Why is the G-spot still such a mystery?

A couple of weeks ago I called out a woman on Dan Savage’s podcast who asserted that we know exactly what the structure of the G-spot is, that all women have it, and that every woman can ejaculate. I called her out because scientists haven’t reached a consensus on the G-spot. They’re not sure what the heck it is, how variable it is in women, or if it even exists at all.But calling her out made me wonder: Why is the G-spot still such a mystery?

To put it simply? The current research sucks.

And that’s not just my personal opinion. The Journal of Sexual Medicine did a big review of G-spot research at the end of 2010 (1). Their conclusion?

Although a huge amount of data (not always of good quality) have been accumulated in the last 60 years, we still need more research on one of the most challenging aspects of female sexuality.

For those of you who don’t speak science-ese, allow me to translate: A lot of this data is crap, and therefore we don’t know what’s going on.

After even the briefest overview of the literature, you start to understand why we’re so confused. For example, let’s look at two very popular G-spot papers from very different camps.

First, the “It’s all in your head!” camp. This is the less popular view, but there are some researchers who think the G-spot is nothing more than the placebo effect. The main study they have supporting this was done by Andrea Burri in 2010 (2). They did a twin study and claimed to find no genetic correlation for the G-spot – that is, if a woman had a G-spot, her twin was not more likely to also have a G-spot. It spread like wildfire in the media, and was even picked up by xkcd:

Except this study was a piece of crap.

For one, they did absolutely no physiological studies. How did they know if a woman had a G-spot, then? Why, they simply asked them! In the most leading, biased way possible (emphasis mine):

“Do you believe you have a so called G spot, a small areas the size of a 20p coin on the front wall of your vagina that is sensitive to deep pressure?”

If we ignore how poorly worded that question was, it still is not going to test genetic correlation of having a G-spot. Relying on personal opinion for physiological data is frankly ridiculous – would we determine how many lobes a liver has by asking people what they believe to be true? What they’re actually testing is if someone’s personal opinion about G-spots is genetic! Someone could think she doesn’t have a G-spot, but still have the exact same physiological reactions as her sister.

The other huge flaw of the study was that it didn’t take into account sexual practices. What if one twin only has sex in the missionary position, while the other is purposefully trying out stuff to reach her “so-called” G-spot? It’s wrong to assume that all types of sex produce the same time of stimulation. The researchers seemed somewhat aware of this, because they excluded bisexuals and lesbians…because they tend to have more digital sex.

Wait, what? So you have a group of people having the type of sex that, from conventional wisdom, is more likely to stimulate the “G-spot” – and you leave them out? Why not test to see if that conventional wisdom is actually right?

Well, maybe because the lead researcher is “anxious to remove feelings of “inadequacy or underachievement” that might affect women who fear they lacked a G-spot.” That’s certainly a noble cause, since women shouldn’t feel inadequate if they lack a G-spot…but it also certainly biases your research if you’re searching for a particular answer to support your world-view. Not to mention just swaps the stigma onto women who are told they’re being delusional based on crappy data.

I’ve been harping on the G-spot deniers, but the research on the other side is just as bad. I looked up the paper by Florian Wimpissinger that’s often cited as showing that female ejaculation is way more similar to semen than urine (3).

Yes, I had a good giggle that his name was Wimpissinger.

Anyway, this study looks very impressive on the surface. They did ultrasounds that found prostate-like structures in women! And urethroscopy that found a duct-like thingy! And biochemical analysis that showed it wasn’t urine! Doesn’t that sound fancy and
scientific?

Except they did a crappy job at those things.

Their ultrasound was so blurry and inconclusive that the article is immediately followed by a letter from concerned researchers saying “Dude, you totally misread that ultrasound. That’s a smudge, not prostate tissue.” And their response is basically “No, we’re right!” Not the best sign.

Maybe a prostate-like thingy.

But you know what’s a bigger problem then their possibly blurry ultrasound?

They had a sample size of two women who could ejaculate, and no control women.

Sample size of two.

No controls.

