Pastor · The journal of sexual medicine 2013 · systematic review · n=?

Female ejaculation orgasm vs. coital incontinence: a systematic review.

Cited 59 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review of observational, cross-sectional, and physiological studies

PubMed 23634659 · doi:10.1111/jsm.12166 · record verified 2026-08-27

What was done

Authors conducted a systematic review searching EMBASE and Web of Science for studies on female fluid expulsion during sexual arousal and orgasm. The review evaluated mechanisms, composition, and prevalence across female ejaculation, squirting, vaginal lubrication, and coital incontinence.

What was found

The reported prevalence of female ejaculation ranged from 10% to 54%, though objective physiological evidence exists in only tens of cases with most data derived from self-report questionnaires. Female ejaculation was characterized as a small-volume whitish prostatic secretion, whereas squirting involved larger volumes of diluted, modified urine. Coital incontinence had a reported prevalence ranging from 0.2% to 66%, with penetration incontinence occurring more frequently (typically linked to stress urinary incontinence) and orgasmic incontinence linked to detrusor overactivity, stress incontinence, or both.

Why it matters

This review provides clinical criteria to distinguish benign physiological sexual responses (female ejaculation and squirting) from pathological coital incontinence that warrants urogynecological evaluation and treatment.

Limits

The total number of included studies and cumulative sample size were not reported in the abstract. Evidence for female ejaculation is heavily reliant on subjective self-report surveys, physiological documentation of squirting is sparse, and the reported prevalence ranges for both ejaculation and incontinence are extremely wide.

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