Periurethral (Skene's) Gland Ejaculation and Squirting: Current Evidence
What We Know About the Anatomy and Mechanisms
Female ejaculation and squirting are two distinct phenomena with different anatomical origins, fluid compositions, and expulsion mechanisms 1, 2.
Female Ejaculation (FE)
The periurethral or Skene's glands—also termed the "female prostate"—are located below the bladder and surrounding the urethra 3. These glands are homologous to the male prostate and represent the anatomical source of true female ejaculation 4.
Key characteristics of female ejaculation:
- Volume: A few milliliters (typically 1-5 mL) of thick, milky or viscous white fluid 1, 2
- Composition: Contains prostate-specific antigen (PSA), prostatic acidic phosphatase, prostate-specific acid phosphatase, and glucose 1, 3
- Mechanism: Secretion from the paraurethral glands during orgasm 2
- Biochemical profile: Lower creatinine and urea levels compared to urine, distinguishing it from urinary incontinence 3
The Skene glands are located on each side of the urethra, and their ducts open into the distal urethra 5. When infected, these glands can present as erythematous areas lateral to the urethra, and anterior pressure may produce discharge from the ducts 5.
Squirting (SQ)
Squirting is fundamentally different from female ejaculation—it represents the transurethral expulsion of approximately 10 milliliters or more of transparent fluid originating from the urinary bladder 2.
Key characteristics of squirting:
- Volume: Tens to hundreds of milliliters of clear, transparent fluid 1, 2
- Source: Urinary bladder, confirmed by visualization studies using indigo carmine dye 6
- Composition: Similar to dilute urine, containing urea, creatinine, and uric acid in varying concentrations 1
- May contain PSA: Four out of five women in one study had PSA-positive squirt fluid, suggesting possible mixing with Skene's gland secretions 6
- Mechanism: Massive transurethral orgasmic expulsion from the bladder 2
- Trigger: Typically occurs with stimulation of the anterior vaginal wall before or during orgasm 6
Both Phenomena Can Occur Simultaneously
The evidence demonstrates that female ejaculation and squirting can happen concurrently, which may explain historical confusion about these phenomena 2. The presence of PSA in squirt fluid suggests that Skene's gland secretions may mix with bladder contents during the expulsion process 6.
Proposed Functional Significance
Antimicrobial Hypothesis
The most compelling functional hypothesis is that female ejaculate serves an antimicrobial purpose, potentially protecting against urinary tract infections 4.
The evidence supporting this includes:
- Female ejaculate contains elevated levels of compounds found in male seminal fluid (excluding sperm) 4
- The secretion may contain antimicrobial compounds including zinc 4
- Evolutionary advantage: Women who could ejaculate antimicrobial secretions into the urethra would be less susceptible to coitus-induced UTIs, potentially increasing reproductive success 4
However, this remains a hypothesis requiring further validation through direct antimicrobial testing of the secretions.
Clinical Differentiation
To distinguish between these phenomena in clinical practice, assess:
- Volume: Few milliliters = FE; tens of milliliters or more = SQ
- Appearance: Thick/milky = FE; clear/transparent = SQ
- Timing: Both typically occur with orgasm or intense sexual stimulation
- Biochemical analysis (if needed):
- High PSA with low creatinine = FE
- Urine-like composition (urea, creatinine) = SQ
- PSA presence in large-volume clear fluid = likely SQ with mixed Skene's secretions
Important Clinical Considerations
Not Coital Incontinence
Both FE and SQ must be distinguished from coital incontinence (CI), which can occur during penetration or orgasm and may be associated with stress urinary incontinence or detrusor hyperactivity 1. The key differentiator is that FE and SQ are normal physiological responses to sexual stimulation, not pathological urinary leakage.
Psychosocial Context
Recent evidence reveals that squirting carries conflicting social meanings in heterosexual encounters, ranging from validation and pride to avoidance, pressure to perform, or even coercion 7. Clinicians should be aware that women may experience:
- Validation when partners respond supportively
- Shame or avoidance when partners respond negatively
- Pressure to perform when partners view it as proof of sexual prowess
- Coercion when pushed beyond boundaries to satisfy partner desires 7
Prevalence and Normalcy
While exact prevalence remains unknown due to methodological challenges in studying sexual phenomena, both FE and squirting appear to be relatively common experiences among women who are sexually active 7. These are normal physiological variations, not disorders requiring treatment.
Evidence Quality and Limitations
The strongest evidence comes from recent anatomical and biochemical studies 6, 2, 3 published between 2018-2022. The 2022 visualization study using indigo carmine dye provides the most direct evidence confirming the bladder as the source of squirting 6. However, sample sizes remain small (typically 5-10 subjects), and most research relies on self-selected participants who can reliably produce these responses.
Critical knowledge gaps include:
- Large-scale prevalence studies
- Definitive proof of antimicrobial function
- Neurophysiological mechanisms triggering both phenomena
- Genetic or anatomical factors determining individual variation
The historical confusion between these phenomena—with all orgasmic fluid expulsions termed "female ejaculation" until 2011 2—explains inconsistencies in older literature and underscores the importance of using current terminology and classifications.