After an unsatisfactory bout of sex for Francine, the lights go out and she hears Hayley making out with her new sex-friend Mauricio. As they leave, a picture drops off the wall which Francine dismisses and returns, and it bursts into flame as she walks away. Klaus heads out for a conference while Roger plays games with Steve. Roger notes that he has observed strange happenings and points out a game hovering over their head. They set up cameras and observe the house, spotting a spirit of Francine on the washing machine which turns demonic before their eyes as it lunges toward the camera.
Roger and Steve share their findings with the family, including a skeptical Stan until he is physically attacked. Roger's persona of Ruby Zeldastein arrives just as Mauricio is sucked into a vortex by the spirit. Ruby explains that the spirit is born out of Francine's sexual frustration. Stan is doubtful and Francine tries to back him up but admits she isn't completely satisfied and he eventually realizes the truth. Tracing things back in her memory, she realizes she faked things for the previous two years which upsets Stan. Trying to rescue Mauricio, the spirit drags him back. Ruby tells them that the spirit won't be satisfied until Francine is. Stan is in a funk and has trouble dealing with things until he hits on having Hayley become his sex coach. Hayley and the rest of the family prepares him by teaching him about foreplay and prepping the bedroom to reenact their anniversary suite. When the kids awake the next day, they find the house back to normal and Francine and Stan both feel satisfied, although Hayley is suspicious that Mauricio didn't return as the house dissolves into a vision from Hell around them. Determined to get Francine to orgasm, Ruby fills Stan full of Mexican Viagra although it still doesn't work and Francine admits that what they needs is for Stan to slow down rather than rush. They slowly work together until Francine orgasms, returning things to normal and freeing Mauricio.
At the conference hotel, Klaus hurts his back watching the local information channel, leaving him stuck for hours watching the same clips over and over.
- The title is wordplay on Poltergeist and "orgasm."
- The official Comic Con poster for the episode is a reference to Silent Hill Revelation 3D.
- Stan's sexual training montage is a parody of the training montage from Rocky IV, complete with "Hearts On Fire" by John Cafferty.
- Stan's water gun practice of shooting out the targets with the letter "G" is a reference to what is referred to as the "G-spot", an erogenous zone which, when stimulated, can lead to strong sexual arousal and powerful orgasms.
- Following the benign-looking spirit turning demonic, Stan said that the video of Francine's Poltergasm is funny scary, making a reference of Screamer Videos which at first show benign pictures, but suddenly reveal frightening images.
- Ruby Zeldastein is a play on the name Zelda Rubinstein, the actor who portrays Tangina in the Poltergeist films.
- This episode was originally titled "The Legend of Zelda Rubinstein".
- This is the first episode in three years that Matt McKenna wrote, and his first writing credit without his brother, Chris McKenna.
- Stan realizes Francine was faking her sexual pleasure when he compares her sex face to that of Meg Ryan's character from When Harry Met Sally when she faked an orgasm in public. Stan then remarks he loved the movie.
- Some of the board games the Smith family owns are Mouse Hunt (Mouse Trap), Hint (Clue), Battle Boats (Battleship) and Trivia Chase (Trivial Pursuit).
- Francine claimed that Stan didn't pleasured her in two years. Slightly more than two years previously, she herself said in "Hot Water" that she had the best sex she ever had with him.