Female Orgasmic Disorder
A sexual dysfunction characterized by the persistent or recurrent delay in, or absence of, orgasm, or marked reduction in intensity of orgasmic sensations following a normal sexual excitement phase. The diagnosis requires that the symptoms cause clinically significant distress and are not better explained by inadequate stimulation.
Prevalence: Depending on definition, 10-42% of women report orgasmic difficulties. It is the second most common female sexual dysfunction after low desire.
Common Symptoms
- Marked delay in orgasm despite high arousal
- Marked infrequency or complete absence of orgasm
- Markedly reduced intensity of orgasmic sensations
- Inability to achieve orgasm with a partner despite being able to alone
- Occurs on almost all or all sexual encounters (75-100%)
- Feelings of sexual frustration or inadequacy
- Distress regarding sexual performance
- Avoidance of sexual intimacy to avoid disappointment
- Faking orgasms to please partner or end the encounter
- Decreased sexual satisfaction
Risk Factors
- Use of SSRI antidepressants
- Post-menopausal status
- Medical conditions affecting nerves or blood flow
- Relationship conflict
- Strict religious upbringing regarding sex
- History of sexual trauma
- Lower education level (correlated with less sexual knowledge)
- Poor body image
Treatment Approaches
- Cognitive Behavioral Therapy (CBT) for sexual anxiety and guilt
- Sex Therapy (individual or couples)
- Directed Masturbation Training (Heiman & LoPiccolo protocol)
- Sensate Focus (Masters & Johnson technique)
- Couples Therapy to improve communication
- Medication adjustment (switching antidepressants or adding bupropion)
- Hormone therapy (local estrogen for atrophy)
- Eros clitoral therapy device (FDA approved for blood flow)
- Education on anatomy and sexual response cycle
Self-Help & Natural Approaches
- Directed masturbation training (learning own response patterns alone first)
- Sensate focus exercises (non-demand touching with partner)
- Kegel exercises (if pelvic floor weakness is present)
- Mindfulness meditation (staying in the moment)
- Use of vibrators or clitoral stimulation devices
- Exploration of sexual fantasies and erotica
- Bibliotherapy (reading books like 'Becoming Cliterate')
- Stress reduction techniques
- Yoga for pelvic floor awareness
- Communication exercises to guide partner
- Lubricants to enhance sensation and comfort
When to Seek Professional Help
- The lack of orgasm causes you personal distress
- You feel your relationship is strained by this issue
- You have never experienced an orgasm and wish to
- Orgasm was previously possible but has stopped
- You suspect medication is the cause
- You have pain associated with sex
Crisis Resources
- AASECT therapist finder (American Association of Sexuality Educators, Counselors and Therapists)
- Planned Parenthood
- NAMI HelpLine
- ISSWSH (International Society for the Study of Women's Sexual Health)
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.