During the years when a woman can have children, her ovaries make hormones. They also take turns each month releasing a ripe egg. The egg travels through a tube into the womb (uterus). When she has sex, a woman gets pregnant if a sperm cell gets in through the opening at the bottom of her uterus (called the cervix) and joins the egg.
An egg is fertile only for about 2 days. If a woman does not get pregnant during that time, the lining of the uterus that has built up over the past weeks flows out her cervix during her “period” (menstruation). If she gets pregnant, the lining stays in place to help feed the growing baby.
Hormones
The ovaries usually stop releasing eggs and greatly cut down their hormone output when a woman is around age 50. This is called menopause or the change of life. Many women are afraid they will not want sex after menopause. But for many women the drop in hormones does not change sexual desire. The main hormones we’ll talk about are estrogen and androgens.
Estrogen
Estrogen helps keep your vagina moist and flexible, and helps it open up when you are aroused. When a woman is not excited, her vagina stays relaxed and folded together so that its walls touch each other. As a woman starts to feel aroused, the vagina gets longer and wider. The cells lining the vagina “sweat” drops of fluid that make the vagina slippery.
After menopause, a woman’s estrogen levels are lower. This means that as the woman gets aroused, it can take longer for the vagina to change shape and sweat fluids. Low estrogen can also cause the lining of your vagina to get thinner and lose some of its ability to stretch. In some women, the vagina may stay a bit tight and dry, even if the woman is very excited.
Androgens
The ovaries also make small amounts of androgens, which are sometimes called male hormones. Androgens help produce sexual desire in women. After menopause, there is less of this hormone, and some women notice a drop in desire.
Female orgasm
As a woman becomes sexually excited, her nervous system sends signals of pleasure to her brain. If she is touched in a way that she likes, the signals can get stronger and may trigger the orgasm reflex. During orgasm, the muscles around the genitals contract in rhythm. The sudden release of muscle tension sends waves of pleasure through the genital area and sometimes over the entire body. Afterward, a woman feels relaxed and satisfied.
A woman’s orgasms may change over time. As she gets older, orgasms may take longer to reach, and more stroking may be needed.
How orgasms happen
An orgasm is a natural reflex, but some women must practice to learn how to trigger it. If cancer treatment changes the sexual response, a woman may need to re-learn this skill.
There are many ways to reach orgasm. They differ for each woman. A few women can reach orgasm just by having a fantasy about sex or by having their breasts touched. But most women need their genitals stroked to reach orgasm.
The areas of a woman’s genitals (see picture) that are most sensitive to touch are the clitoris and the inner lips. The outside part of the genitals (called the vulva) includes the outer lips, inner lips, the clitoris, and the entrance to the vagina. The outer lips are spongy, and protect the delicate inner lips and clitoris. The opening of the urethra (the tube that carries urine out of the body) is between the inner lips and behind the clitoris. The anus (opening of the bowel) is behind the vagina.
Many women reach orgasm most easily by stroking the clitoris. Like a penis, the clitoris has a head and a shaft. Messages of pleasure are sent to the brain when the clitoris is stroked.
The head of the clitoris is so sensitive that it can get sore if it’s rubbed too fast or too hard. Lubricants (gels or liquids) can be used to help prevent soreness. Stroking or touching close to the head of the clitoris — but not right on it — can also help.
Other areas, like the outer lips and anus, can also give a woman pleasure when stroked. Each woman’s sensitive zones are a little different. The opening of the vagina is more sensitive than the deep end (inside) of the vagina. For some women, the front wall of the vagina (stomach side) is more sensitive to pressure during sex than the back wall. Stroking the area about 1 to 4 inches inside the front wall of the vagina can help some women reach orgasm during sex.
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