Orgasmic dysfunction
Alternative names:
anorgasmia; inhibited sexual excitement; sex - orgasmic dysfunction
Information:
DEFINITION
Orgasmic dysfunction is an inhibition of the orgasmic phase of the sexual response cycle. The condition is referred to as primary when the female has never experienced orgasm through any means of stimulation. The problem is called secondary if the woman has attained orgasm in the past but is currently nonorgasmic. Situational orgasmic dysfunction may refer to a woman who can climax through some methods of stimulation (such as manual stimulation, masturbation, and oral sex), but not through others (such as partner stimulation and intercourse).
CAUSES, INCIDENCE AND RISK FACTORS
Primary orgasmic dysfunction, wherein the woman has never experienced an orgasm, appears to characterize about 10 to 15% of women. Surveys generally suggest that somewhere between 33 to 50% of women experience orgasm infrequently and are dissatisfied with how often they reach orgasm. Performance anxiety is believed to be the most common cause of orgasm problems, and 90% or more of orgasm problems appear to be psychogenic (nonorganic) in nature.
Some drugs may sedate and impair orgasmic responsiveness, including alcohol. Infrequently, medical conditions that affect the nerve supply to the pelvis (such as multiple sclerosis, diabetic neuropathy, and spinal cord injury), hormone disorders, and chronic illnesses that affect general sexual interest and health may be factors. Negative attitudes toward sex in childhood may inhibit responsiveness, as may unresolved feelings associated with experiences of sexual abuse or rape. In situations where the woman used to reach orgasm regularly, but is not reaching orgasm currently, the problem may be related to marital strife and lack of emotional closeness, which may also cause low sexual desire. Boredom and monotony in sexual activity may also contribute to secondary anorgasmia.
SYMPTOMS- inability to reach orgasm in general or with certain forms of sexual stimulation
SIGNS AND TESTS
A physical examination is almost always normal. If the onset of the problem coincided with beginning to use a medication, this should be discussed with the prescribing physician. Interviewing of the couple by a qualified specialist in sex therapy is most likely to elicit useful information about the causes.
PREVENTION
Education about sexual stimulation and response, and healthy attitudes toward sex tend to minimize problems. The principle of taking responsibility for one's own sexual pleasure is also vitally important. Couples who realize that they must verbally and nonverbally guide their partner in providing them with the stimulation that feels best will undoubtedly experience this problem less frequently. It is also important to realize that one cannot will a sexual response, and the harder a woman tries to "help out" in willing an orgasm, the more elusive they will become.
TREATMENT
Thorough education about the principles cited above has been found to be helpful. In the treatment of primary anorgasmia, the initial objective is to be able to obtain an orgasm under any circumstances. When it will not be prohibited because of religious or moral values, graduated assignments for masturbation where the partner is not present (to exert an inhibiting influence) usually result in success. This may then be followed by a series of couple assignments that minimize performance anxiety and pressure, and maximize communication, increasingly varied and more effective stimulation, and playfulness. These assignments gradually transfer the ability to reach orgasm to a couple context.
Similar task assignments are usually part of the therapy of the woman with secondary or situational anorgasmia, but masturbation has not generally been found to be helpful as a treatment component with these problems. In secondary dysfunction, marital difficulties sometimes play a role, and thus treatment may also sometimes need to include communication training and relationship enhancement work. It is also important in treatment to ascertain that the problem is only one of anorgasmia, and that there is not also a coexisting problem with inhibited sexual desire. Sometimes hypnosis may also assist in increasing concentration, exploring and overcoming subconscious conflicts, and minimizing performance anxiety. Women's therapy groups focused exclusively on this problem have also been found to have some effectiveness.
PROGNOSIS AND OUTCOME
Success rates when orgasmic dysfunction is treated by specialists in sex therapy usually are in the range of 65 to 85%. In primary orgasmic dysfunction, treatment is usually successful in 75 to 90% of cases. A positive prognosis (probable outcome) is usually associated with being younger, emotionally healthy, and having a loving, affectionate relationship with a partner.
COMPLICATIONS
When enjoyment does not accompany sex, it can become a chore rather than a mutually satisfying, playful, and intimate experience. When anorgasmia persists, sexual desire usually declines, sexual frequency wanes, and this may create resentments and conflicts in the relationship.
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The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Copyright 2000 adam.com, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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