What is an orgasmic problem?

The inability to have orgasm is called anorgasmia. Difficulty reaching orgasm after ample sexual stimulation is significantly more common in women than in men. The evidence strongly suggests that orgasm has more to do with the brain than with the body. The fact that orgasm occurs during sleep is supportive of this concept. 

Abnormalities of orgasmic processes may be "primary" or "secondary."

Primary abnormalities are of lifelong duration, like some women who are never able to experience orgasm throughout their lives.

Secondary abnormalities are acquired disorders that happen after a period of normal function. If an orgasmic problem only occurs under a particular set of circumstances, or only with certain sexual partners, the condition is considered to be "situational".

In other cases it could be "generalized", which means the condition occurs regardless of the circumstances or partner.

How commons is orgasmic problem?

Studies show that as much as 10% of women have never climaxed, in other words never achieved orgasm during intercourse or masturbation, while another 15% of them report difficulties with orgasm. 40–50% of women have either complained about sexual dissatisfaction or experienced difficulty becoming sexually aroused at some point in their lives.

While the figure varies for men in different studies, it is considerably lower than those of females.

Causes of orgasmic problems in females

Just like in males, the causes of FOD can be both physical (physiological) and psychological. In addition, psychological factors are also considered to be responsible for the majority of the cases.

Physiological causes include:

• damage to the blood vessels of the pelvic region
• spinal cord lesions or damage to the nerves in the pelvic area
• side effects of medications (antipsychotics, antidepressants, narcotics) or illicit substance abuse
• removal of the clitoris (also called female genital mutilation, a cultural practice in parts of Africa, the Middle East, and Asia)

Psychological causes include:

• past sexual abuse, rape, incest, or other traumatic sexual experience
• emotional abuse
• fear of becoming pregnant
• fear of rejection by partner
• fear of loss of control during orgasm
• self-image problems
• relationship problems with partner
• life stresses, such as financial worries, job loss, or divorce
• guilt about sex or sexual pleasure
• religious or cultural beliefs about sex
• other mental health disorders such as major depression

Symptoms of orgasmic problems

Symptom that should be present following the DSM-IV-TR diagnostic criteria is “Persistent or recurrent delay in, or absence of orgasm following a normal sexual excitement phase during sexual activity that the clinician judges to be adequate”.

Some additional symptoms would be:

·Anxiety and tension

·Feeling of guilt and shame

·Frustration 

Diagnosis of orgasmic problem

Just like in males, is diagnosed through a medical and psychological history and history of the conditions under which orgasm fails to occur. It is important to understand how long the problem has persisted, and whether it is general or situational.

Certain tests need to be carried in order to be able to know if the condition occurs concurrently with other sexual dysfunctions such as sexual aversion disorder and female sexual arousal disorder.

To diagnose orgasmic disorder in females, the lack of orgasmic response must occur regularly over an extended period of time while adequately ruling out the confounding effect of age, sexual experience, and the adequacy of sexual stimulation.

Treatment of orgasmic problem

When failure to reach orgasm is caused by a physical problem or medical condition, the root problem is treated. Treating the root cause of problems, such as depression could make the orgasmic disorder to resolve.

In other cases, a combination of several therapeutic approaches is used. These include:

·Education

·Counseling

·Psychotherapy

·Sex therapy

·Kegel exercises, which improve the strength and tone of the muscles in the genital area

The female might also be encouraged to masturbate either through self-stimulation or with a vibrator. The practice of total focus and attention is required while masturbating in order to learn to achieve orgasm.

Outcome

The outcome of the patient with orgasmic syndrome (whether male or female) is dependent on whether the condition is lifelong or acquired and the condition's causes.

Outcome is usually favourable when the cause (whether medical or psychological) can be corrected or managed. However, the outcome is unfavorable when the orgasmic disorder is found to be secondary to a deep-seated and chronic psychological or actual psychiatric problem.