Female Orgasmic Disorder

This post is an overview of Female Orgasmic Disorder (FOD). During a group discussion, a group member asked me, do women experience sexual dysfunctions? More specifically, can a woman have an orgasmic disorder? The short answer is yes; the long answer is probably complicated. For example, a woman can experience the sexual response cycle (excitement, late excitement, orgasm, and resolution) and not experience an orgasm. Even if she experiences an orgasm, there is a lack of intensity in the orgasmic sensations.


The long answer is probably more complicated for many reasons: likely, medical, physical, interpersonal, or psychological. For example, a female orgasmic disorder diagnosis in clinical settings is a professional's judgment of the reported symptoms. In addition, the amount of sexual stimulation needed to reach an orgasm is subjective. However, suppose a woman reports having difficulty "coming" during intercourse. In that case, it can be distressing for her and worthy of finding a solution.


The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists three female sexual disorders: female orgasmic disorder, sexual arousal disorder, and sexual pain disorder. As earlier stated, the focus of this post is FOD.


What is female orgasmic disorder? A sexual condition where a woman experiences persistent and recurrent issues or not reaching her climax. The lack of orgasms can be lifelong, acquired, generalized, situational, or the women never experienced orgasm under any circumstances.


Prevalence of FOD


According to a 2012 article published in The Journal of Sexual Medicine, an estimated 16% to 28% of females in the following geographic locations United States, Europe, South/Central American have absent or infrequent orgasms. The same article indicates the estimates are higher among Asian women at 30% to 46%. More recent data, a June 2018 publication from BMC Women's Health, globally, 41% of childbearing age women are affected by a sexual disorder. They also conclude that biological, psychological, and social factors contribute to sexual dysfunctions among women.


Possible Causes of FOD


Psychological factors

  • Mental health disorders (anxiety, stress, and depression)

  • Guilt about enjoying sex

  • Religious and cultural practices

  • Emotional or cognitive interference

  • Past sexual trauma

  • Body image and self-esteem concerns

Interpersonal factors

  • Longterm relationships where both partners have different sexual needs

  • Communication patterns that inhibit the sharing of sexual fantasies

  • Conflict with intimate partner

  • Sexual stimulation is routine and lacks spontaneity

  • Inadequate foreplay

  • Inexperience sexual partner

  • Pressure from sexual partner to experience an orgasm (repeatedly asking if she climaxed)

  • The man climaxing before the woman

  • Declining emotional interest in her sexual partner

Physical

  • Aging

  • Medications (antidepressants, antipsychotics)

  • Hormonal changes (menopause)

  • Blood flow to sexual organs

  • Inhibited sexual arousal and vaginal dryness

  • Alcohol consumption before sex or long term use and abuse

Diagnosis and Symptoms

The woman may have trouble "coming," but it does not mean she meets the diagnostic criteria for a sexual disorder. Her symptom presentation must meet the following diagnostic criteria:

  • She does not climax most of the time or at all 75% - 100% of the time when engaged in sexual activity.

  • Orgasms are delayed, infrequent, absent, or if she does get an orgasm, there is a significant reduction in the intensity of orgasmic sensations.

  • Duration – the symptoms have persisted for a minimum of six months

  • Due to the symptoms, she experiences clinically significant distress from not having orgasms or the pressure to experience an orgasm.

  • The sexual dysfunction is not precipitated by or better explained by nonsexual mental disorder, relationship distress, substance abuse, or a medical condition.

Subtypes of FOD


The female orgasmic disorder has five subtypes: when a woman is diagnosed with FOD, it is within one of the five subtypes.

  • Lifelong – the woman has not reached on orgasm since she became sexually active.

  • Acquired – the woman previously experienced orgasm during sexual intercourse, but lately, she has difficulty reaching her climax during intercourse.

  • Generalized – the stimulation method, situation, partner does not always result in the woman experiencing an orgasm.

  • Situational – the woman experiences orgasms in some situations but not in others. For example, she climaxes during self-pleasuring, with a specific partner, oral sex, or with a sex toy but not during penetration.

  • Never experienced orgasm under any circumstances – the woman has normal sexual functioning, but she never experiences an orgasm.

The severity of the dysfunction is mild, moderate, or severe.


Treatment of FOD


The treatment of FOD is dependent on symptom presentation and the suspected cause of the condition. Suggested therapies may include sex therapy and talk therapy with a licensed professional or from a medical doctor.


We were not drunk, and a female asked the question.


Stay Naturally Curious


Reference

Hyde, J. S. & Delamater, J. D. (2011). Understanding human sexuality, (11th, ed.), McGraw-Hill.

Lacroix, N. (1995), The better sex guide, Anness Publishing Limited.

IsHak WW, Tobia G (2013) DSM-5 Changes in Diagnostic Criteria of Sexual Dysfunctions. Reprod Sys The lack of orgasm is attributed to several psychological and interpersonal factors. Sexual Disorders 2: 122. doi:10.4172/2161-038X.1000122

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