Leonhardt ND, Willoughby BJ, Busby DM, Yorgason JB, Holmes EK. The Significance of the Female Orgasm: A Nationally Representative, Dyadic Study of Newlyweds' Orgasm Experience. J Sex Med 2018. https://www.jsm.jsexmed.org/article/S1743-6095(18)31009-9/abstract BACKGROUND: Self-reported orgasm, perception of partner's orgasm, and misperception of partner's orgasm have each been correlated with individual sexual and relationship satisfaction, but these associations have rarely included dyadic data, have not fully accounted for potentially confounding variables such as sexual communication, and have never been simultaneously studied with a nationally representative sample. AIM: To provide a more complete picture of how the orgasmic experience within the heterosexual couple influences individual and partner sexual and relationship satisfaction. METHODS: Using a nationally representative dyadic sample of 1,683 newlywed heterosexual couples, a structural equation model was estimated to test associations between husband and wife self-reported orgasm frequency, husband and wife report of the other partner's orgasm frequency, and husband and wife misperception of their partner's orgasm frequency, as correlates of relationship and sexual satisfaction. OUTCOMES: Both husband and wife completed the Couples Satisfaction Index to assess their own relationship satisfaction, and completed a sexual satisfaction instrument designed for the CREATE study. RESULTS: 87% of husbands and 49% of wives reported consistently experiencing orgasm. 43% of husbands misperceived how often their wives experienced orgasm. The final structural equation model, including sexual communication, explained moderate amounts of variance in wives' and husbands' relationship satisfaction, and a high level of variance for wives' and husbands' sexual satisfaction. Wives' relationship satisfaction was positively associated with wives' and husbands' sexual communication. Wives' sexual satisfaction was positively associated with self-reported orgasm frequency, and both wives' and husbands' sexual communication. Husbands' relationship satisfaction was positively associated with husbands' and wives' sexual communication. Husbands' sexual satisfaction was positively associated with husbands' perception of wives' orgasm frequency, and both husbands' and wives' sexual communication. CLINICAL TRANSLATION: When counseling couples, clinicians should give particular attention to the wife's orgasm experiences, to potentially help both husbands and wives have higher sexual satisfaction. STRENGTHS & LIMITATIONS: Strengths of this study include the use of a nationally representative sample and dyadic data. Limitations include cross-sectional data, and the assessment of sexual experiences only in newlywed couples. CONCLUSION: Wives' orgasm (wives' self-report of frequency and husbands' perception of frequency) has a unique positive association with sexual satisfaction, even after taking into account other aspects of the orgasm experience and sexual communication.