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FEMALE SEXUAL FUNCTION
ORIGINAL RESEARCH
The Importance of Male Ejaculation for Female Sexual Satisfaction
and Function
Andrea Burri, PhD,
1,2
Joceline Buchmeier,
3
and Hartmut Porst, MD
1
ABSTRACT
Introduction: Although links between ejaculatory control or intravaginal ejaculatory latency time and female
sexual functioning have frequently been reported in the past, no study has investigated the importance of other
male ejaculatory characteristics, such as ejaculation volume and intensity, for women’s sexuality.
Aim: To assess the importance of subjectively perceived ejaculation intensity and ejaculation volume for female
sexual function and satisfaction.
Methods: This was a cross-sectional online survey including 240 sexually active, heterosexual women (median
age 27.4 years), using study-specific questions and validated questionnaires.
Main Outcome Measure: Results are presented as means, percentages, and age-controlled partial correlation
coefficients of the main study variables.
Results: 50.43% of women considered it very important that the partner ejaculates during intercourse. 18.3% of
women preferred that the partner ejaculates before they reach orgasm, whereas for 53.5% this did not matter.
22.6% of women stated that they experienced a more intense orgasm when their partner ejaculated during
vaginal intercourse. 17.4% reported that they definitely experienced a more intensive orgasm depending on the
intensity of their partner’s ejaculation, whereas for 17.8% this did not matter at all. 20.9% of women did not feel
that their orgasm was more intense depending on the subjectively felt ejaculate quantity, whereas the majority
(37.9%) stated that it did not matter. 13.1% of women regarded the quantity of expelled ejaculate as an
expression of their own sexual attractiveness. Women stating that they experienced more intense orgasms when
the partner ejaculated, when the partner experienced a more intense ejaculation, and when he expelled a greater
ejaculate quantity also reported better lifelong orgasmic function (r ¼0.24, r ¼0.15, r ¼.26, respectively) and
more lifelong sexual satisfaction (r ¼.29, r ¼.15, r ¼26, respectively).
Clinical Implications: The perception of ejaculatory characteristics can be related to the female partner’s sexual
satisfaction and overall sexual functioning.
Strength & Limitations: This is the very first study to explore the importance of male ejaculation volume and
intensity for women’s sexual functioning. Data are of self-report nature and ejaculation characteristics were not
objectively measured but by women’s self-report.
Conclusion: Although male ejaculation and its different aspects seem to play an important role for women, the
study demonstrates a considerable variability of women’s attitudes toward ejaculatory characteristics. Further
research is required to examine the sources of this variability. Burri A, Buchmeier J, Porst H. The importance
of male ejaculation for female sexual satisfaction and function. J Sex Med 2018;XX:XXXeXXX.
Copyright 2018, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
Key Words: Ejaculation; Female Sexual Dysfunction; Partner Distress; Ejaculation Volume; Ejaculation
Intensity
INTRODUCTION
Male ejaculatory dysfunctions can severely impact a man’s
mental and physical health, often resulting in heightened distress,
decreased self-confidence, increased risk of psychological disor-
ders, and reduced sexual activity.
1e6
In a study by Brock,
7
men
concerned with ejaculation problems stated feelings of “letting
Received February 20, 2018. Accepted August 24, 2018.
1
European Institute for Sexual Health, Hamburg, Germany;
2
Health and Rehabilitation Research Institute, Auckland University of
Technology, Auckland, New Zealand;
3
Department of Psychology, University of Zurich, Zurich, Switzerland
Copyright ª2018, International Society for Sexual Medicine. Published by
Elsevier Inc. All rights reserved.
https://doi.org/10.1016/j.jsxm.2018.08.014
J Sex Med 2018;-:1e91
their partner down”and showed a reduced frequency of sexual
activity compared with healthy subjects. During sexual inter-
course, subjects with premature ejaculation (PE) further stated
that they were preoccupied with thoughts regarding their control
of ejaculation and maintenance of erection.
8
Adverse conse-
quences for sexual health—such as a decrease in desire, arousal,
or orgasmic function—and relationship satisfaction have also
been observed in female partners of men with PE—in some cases
even leading to subsequent relationship break-ups.
9e11
Because sex and relationship quality and satisfaction are closely
linked, sexual problems always need to be seen as a dyadic prob-
lem. It is therefore not surprising that ejaculatory dysfunctions
such as PE can also affect the intimate relationship, as well as sexual
satisfaction and functioning of the female partner.
