Many studies have found a discordance between women's genital (vaginal pulse amplitude) and subjective sexual arousal responses to erotica. We hypothesized that the association between the physiological and subjective domains would be greater for women with greater orgasmic consistency during penile-vaginal intercourse but not for orgasm consistency during other sexual behaviors. We confirmed this specific hypothesis in a sample (N = 38) of postmenopausal women. In addition, we discovered that the correlation between the domains was unrelated to social desirability responding, that orgasm consistency was not less for intercourse than for other sexual activity, and that orgasm consistency during intercourse was uncorrelated with orgasm consistency during masturbation. We discuss the results in terms of the unique nature of penile-vaginal intercourse, our study's implications for sex therapy, and orgasm consistency during intercourse being an operational measure of functional vaginal sensitivity and sexual pleasure integration and organization.