INTRODUCTION: A limited number of scientific studies explore the frequency with which various sexual positions are used in human populations and the potential of particular sexual position to facilitate female coital orgasm. AIM: The aim of this study was to provide data about the prevalence and frequency of various sexual positions, their rated pleasurability, and their association with female coital orgasm consistency (COC). METHODS: A sample of Czech heterosexual population (11,225 men/9,813 women) were presented with a list of 13 sexual positions in black-and-white silhouettes. For each position, they indicated frequency and pleasurability. COC was assessed as the proportion of penile-vaginal intercourse with a current partner which led to orgasm. MAIN OUTCOME MEASURE: Participants reported the frequency of use of sexual positions and rated their pleasurability. Using ordinal logistic regression, association between the COC and frequency of use of coital positions was tested. RESULTS: In both men and women, the most commonly used sexual positions were face to face/male above, face to face/female above, and kneeling/rear entry. Nonetheless, there emerged some gender differences in the rating of pleasurability of various positions (all P < .001). We found that a higher proportion of female coital orgasms are positively associated with the frequency of use of face to face/female above (odds ratio [OR] = 1.005, P < .001) and sitting/face-to-face positions (OR = 1.003, P < .001) and negatively associated with the frequency of kneeling/rear entry position (OR = 0.996, P < .001). CONCLUSIONS: Our findings suggest that there are no gender differences in the frequency of use of sexual positions, but their rated pleasurability differs between men and women, and higher frequency of use of face-to-face positions with female above increases the likelihood of achieving coital orgasm during penile-vaginal intercourse. Most results, however, were of small effect sizes, and more research is needed to further explore this issue. Krejčová L, Kuba R, Flegr J, et al. Kamasutra in Practice: The Use of Sexual Positions in the Czech Population and Their Association With Female Coital Orgasm Potential. Sex Med 2020;8:767-776.

Department of Philosophy and History of Science Faculty of Science Charles University Prague Czech Republic

Faculty of Humanities Charles University Prague Czech Republic; 1st Faculty of Medicine Charles University Prague Czech Republic; Laboratory of Evolutionary Sexology and Psychopathology Applied Neuroscience and Neuroimaging National Institute of Mental Health Klecany Czech Republic

Faculty of Humanities Charles University Prague Czech Republic; Laboratory of Evolutionary Sexology and Psychopathology Applied Neuroscience and Neuroimaging National Institute of Mental Health Klecany Czech Republic

See more in PubMed

Daniélou A. Inner Tradition; Rochester, VT: 1993. The complete kama sutra, the first unabridged modern translation of the classic Indian text.

McBride K.R., Fortenberry J.D. Heterosexual anal sexuality and anal sex behaviors: a review. J Sex Res. 2010;47:123–136. PubMed

Bullough V.L. John Wiley & Sons; New York, NY: 1976. Sexual variance in society and history.

Herbenick D., Reece M., Schick V. Sexual behavior in the United States: results from a national probability sample of men and women ages 14–94. J Sex Med. 2010;7:255–265. PubMed

Johnson A.M., Mercer C.H., Erens B. Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours. Lancet. 2001;358:1835–1842. PubMed

Mosher W.D., Chandra A., Jones J. Sexual behavior and selected health measures: men and women 15-44 years of age, United States, 2002. Adv Data. 2005;362:1–55. PubMed

de Visser R.O., Smith A.M., Rissel C.E. Sex in Australia: heterosexual experience and recent heterosexual encounters among a representative sample of adults. Aust N Z J Public Health. 2003;27:146–154. PubMed

Weiss P., Zvěřina J. Cegedim; Prague: 2014. Sexuální chování obyvatel v ČR V [Sexual behaviour in CZ, V]

Kinsey A.C., Pomeroy W.B., Martin C.E. Saunders; Philadelphia, PA: 1948. Sexual behaviour in the male.

Kinsey A.C., Pomeroy W.B., Martin C.E. Saunders; Oxford: 1953. Sexual behavior in the human female.