3,9,11,12
2 studies
assessing satisfaction with sexual intercourse, personal distress, and
interpersonal difficulties in healthy female partners of men with
and without PE both found that female partners of men with PE
reported more interpersonal difficulties, were less satisfied with
sexual intercourse, and more personally distressed than female
partners of non-PE men. In addition, results indicated that women
with a PE partner had significantly more sexual problems
compared with women with healthy partners.
4
Other studies using
different samples and psychometric instruments lead to similar
results, therefore further highlighting the detrimental effects of PE
on female sexual satisfaction and functioning.
3,9,11,13,14
The effect
of PE on women’s sexual functioning seems to be particularly
detrimental in terms of orgasm ability. In a study by Hobbs et al,
15
more than half of women with a PE partner displayed orgasmic
problems, whereas only 23.9% of the control group complained of
orgasmic infrequency.
Although the association between PE and the female partner’s
sexual functioning is empirically established, to the best of our
knowledge, no studies have explored the impact of delayed or
retrograde ejaculation and male anorgasmia on the female part-
ner. Furthermore, most of the investigated aspects are closely
linked to the clinical definition of PE, thus mainly focusing on
criteria such as “ejaculatory control”or “intravaginal ejaculation
latency time”(IELT).
3,14
Only very few studies have taken a
closer look into the nature of the relationship between male
ejaculation and female sexuality, such as the specific conse-
quences of PE that could potentially influence female sexual
satisfaction and orgasm ability. In a study conducted by Burri
et al,
9
1,463 females with a PE partner were questioned about
their perception of PE and which specific aspects they perceived
as problematic. Not surprisingly, an orgasm-dependent effect
could be observed, with women with infrequent orgasms
considering versatility (ie, creativity in bed) more important than
the duration of intercourse, whereas women with a high orgasm
ability wished for a longer duration of intercourse and were more
distressed by their partner’s lack of ejaculatory control.
In summary, despite evidence indicating detrimental conse-
quences of ejaculation problems in both partners, only limited
knowledge exists of how important male ejaculation and its
various characteristics such as ejaculation volume and intensity
might be for female sexual function and satisfaction.
AIM
Considering the current state of research and the fundamental
research gap, the present study aimed at investigating the
importance of intravaginal ejaculation characteristics, including
subjectively assessed ejaculation intensity and ejaculation volume
for female sexual functioning with a special focus on sexual
satisfaction and orgasm ability in a population sample of 240
sexually active women.
METHODS
Sample and Study Design
The study was set up in Switzerland as a cross-sectional online
survey, which was accessible to the participants from September
2014 to January 2015. Recruitment was achieved through word-
of-mouth recommendations and by advertisements in various
universities, bars, fitness centers, and on various social media
platforms (eg, Facebook). Self-reported data were collected by
means of a set of validated and study-specific questionnaires (see
the following for more detailed information). The survey took
about 30 minutes to complete and started with a declaration of
consent ensuring the subject’s ethical rights in accordance with
the guidelines of the Declaration of Helsinki. In the survey
introduction, participants were informed about the intimate
nature of the questions and that the assessment was fully anon-
ymous and voluntary, and about their right to withdraw from the
study at any time. As a stipulation, their legal age was confirmed.
Throughout the survey, additional information regarding certain
constructs and terminologies (eg, definition of sexual desire or
arousal) was given to avoid misunderstandings. No monetary or
other reward was provided. Ethical approval was obtained
through the Ethics Committee of the Department of Psychology
at the University of Zurich.
At the end of the 4-month recruitment period, 429 partici-
pants had participated in the survey. Of these initial 429 par-
ticipants, the following numbers were excluded for not meeting
the inclusion criteria: 3 were younger than 18 years, 120
(27.97%) responded “no”to the question “Have you ever been
sexually active?,”21 (4.89%) individuals considered themselves
predominantly or exclusively homosexual (Kinsey scale 5e7),
and 45 had more than 2 items per subscale missing on the
Female Sexual Function Index (FSFI) or the FSFI-Lifelong
(FSFI-LL). In the end, a final sample of 240 women between
20 and 60 years old were included in the study.
Measures
Basic sociodemographic characteristics of the participants were
assessed using self-constructed questions. Subjectively perceived
J Sex Med 2018;-:1e9
2Burri et al
ejaculatory preferences of the woman were assessed using a set of
self-constructed, study-specific items.
Information on female sexual functioning was collected by
means of the validated German version of the FSFI.
