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Key points

Humans—particularly women—have shown themselves capable of hands-free orgasms.
Orgasms that are manually, orally—or externally—unassisted have been referred to as "extragenital orgasms."
The least positive type of spontaneous orgasm is associated with persistent genital arousal disorder (or PGAD).
The erotic imagination—for both genders—plays a far more crucial role in physical arousal and orgasm than had previously been appreciated.



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There are many temptations to organize our life around the experience of earlier trauma. But that may shortchange the future—which starts by our envisioning something better.


Posted October 7, 2013

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It’s fascinating that spontaneous orgasms—meaning sexual climaxes occurring independent of any physical stimulation—“embody” three distinct forms. It’s also intriguing that such episodes are not necessarily experienced as pleasurable. As strange as it may seem, in sufficient quantity and intensity, they’ve even led people to suicide .
In this post, I’ll delineate the three essential ways that humans—particularly women—have shown themselves capable of (or in some cases vulnerable to) hands-free orgasms. Oddly enough, only the final one might be described, paradoxically, as spontaneous yet voluntary and rehearsed.
As a qualification, I should probably add that not included in these characterizations are women who experience orgasms while engaging in particular activities—such as bicycling or horseback riding, exercising, or simply wearing tight clothes. These actions (as emphasized in Wisegeek ) “can cause friction against the clitoris and vulva.” Whether desired or not, all the spontaneous orgasms described here are manually, orally—or externally —unassisted.
All three types have been referred to as "extragenital orgasms." And the basic distinctions between types have yet to be elucidated in the scant literature on autoeroticism.
1. The least positive, as well as the most medically and psychiatrically worrisome, type of spontaneous orgasm, is also the only one that carries an official designation: Persistent Genital Arousal Disorder (or PGAD). Earlier, the malady was called Persistent Sexual Arousal Syndrome (PSAS), as well as Restless Genital Syndrome (RGS). And, because of its similarly vexing nature, it’s sometimes been compared to Restless Legs Syndrome— a far less rare, though perhaps equally tormenting affliction.
Writing for The Daily Beast , Lizzie Crocker observes that while the terms “arousal” and “orgasm” are almost always associated with sexual pleasure and fulfillment, PGAD is more like a biological itch that when scratched only subsides temporarily. To this author, the end result is “an intractable ache often compounded by burning, throbbing, and swelling.” People unfamiliar with the syndrome routinely imagine that the condition must be an enviable one.
Wikipedia defines the ailment as “a spontaneous, persistent, and uncontrollable genital arousal in women, with or without orgasm or genital engorgement, [and] unrelated to any feelings of sexual desire.” There’s also a genital counterpart to this syndrome in men. While men are increasingly reporting it, it appears to occur much less frequently for them.
The limited literature on this is inconclusive as to whether it’s related to high testosterone levels, which would naturally be associated with higher libido. But it doesn’t appear linked to hypersexuality , and those who suffer from it typically report feeling embarrassed, ashamed, or mortified when it occurs.
A condensed summary from Wikipedia:
“Physical arousal caused by this syndrome can be very intense and persist for extended periods, days or weeks at a time. Orgasm can sometimes provide relief, but within hours the symptoms return. . . Failure or refusal to relieve the symptoms often results in waves of spontaneous orgasm in women and ejaculation in men. The symptoms can be debilitating, preventing concentration on mundane tasks. Some situations, such as riding in an automobile or train, vibrations from mobile phones, and even going to the toilet can aggravate the syndrome unbearably, causing the discomfort to verge on pain. . . Some sufferers have said that they shun sexual relations, which they may find to be a painful experience. The condition may last for many years and can be so severe that it has been known to lead to depression and even suicide.”
No single cause has been found for the affliction. Physicians generally agree, however, that its origins are neurological, and it has recently been linked primarily to pudendal nerve entrapment. They also report that it’s most commonly found in postmenopausal women and in those who have hormonal imbalances or have undergone hormonal therapy .
Treatments that have shown some success (in controlling, not eradicating, symptoms) include antidepressants , antiandrogenic agents, regional nerve blocks, anesthetizing gels, and, in certain instances, surgical procedures. Women have sought relief through applying ice or heat packs to their genitalia, yoga, and a variety of other trial-and-error remedies—not to mention joining support groups of fellow sufferers to ameliorate distressing feelings of isolation and being misunderstood.
2. Similar to the third type of spontaneous orgasm, the second type has no official classification—other than the catchall phrase “spontaneous orgasm.” Yet this second type can be clearly distinguished from the third (which is also “hands-free”) by its being associated with nocturnal emissions or wet dreams , and totally unprompted or unprovoked consciously .
Here are some first-hand descriptions of this experience from support group postings :
“Just recently, I think I experienced a spontaneous orgasm. I’m 47, female. No erotic dreams, no touching, nothing. But absolutely feeling vaginal contractions and pleasure . . .”
“I’m a 46-year-old woman with a high sex drive—although I’m not sure if that has anything to do with it. . . [The orgasms] are not as strong as [those] I experience during intercourse but they are still there. It can be a bit unnerving if I’m not expecting it . . .”
“I have it happen to me during my sleep sometimes. I won’t even be having a sexual dream and it happens. . . I’ve never had it while I was awake.”
“I was driving, and was running late to work due to really bad traffic. . . I re-routed and got lost. Long story short, my drive was a little intense, and I was already stressed out. All of a sudden, I got so intensely anxious and felt like I needed to get out of the car, and get air. A few seconds following that, I quickly realized I am about to have an orgasm. It was the strangest feeling. So intense, and my whole body felt it for what seemed like a long time. I felt all the blood pumping in my body, and I was throbbing. Very freaky, and I felt almost embarrassed about it. I have recently started some new meds, and upped the dosage on another. . .” [Note that spontaneous orgasms have at times been linked to elevated stress and anxiety levels, and such orgasms have also been identified as a side effect of certain medications—as, additionally, has priapism or prolonged unwanted erections in males.]
“. . . It happens a lot while I’m sleeping , but only once while I was awake. . . With [me], I’m almost certain [that at night] it’s because of a full bladder.”
“I am 67 years old. Recently I was undergoing a medical examination. I was fully clothed, lying on an examining table on
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