, anterior cervix (“A-spot”), nipples, and other erogenous zones in sensitized individuals (Pfaus et al., 2016).  Although the reflex is a product of “bottom-up” genitosensory stimulation, it is also controlled by “top-down” processing of excitation and inhibition that controls both the timing of parasympathetic and sympathetic blood flow and the subjective ability to “let go” into the orgasm when it is imminent. Indeed, orgasms activate cortical, limbic, hypothalamic, and brainstem structures (Wise et al., 2017), and can be rated subjectively in terms of the quality and type of sensory stimulation, affective experience, and the evaluation of pleasure (King et al., 2011; Mah & Binik, 2002; 2005). Orgasms are also accompanied by neurochemical and endocrine changes that characterize both the pleasurable state and longer-term inhibition (refractoriness). Among these correlates is a consistent, orgasm-induced surge of prolactin released from the anterior pituitary into the peripheral bloodstream (Leeners et al., 2013).  Some women can have orgasms spontaneously without genital stimulation (Whipple et al., 1992). Here we present a case study of a 33-year old woman who developed the ability to attain and control the duration of a subjective orgasmic state without genital stimulation after tantric orgasm training.


First, we examined the general subjective quality of her non-genitally stimulated orgasms (NSOs) relative to those she attained through genital and erogenous self-stimulation using the Mah and Binik (2002) Orgasm Rating Scale. This validated scale measures orgasm quality using 5-pt Likert ratings of adjectives that describe sensory experiences, affective reactions, and the degree of pleasure/relaxation induced by the orgasm. Next, we assessed hormone levels (FSH, LH, prolactin, and free testosterone) from blood drawn before (Pre), immediately after (Post) and 30 min after (After) either a 5-min NSO, a 10-min NSO, or a control condition in which orgasm induction was replaced with 10 min of reading a book. Pituitary peptides were determined from plasma with automated immunoassays that utilize two-site immunometric detection, in which the peptide is captured by an antibody immobilised on a solid phase, and a labelled antibody is then reacted with the captured peptide. Free testosterone levels in plasma were detected using an enzyme-linked immunosorbent assay (ELISA). All assays were conducted by SYNLAB Eesti OÜ, Tallinn, Estonia. FSH and LH were expressed in IU/l, prolactin in mIU/l, and free testosterone as nmol/l. Data are shown as per cent change from the 30-min baseline period.


Subjectively, the NSOs were as pleasurable as externally- or internally induced orgasms, and produced a relatively similar set of sensory experiences, but were somewhat blunted in the affective domain (for evaluative feelings of emotional intimacy and ecstasy).

Prolactin levels from Pre to Post increased by 25% or 48%, respectively, after the 5- or 10-min NSO, and were still elevated from the Pre baseline 30 min after. No changes were recorded in FSH or free testosterone. Interestingly, LH levels were higher to begin with on the day of the 5min NSO (in a range suggesting a preovulatory surge), and the NSO elevated LH levels by 45%, which remained elevated 30 min after.  This elevation did not occur a week later when the 10min NSO was evaluated.


Leeners et al. (2013) proposed using the post-orgasmic prolactin surge as an objective marker of orgasm quality, given that the surge levels followed a lawful increase in women that experienced 1 or 2 orgasms during partnered intercourse, and whose subjective ratings of the orgasm quality also increased progressively from 1 to 2 orgasms. We observed a similar increase from a 5-min to 10-min NSO in the present case study.  In fact, the prolactin surge following the 10-min NSO was in the range reported by Leeners et al. after2 orgasms from partnered intercourse. These data suggest that NSOs are not “faked” or partial orgasms, but rather reflect a top-down induction of a real subjective orgasmic state that includes objective hormonal changes.



King R, Belsky J, Mah K, Binik Y. (2011). Are there different types of female orgasm? Arch Sex Behav, 40, 865-875.

Leeners B, Krüger TH, Brody S, Schmidlin S, Naegeli E, Egli M. (2013). The quality of sexual experience in women correlates with post-orgasmic prolactin surges: results from an experimental prototype study. J Sex Med, 10, 13131319.

Mah K, Binik YM. (2002). Do all orgasms feel alike? Evaluating a two-dimensional model of orgasm experience across gender and sexual context. J Sex Res, 39, 104-113.

Mah K, Binik YM. (2005). Are orgasms in the mind or the body? Psychosocial versus physiological correlates of orgasmic pleasure and satisfaction.  J Sex Marital Ther, 31,187-200.

Pfaus JG, Quintana GR, Mac Cionnaith C, Parada M. (2016). The whole versus the sum of some of the parts: toward resolving the apparent controversy of clitoral versus vaginal orgasms. Socioaffective Neurosci Psychol, 6, 32578.

Whipple B, Ogden G, Komisaruk BR. (1992). Physiological correlates of imagery-induced orgasm in women. Arch Sex Behav, 21, 121-133.

Wise NJ, Frangos E, Komisaruk BR. (2017). Brain activity unique to orgasm in women: An fMRI analysis. J Sex Med, 14, 1380-1391.