Anorgasmia

Anorgasmia is a form of sexual dysfunction sometimes classified as a psychiatric disorder in which the patient cannot achieve orgasm, even with "adequate" stimulation. It is an inhibition of the orgasmic phase of the sexual response cycle. For some men the disorder presents itself in terms of an inability to reach orgasm only during sex. In such cases it is often possible for orgasm to be reached but only after prolonged and intense non-intercourse stimulation.

Proposed explanations have included lack of sexual education, strong religious upbringing, lack of strength in the woman’s pubococcygeus muscle, past sexual abuse, impotence or early ejaculation in male partner, and high levels of anxiety associated with sex.

Primary anorgasmia is a condition where one has never experienced an orgasm. This is significantly more common in women, although it can occur in men who lack the gladipudendal
reflexes. Women with this condition can sometimes achieve a relatively low level of sexual excitement and may think of intercourse or other sexual activities as pleasant despite their inability to orgasm. They may get most of their reward from touching, holding, kissing, caressing, attention, and approval. However, women who regularly achieve high levels of sexual response
without orgasmic release of tension may find the experience frustrating. Emotional irritability, restlessness, and pelvic pain or a heavy pelvic sensation may occur because of vascular engorgement.

Women with this condition can sometimes achieve a relatively low level of sexual excitement and may think of intercourse or other sexual activities as pleasant despite their inability to orgasm. They may get most of their reward from touching, holding, kissing, caressing, without orgasmic release of tension may find the experience frustrating. Emotional irritability, restlessness, and pelvic pain or a heavy pelvic sensation may occur because of vascular engorgement.

Women who have not yet had an orgasm usually have some combination of the following:
* Sociocultural inhibitions that interfere with normal sexual response.
* Unresolved feelings towards a traumatic sexual experience as in sexual abuse or rape.
* A lack of knowledge about sex and sexuality, which interferes with normal sexual development.
* A lack of opportunity to practice in a safe, secure, socially acceptable, and a private
atmosphere (only two partaking) in a situation that offers approval and support.
* A partner who has primary or secondary difficulty in achieving an erection.
* Dyspareunia, or painful intercourse.
* Genital mutilation ("female circumcision") that removes part or all of the clitoris, scars the genital area, or constricts the opening to the vagina. Often, vaginal intercourse is painful not only because of scarring from this procedure but also because of associated infection.

Secondary anorgasmia

Secondary anorgasmia is the loss of the ability to have orgasms. The cause may be alcoholism, depression, grief, pelvic surgery or injuries, certain medications, illness, estrogen deprivation associated with menopause or an event that has violated the patient's sexual value system.

Situational anorgasmia

Women who are orgasmic in some situations may not be in others. A woman may have an orgasm from one type of stimulation but not from another. Or a woman may achieve orgasm with one partner but not another, or have an orgasm only under certain conditions or only with a sexual expression.

Doctors believe that a woman with situational anorgasmia should be encouraged to explore alone and with her partner those factors that may affect whether or not she is orgasmic, such as fatigue, emotional concerns, feeling pressured to have sex when she is not interested, or her partner's sexual dysfunction.

Random anorgasmia

Some women are orgasmic but not in enough instances to satisfy their sense of what is appropriate or desirable. Often such women have trouble momentarily giving up control and
allowing themselves to respond fully. Therapy can be aimed at helping them give up the need to keep their sexual feelings under control at all times.

Treatment


Effective treatment for anorgasmia depends on the cause. In the case of a women suffering from psychological sexual trauma or inhibition, psychosexual counselling might be advisable and could be obtained through GP referral.

Women suffering from anorgasmia with no obvious psychological cause would need to be examined by their GP to check for absence of disease. Blood tests would also need to be done to check for other conditions such as diabetes, lack of ovulation, low thyroid function or hormone imbalances. They would then need to be referred to a consultant specialising in female sexual dysfunction. Just as with erectile dysfunction in men lack of sexual function in women may be treated with hormones to correct imbalances, clitoral vacuum pump devices or medication to improve blood flow and sexual sensation.