Female orgasmic disorder is the non-achievement, or delayed achievement, of maximum pleasure (orgasm) despite a woman’s sufficient sexual stimulation and sexual arousal both mentally and emotionally.
- Women may not orgasm if intercourse ends too soon, if there hasn’t been enough foreplay, or if they fear losing control and letting go.
- They are therefore encouraged to try self-stimulation (masturbation), and for some, psychological therapies are helpful.
The amount and type of stimulation required for orgasm is subjective. Most women can reach orgasm when the clitoris (which corresponds to the male penis) is stimulated, but less than half reach it regularly during intercourse. About 1 in 10 women never reach it, although many of them feel satisfied with sexual activity.
Women with female orgasmic disorder do not achieve orgasm under any circumstances, even if they masturbate or are very aroused. However, failure to orgasm usually occurs because the woman is not sufficiently aroused, therefore it is considered a disorder of arousal and not orgasm. The inability to have an orgasm is considered pathological only if it causes distress for the woman. A relationship without orgasm causes frustration and resentment as well as, sometimes, disgust for everything related to the sexual sphere.
Causes of female orgasmic disorder
Situational and psychological factors can contribute to the disorder, These include:
- intercourse that constantly ends before the woman is sufficiently aroused (for example if the man has premature ejaculation)
- insufficient foreplay
- lack of understanding, on the part of one or both partners, of the functioning of the genital organs
- poor communication about sex (for example about the type of stimulation preferred)
- problems in the relationship, such as unresolved conflicts and a lack of trust
- anxiety about sexual performance
- fear of letting go, being vulnerable, and not knowing how to control oneself (perhaps as part of a fear of not being in control of all aspects of one’s life or a general tendency to rein in emotions)
- traumatic experience on a physical or emotional level, such as sexual abuse
- psychological disorders (such as depression)
Physical ailments can also contribute to female orgasmic disorder. These include nerve injuries (consequences of diabetes, spinal cord injury or multiple sclerosis) and genital organ abnormalities.
Some drugs, especially selective serotonin reuptake inhibitors (SSRIs, a type of antidepressant, Drugs Used to Treat Depression), can specifically inhibit orgasm.
Treatment of female orgasmic disorder
Doctors can encourage women to understand what kind of contact promotes pleasure and arousal through self-stimulation (masturbation). Other useful techniques are relaxation techniques and sensory focus exercises, in which partners take turns touching each other in order to cause pleasure ( Treatment ). Couples can experience different stimuli, such as vibrators, fantasy or erotic movies. In the case of nerve injuries, a vibrator may be particularly useful.
Another help can be education about sexual function. For some women, adding clitoral stimulation may be enough.
Psychotherapy, such as cognitive-behavioral therapy and self-awareness-based therapy (MBCT, ) can help women identify and manage fear of losing control, fear of vulnerability, or problems with trust in their partner and is particularly useful in cases of sexual abuse or other psychological disorders. The practice of self-awareness (focusing on what is happening in the present) can help women pay attention to sexual feelings, without making judgments or monitoring what is happening.
If the cause is an SSRI, it may be helpful to add bupropion (another type of antidepressant) or replace it with another antidepressant. It has been shown that women who no longer have orgasms after starting SSRI therapy can recover from the situation with sildenafil.
In the foreground: aging
The main reason older women give up sex is the lack of a sexually active partner. However, age-related changes, particularly following menopause, can make women more prone to sexual dysfunction. Also, disorders likely to interfere with sexual function, such as diabetes, atherosclerosis, urinary tract infections, and arthritis, become more common with age, but do not end sexual activity and pleasure, and not all sexual dysfunction in women. elderly are consequences of age changes.
In older women, as in young women, the most common problem is low sexual desire.
As female age, they produce less estrogen ,
- the tissues surrounding the vaginal opening (labia) and the walls of the vagina lose elasticity and thin (a disorder called atrophic vaginitis), a painful change during sexual activity that involves penetration.
- Vaginal secretions are reduced and consequently also lubrication during sexual intercourse.
- From age 30 to age 70, women produce less and less testosterone ; however, it is unclear whether this reduction leads to reduced sexual interest and response.
- The acidity of the vagina decreases, making the genitals more prone to irritation and infection.
- Lack of estrogen can contribute to age-related weakening of the muscles and other supporting tissues in the pelvis, sometimes causing a pelvic organ (bladder, bowel, uterus or rectum) to protrude into the vagina. As a result, urine can pass out involuntarily, resulting in embarrassment.
- As the years progress, the blood supply to the vagina decreases and the organ shortens, shrinks and becomes drier. Vascular disorders (such as atherosclerosis) can further reduce blood flow.
Other problems can interfere with sexual function. For example, older women may feel distressed by changes in their body due to ailments, surgery, or aging itself. They may think that erotic desire and fantasies are not suitable or that they are shameful in old age. They may be concerned about their partner’s general health or sexual function, or about their own sexual performance. Many older women experience sexual desire, but if the partner doesn’t match, the desire slowly subsides;
however, they do not need to be convinced that sexual dysfunction is normal for their age. If they are bothered by this, they should talk to their doctor. In many cases, treating a disorder (such as depression), stopping or replacing a drug, learning more about your sexual function, or talking to professionals or a health care counselor can help.
If the problem is atrophic vaginitis, it is possible to intervene with estrogen, in vaginal cream formulations (with a plastic applicator), in eggs or in rings. Estrogen can be taken orally or applied in the form of a patch or gel to the arm or leg, but only if the woman has recently entered menopause. Sometimes, if all attempts have proved ineffective, testosterone is prescribed in addition to estrogen therapy, although it is not a recommended combination, as it is still being investigated and is not known for long-term safety.