So while you can say some women may have a prostate-like structure (assuming their ultrasound doesn’t suck), you can’t say they all do. Because you tested two women out of 3 billion. What do the non-ejaculators look like? What do the women who think they don’t have G-spots look like? Humans are highly variable – height, skin color, breast size – the same could definitely apply to G-spots.

This is especially important in their biochemical study. They took ejaculate and urine samples from both women and compared them to the ejaculate from men using biochemical assays. They didn’t have a urine sample from men or non-ejaculating women to compare it to as a control. And for the second woman, they didn’t even do 5/9 of the tests! So basically they have a couple tests that vaguely show female ejaculate is more ejaculate-like than urine-like. I say vaguely because they didn’t do any sort of statistical analysis to see if this is significant or due to random chance – probably because they have a freaking sample size of two.

So from looking at these two important studies, it’s crystal clear why we don’t know what’s going on yet. The research just isn’t high quality.

But why haven’t scientists figured this out by now? How is it that we can track every individual cell in a developing worm, but we can’t tell if a structure is there or not in women? How is it that we know genetic variation at millions of sites in the genome across human populations, but we don’t know structural or physiological variation of an often discussed phenomena?

For one thing, the G-Spot is probably complicated. If I had to put my money on a hypothesis, I’d guess the G-spot is actually a combination of structures – maybe the Skene’s glands, the internal part of the clitoris, prostate-like tissue, or vaginal thickness. And I’d guess that it’s variable across women – either due to genetics or hormonal context during development. And when something is complicated, it’s a bit harder to figure out.

Part of the problem of getting a really good study is that sexual science is somewhat of an echo chamber. Almost all of the research is published in the Journal of Sexual Medicine, and almost all of the reviewers of papers are part of the same little group. They don’t have random molecular biologists reviewing their papers and weeping at their sample size, or screaming “Why didn’t you just do a mass spec run?!” There’s a reason why this stuff isn’t getting published in PNAS, Science, or Nature – maybe partly due to blushing editors, but mainly due to quality.

Another problem is that a good study of something complicated calls for thousands of samples – and it’s not easy to find thousands of women willing to participate in such a study. That’s not just because of puritanical views, though that’s definitely a contributing factor. Women have been historically mistreated under the guise of medicine, especially within the realm of sexual medicine. Treatments for hysteria, forced sterilization – those things may be in the past, but they still linger in people’s memories.

But even if you had the best scientists and a thousand volunteers, a lot of it boils down to the politics of science – especially the politics of the science of sex. In the US, the type of research that’s being done is the type of research that’s being funded – mostly from the government. And when you look at these studies, almost none of them are coming from the US – the two I mentioned were from the UK and Austria. Our puritanical views make it less likely that a massive G-spot study is going to be funded to put this question to rest.

I’m not trying to be overly patriotic, but the US produces some of the highest quality scientific research in the world. And when it’s too scared to finance the investigation of women’s sexuality, it’s no wonder we’re left in the dark.

Yet somehow there’s no shortage of money so men can keep having erections. Funny how that works.

So the next time someone claims to know exactly what a G-spot is – especially when they’re trying to sell you something – think of the science behind it. And remember, it’s okay for science to say “I don’t know – yet.”

1. Jannini, EA et al. (2010) Who’s Afraid of the G-spot? Journal of Sexual Medicine. 7:25-34.
2. Burri, AV et al. (2010) Genetic and Environmental Influences on self-reported G-Spots in Women: A Twin Study. Journal of Sexual Medicine. 7:1842-1852.
3. Wimpissinger, F et al. (2007) The female prostate revisited: perineal ultrasound and biochemical studies of female ejaculate. Journal of Sexual Medicine. 4:1388-1393.

Hey Dan Savage: Did you turn your skepticism off?

Everyone here probably knows that I’m a huge fan of Dan Savage – but this week’s Savage Lovecast was a massive failure.
A guest on the show was Heike Rodriguez, who “teaches Female Ejaculation in West Seattle.” Not exactly sure what that entails, but that’s not the problem. When she wasn’t spewing woo-woo unscientific bullshit, she was claiming women who can’t ejaculate have some sort of emotional issues, and maybe were even raped and don’t remember it.

