Orgasmic & Sexual Dysfunction

What is orgasmic dysfunction?

Orgasmic dysfunction is a condition that occurs when someone has difficulty reaching orgasm. This difficulty occurs even when they’re sexually aroused and there’s sufficient sexual stimulation. When this condition occurs in women, it’s known as female orgasmic dysfunction. Men can also experience orgasmic dysfunction, but this is much less common.

Orgasms are intense feelings of release during sexual stimulation. They can vary in intensity, duration, and frequency. Orgasms can occur with little sexual stimulation, but sometimes much more stimulation is necessary.

Many women have difficulty reaching orgasm with a partner, even after ample sexual stimulation. Studies suggest orgasmic dysfunction affects 11 to 41 percent of women.

Orgasmic dysfunction is also known as anorgasmia or female orgasmic disorder.

What causes orgasmic dysfunction?

It can be difficult to determine the underlying cause of orgasmic dysfunction. Women may have difficulty reaching orgasm due to physical, emotional, or psychological factors. Contributing factors might include:

Sometimes, a combination of these factors can make achieving an orgasm difficult. The inability to orgasm can lead to distress, which may make it even harder to achieve orgasm in the future.

What are the symptoms of orgasmic dysfunction?

The main symptom of orgasmic dysfunction is the inability to achieve sexual climax. Other symptoms include having unsatisfying orgasms and taking longer than normal to reach climax.

Women with orgasmic dysfunction may have difficulty achieving orgasm during sexual intercourse or masturbation.

There are four types of orgasmic dysfunction:

  • Primary anorgasmia: A condition in which you’ve never had an orgasm.
  • Secondary anorgasmia: Difficulty reaching orgasm, even though you’ve had one before.
  • Situational anorgasmia: The most common type of orgasmic dysfunction. It occurs when you can only orgasm during specific situations, such as during oral sex or masturbation.
  • General anorgasmia: An inability to achieve orgasm under any circumstances, even when you’re highly aroused and sexual stimulation is sufficient.
How is orgasmic dysfunction diagnosed?

If you think you have orgasmic dysfunction, you should schedule an appointment with your doctor. Your doctor will be able to diagnose your condition and provide a proper treatment plan. Getting help from your doctor is the best way to ensure that you can fully enjoy sexual activity again.

During your appointment, your doctor will ask questions about your sexual history and perform a physical examination. Your responses and exam results can reveal any underlying causes of orgasmic dysfunction and can help identify other factors that may be contributing to your condition.

Your doctor may refer you to a gynecologist for a follow-up exam. A gynecologist can recommend further treatments for orgasmic dysfunction.

How is orgasmic dysfunction treated?

Treatment for orgasmic dysfunction depends on the cause of the condition. You may need to:

Couples counseling is another popular treatment option. A counselor will help you and your partner work through any disagreements or conflicts you may be having. This can resolve the issues that are occurring both in the relationship and in the bedroom.

In some cases, estrogen hormone therapy may be used. Estrogen can help increase sexual desire or the amount of blood flow to the genitals for heightened sensitivity. Estrogen hormone therapy may involve taking a pill, wearing a patch, or applying a gel to the genitals. Testosterone therapy is another an option. However, the U.S. Food and Drug Administration (FDA) hasn’t approved it for treating orgasmic dysfunction in women.

Some over-the-counter (OTC) products and nutritional supplements may also help women with orgasmic dysfunction. Arousal oils, such as Zestra, warm the clitoris and increase stimulation. These oils may be beneficial to use during sexual intercourse and masturbation.

Make sure you speak with your doctor before using any OTC products or medications. They may cause an allergic reaction or interfere with other medications you’re taking.

What’s the outlook for people with orgasmic dysfunction?

The inability to orgasm can be frustrating and may have an impact on your relationship. However, you may be able to reach climax with proper treatment. It’s important to know that you’re not alone. Many women deal with orgasmic dysfunction at some point in their lives.

If you have orgasmic dysfunction, you may find therapy to be particularly helpful. Part of individual or couples therapy focuses on how you view sexual intercourse. Meeting with a therapist can help you and your partner learn more about one other’s sexual needs and desires. It will also address any relationship issues or everyday stressors that may be contributing to your inability to orgasm. Resolving these underlying causes can help you reach orgasm in the future.

The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) has a directory of certified therapists and resources for women with orgasmic dysfunction. You can also find helpful information on sexual health and orgasms at Go Ask Alice, a sex education website managed by Columbia University.

What Is Sexual Dysfunction?

Sexual dysfunction occurs when you have a problem that prevents you from wanting or enjoying sexual activity. Sexual dysfunction is different from asexuality. It can happen anytime. People of all ages experience sexual dysfunction, although the chances increase as you age.

Stress is a common cause of sexual dysfunction. Other causes include:

  • sexual trauma
  • psychological issues
  • diabetes
  • heart disease or other medical conditions
  • drug use
  • alcohol use
  • certain medications
When does a bad night become a disorder?

