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Alternative namesInhibited sexual excitement; Sex - orgasmic dysfunction; Anorgasmia
InformationOrgasmic 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.
CAUSES, INCIDENCE, AND RISK FACTORS
Performance anxiety is believed to be the most common cause of orgasm problems, and 90% or more of orgasm problems appear to be psychological in nature.
Infrequently, medical conditions that affect the nerve supply to the pelvis (such as multiple sclerosis , diabetic neuropathy , and spinal cord injury ), hormonal disorders, and chronic illnesses that affect general sexual interest and health may be factors.
Negative attitudes toward sex related to childhood experiences 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. Frequently, women are too shy or too embarrassed to ask for the kind of stimulation (and the timing of stimulation) that works best for them and this, too, can lead to this condition.
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 focuses on willing an orgasm to happen, the more elusive the achievement of orgasm may become.
SIGNS AND TESTS
A physical examination is almost always normal. If the onset of the problem coincided with starting 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.
Treatment through 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.
Most women require clitoral stimulation to reach an orgasm. Incorporating this into sexual activity may be all that is necessary. If orgasm difficulties persist, individual teaching of self masturbation when the partner is not present (to exert an inhibiting influence) can be helpful in helping the woman understand what she requires for excitation.
This may then be followed by a series of couple excercises that minimize performance anxiety and pressure, and maximize communication, increasingly varied and more effective stimulation, and playfulness. Gradually, these assignments make it possible for the woman to achieve orgasm with her partner.
In secondary dysfunction, relationship 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.
A positive prognosis (probable outcome) is usually associated with being younger, emotionally healthy, and having a loving, affectionate relationship with a partner.
Update Date: 9/9/2002Angela Smyth, M.D., Department of Psychiatry, University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT