Female Orgasmic Disorder involves a marked delay in, marked infrequency of, or absence of orgasm experienced for women on all or almost all occasions of sexual activity (i.e., more than 75% of the time). Female Orgasmic Disorder may also include a markedly reduced intensity of orgasmic sensations. Many women experience natural variations in the ease with which they can achieve orgasm. Hence, if difficulties achieving orgasm are not persistent over time then a diagnosis of Female Orgasmic Disorder is not made. The disorder is only diagnosed if the difficulties achieving orgasm persist for a minimum period of 6 months or longer. Difficulties achieving orgasm may also be influenced by illicit drug use and some medications so a diagnosis of Female Orgasmic Disorder is not made if substance use or a prescribed medication better accounts for a woman’s difficulties achieving orgasm.
Many women are unable to achieve orgasm every time they have sex and this by itself is not necessarily a problem. In fact, many women report high levels of sexual satisfaction despite an inability to achieve orgasm regularly or at all. Hence, Female Orgasmic Disorder is only diagnosed if the difficulty achieving orgasm causes significant emotional distress for the woman concerned. It’s also important to note that most women need direct clitoral stimulation to achieve orgasm and a majority of women are unable to climax just from sexual intercourse. Hence, difficulties climaxing during sex alone is not a basis for this diagnosis. The level of emotional distress Female Orgasmic Disorder causes is also unique to the individual woman. Such distress may be Mild, Moderate or Severe.
Other factors include whether the problem is lifelong or acquired. If the problem has been present since the individual became sexually active it is considered lifelong. If the problem commenced after some months or years of normal sexual functioning it is considered acquired. The condition may also be situational or generalised. If situational, the problem only occurs with specific types of stimulation, situations or partners. If generalised, the problem is not limited to specific types of stimulation, occurs in different situations and/or with different partners.
What causes Female Orgasmic Disorder?
Difficulties achieving orgasm for women can be caused either by psychological or physical factors or a combination of both. A good place to start if you suspect you’re experiencing Female Orgasmic Disorder is to speak with your GP or a sexual health physician first to determine if there is a physical basis for the problem. Female Orgasmic Disorder often occurs at the same time as other female sexual disorders such as Female Low Sexual Desire. Women who have a very low desire for sex and/or who find it difficult to become sexually aroused understandably also find achieving orgasm difficult.
Physical causes of Female Orgasmic Disorder:
Some medical conditions and medications may influence a woman’s ability to achieve orgasm. These conditions include Multiple Sclerosis, pelvic nerve damage from radical hysterectomy or back injuries that involve spinal cord injury. Some anti-depressants (known as Selective Serotonin Re-uptake Inhibitors) have also been found to inhibit or delay orgasm in women. Perhaps surprisingly, Menopause is not consistently associated with the likelihood of orgasm difficulties and it should also be noted that some women are able to climax more easily than others due to genetic factors.
Psychological causes of Female Orgasmic Disorder:
Anxiety and worry can greatly hinder a woman’s ability to achieve orgasm. Women need to feel relaxed, safe and stress free for their body to become sexually aroused and to experience orgasm. Any worries including unresolved relationship problems with a partner or family/friends, stress from work or study, financial difficulties and feelings of low mood hinder a woman’s ability to relax, enjoy sexual activity and hence achieve orgasm.
Cultural factors may also influence a woman’s ability to climax. For example, some religions have injunctions against masturbation. If a woman feels unable to explore her own body and/or masturbate then she loses the opportunity to discover what feels good sexually and what may lead to orgasm. Difficulties talking openly with a partner about what feels good may also play a role in Female Orgasmic Disorder. If a woman feels sex is a ‘taboo’ subject or if she feels embarrassed to discuss sex openly, then this deprives her of the opportunity to describe what type of physical stimulation works for her.
How common is Female Orgasmic Disorder?
It’s difficult to ascertain how common this problem is for women. Estimates vary from 10% to 42% of women depending on factors such as age, culture and duration and severity of those difficulties. It is estimated that approximately 10% of women have never experienced an orgasm in their life. Generally, women report that they can achieve orgasm more easily during masturbation than when with a partner. This is usually because a woman can focus on exactly what feels good to achieve orgasm without any distractions and it can also be easier than guiding or teaching a partner to stimulate her in such a manner that feels good. The older the woman the more likely she will have experienced orgasm as she has had more time to get to know her own body and what feels pleasurable.
What are the steps in treatment for Female Orgasmic Disorder?
Treatment for Female Orgasmic Disorder can include several areas of focus. For some women, simply identifying what medications may be hindering their ability to enjoy sexual arousal (and trialling alternative medication where that’s possible) may reduce or eliminate the problem. Anti-depressants of the SSRI type (Selective Serotonin Re-uptake Inhibitors) may influence sexual functioning as may other medications, so it’s important to discuss these with your GP.
In many instances of Female Orgasmic Disorder there is nothing wrong with the woman physically. What relationship or individual counselling covers is then unique to the concerns a woman (or couple) has. For example, it may be difficulties in communication with her partner about what the woman enjoys sexually that underlies the condition. In this case counselling may focus on interpersonal strategies to overcome any roadblocks to communication in the relationship. A woman’s ability to achieve orgasm may also be related to non-sexual problems such as recurrent fighting or arguing. In these cases therapy may focus on conflict resolution and once this is achieved a woman’s sexual difficulties may recede of their own accord.
Disclaimer: The information covered on this website is for educational purposes only. A diagnosis of any psychiatric or medical condition must only be made by a medical or mental health specialist. Diagnosing a psychiatric concern is a complex process that involves formal training, do not ‘diagnose’ yourself. If you have concerns that a particular disorder or condition applies to you, please speak with your General Practitioner for further assessment and medical/psychological care.
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