Female Orgasmic Disorder (FOD) – Overview and Treatment

Female Orgasmic Disorder (FOD) also known as Anorgasmia, is the persistent or recurrent delay or absence of orgasm (climax or sexual release) after a normal excitement phase of sexual arousal and sexual stimulation that is assessed as adequate in focus, intensity, and duration. To be considered FOD, the condition must cause personal distress or problems in a relationship.

Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. About 50{7b225fbeff640dd30b4b8b66650188099c7e8b184e2fb5b5b9f806a74d59162d} of women experience orgasm through direct clitoral stimulation but not during intercourse, thus not meeting the criteria for a diagnosis of FOD. As many as 10{7b225fbeff640dd30b4b8b66650188099c7e8b184e2fb5b5b9f806a74d59162d} of women in the United States have never experienced an orgasm regardless of the situation or stimulation and these women are more likely to be unmarried, young, and sexually inexperienced. Many women who experience orgasm regularly only climax about 50-70{7b225fbeff640dd30b4b8b66650188099c7e8b184e2fb5b5b9f806a74d59162d} of the time.

Women with orgasmic disorder cannot have an orgasm under any circumstances, even when they masturbate and when they are highly aroused. Thus in FOD, sexual arousal and lubrication occurs. Body tension builds, but the woman is unable or has extreme difficulty reaching climax and releasing the tension. This inability can lead to frustration and unfulfilling sexual experiences for both partners.

Most studies examining orgasmic dysfunction in women refer to orgasm problems as either “primary orgasmic dysfunction” or “secondary orgasmic dysfunction.” In general, the term primary orgasmic dysfunction is used to describe women who report never having experienced orgasm under any circumstances, including masturbation. These women suffer from a lifelong and generalized anorgasmia. Secondary orgasmic dysfunction relates to women who meet criteria for situational and/or acquired lack of orgasm. This includes a heterogeneous group of women with orgasm difficulties including women who are able to obtain orgasm only in certain contexts, with certain types of sexual activity, or with certain partners.

Diagnosis of Female Orgasmic Disorder

To receive the diagnosis of FOD, the inability to have an orgasm must not be caused only by physiological problems or be a symptom of another major mental health problem. FOD may be diagnosed when the disorder is caused by a combination of physiological and psychological difficulties. To be considered FOD, the condition must cause personal distress or problems in a relationship.

Treatment of Female Orgasmic Disorder

Female orgasmic disorder is quite responsive to therapy. Typical treatment would involve discovering and resolving underlying conflicts of life difficulties. Psychotherapy and sex therapy are the two most common types of treatment for women suffering from female orgasmic disorder.

If the cause of FOD is as a result of psychological sexual trauma or inhibition, then psychotherapy may help women identify and manage fear of relinquishing control, fear of vulnerability, or issues of trusting a partner. Also, orgasm can be considered a momentary loss of control. If a woman has difficulty trusting her partner, she may not feel safe and comfortable enough to lose control (orgasm) in the presence of her partner. Psychotherapy may be particularly useful for women who have been sexually abused or have psychological disorders.

Orgasm in females is a learned response, not inherent. The capacity for orgasm increases with age thus female orgasmic disorders are more common in younger women. Many women increase orgasmic capacity as they acquire more knowledge of the responses of their own bodies.

Therefore sex therapy could rely on techniques that may enhance sexual pleasure by maximizing stimulation and minimising inhibition. Focusing on relaxation techniques, sexual exploration, improving sexual communication, masturbation with prolonged stimulation, and increasing direct clitoral stimulation will help couples in therapy to overcome female orgasmic disorder. Methods to minimise inhibition include distraction by “on-looking” (observing oneself from a third-party perspective), fantasizing or listening to music.

If a selective serotonin reuptake inhibitor is the cause, adding bupropion (a different type of antidepressant) may help. Or another antidepressant may be substituted.

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