Four categories of sexual dysfunction exist. It’s normal not to be in the mood sometimes. None of these should be considered a disorder unless it happens regularly and significantly affects your sexual life:

  • Desire disorder is when you have little or no interest in sexual relations on an ongoing basis.
  • Arousal disorder means you’re emotionally in the mood, but your body isn’t into it.
  • Orgasm disorder means you’re emotionally in the mood, but you have an inability to climax that leaves you frustrated.
  • Pain disorder involves having pain during intercourse.
Libido lowdown

Low testosterone can cause a loss of libido, or sexual desire for any person. For those with female reproductive organs, other contributing factors include:

  • hormonal changes following childbirth
  • breast-feeding
  • menopause

Other causes include:

  • high blood pressure
  • diabetes
  • certain medications
  • relationship problems
  • sexual inhibitions
  • stress
  • fatigue
  • a fear of pregnancy
Sexual dysfunction in penises: Erectile dysfunction (ED)

ED occurs when a penis cannot get or stay erect to engage in intercourse. This can occur due to:

  • a problem with blood flow
  • a nerve disorder
  • an injury to the penis
  • psychological problems, like stress or depression
  • relationship issues
  • Peyronie’s disease
  • chronic illness
  • some medications

Ongoing ED can cause anxiety.

Sexual dysfunction in penises: Ejaculation disorders

Premature ejaculation is ejaculation that happens before or immediately after penetration. This is often a consequence of performance anxiety. It can also be due to:

  • other psychological stressors
  • sexual inhibitions
  • nerve damage
  • spinal cord damage
  • certain medications

Impaired ejaculation occurs when you can’t ejaculate at all. Retrograde ejaculation can happen in people with penises, particularly in those who also have diabetic neuropathy.

During orgasm, ejaculation enters the bladder instead of exiting out of the penis. Although this doesn’t cause major medical issues, it can impair fertility. You should see your doctor about it if you have it.

Sexual dysfunction in vaginas: Pain and discomfort

Many things can cause pain during sexual activity. Inadequate lubrication and tense vaginal muscles make penetration painful. Involuntary vaginal muscle spasms, or vaginismus, can make intercourse hurt. These may be symptoms of neurological, urinary tract, or bowel disorders.

The hormonal changes of menopause can make intercourse uncomfortable. A drop in estrogen levels can result in thinning of the skin in the genital area. It can also thin the vaginal lining and decrease lubrication.

Sexual dysfunction in vaginas: Difficulty having an orgasm

Stress and fatigue are the enemies of orgasm. So are pain and discomfort during sexual activity. Achieving orgasm may not be possible when your sex drive is low or when your hormones are out of whack.

According to Harvard Medical School, the norm for female sexual response isn’t easily measurable and is based on quality. Basically, you don’t have sexual dysfunction if you’re satisfied with your sex life, even if you don’t have orgasms.

When to see your doctor

When sexual problems keep happening, both partners can have anxiety. Things can escalate if you don’t discuss it.

If the situation doesn’t improve or you suspect a physical reason, it’s time to see your doctor. Be prepared to give a complete medical history, including a list of prescription and over-the-counter medications. Tell your doctor the specifics of your problem.

Your doctor will begin with a physical exam. Depending on the outcome, this may be followed by a diagnostic testing. If they don’t find a physical cause, consider seeing a therapist.

Treating physical causes

Treatment depends on the specific cause. Sometimes, treating an underlying medical condition will resolve the situation. In some cases, switching medications may work.

ED treatment has advanced a lot in recent years. Many men have positive results using prescription medications like Viagra. Other remedies include mechanical aids, penile implants, or surgery.

Lubricating gels or creams or hormone therapy may solve the problem of vaginal dryness.

Treating psychological causes

Psychological counseling may help. A therapist can teach you how to cope with stress and anxiety. Joint counseling with your partner can help improve communication and increase intimacy.

Sometimes, support and education about sexual behavior are all that you need. You can address body image and other inhibitions in counseling. For deeply rooted sexual dysfunction, psychotherapy may be necessary.

Long-term outlook

Often, the longer a sexual dysfunction goes on, the more your level of stress and anxiety rises. This can perpetuate the problem. Most of the time, the outlook for people with sexual dysfunction is quite good. However, some medical conditions make it more difficult to overcome.

You can reverse sexual dysfunction due to stress or temporary circumstances if you approach them openly. Deep-seated psychological issues may take longer to manage or may never fully resolve, but you can improve them.

Points to ponder

Communication is important. If you have any type of sexual dysfunction, talk to your partner. Don’t hesitate to seek medical advice. The National Institutes of Health urge victims of sexual assault to seek counseling.

You’re more likely to experience sexual dysfunction if you abuse alcohol or drugs. Before taking a new medication, learn about the potential side effects. You should take them only as directed.

Sexual dysfunction happens to most people at one time or another. If it becomes an ongoing problem, you should seek help.

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