Female ejaculation
Female ejaculation is the expulsion of a small volume of thick, whitish fluid from the paraurethral glands, known as Skene's glands or the female prostate, through the urethra during sexual stimulation or orgasm in some women.[1] Anatomical evidence confirms that these glands, homologous to the male prostate, produce the fluid, which contains prostate-specific antigen (PSA) and prostatic acid phosphatase, distinguishing it biochemically from urine.[2] [1] This phenomenon differs from squirting, which involves larger volumes of dilute fluid primarily composed of urine, though potentially admixed with prostatic secretions from Skene's glands.[3] [4] Peer-reviewed studies, including biochemical analyses of ejaculate samples, support the existence of true female ejaculation as a distinct physiological event, though its prevalence varies and is estimated to occur in 10-54% of women depending on self-reported surveys and methodological rigor.[1] Controversies persist regarding the precise mechanisms, with historical dismissal in Western medicine contrasting ancient recognitions in other cultures, and ongoing debates fueled by small sample sizes in empirical research rather than ideological biases.[1] Recent imaging and fluid composition studies reinforce causal links to glandular activity rather than mere urinary incontinence.[4]Physiology and Anatomy
Definition and Characteristics
Female ejaculation refers to the expulsion of a viscous, milky fluid from the female urethra during sexual stimulation or orgasm, distinct from vaginal lubrication. This phenomenon involves the release of a small volume of fluid, typically ranging from a few drops to several milliliters, produced by the Skene's glands, also known as the paraurethral or female prostate glands. [5] [1] The fluid is emitted through the urethral opening and is not associated with urinary incontinence, though it shares the urethral pathway. [6] The ejaculate is characterized by its opaque, whitish appearance and alkaline pH, contrasting with the clearer, more dilute nature of urine or squirting fluids. Biochemical analysis reveals the presence of prostate-specific antigen (PSA), prostatic acid phosphatase (PSAP), and elevated levels of glucose and fructose, components analogous to those in male seminal fluid from the prostate. [7] [8] These markers indicate prostatic origin, with studies showing low concentrations of urea and creatinine compared to urine, confirming it is not primarily urinary in composition. [7] Empirical ultrasounds and fluid assays in small cohorts demonstrate that the glands enlarge prior to expulsion, supporting a glandular secretory mechanism rather than bladder-derived release. [1] Occurrence varies, with self-reported prevalence in surveys ranging from 10% to 54% of women experiencing it at least once, though not all report it consistently or associate it with orgasmic intensity. [9] The fluid may possess antimicrobial properties due to its enzymatic content, potentially aiding urethral protection post-intercourse, as suggested by in vitro analyses. [7] Unlike squirting, which involves larger volumes (often 10-150 ml) predominantly composed of urine diluted with trace prostatic elements, female ejaculation remains a discrete, low-volume event tied to Skene's gland activation. [10] [3]Anatomical Structures Involved
The primary anatomical structures involved in female ejaculation are the Skene's glands, also known as the paraurethral glands, which are homologous to the male prostate gland.[11] [1] These glands consist of two small ductal structures located bilaterally along the urethra, embedded in the anterior vaginal wall near the lower end of the urethra.[8] [12] The Skene's glands contain secretory cells capable of producing a fluid that is expelled during ejaculation, with ducts that open directly into the urethra, facilitating the release of this material.[13] [14] The urethra serves as the conduit for expulsion, with the ejaculate originating from the Skene's glands and passing through its lumen, distinct from urinary flow under normal conditions.[1] Anatomical studies indicate that the glands can exhibit variability in size and number of orifices, potentially adapting to increased secretory demands, though their presence is universal in females, even if ejaculation does not occur in all individuals.[15] The surrounding tissue, including the erectile components of the clitoral complex, may contribute to the pressure dynamics enabling expulsion, but the Skene's glands remain the source of the ejaculatory fluid.[11]Mechanisms of Expulsion
The expulsion of fluid in female ejaculation primarily occurs through rhythmic, involuntary contractions of the pelvic floor musculature during the orgasmic phase, analogous to the emission and expulsion phases in male ejaculation. These contractions, involving striated muscles such as the pubococcygeus (PC) and bulbospongiosus, compress the paraurethral (Skene's) glands and ducts, forcing the prostatic-like secretions—typically 1-5 mL in volume—out through the urethral meatus.[16][17][18] Electromyographic studies demonstrate that women capable of ejaculation exhibit significantly stronger PC muscle contractions and uterine activity compared to non-ejaculators, suggesting that enhanced pelvic floor strength facilitates the forceful propulsion of glandular fluid rather than mere passive leakage.[18] This mechanism depends on prior accumulation of fluid in the Skene's glands during sexual arousal, triggered by sympathetic and parasympathetic neural inputs, but expulsion is driven by somatic motor neurons innervating the pelvic striated muscles.[19][5] In contrast to coital incontinence or squirting, where bladder detrusor contractions or sphincter relaxation may contribute to larger-volume expulsion of urine-diluted fluid, true female ejaculation relies on these localized pelvic floor dynamics without evidence of detrusor overactivity or pathological urethral incompetence.[20][21] Urodynamic assessments of ejaculating women confirm normal voiding patterns and absence of involuntary bladder involvement, underscoring the distinct neuromuscular pathway.[20] The process can occur with or without concurrent vaginal contractions, though intensified perivaginal muscle activity often enhances expulsion force.[22]Historical Perspectives