16,17
The
FSFI is a 19-item self-report questionnaire assessing female sexual
functioning within the past 4 weeks. It covers the 6 subdomains
of desire, arousal, lubrication, orgasm, satisfaction, and sexual
pain. Furthermore, a total sexual functioning score can be
computed. Response options are on a Likert-type scale ranging
from 1e5 for the domain of desire and from 0e5 for all the
other domains. For details on domain score computations and
domain factor weights, please see Rosen et al.
11
A cut-off of
26.55 has been proposed for differentiating women with and
without sexual dysfunction.
18
In addition to the FSFI, the FSFI-
LL was administered to capture sexual functioning “ever since
sexually active.”Similar to the original FSFI, the FSFI-LL, as well
as the translated German version, have both shown good to
excellent psychometric properties.
19
Statistical Analyses
All analyses were conducted using Stata 14 (StataCorp LP,
College Station, TX, USA). Normal distribution of the variables
was assessed by visual inspection of the histograms and by per-
forming ShapiroeWilk tests. Because of deviation from normal
distribution of most variables, non-parametric methods of ana-
lyses were used. Ordinal scaled variables and the FSFI and FSFI-
LL subscales and total scores were treated as continuous variables.
For correlation analyses involving ejaculation characteristics, the
response options “doesn’t matter and never paid attention”were
dropped, resulting in a response-format ranging from “Very
important”to “Not at all important.”Descriptive statistics were
calculated as means and standard deviations for continuous and
ordinal measures and as percentages for categorical and dichot-
omous measures. In cases where participants had <2 items
missing in the FSFI and the FSFI-LL, the missing values were
replaced with the calculated mean of all non-missing observations
of this particular item. Previous research has repeatedly estab-
lished the important influence of age on female sexual func-
tioning,
20,21
and although no significant association between age
and female functioning (across the various domains) could be
consistently detected in our study, the relationships between our
variables of interest were investigated using age-controlled partial
Spearman correlations. The effects of different sexual preferences
were analyzed by dividing the sample according to the original
item scales (kissing, cuddling, petting, vaginal intercourse, anal
intercourse, oral sex active and passive) and into 3 groups: (i)
women stating kissing, cuddling, petting to be their preferred
activity, (ii) women preferring vaginal intercourse, and (iii)
women preferring oral sex active and passive). For group com-
parisons, KruskaleWallis tests were performed on age-adjusted
residuals. These were obtained from the overall regression line
fit to the entire data set. All tests were 2-tailed. For all analyses, a
Pvalue <.05% was considered statistically significant, unless
stated otherwise.
RESULTS
Sample Characteristics
Table 1 displays the sociodemographic characteristics of the
sample. The mean age of the sample was 27.4 (SD ¼6.3; range
20e60). 64.58% of women were in a committed relationship
with an average relationship duration of 50.2 months (SD ¼
40.22, range 12e277). The majority of women reported having
had between 1 and 4 sexual relationships (59.6%). The average
number of sexual partners in the past 12 months was 1.9,
ranging from 1 to 10 (Table 1).
Table 1. Sociodemographic characteristics of the study population
(N ¼240)
Variable Mean SD Range
Age 27.38 6.25 20e60
Weight (kg) 60.34 9.47 46e125
Height (cm) 167.16 9.05 73e187
Relationship duration (mo) 50.16 40.22 12e277
Number of sexual partners
within last 12 mo
1.93 1.62 1e10
N%
Nationality
Austrian 25 10.46
Swiss 200 83.68
German 14 5.86
Marital status
Single without partner 72 30.0
Single with changing sex partners 13 5.42
With partner, living separate 108 45.00
With partner, living together 37 15.42
Married, living separate 2 0.83
Married 8 3.33
Occupation
Full time (100%) 89 37.08
Part time 106 44.17
No regular employment 45 18.75
Highest education
In training 36 15.0
Mandatory graduation 1 0.42
Apprenticeship 27 11.25
“Matura“graduation 69 28.75
University/Academy 107 44.58
In a relationship 160 69.57
Number of sexual relationships
20 1 0.43
10e19 26 11.30
5e9 40 17.39
1e4 137 59.56
1 26 11.30
J Sex Med 2018;-:1e9
Male Ejaculation and Female Sexuality 3
For 59.1% of women, sex was important or very important,
whereas 2.6% considered it not important (Table 2). The ma-
jority of women (43%) stated having engaged in sex several times
a week in the past month. Similarly, 69.6% of women said that
they considered several times a week to be ideal. Only 6.1%
wished to engage in sex everyday (Table 2). For 46.9% the
preferred sexual activity was vaginal intercourse, followed by
cuddling (14.8%), petting (12.2%), passive oral sex (12%), and
kissing (10.4%). Only a small minority of women preferred anal
intercourse (0.8%) or active oral sex (2.6%) over the other ac-
tivities (Table 2).
