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Orgasm Disorders

Female orgasmic disorder, sometimes called inhibited female orgasm or anorgasmia is defined as the recurrent or persistent inhibition of female orgasm as manifested by the recurrent delay in, or absence of, orgasm after a normal sexual excitement phase that a clinician judges to be adequate in focus, intensity, and duration.

A woman with lifelong female orgasmic disorder has never experienced orgasm by any kind of stimulation. A woman with acquired orgasmic disorder has previously experienced at least one orgasm, regardless of the circumstances or means of stimulation, whether by masturbation or while dreaming during sleep. The incidence of orgasm increases with age. The overall prevalence of female orgasmic disorder from all causes is estimated to be 30 percent. A recent twin study suggests that orgasmic dysfunction in some females has a genetic basis and cannot be attributed solely to cultural differences. Numerous psychological factors are associated with female orgasmic disorder. They include fears of impregnation, rejection by a sex partner, damage to the vagina, hostility toward men and feelings of guilt about sexual impulses. Non-orgasmic women may be otherwise symptom free or may experience frustration in a variety of ways; they may have such pelvic complaints as lower abdominal pain, itching and vaginal discharge, as well as increased tension, irritability and fatigue.

Decreased testosterone, oxytocin release and underlying primary psychiatric disorders are common in these patients. Hyperprolactenemia is also an important cause.

Focused treatment for Anorgasmia

Anorgasmia is a female sexual dysfunction that did not receive much attention until relatively few years ago. Anorgasmia, or the failure/inability of women to achieve orgasm, was never seen as a problem in the male-focused culture of the past. If the problem of anorgasmia is treated by a qualified sex therapist who takes time to consider the many variables which can contribute to the problem, then the couple can expect a positive outcome. And although successful treatment of this condition depends a great deal on the specific nature of the diagnosis (primary vs. secondary, age of woman effected, willingness of partner to attend counseling, depth of emotional cause, level of anxiety associated with becoming orgasmic etc.), research has shown a success rate of 80-90% for treatment of primary anorgasmia and between 10-75% success rate for treatment of secondary anorgasmia. These successful treatment rates are encouraging for the millions of women who live with the frustration of not being able to reach orgasm in their sexual lives. It appears that our society has finally come to the realization that women too are sexual beings, beings who desire, need, and deserve similar pleasure from the act of sex as men have enjoyed for centuries. Fortunately, sex therapists have evolved along with society in their ability to help women live fully satisfying sex lives if they so desire.

In male orgasmic disorder, sometimes called inhibited orgasm or retarded ejaculation, a man achieves ejaculation during coitus with great difficulty, if at all. Some researchers think that orgasm and ejaculation should be differentiated, especially in the case of men who ejaculate but complain of a decreased or absent subjective sense of pleasure during the orgasmic experience (orgasmic anhedonia).

The incidence of male orgasmic disorder is much lower than the incidence of premature ejaculation or impotence. A general prevalence of 5 percent has been reported. In an ongoing relationship, acquired male orgasmic disorder frequently reflects interpersonal difficulties. The disorder may be a man’s way of coping with real or fantasized changes in a relationship.

In premature ejaculation, men persistently or recurrently achieve orgasm and ejaculation before they wish to. No definite timeframe exists within which to define the dysfunction; the diagnosis is made when a man regularly ejaculates before or immediately after entering the vagina.

Masters and Johnson conceptualized the disorder in terms of the couple and considered a man as a premature ejaculator if he could not control ejaculation sufficiently long enough during intravaginal containment to satisfy his partner in at least half their episodes of coitus. This definition assumes that the female partner is capable of an orgasmic response.

Premature ejaculation is the chief complaint of about 35 to 40 percent of men treated for sexual disorders. Some researchers divide men who experience premature ejaculation into two groups: those who are physiologically predisposed to climax quickly because of shorter nerve latency time and those with a psychogenic or behaviorally conditioned cause. Difficulty in ejaculatory control can be associated with anxiety regarding the sex act or with negative cultural conditioning.

In ongoing relationships, the partner has a great influence on a premature ejaculator, and a stressful marriage exacerbates the disorder.

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