Ancient and Non-Western Accounts
In ancient Indian texts, female ejaculation is referenced as "female semen" that falls continually from the yoni during intercourse, as described in the Kāmaśāstra literature, including the Kama Sutra compiled between 200 and 400 CE, where it is portrayed as a natural emission aiding conception and pleasure.[23] Earlier mentions appear in a 7th-century poem, framing it within sexual techniques emphasizing mutual satisfaction.[24] These accounts, rooted in empirical observations of sexual practices rather than anatomical dissection, viewed the fluid as distinct from urine and symbolically potent, though modern analysis questions their biochemical precision due to pre-scientific methodologies.[25] Ancient Chinese Taoist writings, dating from the 4th century CE onward, extensively document female ejaculation as a vital essence called jing, independent of reproduction and linked to health preservation through sexual alchemy practices like huanjing bunao, where prolonged arousal without male emission conserved energy.[26] Texts such as those by Ge Hong emphasize women's emission of "white nectar" during peak arousal, advising men to stimulate it for mutual longevity, reflecting a causal view of fluid exchange balancing yin and yang without Western dualism of reproductive versus non-reproductive sex.[24] These descriptions, drawn from introspective and observational traditions, predate anatomical confirmation but align with later biochemical findings of prostatic-specific antigen in the fluid, underscoring empirical continuity despite cultural framing.[25] In Tantric traditions of medieval India, female ejaculation is termed amrita or "nectar of the gods," symbolizing divine energy release during ritualized intercourse, as elaborated in texts like the Vigyan Bhairav Tantra, where it facilitates spiritual transcendence beyond mere physicality.[27] Practitioners documented techniques to elicit copious emissions, attributing therapeutic and ecstatic properties to the fluid, though sourced from esoteric oral lineages prone to interpretive bias rather than controlled study.[28] Among non-Western African accounts, Rwandan oral traditions describe the kunyaza technique—rapid penile tapping on the vulva—as inducing female ejaculation (kunyara), historically tied to fertility rites and viewed as a sign of female vitality, with ethnographic reports from the 20th century confirming its cultural persistence based on participant testimonies.[29] These practices, empirically derived from communal sexual knowledge, highlight expulsion as a pleasurable, non-pathological phenomenon, contrasting with later Western pathologization.Early Modern Western Observations
In the 16th century, Flemish anatomist Andreas Vesalius, in his detailed anatomical illustrations and descriptions, noted that women produce a semen-like liquid during sexual intercourse and ejaculate it similarly to men, reflecting early empirical observations derived from cadaver dissections and comparative anatomy.[29] The most systematic Western description emerged in 1672 from Dutch physician Regnier de Graaf's treatise De mulierum organis generationi inservientibus tractatus novus, where he identified paraurethral glands—analogous to the male prostate—that become engorged during sexual arousal and expel a milky fluid through the urethra upon orgasmic contraction.[30][31] De Graaf's account stemmed from vivisections of female dogs and anatomical examinations of human cadavers, emphasizing the glands' role in lubrication and potential contribution to conception, though he distinguished this fluid from urine based on its viscosity and odor.[26] French obstetrician François Mauriceau, in his 17th-century midwifery texts, corroborated these findings by describing urethral meatus glands in women that "pour out great quantities of saline liquor" during coitus, observed through clinical examinations of laboring patients and post-coital states.[31] These accounts marked a departure from medieval humoral theories toward mechanistic explanations rooted in observable glandular function, yet they remained embedded in generation-focused paradigms where female fluid was often deemed essential for fertility.[26] By the late 17th century, such observations influenced European medical discourse, though debates persisted over whether the emission constituted true semen or mere lubrication, with de Graaf's work sparking anatomical rivalries, including accusations of plagiarism from contemporaries like Jan Swammerdam.[32]19th and 20th Century Developments