In terms of current levels of sexual functioning, lowest scores
on the FSFI, therefore more sexual problems, were reported for
desire (4.25, SD 0.9), whereas highest scores were found for
lubrication (ie, least problems; 5.44, SD 0.82; Table 3). The
same picture emerged for lifelong sexual functioning (desire 3.51
vs lubrication 5.15). 5.2% of women said they always reached
orgasm during vaginal intercourse, as opposed to every fifth
(21.7%) woman stating that she never reached orgasm during
vaginal intercourse (Table 2).
All domains of current sexual functioning correlated signifi-
cantly with each other apart from desire and pain (r ¼0.1017,
P¼.11), desire and satisfaction (r ¼0.004, P¼.94), and
satisfaction and pain (r ¼0.10, P¼.11; results not shown).
Similarly, for lifelong sexual functioning, no significant correla-
tion between desire and pain (r ¼0.05, P¼.41) and satisfaction
and pain (r ¼1.22, P¼.0604) could be observed, whereas all
other domains correlated significantly with each other. Highest
intercorrelations were observed between current satisfaction and
arousal (r ¼0.61, P<.001) and between lifelong orgasm and
arousal (r ¼55, P<.001).
Importance of Male Ejaculation and Its
Characteristics for the Female Partner
50.43% of women considered it very important that the
partner ejaculates during intercourse, however, variability could
Table 2. Women’s answers to the study-specific, sex-related
questions (N ¼240)
Question Response %
How important is sex for you?
Very important 19.13
Important 40.00
Rather important 29.57
Neither important nor unimportant 6.96
Rather unimportant 1.74
Not important 2.61
Not at all important e
How often have you engaged in sexual
intercourse in the past month?
Never 6.52
Once a month 11.30
Twice a month 18.26
Once a week 20.00
Several times a week 43.04
Every day 0.87
How often would you ideally engage in
sexual intercourse?
Never e
Once a month 0.43
Twice a month 2.61
Once a week 21.30
Several times a week 69.57
Every day 6.09
Which is your preferred sexual activity?
Kissing 10.43
Cuddling 14.78
Petting 12.17
Vaginal intercourse 46.96
Anal intercourse 0.87
Oral sex active 2.61
Oral sex passive 12.17
How often do you orgasm during vaginal
intercourse?
Always 5.22
Almost always (75%) 26.96
Sometimes (50%) 21.30
Rarely (<25%) 24.78
Never 21.74
Do you generally prefer that your partner
ejaculates before you reach orgasm?
Yes 18.26
No 28.26
Doesn’t matter 53.48
Do you perceive the quantity of the expelled
ejaculate as an expression of your own
sexual attractiveness?
Completely agree 1.30
Agree 11.74
Neither agree nor disagree 19.13
Disagree 28.26
Completely disagree 39.57
Table 3. Current and lifelong sexual functioning as assessed by
the FSFI and FSFI-LL (N ¼240)
FSFI FSFI-LL
Mean SD Mean SD
Desire 4.25 0.91 3.51 0.87
Arousal 4.80 0.79 3.82 0.77
Lubrication 5.44 0.83 5.15 0.85
Orgasm 4.70 1.23 4.28 1.23
Satisfaction 5.13 1.01 4.71 1.10
Sexual Pain 5.22 1.01 4.98 1.05
Total FSFI 29.56 3.79 26.48 3.79
FSFI ¼Female Sexual Functioning Index; FSFI-LL ¼Female Sexual Func-
tioning Index-Lifelong.
J Sex Med 2018;-:1e9
4Burri et al
also be observed (Figure 1). This was positively associated with
women’s importance of their own orgasm (“How important is
it for you that you reach orgasm during a sexual encounter?”;
r¼0.29, P<.001). Furthermore, older women considered it to
be more important that the partner ejaculates during intercourse
(r ¼0.16, P¼.014) compared with younger women. No sig-
nificant relationship between importance of partner ejaculation
and women’s own orgasm ability could be detected (“How often
do you orgasm during vaginal intercourse?”;r¼0.11, P¼.11).
Furthermore, importance of partner ejaculation was not associ-
ated with levels of self-reported sexual experience or previous
numbers of partners (r ¼0.08 and r ¼0.10, P>.05 for both).
