Female ejaculation vs. squirting or gushing
Some research has distinguished between female ejaculation and what is colloquially known as squirting or gushing. These terms are used by the public interchangeably, which often leads to confusion. In these research publications, it is suggested that "real" female ejaculation is the release of a very scanty, thick, and whitish fluid from the female prostate, while the "squirting" or "gushing" (shown frequently in pornography) is a different phenomenon: the expulsion of clear and abundant fluid, which has been shown to be a diluted fluid from the urinary bladder.[1][2]
Relation to urinary incontinence
Towards the later part of the 20th century, there was significant confusion between female ejaculation and coital incontinence. In 1982, Bohlen explained the accepted wisdom:[39]
The previously accepted notion that all fluid expelled during a woman's orgasm is urine is now being challenged... sexologists must take care not to assume now that any fluid produced at orgasm is "female ejaculate".
Scientific studies from the 1980s and later have demonstrated that the substance produced is distinct from urine, though it does show similarities such as alkalinity with urine.[15] A recent study of women who report ejaculation found no evidence of any urological problems, suggesting these two conditions (ejaculation and coital incontinence) are quite distinct physiologically, although perhaps not always distinguishable in a particular individual's mind.[citation needed] Davidson's study of 1,289 women found that the sensation of ejaculation was very similar to that of urination.[11] One study by Gary Schubach used urethral catheterization in order to separate urine from orgasmic expulsions from elsewhere in the body. Seven women claiming to have ejaculations expelled large volumes of urine through the catheter at orgasm, and little to no other fluid.[52]
It may be important for physicians to establish whether there is in fact any incontinence in women who report ejaculation, to avoid unnecessary interventions.[3][4] It is also important for physicians to distinguish orgasmic ejaculation from vaginal discharges which may require further investigation and treatment. In individual cases, the exact source of any reported discharge may not be obvious without further investigation.[53]
Nature of different fluids
Critics have maintained that ejaculation is either stress incontinence or vaginal lubrication.[7] Research in this area has concentrated almost exclusively on attempts to prove that the ejaculate is not urine,[54][55] measuring substances such as urea, creatinine, prostatic acid phosphatase (PAP), prostate-specific antigen (PSA),[14] glucose and fructose[56] levels. Early work was contradictory; the initial study on one woman by Addiego and colleagues, reported in 1981,[36] could not be confirmed in a subsequent study on 11 women in 1983,[57] but was confirmed in another 7 women in 1984.[58] In 1985, a different group studied 27 women and found only urine,[59] suggesting that results depend critically on the methods used.[citation needed]
A 2007 study on two women involved ultrasound, endoscopy, and biochemical analysis of fluid. The ejaculate was compared to pre-orgasmic urine from the same woman, and also to published data on male ejaculate. In both women, higher levels of PSA, PAP, and glucose but lower levels of creatinine were found in the ejaculate than the urine. PSA levels were comparable to those in males.[13]
Ultrasounds from a 2014 study, involving seven women who reported recurring massive fluid emission during sexual arousal, confirmed thorough bladder emptiness before stimulation, noticeable bladder filling before squirting and demonstrated that the bladder had again been emptied after squirting. Although small amounts of prostatic secretions are present in the emitted fluid, the study suggests that squirting is essentially the involuntary emission of urine during sexual activity.[2]
