No. Local genital stimulation is not mandatory for reaching orgasm. The female anatomy provides for multiple erogenous zones any of which may be stimulated to reach orgasm. In fact, it has been observed that in the event of absence or trauma to the external genitalia, existing alternate erogenous zones become more sensitive and new ones develop. Some women can reach orgasm by nipple stimulation alone. I have come across women with absent vagina who are able to reach orgasm satisfactorily by alternate means.

In a study carried out on ritually circumcised South African women, Hanny Light foot Klein reports that these women had retained their orgasmic capacity in spite of the local genital mutilation.

When one reaches orgasm, one usually has gasping uncontrolled movements, or a sense of suspension which are nonverbal communications to the partner that one has had an orgasm. It is usually accompanied by vaginal contractions in female and the visible associate of ejaculation in males. Later, after completion of the sex act, one appears calm and physically satisfied. The signs of having had an orgasm are quite fleeting. The best way is to ask the partner.

Is it normal to reach orgasm by clitoral stimulation?

Absolutely. There are women who are unable to reach climax by vaginal intercourse alone. Climaxing by clitoral stimulation is in no way inferior.

Are different erogenous zones important?

Yes. One need not reach orgasm by genital stimulation alone. One may stimulate any erogenous zone to the point of orgasm.’What is important is the end and not the means to the end’.

When an individual has sexual desire he departs from the normal state and enters into the ‘sexual state’ and is deemed to have undergone ‘sexual grounding’. ‘Sexual grounding’ or the ‘Sexual state’ is a state in which the subject becomes receptive to the perception of stimuli inputs as sexual. Once this occurs, psycho-biological stimuli arouse the sex centre in the brain which starts sending out impulses, which are usually pleasurable. When such impulses reach the genitalia they lead to congestion of blood which is usually manifested as erection in the male and lubrication in the female. Further stimuli further arouse the individual and eventually lead to orgasm.

Here we classify orgasmic dysfunctions, on the basis of one single central parameter - the subjectively reported orgasmic experience, into four broad categories. They represent the discrepancy between one’s idealized expectation and one’s actual experience.

1. Early Orgasmic Response - (EOR): This category includes cases in which orgasm is experienced earlier than one’s idealized expectations, which are within rational limits.
2. Delayed Orgasmic Response - (DOR): This category includes cases in which orgasm does ultimately occur, but is delayed beyond one’s idealized expectations, which are within rational limits.
3. Impaired Orgasmic Response - (IOR): This category includes cases in which there is a reduction in the intensity of orgasmic pleasure.
4. Absent Orgasmic Response - (AOR): This category includes cases in which there is a complete failure to experience orgasmic pleasure.

This classification, based on one central subjective parameter provides conceptual clarity, specific terminologies for different disorders, uniformly encompasses all known male and female disorders, gives information whether a disorder is primary or secondary to some other pathology, and has the scope to include other associated parameters, if and when they are disturbed, along with the main diagnosis.