The Coital Alignment Technique (CAT) is a modified version of the missionary sex position that has been shown to increase female orgasm frequency. This technique involves a man adjusting his position slightly higher than in a traditional missionary stance, allowing the base of his penis to rub against the woman's clitoris.
In a study published in the Journal of Sex and Marital Therapy, women who were unable to orgasm from missionary sex reported a 56% increase in their orgasm frequency after learning the CAT. Sex therapists explain that many women require direct clitoral stimulation to achieve orgasm, and penetration alone is often insufficient.
Approximately two-thirds of women do not reach orgasm through penetration alone, according to sex therapist Megan Fleming. The CAT provides additional clitoral stimulation through direct pressure and grinding motions. To perform the technique, a small pillow can be placed under the woman's hips to elevate her pelvis. The man then positions himself higher on the woman, aligning his pelvis with hers so that his penis shaft provides friction against her vulva and clitoris during thrusting. Adding a grinding or circular pelvic motion can further enhance stimulation. Therapists suggest focusing on the clitoris during these movements and maintaining close contact rather than frequent in-and-out thrusting.
Beyond enhancing partner pleasure, the CAT may also offer benefits for men, potentially helping them last longer by avoiding the heightened arousal associated with faster, deeper thrusting, according to sex therapist Lori Buckley.