There was, however, a statistically significant relationship be-
tween importance of sex (“How important is sex for you?”) and
importance of partner ejaculation and the importance of
women’s own experience of orgasm during vaginal intercourse
(r ¼0.19 and 0.14, P<.005 for both).
18.3% of women preferred that the partner ejaculates before
they reach orgasm, 28.3% did not, and for the majority (53.5%)
it did not matter. 22.6% of women stated that they experienced a
more intense orgasm when their partner ejaculated during
vaginal intercourse (Figure 2). For 21.7% it did not matter
whether he ejaculated and 10.4% never paid attention to this
fact. Almost every sixth woman (17.4%) further reported that
she definitely experienced a more intensive orgasm depending on
the intensity of her partner’s ejaculation/orgasm, whereas for
17.8% this did not matter at all (Figure 2). 20.9% of women did
not feel that their orgasm was more intense depending on the
subjectively felt quantity of their partners’ejaculate, whereas the
majority (37.9%) stated the ejaculation volume did not matter
and 27% had never paid attention (Figure 2). Only 13.14 % of
women regarded the quantity of expelled ejaculate as an
expression of their own sexual attractiveness (completely agree
and agree); here, again, an age-dependent effect could be
observed (r ¼0.16, P¼.16). Importance of partner ejaculation
did not differ depending on the women’s preferred sexual
activity, neither when including the original 7 groups (kissing,
cuddling, petting, vaginal intercourse, anal intercourse, oral sex
active and passive) (c
2
¼5.90, P¼.43), nor when categorizing
into 3 groups (1 ¼kissing, cuddling, petting; 2 ¼vaginal
intercourse; 3 ¼anal intercourse, oral sex active and passive)
(c
2
¼1.18, P¼.56).
Figure 1. Women’s answers to the question “How important is it for you that your partner ejaculates/reaches orgasm during a sexual
encounter?”
Figure 2. Women’s answers to the questions: 1. “Do you experi-
ence a more intensive orgasm depending on a higher intensity of
your partner’s ejaculation/orgasm? (eg, louder moaning heavy
groaning, deeper breathing)”2. “Do you experience a more inten-
sive orgasm depending on the subjectively perceived greater
quantity of the expelled ejaculate?”3. “Do you experience a more
intensive orgasm when your partner ejaculates during vaginal
intercourse?”
J Sex Med 2018;-:1e9
Male Ejaculation and Female Sexuality 5
Male Ejaculation Characteristics and Female Sexual
Functioning
Significant positive associations (ie, the more important the
ejaculation, the better the woman’s sexual functioning) could be
detected between the overall importance of male ejaculation
during intercourse and current and lifelong lubrication (r ¼0.15
and r ¼0.13, P<.05 for both), and lifelong total sexual
functioning (r ¼0.16, P<.005; Table 4). A tendency toward a
positive association between the importance of ejaculation and
lifelong orgasm ability could be observed, which, however, did
not reach statistical significance (r ¼0.12, P¼.073). Women
with a current better orgasmic ability experienced more intense
orgasms when the partner ejaculated (r ¼0.14, P¼.046;
Table 4). Women stating that they experienced more intense
orgasms when the partner ejaculated, when the partner experi-
enced a more intense ejaculation, and when he expelled a greater
ejaculate quantity also reported better lifelong orgasmic function
(r ¼0.14, P¼.046; r ¼0.15, P¼.010; r ¼.26, P¼.003,
respectively) and more lifelong sexual satisfaction (r ¼.29,
P¼.007; r ¼.15, P¼.014; r ¼26, P¼.005, respectively;
Table 4). Furthermore, a significant association between desire
and more intense orgasms depending on the partner’s ejaculate
volume could be detected (r ¼.37, P¼.002).
DISCUSSION
To the best of our knowledge this is the first study to report on
the importance of male ejaculation and specific ejaculatory
characteristics such as timing (before or after the woman reaches
orgasm), intensity, and quantity for the female partner, her
sexual satisfaction and function.
