(785) Vaginal Squirting: Origin, Experiences and Discoveries: A Systematic Review

Introduction Female ejaculation and vaginal squirting have long been conflated with coital incontinence due to inconsistent terminology, methodological variability, and cultural taboos. This confusion impedes accurate clinical assessment and sexual health education, leaving a critical gap in understanding their distinct physiological origins and psychosocial implications. Objective To systematically synthesize evidence on the origin, prevalence, subjective experience, and socio-cultural impact of female ejaculation and vaginal squirting. Methods A systematic review was conducted in accordance with PRISMA guidelines. Comprehensive searches of PubMed, Scopus, and Web of Science identified studies addressing biochemical composition, ultrasound imaging, prevalence surveys, validated questionnaires (e.g., FSFI), and qualitative assessments of female ejaculation and squirting. Data extraction included biochemical assay data, imaging findings, prevalence rates, and data from any identified validated questionnaires or qualitative assessment frameworks. Findings were synthesized qualitatively, with key quantitative metrics summarized. Results Nine studies met the inclusion criteria. Regarding origin, prevalence, and differentiation, studies confirm two distinct phenomena. Female ejaculation originates from Skene’s glands, evidenced by high concentrations of prostate-specific antigen (PSA) comparable to male prostatic fluid. Vaginal squirting originates from the urinary bladder, confirmed by biochemical analyses showing elevated urea and creatinine levels and real-time ultrasound imaging demonstrating bladder filling during arousal and complete bladder emptying concurrent with fluid expulsion. Prevalence estimates ranged from 10% to 54% across four studies. Also, regarding the experience of female ejaculation/squirting the Subjective reactions spanned pride and sexual empowerment to confusion and shame. Validated Questionnaire, such as the Female Sexual Function Index (FSFI), along with custom surveys were used to capture experiential data. Over 80% of partner reactions were reported as positive, correlating with women’s positive appraisals. Only approximately 20% of women reported that ejaculation/squirting always coincided with orgasm; the majority described variable temporal associations. Historical practices such as Rwandan/Kenyan kunyaza illustrate cultural validation of fluid expulsion, contrasting with Western pathologization and mislabeling as urinary incontinence. Pornographic depictions frequently exaggerate volume and orgasmic consistency, contributing to unrealistic expectations and performance pressure. Psychological themes include shame-rooted primarily in fear of having urinated during sex, reported by approximately 25% of women-embarrassment, empowerment, and avoidance behaviors. Lack of accurate sexual education was directly linked to initial misperceptions of urinary leakage. Conclusions Female ejaculation and vaginal squirting are distinct, normal variants of sexual response, not pathological conditions. Skene’s gland–derived, PSA-rich female ejaculation and bladder-derived, urine-like squirting differ in origin, volume, and composition. Recognition of these separate mechanisms is essential for accurate diagnosis and counseling. Evidence-based clinical guidance and public education are urgently needed to destigmatize these phenomena, correct misinformation, and support women’s sexual health and well-being. Disclosure No