In the late 19th century, American gynecologist Alexander J. C. Skene described the paraurethral glands, now known as Skene's glands, in 1880, identifying them as structures homologous to the male prostate capable of secreting fluid near the urethra.[33] These glands were noted for their potential role in lubrication and fluid expulsion during sexual activity, building on earlier anatomical observations but providing a detailed Western medical account.[34] Concurrently, sexologist Richard von Krafft-Ebing referenced female ejaculation in his 1886 treatise Psychopathia Sexualis, framing it primarily within contexts of sexual deviation rather than normal physiology.[35] Medical discourse of the era often pathologized female sexual expression, associating phenomena like fluid emission with hysteria or moral deviance, which limited objective inquiry.[36] The 20th century witnessed sporadic acknowledgments amid prevailing skepticism and cultural reticence toward female sexuality. Alfred Kinsey's 1953 survey-based study, Sexual Behavior in the Human Female, documented self-reported instances of urethral fluid expulsion during orgasm in a subset of women, estimating prevalence around 10-14% and noting the fluid's similarity to prostatic secretion rather than urine.[26] However, empirical laboratory research, such as that by William Masters and Virginia Johnson in their 1966 volume Human Sexual Response, largely omitted explicit discussion of ejaculation, focusing instead on vasocongestive and orgasmic phases without emphasizing fluid dynamics.[37] This omission reflected broader institutional biases and methodological constraints, including small sample sizes and avoidance of controversial topics, perpetuating debates over whether such emissions constituted a distinct physiological event or mere incontinence.[26] By mid-century, while anthropological accounts from non-Western contexts reinforced earlier descriptions, Western science prioritized orgasmic universality over variant expressions like ejaculation, delaying comprehensive validation until later decades.[25]Scientific Investigations
Early Empirical Studies
The first empirical investigation into female ejaculation was conducted by Dutch anatomist Regnier de Graaf in 1672, who performed dissections on female genitalia and documented the expulsion of a milky fluid from paraurethral glands during sexual arousal, likening these structures to a rudimentary female prostate capable of seminal emission.[26] De Graaf's observations, detailed in his treatise De Mulierum Organis Generationi Inservientibus Tractatus Novus, emphasized the glands' role in producing a viscous secretion distinct from urine, based on direct anatomical examination of cadavers and live subjects, though limited by the era's technological constraints and lack of biochemical analysis.[25] Subsequent centuries saw minimal empirical advancement, with observations largely anecdotal or tied to anatomical speculation rather than systematic study, until German gynecologist Ernst Gräfenberg revived the topic in 1950 through clinical case reports.[26] In his paper "The Role of the Urethra in Female Orgasm," published in the International Journal of Sexology, Gräfenberg described urethral sensitivity and fluid emission in multiple patients, noting that stimulation of an erogenous zone along the anterior vaginal wall—adjacent to the urethra—triggered orgasm accompanied by the ejection of a clear or milky fluid from the urethral meatus in at least several documented instances.[38] He hypothesized this fluid originated from glandular tissue homologous to the male prostate, based on patient histories and palpation during examinations, but lacked fluid sampling or controls to differentiate it conclusively from urinary leakage. These early efforts established female ejaculation as a observable physiological event but were constrained by small sample sizes, subjective reporting, and absence of modern verification methods, prompting later researchers to question the reliability of de Graaf's and Gräfenberg's interpretations amid prevailing medical skepticism toward non-urinary female genital fluids.[26] Gräfenberg's work, in particular, influenced mid-20th-century sexology by linking urethral structures to orgasmic expulsion, though it faced criticism for conflating anecdotal evidence with empirical proof.[38]Fluid Composition and Biochemical Analysis
The biochemical composition of fluid associated with female ejaculation, primarily secreted by the Skene's glands, differs markedly from urine. Key components include prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), glucose, and fructose at elevated levels, alongside lower concentrations of creatinine, urea, and uric acid.[7][14] This profile aligns with prostatic secretions in males, underscoring the homologous function of the Skene's glands.[1] Analytical studies, such as those examining ejaculate via enzymatic assays and chromatography, confirm PSA presence, often in quantities sufficient to confound semen exposure biomarkers.[39] Glucose and fructose levels exceed those in urine, potentially supporting sperm motility if present in reproductive contexts.[40] In contrast, urinary markers like urea and creatinine are minimal, distinguishing the fluid from bladder-derived emissions.[7]| Component | Presence in Female Ejaculate | Relative to Urine |
|---|---|---|
| Prostate-specific antigen (PSA) | Elevated | Low or absent |
| Prostatic acid phosphatase (PAP) | Elevated | Low or absent |
| Glucose | Elevated | Lower |
| Fructose | Elevated | Lower |
| Creatinine | Low | Elevated |
| Urea | Low | Elevated |
| Uric acid | Low | Elevated |
Distinction from Squirting and Gushing