Swieczkowski J.B., Walker C.E. Sexual behavior correlates of female orgasm and marital happiness. J Nerv Ment Dis. 1978;166:335–342. PubMed

Fugl-Meyer K.S., Öberg K., Lundberg P.O. On orgasm, sexual techniques, and erotic perceptions in 18- to 74-year-old Swedish women. J Sex Med. 2006;3:56–68. PubMed

Eichel E.W., De Simone Eichel J., Kule S. The technique of coital alignment and its relation to female orgasmic response and simultaneous orgasm. J Sex Marital Ther. 1988;14:129–141. PubMed

Pierce A.P. The coital alignment technique (CAT): an overview of studies. J Sex Marital Ther. 2000;26:257–268. PubMed

Flegr J., Kuba R. The relation of toxoplasma infection and sexual attraction to fear, danger, pain, and submissiveness. Evol Psychol. 2016;14

Kratochvíl S. Grada Publishing; Praha: 2005. Sex jako obohacení života. Sexuální trénink v sedmi lekcích.

Cohen J. Routledge; New York, NY: 1988. Statistical power analysis for the behavioral sciences.

Leichliter J.S., Chandra A., Liddon N. Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States. J Infect Dis. 2007;196:1852–1859. PubMed

Hite S. Seven Stories Press; New York, NY: 2004. The hite report: a Nationwide Study of Female Sexuality.

Stone N., Hatherall B., Ingham R. Oral sex and condom use among young people in the United Kingdom. Perspect Sex Reprod Health. 2006;38:6–12. PubMed

Haavio-Mannila E., Kontula O. Correlates of increased sexual satisfaction. Arch Sex Behav. 1997;26:399–419. PubMed

Forsberg M. Does pornography influence sexual activities? In: von Feilitzen C., Carlsson U., editors. Children in the new media landscape: games, pornography, perceptions. UNESCO International Clearinghouse on Children and Violence on the Screen; Goteborg: 2001. pp. 159–161.

Brody S., Weiss P. Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis. J Sex Med. 2010;7:2774–2781. PubMed

Mustanski B.S. Getting wired: exploiting the Internet for the collection of valid sexuality data. J Sex Res. 2001;38:292–301.

Meston C.M., Levin R.J., Sipski M.L. Women's orgasm. Annu Rev Sex Res. 2004;15:173–257. PubMed

Brody S. The relative health benefits of different sexual activities. J Sex Med. 2010;7:1336–1461. PubMed

Brody S., Costa R.M. Vaginal orgasm is associated with indices of women’s better psychological, intimate relationship, and psychophysiological function. Can J Hum Sex. 2017;26:1–4.

Kontula O., Miettinen A. Determinants of female sexual orgasms. Socioaffect Neurosci Psychol. 2016;6:31624. PubMed PMC

King R., Belsky J. A typological approach to testing the evolutionary functions of human female orgasm. Arch Sex Behav. 2012;41:1145–1160. PubMed

Brody S., Klapilova K., Krejčová L. More frequent vaginal orgasm is associated with experiencing greater excitement from deep vaginal stimulation. J Sex Med. 2013;10:1730–1736. PubMed

Brody S., Weiss P. Heterosexual anal intercourse: increasing prevalence, and association with sexual dysfunction, bisexual behavior, and venereal disease history. J Sex Marital Ther. 2011;37:298–306. PubMed

Rosen N.O., Bergeron S., Lambert B. Provoked vestibulodynia: mediators of the associations between partner responses, pain, and sexual satisfaction. Arch Sex Behav. 2013;42:129–141. PubMed

Kaneshiro B., Jensen J.T., Carlson N.E. Body mass index and sexual behavior. Obstet Gynecol. 2008;112:586–592. PubMed

McCormick G.P., Riffer D.J., Thompson M.M. Coital positioning for stroke afflicted couples. Rehabil Nurs. 1986;11:17–19. PubMed

Lee J.T., Lin C.L., Wan G.H. Sexual positions and sexual satisfaction of pregnant women. J Sex Marital Ther. 2010;36:408–420. PubMed

Frederick D.A., John H.K.S., Garcia J.R. Differences in orgasm frequency among gay, lesbian, bisexual, and heterosexual men and women in a US national sample. Arch Sex Behav. 2018;47:273–288. PubMed