Krejčová · Sexual medicine 2020 · cross-sectional survey · n=21038

Kamasutra in Practice: The Use of Sexual Positions in the Czech Population and Their Association With Female Coital Orgasm Potential.

Cited 10 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional self-report survey

PubMed 32800750 · doi:10.1016/j.esxm.2020.07.003 · record verified 2026-08-27

What was done

A cross-sectional survey of 21,038 Czech heterosexual adults (11,225 men and 9,813 women) evaluated the frequency and pleasurability of 13 sexual positions illustrated with black-and-white silhouettes. Female coital orgasm consistency was measured as the proportion of penile-vaginal intercourse episodes resulting in orgasm with a current partner. Associations between position frequency and orgasm consistency were analyzed using ordinal logistic regression.

What was found

The most commonly used positions for both men and women were face-to-face/male-above, face-to-face/female-above, and kneeling/rear-entry. Ratings of pleasurability differed significantly by sex across positions (all P < .001). Female coital orgasm consistency had statistically significant positive associations with the frequency of face-to-face/female-above (OR = 1.005, P < .001) and sitting/face-to-face positions (OR = 1.003, P < .001), and a negative association with kneeling/rear-entry (OR = 0.996, P < .001). Effect sizes were very small.

Why it matters

This study provides large-sample descriptive data on coital position preferences and indicates that while certain positions statistically correlate with female orgasm consistency, their practical effect sizes are negligible.

Limits

The cross-sectional design relies entirely on self-reported recall and cannot establish causal relationships. Because the sample size was very large, statistical significance was reached for odds ratios that are clinically trivial (ORs ranging from 0.996 to 1.005). The findings are limited to a Czech heterosexual cohort and the abstract does not control for concurrent clitoral stimulation, relationship factors, or intercourse duration.

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