The intensity, duration and frequency of orgasms vary a great deal among women, as does the amount of stimulation required to have one.
Some women require stimulation beyond what would be considered normal, and others can’t achieve an orgasm at all. Difficulty in achieving orgasm is known as female orgasmic disorder. It’s also referred to as female sexual dysfunction, orgasmic dysfunction and anorgasmia.
Female orgasmic disorder is a persistent problem and can cause women significant distress. It’s the second most common sexual disorder among women. It’s estimated that 15 to 18 per cent of women in the United States, Europe, Central America and South America are affected by it. In Asia, rates range from 30 to 46 per cent. Moreover, the condition becomes more common as women get older.
What are the causes of orgasmic dysfunction in women?
Female orgasmic disorder can be caused by several physical, emotional and psychological factors, including :
- Medical conditions. Diabetes, vascular disease, multiple sclerosis, spinal cord injuries and some pelvic conditions can be contributing factors to orgasmic dysfunction. Additionally, arthritis, thyroid problems and asthma are associated conditions. A medical history that includes a gynecological surgery, such as a hysterectomy, can also play a role.
- Medication. Certain medications can have unwanted side effects that impact a woman’s ability to have an orgasm. This includes certain antidepressants and antipsychotics as well as particular drugs used to treat cancer, high blood pressure and heart disease.
- Limited sexual experience. Some women have limited sexual experience and haven’t learned what types of stimulation bring them to orgasm. Or, they may not know how to talk to their partner about what gives them pleasure and helps them have a better orgasm.
- Negative feelings about sex. Some women feel anxious about sexual activity and can’t relax enough to have an orgasm. Others focus so much on the negative aspects of intercourse that they can’t enjoy stimulation. Additionally, some women experience anxiety because of a negative body image. Finally, some fear losing control of themselves during the orgasm.
- Societal pressure. Societal pressures and religious beliefs can also cause orgasm problems for some women.
- Interpersonal conflict. Conflict within a relationship can make a woman less likely to orgasm, regardless of whether this conflict has its roots in the couple’s sexual activity or more general relationship problems.
- Abuse. Women who’ve been physically, psychologically or sexually abused may have problems achieving orgasm.
What are the symptoms of female orgasmic disorder?
The main symptom of female orgasmic disorder is the inability to achieve sexual climax. Other symptoms include unsatisfactory orgasms or a very long delay in reaching orgasm.
Women with an orgasmic disorder may have difficulty reaching orgasm both during intercourse and masturbation.
Women with an orgasmic disorder may have difficulty reaching orgasm both during intercourse and masturbation.
What are the different types of orgasmic dysfunction?
If a woman has never had an orgasm, this is known as primary anorgasmia.
If a woman has difficulty achieving orgasm, even if she’s had an orgasm in the past, this is referred to as secondary anorgasmia.
If a woman is only able to reach orgasm under specific circumstances, such as during oral sex or masturbation, this is referred to as situational anorgasmia. This is the most common type of female orgasmic dysfunction.
If a woman is unable to achieve orgasm, even when highly aroused and after satisfactory stimulation, this is called generalized anorgasmia.
If a woman has difficulty achieving orgasm, even if she’s had an orgasm in the past, this is referred to as secondary anorgasmia.
If a woman is only able to reach orgasm under specific circumstances, such as during oral sex or masturbation, this is referred to as situational anorgasmia. This is the most common type of female orgasmic dysfunction.
If a woman is unable to achieve orgasm, even when highly aroused and after satisfactory stimulation, this is called generalized anorgasmia.
How is female orgasmic dysfunction diagnosed?
There are several steps involved in a medical diagnosis of female orgasmic dysfunction:
- A medical questionnaire reviewing the patient’s sexual history.
- A questionnaire on medical conditions and medications that may affect sexual performance, such as pregnancy, menopause, surgeries, cancer, arthritis, etc.
- A questionnaire on the patient’s current sex life (her sexual orientation, use of contraception, any issues with pain, masturbation habits, etc.), including her sexual satisfaction (level of desire and arousal) and details relating to orgasms (frequency of reaching orgasm, ease of doing so, the importance of context, etc.).
- A physical examination.
What treatments are available for female orgasmic disorder?
The best treatment for female orgasmic disorder depends on the underlying cause. The treatment is generally multifaceted and may include:
- Attending to all underlying medical conditions.
- Having the patient switch to different antidepressants.
- Having the patient attend sex therapy with her partner or on her own.
- Advising the patient to seek increased stimulation of the clitoris during masturbation and sex.
- Advising the woman and her partner to favour sex positions and techniques that are more likely to allow the woman to achieve orgasm. For example, it may be suggested that a couple have sex face to face, with the man on top of the woman, using mutual rocking (instead of thrusting) so that the shaft of the penis is more in contact with the clitoris.
- Estrogen hormone therapy (for postmenopausal women) can help increase sexual desire and blood flow to the genitals, resulting in increased sensitivity.
- Platelet-rich plasma injection is a simple, painless injection that increases blood flow and sensitivity in the clitoral, periurethral and anterior vaginal regions.
- Vaginal tightening for enhanced sensitivity in the vagina.