Ready for better orgasms? Meet the Coital Alignment Technique
In my work as a sex therapist and educator, one of the most common conversations I have with patients is how they think they’re broken because they aren’t orgasming from PIV intercourse.
Let me say this with a healthy dose of compassion, my friends: It makes total sense.
Not the broken part, obviously, but the part about not orgasming through penetration alone.
Most vulva-owners are wired to orgasm primarily from direct clitoral stimulation, not depth of penetration or vigorous thrusting. And yet, the cultural script for intercourse has historically centered penetration alone.
This is exactly why the Coital Alignment Technique (CAT) is so clinically fascinating to me. It doesn’t try to replace missionary, it simply optimizes it so the clitoris becomes part of the experience instead of being overlooked.
The benefits of CAT
CAT is, in essence, a pelvic-alignment adjustment to missionary intercourse.
How it’s done and why it works:
The partner on top shifts their pelvis up slightly, riding a little higher on the receiver’s body, so that the base of the penis, toy, or inside thigh naturally maintains contact with the clitoris and pubic bone.
Penetration remains part of the positioning, but movement changes from traditional in-and-out thrusting to slow, rhythmic anterior-posterior rocking or grinding.
The entire premise is sustained clitoral pressure and friction, delivered through intentional alignment and rhythmic motion rather than depth or speed of a thrusting peen.
I’ve explained before (and will continue to remind clients until the end of my days) that there is often a small but noteworthy distance between the clitoral glans and the vaginal entrance. This means many intercourse positions don’t have the clitoral stimulation a woman needs to have an orgasm. CAT was developed to close that gap through consistent, intentional clitoral contact during penetrative intercourse.
CAT also translates beyond cishet sex. For queer clients with two vulvas in play, the top partner can place a thigh between the legs of the receiver, allowing the clitoris to rub against a thigh or a pubic bone in that position. Bing, bang, boom! We have clitoral contact, folx.
What the research shows
The first CAT study was published by psychotherapist Edward Eichel in 1988. Participants who were taught CAT reported, higher rates of orgasm during intercourse, more frequent simultaneous orgasms with a partner, and a greater sense that orgasms felt “complete and satisfying”
A small clinical trial later observed a larger increase in self-reported orgasms during intercourse among women who were taught CAT compared to women encouraged only to explore self-stimulation without a positional technique.
However, later replication attempts did not show significant improvement for every participant — which is both unsurprising and clinically useful. Human sexuality never comes with universal guarantees. We’re all unique as snowflakes, after all.
The core interpretation I share with folx is this:
When intercourse includes direct, sustained clitoral stimulation (and not accidental or occasional stimulation) many vulva-owners orgasm more frequently during penetration-based sex.
The orgasm gap is not a libido problem or a desire problem problem. It is often a biomechanical positioning mismatch. And it is one that is absolutely solvable.
Why CAT can be so important and helpful
I teach CAT because it accomplishes three powerful clinical goals at once:
It validates the body instead of making the client feel like something is “wrong with them.”
It slows sex down in a way that reduces performance pressure and increases sensation.
It requires communication and collaboration, which improve desire, pleasure, and arousal.
When partners focus on sensations rather than outcomes, orgasm often arrives with far less effort and far more willingness.
How to try CAT
Talk about the intention first.
Frame it as an exploration, not a test. This is a two-way conversation that invites everyone to share their experiences and needs.
Shift position
Shift into a higher missionary angle so your pelvis overlaps with the clitoral region.
Get your rhythm on
Prioritise rhythmic rocking or grinding over penetration depth and speed.
Bring in the legs
Use legs, hip tilt, or thigh placement to adjust pressure and intensity.
Be sure to check in
Check in often — pressure, rhythm, and angle are personalised.
Don’t focus on orgasm as the final boss
Let orgasm be optional, but pleasure be the whole point.
This is not about perfect technique. It is about guided experimentation, embodied sensation, and communication.
What we can all learn from this
Orgasms are not mystical. They are neuro-physiological responses to the right kind of stimulation delivered in a way the body can actually register.
CAT matters because it allows us to orient sex toward the structure most responsible for orgasm, with intentional alignment, consistent pressure, and rhythmic contact, while removing performance pressure from the experience.
If orgasm during intercourse has ever felt like something you were supposed to be able to do but simply couldn’t, it wasn’t personal. It was likely positional.
And positional issues are the easiest kind to fix. You just need information, curiosity, and a partner who is willing to slow down and adjust the angle.
CAT is one of many tools in the pleasure toolbox, but it is a tool grounded in anatomy and intention.
Give it a go. Listen to the sensations. Make small adjustments. Keep the communication open. That’s how real pleasure works. And we all deserve it!
SOURCES
Eichel, E. (1988). The New Coital Alignment Technique: An Approach to Simultaneous Orgasm and Enhanced Sexual Pleasure. Journal of Sex & Marital Therapy, 14(2), 88–102.
Eichel, E., & Eichel, J. (1990). Coital Alignment Technique and the Female Orgasm: A Follow-Up Study. Journal of Sex Education and Therapy, 16(2), 92–100.
Hurlbert, D. F., & Apt, C. (1994). The Coital Alignment Technique: A Controlled Investigation of a Psychophysiological Approach to the Treatment of Female Orgasmic Disorder. Journal of Sex & Marital Therapy, 20(2), 102–114.
Sloan, E. P., & Conklin, L. D. (1992). Replication Attempt of Coital Alignment Technique Outcomes: An Empirical Assessment. The Journal of Sex Research, 29(4), 559–570.