One of the very first things she says about female ejaculation is “That’s actually a myth. Every woman can do it. Everybody has a G-spot. There’s no argument about that. The anatomy is there for pretty much everybody.”

Uh, false. Researchers still have no freaking clue what’s going on down there. Some think it’s the Skene’s gland. Some think it’s the urethral sponge. Some think it’s the thickness of the vaginal wall. Some think it’s the internal parts of the clitoris. If scientists in 2011 are still arguing over a bit of human anatomy, it’s not as cut and dry as you think.

There’s also the fallacy of “Well I’ve experienced it, therefore it must be there for everyone.” Let’s assume the G-spot does exist in some women, and it’s not just psychological. That doesn’t mean it has to exist in everyone. A lot of human traits are variable – height, weight, breast size. And some people completely lack certain structures – for example, people who are born without wisdom teeth.

Now, you’re not going to be missing something like a heart or a stomach, but the G-spot isn’t exactly necessary for survival. More likely it’s the evolutionary side effect of certain male structures, in which case it would be completely plausible that it’s variable in women.

But to say all women have it, and as definitively as she did? Outright lie.

To illustrate how little Heike knows about sexual physiology, Dan asks her if female ejaculate is urine, and her response is “It’s impossible to pee while you’re aroused. It’s really simple. You can’t pee.”

Again, untrue. Both men and women can pee while aroused. Men can’t pee when they’re close to ejaculating (not the same as arousal) or soon after ejaculation because the bladder neck closes so semen won’t go into the bladder. Totally not the same as “You can’t pee while aroused.”

At this point Dan was tries to call her out on the idea that all women can ejaculate…and that’s where it gets even worse. “It has a lot to do with emotions. […] It has a lot to do with connecting intimacy with sex. It has a lot to do with letting your emotions flow, with being willing to cry when you feel something intensely. And that’s not something thats really out there as part of sex. And I think that’s why a lot of women can’t do it. Because they haven’t connected their heart with their vaginas.”

Oh bugger off with the new-age hippy bullshit. You have absolutely no evidence to support anything you’re saying, and it’s insulting to say that women who can’t ejaculate are somehow just not being intimate enough.

And when Dan gently calls her out on that, saying that some women are just anorgasmic, she responds that she was anorgasmic because she was raped. And then implies that emotional or sexual trauma are the real reasons why women can’t orgasm or ejaculate.

Again, not an ounce of evidence, and perpetuating the mindset that women are somehow damaged if they don’t react in a certain way. Sorry, but saying “I don’t think women should feel bad” over and over doesn’t make them not feel bad when you say the only reason they don’t squirt is because they aren’t intimate enough or are traumatized.

Even though Dan tried to (too politely) question her claims, I wonder why he even had her on the show to begin with. I thought something smelled fishy when she said “If it’s really painful, then maybe some emotional pain needs to be released.” Yes, “energy.” It must be “released,” or something. A quick glance at her group’s website doesn’t list any sort of credentials for her. The only “credentials” she mentions on the show is being able to ejaculate (good for you) and being a partner of her “co-facilitator.” And the credentials for her “co-facilitator”? He’s a former minister with a Masters in Divinity in degree, and “facilitates” stuff like “dreamwork.”

If that doesn’t set off skeptical red flags, I don’t know what will.

So massive fail, Dan. How are you so skeptical about religion, but invited someone like this on your show? Did no one call in that week and you were desperate to fill the air time? I have a feeling there are at least a couple people in Seattle with actual credentials to back up their sexual information that you could have turned to. Hell, people who can use Google are more informed than she was.

I have a feeling you got a lot of angry calls because of her. I hope we get to hear some of them in the next podcast.

Looking at your vagina, or criticising religion?

Which offends religious people the most?

This is a toughie. Why don’t we look at the faux controversy coming from Dartmouth College. Mayuka Kowaguchi created “The Orchid Project” for her sexual health peer-advising group on campus. What was this horrifying project? Small hand mirrors were distributed to women on campus, with an accompanying note describing female anatomy and the statement that the project was “to shift [women’s] perspective from the expectations and limitations of belief patterns, societal cultural or religious conditioning.”