Importance of Ejaculation for the Female Partner
Drawing attention away from lack of control or short IELT,
we were interested in how important women considered the
overall event that their partner ejaculates during intercourse. No
studies have systematically investigated the impact of delayed or
absent ejaculation on the female partner. This represents an
important research gap, because 50.43% of women in our study
considered it very important that the partner ejaculates during
vaginal intercourse. Furthermore, almost every second woman
(55.7% and 59,2%, respectively) also reported that she experi-
enced a more intensive orgasm depending on whether her part-
ner ejaculated and depending on his ejaculation intensity (ie,
louder moaning and heavier breathing). In addition, a significant
correlation between the importance of ejaculation and lifelong
overall sexual functioning could be detected. Women with a
better sexual functioning considered ejaculation more important
compared with women reporting more sexual complaints
according to the FSFI-LL. Although no direct conclusion can be
drawn from these findings, future studies are clearly needed to
investigate whether and how ejaculatory disorders such as anor-
gasmia can impact women’s sexual function and satisfaction,
because our results clearly show how ejaculatory characteristics
can influence women’s sexual well-being.
This is somewhat in agreement with previous results by Burri
et al,
9
who found significant differences in the sexual functioning
(ie, orgasm ability) of women in relation to the importance they
assigned to ejaculatory control. Moreover, in their study, women
reporting a high orgasm frequency also preferred a longer inter-
course duration and were more distressed by the lack of ejaculatory
control compared with women with a lower orgasmic ability.
Overall, only a minority of women considered ejaculatory
characteristics such as expelled ejaculate as a reflection of their
own attractiveness. However, for those who did, ejaculation was
considered more important for women who believed that the
ejaculation volume reflected their sexual attractiveness. This link
between ejaculate volume and a women’s felt attractiveness
might ground on evolutionary instincts but also on cognitive-
affective reasons. Women might perceive a higher ejaculation
Table 4. Relationship between women’s importance of partner ejaculation and their own sexual functioning
Importance of partner
ejaculation Women’s orgasm intensity*Partner’s ejaculate quantity*Partner’s ejaculate intensity*
FSFI
(r, Pvalue)
FSFI-LL
(r, Pvalue)
FSFI
(r, Pvalue)
FSFI-LL
(r, Pvalue)
FSFI
(r, Pvalue)
FSFI-LL
(r, Pvalue)
FSFI
(r, Pvalue)
FSFI-LL
(r, Pvalue)
Desire 0.06, .296 0.08, .204 e0.03, .628 0.232, .083 e0.03, .708 0.367, .002 0.06, 0.352 0.064, .424
Arousal 0.05, .421 0.08, .170 0.07, .345 0.134, .381 e0.02, .842 0.220, .135 0.03, 0.667 0.146, .101
Lubrication 0.15, .025 0.13, .047 0.02, .800 0.142, .303 e0.09, .218 e0.052, .675 0.02, 0.818 0.076, .367
Orgasm 0.07, .179 0.12, .073 0.14, .046 0.235, .014 0.00, .953 0.257, .003 0.05, 0.505 0.146, .010
Satisfaction 0.02, .768 0.07, .261 0.06, .399 0.293, .007 e0.01, .263 0.260, .005 0.08, 0.269 0.154, .014
Pain 0.02, .798 0.08, .173 0.08, .250 0.093, .415 e0.08, .341 e0.001, .990 0.03, 0.629 0.022, .738
Total FSFI 0.05, .494 0.16, .023 0.083, .246 0.082, .534 e0.09, .246 0.075, .347 0.06, 0.433 0.040, .122
Correlations for current sexual functioning are on the left (FSFI) and for lifelong sexual function on the right (FSFI-LL). Significant results are shown in bold.
FSFI ¼Female Sexual Functioning Index; FSFI-LL ¼Female Sexual Functioning Index-Lifelong.
*Women’s answers to the questions: Do you experience a more intensive orgasm when your partner ejaculates during vaginal intercourse?”;“Do you
experience a more intensive orgasm depending on the intensity of your partner’s ejaculation/orgasm? (eg, louder moaning, heavy groaning, deeper
breathing)”;“Do you experience a more intensive orgasm depending on the subjectively perceived quantity of the expelled ejaculate?”
J Sex Med 2018;-:1e9
6Burri et al
volume as an indicator of greater evolutionary fitness owing to
higher fertility (although studies have failed to find a link be-
tween greater sperm volume and higher fertility). It is equally
possible that men with better ejaculatory functioning and a
greater ejaculation volume might feel more self-confident which
could reflect itself in their sexual scripts during sexual activities
(eg, being more passionate, manlier, more assertive), whereas
men with ejaculatory difficulties might feel more insecure and be
less sexually experienced.
