Understanding Female Orgasmic Disorder

Many women may see the inability to orgasm as some defect on their part, but it is a legitimate and widespread medical disorder. While this problem can cause many understandable complications, you’re not alone—and help is available. Read on to learn about female orgasmic disorder, how it can be diagnosed and treated, and tips to live with this medical issue.

What Is Female Orgasmic Disorder?

Female orgasmic disorder (FOD), or anorgasmia, is difficulty achieving orgasm following typical sexual arousal characterized by a persistent or recurrent delay or absence of orgasm for at least six months and affecting at least 75% of sexual experiences. According to a 2011 study, this disorder is prevalent worldwide, affecting between 11% and 41% of women globally. Anorgasmia can significantly impact a person’s overall quality of life and well-being.  

How Can Anorgasmia Affect Your Sex Life?

Any kind of sexual dysfunction can be distressing, no matter how common it may be. According to the International Society for Sexual Medicine, a lack of orgasms is not technically a problem in and of itself. However, if you are experiencing sexual arousal and have no way to relieve it, the situation can quickly become distressing. The inability to reach orgasm can also make your partner feel inadequate, potentially causing problems in your relationship. If you are concerned about the frequency and intensity of your orgasms, speak to your healthcare provider or sex therapist.

How Is Female Orgasmic Disorder Diagnosed

Diagnosing anorgasmia typically involves an appointment with your primary care provider or gynecologist, where your medical history is reviewed. You will likely undergo a general medical and pelvic exam, which could help identify other medical conditions that could contribute to the orgasm interference. You should expect to answer questions about your experiences with sexual desire, orgasms, and other related subjects over at least the past six months.

Anorgasmia Symptoms

The Mayo Clinic defines female orgasmic disorder as experiencing any of the following symptoms in a persistent or recurring way:

• Delayed Orgasm: It may take a long time to achieve orgasm.

• Absent Orgasm: You may not be able to orgasm at all. 

• Fewer Orgasms: The orgasms you experience may be less intense than expected. 

• Less Intense Orgasms: You may have fewer orgasms than you should. 

Types of Female Orgasmic Disorder

While the frequency and intensity of orgasms vary significantly among women, the experience itself can change from one time to the next, according to the Mayo Clinic. There are four types of anorgasmia, depending on how you experience symptoms. 

Lifelong

With lifelong or primary anorgasmia, you have never experienced an orgasm. 

Acquired

Though you’ve experienced an orgasm before, you may have difficulty reaching that point. Acquired or secondary FOD can also involve new challenges with orgasms. You may previously have been able to achieve orgasm but are developing trouble due to some change in your life, such as medication or traumatic events. 

Situational

The most common type of orgasmic dysfunction, situational, often means you can orgasm, but only in certain situations or with specific stimulation. For example, you may only be able to orgasm through masturbation or oral sex. 

Generalized

You may experience a total inability to achieve orgasm, despite sufficient sexual stimulation and arousal. 

What Causes Anorgasmia?

For many people, the ability to achieve orgasm depends on a complicated balance of mental, physical, and emotional factors, according to a recent study. Trouble in any of these areas can cause anorgasmia, though this is by no means an exhaustive list. Symptoms can be as unique as the people they affect. 

It is important to note that some people experience a lack of sexual desire and are not troubled by it. Asexuality is a valid sexual identity. This article focuses on those who wish to achieve orgasm and cannot. 

“Sexual response involves the mind and body working together in a complex way. Both need to function well for an orgasm to happen.” — Orgasmic Dysfunction in Women, National Library of Medicine Medical Encyclopedia

Psychological Factors

Sexual desire and arousal are complex reactions to various forms of stimulation. It should be no surprise that sex can be an intensely mental activity, so psychological factors can interfere. 

• Mental health conditions like depression and anxiety

• A history of emotional or sexual abuse

• Stress brought on by stressors like bereavement or financial issues 

• Poor self-esteem and body image

• Embarrassment, guilt, or other unhealthy feelings about sex

• Negative religious or cultural beliefs about sex

Relationship Factors

If you’re having trouble with your partner in other areas, it may be difficult to relax enough to reach orgasm. 

• Boredom with sexual activity in a relationship, or losing interest in the relationship itself

• Embarrassment about asking for what you want sexually

• Lack of emotional intimacy with your partner

• Poor communication skills in expressing sexual needs and preferences

• Infidelity or lack of trust

• Intimate partner violence

• Sexual dysfunction in a partner, such as erectile dysfunction in males

Physical Factors

Sex is undeniably physical, and the condition of your body can impact how well you’re able to enjoy it. 

