FEMALE ORGASMIC DISORDER

Female orgasmic disorder or Anorgasmia is a condition associated with slowed down or absence of proper orgasmic response even after complete sexual arousal or when a female is sexually active and this occurs for medical or psychological reasons.   

The Female Orgasmic Disorder symptoms are present most or all of the time and lead to clinically significant distress. Female Orgasmic Disorder has several specifications in the Diagnostic and Statistical Manual that include whether the condition includes lifelong anorgasmia, acquired anorgasmia, generalized anorgasmia, or situational anorgasmia. Female Orgasmic Disorder is co-morbid with depression and a number of medical conditions.

Overview:

Females affected by the orgasmic disorder are not able to have an orgasm under any possible method undertaken. Even if they become highly aroused through foreplay or masturbation they cannot reach orgasm which leads to frustration and agitation because of the lack of physical relief.  The inability to have an orgasm is considered a disorder only when the lack of orgasm causes distress or without experiencing orgasm during sexual relations it results in resentment and/or creates a dislike for future sexual relations with a partner. 

Whether the problem is due to psychological or medical reasons, remaining unsatisfied physically can have drastic effects on your psychosocial life factors. If the condition is ignored it can result in depression, dysmorphia, cause problems in your significant relationship, lead to social isolation, or other physical health problems can develop. 

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Female orgasmic disorder (FOD) /Anorgasmia is broken down into two major subtypes:

  1. Primary Anorgasmia:  a female has never been able to experience an orgasm.
  2. Secondary Anorgasmia:  females that previously were able to experience or reach an orgasm but are now no longer able to do so.

 FEMALE ORGASMIC DISORDER CAUSES (FOD)

  1. PHYSICAL CAUSES:
  • Disease association: Serious conditions like multiple sclerosis (MS) and Parkinson’s disease (PD) and their associated effects on psychological well-being.
  • Recent surgeries: Gynecologic surgical procedures, for example, a hysterectomy, or cancer surgeries can affect orgasm.
  • Medication side effects: Many prescribed medications and over-the-counter medications can inhibit orgasm. This includes antihypertensive medications, antipsychotic drugs, antihistamines, and antidepressants in the serotonin reuptake inhibitors (SSRIs) class.
  • Alcohol abuse and tobacco smoking:  Alcohol abuse can result in a lack of ability to reach climax. Smoking can decrease blood flow to the genitalia and causes an alcohol orgasm.
  • Aging:  When we age degenerative changes occur which can affect body functioning, hormones, the neurological system, and the circulatory. This can affect sexuality. The difference in estrogen levels post-menopause and menopausal symptoms, such as night sweats and mood changes, can have an impact on sexuality.
  1. PSYCHOLOGICAL CAUSES:
  • Anxiety, depression, or other mental disorders
  • Poor body image or dysmorphia
  • High-stress levels 
  • Cultural and religious beliefs/differences
  • Severe exposure to embarrassing situations
  • Guilt about enjoying sex 
  • Past sexual or emotional abuse
  1. RELATIONSHIP ISSUES:
  • Lack of emotional connectedness with your partner
  • Prolonged unresolved 
  • Poor communication of sexual needs, orientation, and preferences
  • Infidelity or breaching of trust
  • Unprotected or unhealthy sexual practices

FEMALE ORGASMIC DISORDER SYMPTOMS AND SIGNS

Persistent delay in reaching orgasm for a long period

  1. Absence of female orgasm for an extended period of time
  2. No orgasmic response even after seeking physical or psychological professional help. 
  3. Psychological distress related to the absence of orgasm
  4. Interpersonal difficulties

Female orgasm symptoms and signs are not easy to detect because women can fake an orgasm and usually do not report this condition. They may remain in denial. 

There are 4 female orgasmic disorder types that are used to identify symptoms of orgasm in women:

  1. Primary anorgasmia:
  • This type is associated with a condition in which the woman never experienced an orgasm.
  1. Secondary anorgasmia: 
  • Difficulty in achieving orgasm after having no difficulty in the past. 
  1. Situational anorgasmia:
  • One of the most common types of orgasmic dysfunction is situational female orgasmic disorder (FOD). It occurs when a woman can only orgasm under specific conditions like during oral sex, masturbation, or foreplay that elicit deep sexual fantasies
  1. General Anorgasmia: 
  • An absence of the ability to reach orgasm under any possible condition, even when you are highly aroused and sexual stimulation is sufficient.

DIAGNOSTIC METHODS FOR FEMALE ORGASMIC DISORDER

 It is done in 2 steps:

  • complete history
  • physical assessment
  • the DSM-5 criteria
  1. COMPLETE HISTORY

It includes both subjective and objective information of history taking: 

  • Past medical/surgical history
  • Discussion and interviews with the patient
  • Social history
  • Family history
  • Birth history
  • Sexual history
  • Psychological history

This can provide possible ideas about any chronic or disabling condition which can lead to FOD.

  1. PHYSICAL ASSESSMENT FOR FOD:

This includes proper evaluation by a certified gynecologist and includes:

  • Inspection by proper observation
  • Palpation of female sexually responsive areas for any abnormality
  • Assessment for any chronic/acute medical associated condition
  1. THE DSM-5 CRITERIA FOR FOD

To be diagnosed with Female Orgasmic Disorder, the problem must be apparent for a minimum of six months. It must not be connected to another physical or mental health problem. Some of the Female Orgasmic Disorder factors listed in the DSM-5 are:

  • Difficulties in a relationship (arguments, abuse).
  • Having a partner who is ill, has health problems, or has sexual difficulties.
  • Past sexual abuse.
  • Low opinion of the body image.
  • Anxiety and depression.
  • Religious ideas about sex.
  • Low intelligence level.
  • Has a health problem.
  • Taking particular types of medication.
  • Spinal cord lesions.
  • Chronic illness.
  • Damage to the pelvic blood vessels.
  • Substance abuse problems.
  • Genetics 

FEMALE ORGASMIC DISORDER TREATMENT/ ANORGASMIA

  1. LIFESTYLE MODIFICATIONS:

Understand and explore your body. Learn how to generate a response to the exact area. Speak to your gynecologist for further insight on how the female sexual functions work rather than believing everything that you read on the Internet. 

  1. INCREASE SEXUAL STIMULATION:

Use a vibrator or fantasize during sex. This can help trigger an orgasm. For some women, a device called a clitoral vacuum can improve blood flow and increase stimulation. This device is battery operated and hand-held, with a cup that fits over the clitoris.

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  1. SEEK COUPLES COUNSELING:

Once a medical condition is ruled out, a counselor can help with working through conflicts in your relationship that may be affecting the ability to achieve an orgasm.

  1. TRY SEX THERAPY:

The purpose of this therapy is to provide sex education in a proper way that can have a positive effect on your sex life

FEMALE ORGASMIC DISORDER TREATMENT AND MEDICINES:

  1. ESTROGEN THERAPY FOR POSTMENOPAUSAL WOMEN:

If anorgasmia is associated with menopausal symptoms, such as night sweats and hot flashes, systemic estrogen therapy might relieve those symptoms and improve sexual response.

Estrogen vaginal cream, a slow-releasing suppository, or a ring can increase blood flow to the vagina and help improve sexual arousal.

  1. TESTOSTERONE THERAPY:

Testosterone plays a role in female sexual function but it can cause side effects such as acne, hirsutism, and male-pattern baldness. Testosterone seems most effective for women with low testosterone levels as a result of surgical removal of the ovaries (oophorectomy).

If you choose to use this therapy, your doctor should monitor your blood levels.