Orgasmic dysfunction

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Male and female reproductive systems

Inhibited sexual excitement; Sex - orgasmic dysfunction; Anorgasmia

Orgasmic dysfunction is when a woman either can't reach orgasm, or has difficulty reaching orgasm when she is sexually excited.

CAUSES, INCIDENCE, AND RISK FACTORS

The condition is called primary orgasmic dysfunction when a woman has never had an orgasm. This is the case in 10 - 15% of women. It is called secondary orgasmic dysfunction when a woman has had at least one orgasm in the past, but is currently unable to have one. Surveys suggest that 33 - 50% of women are dissatisfied with how often they reach orgasm.

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Many factors can contribute to orgasmic dysfunction. They include:

• A history of sexual abuse or rape
• Boredom and monotony in sexual activity
• Certain prescription drugs, including fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
• Hormonal disorders, hormonal changes due to menopause, and chronic illnesses that affect general health and sexual interest
• Medical conditions that affect the nerve supply to the pelvis (such as multiple sclerosis, diabetic neuropathy, and spinal cord injury)
• Negative attitudes toward sex (usually learned in childhood or adolescence)
• Shyness or embarrassment about asking for whatever type of stimulation works best
• Strife or lack of emotional closeness within the relationship

PREVENTION

A healthy attitude toward sex, and education about sexual stimulation and response will minimize problems.

Couples who clearly communicate their sexual needs and desires, verbally or nonverbally, will experience orgasmic dysfunction less frequently.

It is also important to realize that sexual response is a complex coordination of the mind and the body, and both need to be functioning well for orgasms to happen.

SYMPTOMS

The symptom of orgasmic dysfunction is being unable to reach orgasm, taking longer than you want to reach orgasm, or having only unsatisfying orgasms.

SIGNS AND TESTS

A complete medical history and physical examination needs to be done, but results are almost always normal. If the problem began after starting a medication, this should be discussed with the doctor who prescribed the drug. A qualified specialist in sex therapy may be helpful.