• Medical conditions, such as diabetes, polycystic ovarian syndrome, or endometriosis

• Advanced age

• Gynecological surgeries like a hysterectomy

• Physical symptoms of stress

• Mental health conditions like depression and anxiety

• Certain medications, such as SSRIs (selective serotonin reuptake inhibitors) for depression

Treating Anorgasmia

The treatment for FOD depends on what caused the problem. If there are underlying medical issues, they need to be treated. Generally, treatment plans for female anorgasmia include lifestyle changes, therapy, and medication. Though no drugs are currently approved as a treatment directly for FOD, some have shown promise in the trial stage.

Ways To Cope With Female Orgasmic Disorder

Treatment options typically include one or more of the following approaches:

• Educate yourself. Learn about your body, what you like, and how to explain your needs to your partner. 

• Cognitive behavioral therapy, either individual or couples therapy, can help you shift your perspective and mindset about sex, promote positive sexual relations, and develop coping skills to manage stress. 

• Sensate focus therapy starts with non-erotic touch during at-home instruction to teach you and your partner how to touch each other, working up to sexual stimulation. The goal is to teach partners to understand each other’s needs and to be able to communicate their needs and desires to one another. 

• Directed masturbation: Utilize a program of at-home exercises to help you become familiar with your body during self-directed sexual stimulation. Learn what you like and how to bring yourself to orgasm, then tell that knowledge with your partner. 

• Sexual enhancement devices can introduce additional stimulation to help you achieve orgasm. For example, certain devices are explicitly designed for clitoral stimulation. When used during sex, these sexual enhancement devices may help you reach orgasm. 

• Experiment with sexual positions. Some sexual positions stimulate the clitoris more than others. Your sex therapist or healthcare provider may recommend certain positions that may be more pleasurable for you. 

Living With Female Orgasmic Disorder

Beyond the work you do with your healthcare provider and therapist, there are numerous ways you can develop coping skills to live with anorgasmia. 

Work Toward Acceptance

It makes perfect sense that you may struggle to accept that anorgasmia is part of your life. However, once you accept that this condition is confirmed, you can begin to work toward solutions and ways to live around it. 

Talk To Your Partner

Communication is a vital part of any treatment plan for female orgasmic disorder. The inability to give you an orgasm may have been weighing heavily on them, and they could be eager to help you explore solutions. While the conversation could be awkward, the potential benefits far outweigh the discomfort. Express your feelings about your disorder and how you want to address it. Explain how you want your partner to help, and eventually, you can speak about what can be done to make sex more pleasurable for you. 

Build Up Your Sexual Intelligence and Literacy

Learn to identify what you want and build up the skill so you can direct your partner to provide the desired effect. This skill should get stronger with time, so continue practicing. 

Learn To Enjoy Sex Even Without Orgasms

Being unable to orgasm is indisputably frustrating, but that doesn’t mean you can’t enjoy sex at all. You may find FOD isn’t quite as intimidating when you let it fade into the background and focus on the intimacy with your partner. Stressing yourself out about whether you’re going to achieve orgasm likely only reduces your chances. 

Remember That Orgasms Are Possible

Being diagnosed with anorgasmia doesn’t mean you aren’t physically capable of orgasm. However, it does mean you may have a more arduous journey to that lofty peak. Plan for success by getting into the right mindset and using the methods you know are practical. If your partner cannot help you reach orgasm, try it on your own. Reduce your stress level as much as possible and remember—orgasms are possible, even if you have to achieve them alone. 

How Therapy Can Help

Working with a licensed individual or couples’ therapist can help you work through underlying emotional and mental issues preventing your orgasms. Many people prefer online therapy through virtual platforms like BetterHelp for the convenience of receiving treatment at home, the reduced cost, and shorter wait times. 

A 2011 study measured the effectiveness of online sex therapy for women experiencing sexual dysfunction and found it was a suitable alternative to in-person treatments, with participants demonstrating an improvement in sexual and relationship function. 

Takeaway 

Many people experience difficulty reaching orgasm—alone or with a partner. It is a common problem for women worldwide. The information outlined in this article may make it easier to decide to speak with your partner or healthcare provider about female orgasmic disorder.