What is the medical difference between squirting and female ejaculation?
Executive summary
Two related but medically distinct phenomena are described in the literature: "female ejaculation" refers to a small-volume, whitish, protein-rich secretion thought to originate from the paraurethral (Skene’s) glands, while "squirting" (or gushing) refers to the sudden expulsion of a larger volume of clear, dilute fluid largely coming from the urinary bladder and chemically similar to urine [1] [2] [3]. Researchers agree the terms have been conflated historically and that both events may sometimes occur together, but disagreement remains about mechanisms, prevalence, and precise biochemical composition [4] [5].
1. What clinicians mean by "female ejaculation" and why the Skene’s gland matters
Medical reviews and immunohistochemical studies describe female ejaculation as a small, whitish fluid that contains markers such as prostate-specific antigen (PSA) and other components overlapping with seminal fluid, implying origin from paraurethral or "female prostate" tissue—commonly called the Skene’s glands—rather than the bladder [1] [6] [7]. Systematic reviews classify this secretion as a distinct, lower-volume event driven by periurethral gland activity and periurethral myofibril contraction during sexual arousal or orgasm [8] [4].
2. Squirting: bladder filling, detrusor contraction and urine-like fluid
Ultrasonographic monitoring plus biochemical analysis in provoked-arousal studies have shown that women who "squirt" can have bladder filling during stimulation followed by detrusor contraction that expels a clear, voluminous fluid whose composition is largely consistent with diluted urine, sometimes with marginal contributions of prostatic/Skene-derived secretions [3] [2]. Narrative and clinical reviews therefore treat squirting as essentially an involuntary emission of urine during sexual activity, distinct from the smaller Skene gland secretions labeled female ejaculation [2] [8].
3. When the two phenomena overlap—and why that complicates study
Some case reports and a recent Swedish cross-sectional study describe sequences where a clear, abundant bladder-derived fluid is expelled first (squirting) and is then followed immediately by a thicker whitish secretion interpreted as female ejaculation, suggesting both can occur in one episode and share biochemical markers in varying proportions [9] [5]. This overlap, plus inconsistent terminology in older literature, explains why prevalence estimates vary widely and why many studies historically conflated the phenomena [4] [5].
4. What is settled, and what remains controversial
There is broad agreement in recent reviews that expelled fluids during sexual arousal differ in quantity and composition and can be usefully classified as female ejaculation versus squirting [2] [6]. But controversy persists over the universality of Skene’s-gland origin, the functional significance of either phenomenon, and whether squirting should be clinically framed as benign variation or as a form of orgasmic incontinence in some people [1] [8] [10]. Several authors caution that small sample sizes and protocol differences mean conclusions remain provisional [5] [4].
5. Practical implications for patients, partners and clinicians
Clinicians and sexual-health resources advise distinguishing squirting from coital incontinence (pathological leakage) and suggest assessment when urinary symptoms or distress exist, while noting many people experience these emissions as normal sexual responses [8] [10]. Because biochemical studies show mixed origins for expelled fluids, individual evaluation—when desired—can include ultrasound, biochemical testing, and pelvic assessment to clarify whether bladder dynamics or paraurethral secretions predominate [3] [5].
6. Bottom line and the shape of future research
The medical difference rests on origin, volume and biochemical profile: female ejaculation — small, whitish, Skene/paraurethral secretions with PSA-like markers; squirting — larger, clear, mostly bladder-derived dilute urine sometimes mixed with prostatic-like fluid [1] [3] [8]. Robust, larger, standardized studies combining imaging and biochemical assays are needed to resolve prevalence, mechanisms and whether the two should always be treated as separate entities or points on a physiological spectrum [4] [5].