A fake orgasm occurs when a person pretends to have an orgasm without actually experiencing one. It usually involves simulating or acting out behaviors typically associated with orgasm, such as body movements, vocal sounds, and sequences of intensification followed by apparent release. It can also include giving verbal indications that orgasm occurred. Sex differences Both men and women do it, but women fake orgasms more frequently than men. In a survey of 180 male and 101 female college students (introductory psychology students from the University of Kansas), Muehlenhard & Shippee (2009) found that 25% of men and 50% of women had pretended orgasming (28% and 67%, respectively, for participants with experience in penile–vaginal intercourse (PVI)). Although most pretended orgasms during PVI, some also pretended during oral sex, manual stimulation, and phone sex. The ABC News 2004 "American Sex Survey", a random-sample telephone poll of 1,501 Americans, showed that 48% of women and 11% of men faked orgasm. A 2012 joint survey of men's lifestyle site AskMen and women's lifestyle site TresSugar (now PopSugar) found that 34% of men and 54% of women had at some point faked an orgasm; 26% of women even said they faked an orgasm every time they had sex. Other studies have found that anywhere from 25 to 74% of women admit to having faked an orgasm at some point in their lives. This is more than the 25 percent of women who, according to Psychology Today in 2010, reported consistently having an orgasm during coitus. Women tend to achieve orgasm during intercourse less readily than men because most women require direct clitoral stimulation to achieve orgasm, and not all sexual positions provide access to the clitoris, which often makes orgasms difficult to achieve for women. For women in heterosexual relationships, faking an orgasm can also be based on deference to the man, need for his approval, or feelings of shame or sexual inadequacy. As there appears to be 'a sexual script in which women should orgasm before men, and men are responsible for women's orgasms', a woman could feel pressured to fake an orgasm before her male partner orgasmed in order to please her male partner and avoid hurting his feelings. A man could also decide to fake an orgasm for several reasons; for example, when he failed to orgasm but didn't want to hurt his partner's feelings by perhaps giving the impression he did