Cue the religious hysterics:

If these mirrors were truly meant to encourage the consideration of issues surrounding body-awareness, then, I believe, those who consider themselves to be members of Dartmouth communities of faith — which do not support acting on this knowledge in a sexual fashion — would not have been offended.

[…]This is one of many occasions where I have found the liberal body at Dartmouth to completely violate those principles that it purports to advance: respect and freedom. Regardless of the offensiveness of the message, if the Orchid Project’s main goal was to encourage consideration, what possessed them of the idea that a direct attack on all faiths was the way to do that?

[…]The body of believers at Dartmouth and the body of non-believers would often mutually benefit from sitting down and “considering” the issues surrounding sexuality. Respectful discussion will only bred further respect and discussion, but blatant attacks on an entire outlook on life, will only bred further animosity, ignorance and offense.”

Oh boo hoo! Someone dared to suggest that my religious beliefs are wrong! Don’t they know that criticizing belief patterns and societal culture are okay, but irrational religious beliefs are untouchable? Who missed the political correctness memo?! Help, help, I’m being oppressed!

I can’t even conceive how someone can read that initial statement to mean that all religious beliefs are completely wrong, unless they’re trying to play the victim. And then turn around and presume to speak for every religious person at Dartmouth. And then go and condemn “acting on this knowledge in a sexual fashion,” thus proving the initial point that some religious beliefs can lead to sex-negative beliefs.

If you think a simple suggestion that you’re incorrect is a “blatant attack,” then what the hell is “respectful discussion”? Bashfully going “Shucks, whatever you want to believe must be right! I sure won’t ever present a viewpoint that disagrees with you! Because your beliefs cannot be criticized, even if it means my beliefs must be silenced”?

Fuck that. I’ll respect your beliefs once they’re deserving of respect – that is to say, when they’re not based on some ancient book about a invisible sky daddy and his zombie self-child that was scribbled together by some misogynistic dudes in a desert – or whatever particular illogical mythology you prefer to subscribe to. Feel free to keep believing, but don’t assume that gives you immunity from criticism. Pleasantries and political correctness only allows insane ideas to flourish.

Why are so many people starting to criticize Christianity? It’s not a mass conspiracy – it’s because you’re wrong.

So back to my original question: I guess that’s a vote for “criticising religion.” Meh, I’ll go look at my own vagina too, just in case.

(Via Jezebel)

Homeopathy: Now for vaginas too!

Phil over at Skeptic Money is always keeping his eye out for silly homeopathic scams. Now he’s “found one just for the ladies“:

There is now a “treatment” for a yeast infection. It is called Yeast Gard. It has no side effects. Actually, it has no effects. Here are the “active” ingredients: Candida albicans 28x, Candida parapsilosis 28x, Pulsatilla 28x. Since I had no idea what these things are – I had to look them up. You’re gonna love this…. (From Wikipedia)

Candida albicans is a diploid fungus (a form of yeast) and a causal agent of opportunistic oral and genital infections in humans.

Candida parapsilosis is a fungal species of the yeast family that has become a significant cause of sepsis and of wound and tissue infections in immuno-compromised patients.

The genus Pulsatilla includes about 30 species, many of which are valued for their finely-dissected leaves, solitary bell-shaped flowers, and plumed seed heads. The anthers are bright yellow and the purple bell consists of sepals.

Ah, that’s lovely. Add a bunch of gel with the “memory” of yeast (aka, a bunch of gel with nothing in it) to your vagina, and your yeast infection should clear up in a couple of days! Even though your yeast infection probably would have cleared up in a couple of days if you did nothing. Ah, scams, aren’t they lovely?

Though the thing I find most amusing is that whenever someone recommends a post or article to me (like this one), 90% of the time it’s about vaginas/penises/boobies/sex. Well, there’s usually some sort of skeptical bent to it, or it’s inane enough to need my commentary or debunking. You guys know me too well (I mean, look, I already had a “vagina” tag). Kind of love it that sex makes you think of me!