8,12
Also, the perception of a large
ejaculation volume can make the woman feel “sexy”and wanted
and in contrast, a perceived smaller ejaculation volume might
negatively affect her self-esteem. Hence, it seems reasonable that
women who attach greater emotional value to ejaculatory aspects
will consider the ejaculation to be more important than women
who do not feel such a link. Consequently, one might hypoth-
esize that besides physiological reasons, for some women there
might additionally be emotional and cognitive reasons why they
consider the ejaculation to be important. Interestingly, ejacula-
tion was considered equally important by women preferring
intravaginal intercourse compared with women preferring other
sexual activities, such as petting or oral sex. These findings
suggest that the reasons or characteristics making ejaculation an
important aspect for women are maintained across all different
kinds of sexual activities and are therefore of a very general na-
ture. Further research would be needed to specify the nature and
context of the reasons why women consider a large ejaculation
volume to be important, but one could then possibly identify
subgroups of women holding specific beliefs in regard to their
partner’s ejaculation.
Ejaculatory Characteristics, Orgasm Ability, and
Sexual Satisfaction
Women reporting an intensifying effect of their partner’s
ejaculation on their orgasm intensity showed a better orgasm
ability than women who did not notice such an association. This
finding is somewhat in line with earlier results showing a positive
relationship between sexual expectancies and their eventuation.
In an interview study by Nicolson and Burr,
22
women with high
expectations of reaching orgasm reported a higher orgasm fre-
quency. In another longitudinal study, the expectations regarding
future sexual satisfaction proved to be a significant predictor for
the actual sexual satisfaction 6 months later.
23
More positive
expectancies predicted an increase in satisfaction whereas less
positive expectancies led to a decrease in satisfaction.
A possible explanation for the presented result might be a
“behavioural confirmation”effect.
24
According to this mecha-
nism, women with positive expectations regarding the effects of
their partners’ejaculation on their orgasm might display specific
behaviours that will in turn help them experience an orgasm. For
instance, they might be more relaxed than other women or get
more aroused noticing a forthcoming ejaculation, which in turn
might intensify their own orgasms. Another potential mechanism
could be a “perceptual confirmation”effect, which proposes a
perceptual bias in favor of an expectancy-consistent outcome.
25
Women holding positive expectations regarding the ejaculation
effect might be more focused on their partner’s ejaculation than
other women, thus making ejaculation responsible for their
sexual experience. Further research should be conducted exam-
ining the implications of women’s different sexual expectations,
especially if they are not met.
Similar to orgasmic ability, women stating that they experi-
enced more intense orgasms when the partner ejaculated, when
the partner experienced a more intense ejaculation, and when he
expelled a greater ejaculate quantity also reported higher sexual
satisfaction. Examining the respective importance of different
influences on sexual satisfaction, Pronier and Monk-Turner
26
found that emotional and relationship-based variables, such as
consensual sex, intimacy, or self-love were more important
predictors of sexual satisfaction than physical factors. In their
analyses, the influence of physical functioning decreased as soon
as social factors were included in the models. In accordance with
these findings, a multivariate analysis by Philippson et al
27
revealed a 2-dimensional model of female sexual satisfaction
during intercourse, with the first dimension referring to a
woman’s own physical and emotional experiences and the second
1 representing relationship aspects. Although our results seem to
be in contrast to these earlier findings, they suggest that sexual
satisfaction is influenced by a multitude of factors, including
physical, emotional, psychological, and dyadic aspects, therefore
warranting an important role of physiological factors such as
ejaculatory characteristics as well.
Our and previous findings hold important conclusions that
emphasize the importance of women’s subjective evaluations of
ejaculatory characteristics that could be relevant in a clinical
setting. Even though both partners might be equally aware of the
presence of male ejaculatory difficulties, their opinions on which
specific aspects are viewed as problematic might differ. Whereas
men might be more preoccupied with the lack of ejaculatory
control and the short duration of intercourse, women seem to be
more troubled by feeling less attractive, impaired intimacy,
reduced partner self-confidence, and his distraction during in-
tercourse.
9
Thus, it becomes clear that the partners may not
assign the same importance or weight to the same issues.
Consequently, treatment approaches solely focusing on men will
not naturally result in an improvement of the situation for both
partners and should therefore target cognitive and emotional
sequelae of ejaculatory difficulties as perceived by the female
partner also.
9,28
LIMITATIONS
A number of limitations need to be considered when inter-
preting the present findings. Most importantly, all analyses relied
on subjective data as opposed to objective data. This can be
particularly problematic in terms of women’s assessment of the
quantity of the expelled ejaculate.
