Merry Christmas and happy holidays, everyone! I’m pleased to update that I was recently interviewed for a monthly column on Best Health, titled “The Absolute Best Sex Position, According to Experts.” Our target audience is all beautiful people with vaginas/vaginae and clitorises/clitorides.

For those of you who want a more in-depth read about achieving the big O, I’ve included a few Q&As below:
1. Why do sex positions matter when it comes to achieving orgasm and feeling the most comfort and satisfaction?
Sexual activity for individuals with vaginas can be affected by several factors, including loss of libido/interest, physical discomfort, awkwardness in having sex, self-image/self-confidence, perceived loss of attractiveness, and painful intercourse. Comfortable positions are important to avoid not only a loss of sexual interest or satisfaction but also in preventing pain or even spotting that can occur with deep penetration. There are also some studies that suggest sexual positions having different impacts on the potential of orgasm (e.g., Krejčová et al., 2020), so creativity in sex positions can be very important!
2. What specifically about a certain position makes it “easier” to orgasm for some? Is it significant to have hand access, for example?
There are some studies that suggest coital orgasms for individuals with vaginas to be associated with face-to-face positions when in the superior or top positions (e.g., Kontula & Miettinen, 2016). The general belief is that these positions allow the one on top more control of the depth of penetration and access to other body parts, including clitoral and labia stimulation, which has the potential to bring about orgasm; however, it is important to note that sex is personal, so individual preferences are the most important. Some can achieve orgasm through external stimulation on the clitoris and nipples while others can orgasm through vaginal stimulation alone, and positions that give advantageous access to any one part may conflict with individual levels of comfort. For example, positions that offer more mobility and other physiological benefits may also require more energy and lubrication. Rather than recommending certain positions, I’d encourage people to experiment and find which positions are the most satisfying and comfortable to them. In support, studies have suggested that changing sexual positions or activities creatively can increase couple’s sexual satisfaction, especially when it helps them obtain pleasure in a way that strengthens emotional bond and helps with the expression of affection and desire. Remember that everyone’s body is unique and sexual function can be affected by biopsychosocial factors beyond the usual desire, arousal and lubrication, and even body sizes and abdominal girth can play a role in making certain positions easier or more difficult to execute.
3. Can the best position depend on size of penis or size and type of sex toy?
In my opinion, I do not think it would depend on the size and type of the device used. My understanding of the literature is that orgasmic function can be related to the repertoire of sexual techniques, including use of sex toys and manual/oral stimulation (e.g., Shaeer et al., 2020). Therefore, the “best position for penile-vaginal sex” may reasonably be affected by individual preferences in the size and type of the penetrating instrument – be it a penis, dildo, or other sex toys – but I don’t think it would be the most decisive factor.
4. How do the best sex positions differ for sex with a person with a penis versus a vagina, if at all?
Again, although there are positions that may increase the potential for vaginal/clitoral stimulation, longer penile erections, and/or sustained energy, my belief is that the most important aspect when it comes to preferred positions boils down to individual differences. I’d also like to encourage readers to think about how they would define “the best” – is it comfort, control, sexual stimulation, confidence, or potential to orgasm? How you answer the question depends also on the influences of cultural and social views on penile-vaginal intercourse (PVI) in which there may be a sociocultural component to adopting different positions depending on your gender identity and orientation.
5. What are some common misconceptions about sex positions?
I heard ones such as there are fool-proof sex positions will make it more likely to help determine a fetus’ gender or more likely to help or hinder getting pregnant. Also, that there is a “best” position and that the “best” position is the one that will produce orgasms without fail. Principles of Sensate Focus, a wonderful aid to sex, encourage people to focus on sensations rather than sexual responsiveness that are often equated with orgasm. Sex positions are only tools to increase the likelihood that the natural function of sexual responsiveness will occur, but they cannot “make it happen.”
6. Are there any positions we should avoid, or that might actually be more helpful?
I’d say unless it is uncomfortable for you and/or your partner, feel free to try out different positions and experiment! Couples are encouraged to try out positions and communicate about not only physical discomfort, but potential psychological vulnerabilities. Face-to-face positions provide easy opportunity for both partners to kiss and hug each other to nourish intimacy needs, while some positions, such as the sitting astride position, may make the on-top person feel more exposed and self-conscious but can also be used to boost self-confidence. In addition, sexual stimuli not restricted to the genitals can lead to adaptations of different sexual positions that do not always have to lead to penile-vaginal penetration.
7. Finally, do you have any toys or tools you like to recommend that can help in this arena?
As a healthcare professional, my priority is the client’s safety and comfort. To help with safe use of sex toys, I’d recommend nonporous ones such as those based on silicone or glass. If it is porous, try to be careful and cover it with a lubricated condom as part of a safe practice. For toys that will be anally inserted, a safer practice is to have ones with a wider base or an attached string. Of course, if one does not feel positive about the use of sex toys, that is perfectly okay as well! Finally, it’s encouraged for people to have lubricants! Water- and silicone-based lubricants without any glycerin may pose less problems than petroleum- and natural oil-based ones with sex toys that are made using latex and silicone. Always check to see if the material of your sexual device will be compatible with your choice of lubricants. In addition, if you have erectile dysfunction, check to make sure if you can still use silicone-based lubricants as the slipperiness may decrease friction, making it harder to maintain an erection.
Here’s to ending the year with a satisfying bang 😉
For those interested in working with me to support you with your life’s pleasures and struggles – not only in but also out of the bedroom – feel free to contact me.
References
Kontula, O., & Miettinen, A. (2016). Determinants of female sexual orgasms. Socioaffective Neuroscience & Psychology, 6, 1-21. https://doi.org/10.3402/snp.v6.31624
Krejčová, L., Kuba, R., Flegr, J., & Klapilová, K. (2020). Kamasutra in practice: The use of sexual positions in the Czech population and their association with female coital orgasm potential. Sexual Medicine, 8(4), 767-776. https://doi.org/10.1016/j.esxm.2020.07.003
Shaeer, O., Skakke, D., Giraldi, A., Shaeer, E., & Shaeer, K. (2020). Female orgasm and overall sexual function and habits: A descriptive study of a cohort of U.S. women. The Journal of Sexual Medicine, 17(6), P1133-1143. https://doi.org/10.1016/j.jsxm.2020.01.029