Is your vagina pink enough?!

Oh goodie! Just when I thought society was starting to run out of ways to make women shameful about their bodies, we get My New Pink Button, “a temporary dye to restore the youthful pink color back to your labia.” I can’t make this shit up, people.As if women didn’t already have seventy billion “beauty products” marketed to them as necessary essentials, now we have to worry about the color of our fucking vaginas? If a guy complained to me that my vagina wasn’t pink enough, I wouldn’t have to buy this product because that guy would not be seeing my vagina again any time soon.

I’m not going to stop women from wearing make up, using creams, attempting bizarre diets, or dying their vagina. Whatever, that’s your choice – even I enjoy getting dolled up once in a blue moon. But feeling beautiful is different from being shamed into body modification. Not only are we adding insecurities, but it’s simply a waste of money. One jar is $29.95 and contains 20 uses, each which last up to 72 hours. If somebody is seeing your vagina frequently enough that you need it pinkified every day, minus a week each month for a period let’s say, you’ll spend about $140 on this stuff a year. I’m sorry, but I have better things to do with my money.

At least they give you options, though. You can choose from four shades of pink, cutely named Marilyn, Bettie, Audry, and Ginger, the last one specifically made for “Women of Color.” …Yeah, I don’t need to say any more, do I?

(Via Womanist Musings)

No G-Spots?! …Wait, what?

If you have the same taste in blogs that I do (aka you’re obsessed with sex), you’ve probably been inundated with posts about how a new study has proven that G-spots don’t exist!

The scientists at King’s College London who carried out the study claim there is no evidence for the existence of the G-spot — supposedly a cluster of internal nerve endings — outside the imagination of women influenced by magazines and sex therapists. They reached their conclusions after a survey of more than 1,800 British women.

Well, I’ll be damned. I was fairly certain from personal experience that G-spots do exist, but I can’t argue with scientists, can I? They must have carefully inspected all 1,800 of those British women (what a lucky grad student!), right?

In the research, 1,804 British women aged 23-83 answered questionnaires. All were pairs of identical or non-identical twins. Identical twins share all their genes, while non-identical pairs share 50% of theirs. If one identical twin reported having a G-spot, this would make it far more likely that her sister would give the same answer. But no such pattern emerged, suggesting the G-spot is a matter of the woman’s subjective opinion.

And what was that questionnaire? Just a single question:

“Do you believe you have a so called G spot, a small areas the size of a 20p coin on the front wall of your vagina that is sensitive to deep pressure?”

…Alright boys and girls, it’s time for a lesson on why this is “Bad Science.”

Questionnaires are always a bit subjective and iffy – especially when asking someone about their anatomy. If you ask people how many chambers their heart has, and some say 3, that doesn’t mean they’re actually missing a chamber. Simply asking people if they have a G-spot doesn’t confirm it’s existence or lack thereof. I can’t believe that this study would rely on opinion rather than medically examining females to see if it is there or not.

The fact that they didn’t see any correlation in identical twins just illustrates that personal opinion about the existence of a G-spot is not genetically determined. Their initial logic that genetically identical twins should have identical sexual responses is flawed. Sexual response has a huge environmental component, which the study finds but apparently ignores:

While 56% of women overall claimed to have a G-spot, they tended to be younger and more sexually active.

That makes perfect sense. Finding the G-spot isn’t easy. It usually takes a patient partner, sex positions other than missionary, or specialized sex toys – all of which are more likely to be found in younger, sexually active people. What’s more likely: that these women are partaking in activities that make them more likely to find their G-spot, or that the majority of women are all delusional about a specific area that causes intense pleasure? I don’t know about you, but if I’m going to hallucinate a pleasure button, I’m going to put it somewhere I little easier to reach.

A quote from the researcher also sends up a red flag for me:

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.

Yep, it’s always great to go into research with an agenda and preconceived result in mind!

This all may be the result of bad science reporting, which is always a likely cause, since the actual paper is coming out next week. I’ll look forward to reading it and seeing if it’s also so strident in its claims.