J Sex Med 2018;-:1e9
Male Ejaculation and Female Sexuality 7
Also, a number of potentially confounding variables could not
be incorporated in the study, such as “condom use.”Being a central
element of intravaginal insemination, it might interfere with the
relationship between ejaculatory characteristics and female orgasm
ability and sexual satisfaction.
29
In addition, sample characteristics
might have limited the generalizability of our study results. The
majority of our respondents were relatively well educated with
more than three-quarters (75.5%) having graduated from Gym-
nasium and 44.5% receiving an academic degree. Furthermore, the
mean age of our sample was relatively young (25.5 years). Even
though statistical analyses accounted for the potential confounding
effect of age, studies including older participants would be desir-
able. Age-stratified analyses were not feasible owing to the relatively
small sample size, which per se is also a limitation of our study that
is important to mention. Also, the study did not exclude bisexual
women, although they might hold different attitudes regarding
ejaculatory aspects. However, owing to the low percentage of
bisexual women, a bias in the results is unlikely. Very importantly,
the partners’potential sexual problems such as PE or anorgasmia
were not assessed and consequently could not be included in the
analyses that could also have affected the correlational results. A
number of biases must be considered such as volunteer bias, which
is a common problem encountered in sex research and which also
might have affected our study. Studies have shown that individuals
participating in surveys and studies of a sexual nature tend to be
more sexually experienced and to hold less traditional views on
sexuality.
30
Furthermore, an effect of social desirability must be
assumed, because most of the questions asked about intimate
sexual topics, some of which are still considered taboo.
31
As a
result, the online format proves to be a strength of this study
because it allows a high degree of anonymity.
17
There is also no
clear protocol on how to assess or parameterize orgasm or ejacu-
lation “intensity.”In our study, we proposed “loud moaning”and
“deep thrusting”as indicators of ejaculation intensity. These
criteria, however, are prone to a high degree of subjectivity and
future research efforts should focus on the identification of other,
more objective criteria to capture orgasm and ejaculation intensity.
The cross-sectional design of our study did not allow determina-
tion of a direction of causality between ejaculatory characteristics
and female sexual function and satisfaction. Future studies with a
prospective design would be needed to investigate such relation-
ships. Last but not least, sexual distress as a cardinal criterion for the
definition of sexual dysfunctions was not assessed to not burden
participants with a too-lengthy survey and to achieve an appro-
priate sample number. Therefore, this study only allows statements
in terms of levels of sexual functioning and not “sexual dysfunc-
tions”per se. Inclusion of women’s sexual distress and how it relates
to ejaculation properties in the male is crucial for future studies.
CONCLUSION
In summary, the importance of partner ejaculation during
intercourse was positively associated with women’s importance of
their own orgasm and importance of sex in general but not with
their own orgasm ability or levels of self-reported sexual experi-
ence or previous numbers of partners. Furthermore, significant
positive associations could be detected between the overall
importance of male ejaculation during intercourse and current
and lifelong lubrication and lifelong total sexual functioning.
Also, women stating that they experienced more intense orgasms
when the partner ejaculated, when the partner experienced a
more intense ejaculation, and when he expelled a greater ejacu-
late quantity also reported better lifelong orgasmic function and
more lifelong sexual functioning. Finally, a significant link be-
tween desire and more intense orgasms depending on the part-
ner’s ejaculate volume could be detected. Although male
ejaculation and its different aspects seem to play an important
role for women, the study demonstrates a considerable variability
of women’s attitudes toward ejaculatory characteristics. Further
research is required to examine the sources of this variability.
Corresponding Author: Andrea Burri, PhD, European Insti-
tute for Sexual Health, Neuer Jungfernstieg 6a, 20354
Hamburg, Germany. Tel: þ49 40 346184; Fax: þ49 40
351117; E-mail: andrea.burri@kcl.ac.uk
Conflict of Interest: Andrea Burri is an advisory board member for
A. Menarini, Switzerland.
Funding: None.
STATEMENT OF AUTHORSHIP
Category 1
(a) Conception and Design
Andrea Burri; Hartmut Porst; Joceline Buchmeier
(b) Acquisition of Data
Andrea Burri; Joceline Buchmeier
(c) Analysis and Interpretation of Data
Andrea Burri; Joceline Buchmeier; Hartmut Porst
Category 2
(a) Drafting the Article
Andrea Burri
(b) Revising It for Intellectual Content
Andrea Burri; Hartmut Porst
Category 3
(a) Final Approval of the Completed Article
Andrea Burri; Hartmut Porst; Joceline Buchmeier
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