Orgasmic dysfunction in women
Orgasmic dysfunction is when a woman either cannot reach orgasm, or has trouble reaching orgasm when she is sexually excited.
When sex is not enjoyable, it can become a chore instead of a satisfying, intimate experience for both partners. Sexual desire may decline, and sex may occur less often. This can create resentment and conflict in the relationship.
Inhibited sexual excitement; Sex - orgasmic dysfunction; Anorgasmia; Sexual dysfunction - orgasmic; Sexual problem - orgasmic
About 10% to 15% of women have never had an orgasm. Surveys suggest that up to one half of women are not satisfied with how often they reach orgasm.
Sexual response involves the mind and body working together in a complex way. Both need to function well for an orgasm to happen.
Many factors can lead to problems reaching orgasm. They include:
Health problems that can cause problems reaching orgasm include:
The symptoms of orgasmic dysfunction include:
Exams and Tests
A complete medical history and physical exam needs to be done, but results are almost always normal. If the problem began after starting a medicine, tell the health care provider who prescribed the drug. A qualified specialist in sex therapy may be helpful.
Important goals when treating problems with orgasms are:
How to make sex better:
Discuss the following with your provider:
The role of taking female hormone supplements in treating orgasmic dysfunction is unproven and the long-term risks remain unclear.
Treatment can involve education and learning to reach orgasm by focusing on pleasurable stimulation and directed masturbation.
Treatment may include sexual counseling to learn series of couples' exercises to:
Women do better when treatment involves learning sexual techniques or a method called desensitization. This treatment gradually works to decrease the response that causes lack of orgasms. Desensitization is helpful for women with significant sexual anxiety.
Biggs WS, Chaganaboyana S. Human sexuality. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 42.
Cowley DS, Lentz GM. Emotional aspects of gynecology: depression, anxiety, post-traumatic stress disorder, eating disorders, substance use disorders, "difficult" patients, sexual function, rape, intimate partner violence, and grief. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 9.
Review Date: 4/19/2018
Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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