Female ejaculation and squirting - definition, classification and differential diagnosis

Women may release various types of fluids during sexual arousal and orgasm, representing either a physiological sexual response or a manifestation of urinary incontinence. The origin of periorgasmic fluids, their volume, biochemical composition, and mechanism of expulsion depend on anatomical and physiological predispositions as well as the degree of sexual arousal. These phenomena include vaginal lubrication, female ejaculation, squirting, and coital incontinence. This paper provides an overview of the evolution of perspectives on these phenomena and highlights inaccuracies in some previous studies. Differential diagnosis of these "sexual" fluids is based on their volume, appearance, characteristics, and women's subjective perceptions - however, objective verification requires biochemical analysis and use of imaging methods. Squirting is defined as massive transurethral expulsion of a clear fluid originating from the urinary bladder, whereas female ejaculation represents the secretion of a very small amount of thick fluid from the paraurethral (Skene's) glands. The paper presents current definitions, systematic classification, and differential diagnosis of these phenomena.