Female ejaculation involves the expulsion of a small volume—typically 1-5 milliliters—of thick, whitish fluid originating from the paraurethral (Skene's) glands, which are homologous to the male prostate.[3] This fluid is biochemically distinct, containing elevated levels of prostate-specific antigen (PSA), prostatic acid phosphatase, and fructose, markers indicative of prostatic origin rather than urinary composition.[41] In contrast, squirting and gushing refer to the release of much larger volumes (often 10-300 milliliters or more) of clear, odorless, watery fluid primarily sourced from the urinary bladder.[42]| Aspect | Female Ejaculation | Squirting/Gushing |
|---|---|---|
| Volume | Small (1-5 mL) | Large (10-300+ mL) |
| Appearance | Thick, milky/whitish | Clear, watery/dilute |
| Primary Origin | Paraurethral/Skene's glands | Urinary bladder |
| Composition | High PSA, prostatic enzymes, low urea/creatinine | Dilute urine (high urea, creatinine, uric acid); trace PSA possible |
Association with Orgasm and Incontinence
Female ejaculation is commonly associated with orgasm, occurring as an expulsion of fluid from the Skene's glands during or immediately preceding orgasmic contractions. Empirical studies, including case reports and surveys, document this linkage, with fluid emission reported in conjunction with heightened sexual arousal and multi-orgasmic experiences among affected women.[19][44] For instance, a 1981 case study demonstrated physiological evidence of fluid release tied to orgasmic response, independent of urinary origin.[45] This association aligns with anatomical observations of Skene's gland activation during sexual stimulation, producing a viscous secretion homologous to male prostatic fluid.[1] Distinctions from urinary incontinence are critical, as coital incontinence—defined as involuntary urine leakage during penetration or orgasm—affects fluid emission dynamics differently. A 2013 systematic review differentiated female ejaculation (prevalence 10–54%) from orgasmic coital incontinence (prevalence up to 66%), noting that while both may coincide, ejaculation involves non-urinary fluid rich in prostate-specific antigen (PSA), whereas incontinence stems from bladder contraction and urethral relaxation.[22][46] Biochemical analyses confirm ejaculate's milky composition, contrasting with urine's urea content, though misidentification persists due to expulsion via the urethra.[41] Women experiencing ejaculation often exhibit normal voiding patterns without detrusor overactivity or bothersome incontinence symptoms.[20] Overlap occurs in subsets of women, where orgasm triggers simultaneous bladder emptying mimicking squirting, but urodynamic studies reveal incontinence as a separate sphincteric dysfunction rather than ejaculatory physiology.[47] Approximately 60% of women with general urinary incontinence report leakage during intercourse, but this does not equate to ejaculation, which lacks urea and exhibits PSA markers.[48][49] Peer-reviewed evidence underscores that true ejaculation enhances orgasmic satisfaction without implying pathology, countering conflations rooted in anecdotal or under-controlled observations.[50]Prevalence and Individual Experiences
Reported Rates Across Populations
Self-reported prevalence of female ejaculation, defined as the expulsion of fluid from the urethra during sexual arousal or orgasm, ranges from 10% to 54% across studies, with higher estimates often derived from smaller, non-representative samples prone to selection bias toward sexually experienced or exploratory participants.[21] This variability stems from inconsistent distinctions between true ejaculation (small-volume, prostate-specific antigen-containing fluid from Skene's glands) and squirting (larger-volume dilute urine), as well as reliance on retrospective surveys without physiological verification.[51] Population-based epidemiological data remain limited, with most research drawing from Western, educated cohorts where cultural openness to discussing sexual physiology may inflate reporting.[52] Early surveys provide foundational estimates. In a 1984 study of 227 American women, 54% reported at least one instance of orgasmic fluid expulsion, described as a sudden release unrelated to urination.[53] A 2013 Brazilian clinical sample of sexually active women found a 69% prevalence under targeted stimulation, though this was observed in a urological context and may not generalize.[54] More recent international online surveys, which frequently encompass both ejaculation and squirting, report intermediate rates. A 2023 study of 2,354 women across multiple countries indicated that 48% experienced squirting during penile-vaginal intercourse and 53% during masturbation, with only 20% associating it consistently with orgasm.[52] A 2024 Swedish cross-sectional analysis of 1,000+ women similarly found 52% reporting occasional occurrences and 7% frequent ones, highlighting infrequency as the norm even among affirmers.[55]| Study/Source | Year | Sample Size/Description | Reported Rate | Notes |
|---|---|---|---|---|
| Pastor et al. (systematic review)[21] | 2013 | Multiple studies aggregated | 10–54% | Distinguishes ejaculation from incontinence; self-reports dominant |
| Hurlbert & Apt[53] | 1984 | 227 U.S. women | 54% (at least once) | Orgasmic expulsion; no volume distinction |
| Salama et al. (Brazilian clinical)[54] | 2017 | Sexually active women (size unspecified) | 69% | Observed with stimulation; potential selection bias |
| Chalker et al. (international online)[52] | 2023 | 2,354 women globally | 48% (PVI), 53% (masturbation) | Includes squirting; 60% found pleasurable |