Dear Alice,

I have a really big problem. I have orgasms all the time! Some people might like this, but I don't. And, it's really embarrassing when I get one in the middle of class. It's not because I get turned on, it just happens. If someone sits on my lap, I get one! It's very embarrassing, and I don't know why it happens. Also, my vagina sometimes hurts and itches and sometimes has a foul odor. I want to go to the gyno to get this checked out, but I'm afraid I'll have an orgasm while the doctor is examining me! Please help! I'm too embarrassed to tell anyone about this.

Dear Reader,

An orgasm is a reflex, a release of the build-up of sexual tension. However, some women do experience orgasms or symptoms of sexual arousal despite not being "turned on." These spontaneous orgasms may be a sign of Persistent Sexual Arousal Syndrome (PSAS), a condition that has only begun to be identified and investigated. Symptoms of PSAS may include:

  • physical signs of sexual arousal (e.g., sensitivity, increased blood flow to the genitals) that last for an extended period of time and don't go away on their own
  • persistent, frequent, and/or continuous orgasm
  • physical arousal that persists despite orgasm

Also, this persistent arousal and/or orgasm isn't related to sexual desire; it may be triggered by nonsexual stimulation (e.g., someone sitting on your lap) or have no apparent cause at all. PSAS isn't well-studied, but it's thought that there can be a variety of potential causes, both physical (whether related to blood vessels, the nervous system, or medication) and psychological. The symptoms are unwanted and can cause quite a bit of distress — women experiencing them may want to visit a health care provider. The provider may be able to offer a diagnosis and then look at different possible causes in order to determine the best course of treatment. S/he might recommend seeing a specialist (like a neurologist) to address any underlying causes. Counseling can also help women with PSAS manage the frustration and embarrassment the syndrome can bring about.

In addition to seeing a health care provider, there may be things that you can do on your own to help deal with your orgasms. Maybe you can figure out when an orgasm is coming, so that you can at least be prepared, or even excuse yourself to somewhere more private, like the bathroom. You can also try to determine if there are any triggers for your orgasms that you can then try to avoid. If tight clothing is a cause, consider wearing looser pants or skirts. Since you orgasm if someone sits on your lap, before someone sits down, let him or her know that you find this to be uncomfortable and prefer that s/he sit somewhere else. Another thing you can do is to teach yourself to relax your pelvic muscles, releasing any tension as you notice it building — some women find Kegel exercises helpful. You can also masturbate in private more frequently to see if having fuller orgasms or more frequent "controlled" orgasms reduces the number of spontaneous ones you have.

It's a good idea to consider visiting a health care provider to also address the vaginal pain, itching, and odor you've noticed, since these could be signs of an infection. You might think about discussing your orgasms and your nervousness at the beginning of the appointment. This may be difficult to talk about, but it may help you feel more comfortable and be less embarrassed if you do orgasm during the exam. Remember, many patients pass gas, urinate, orgasm, and have erections (for men) during a physical examination. Providers realize that the human body can be unpredictable and respond uniquely, that a person's body functions in ways that can't always be controlled.

Good luck!


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