This post is part of a series of guest posts on GPS by the graduate students in my Psychopathology course. As part of their work for the course, each student had to demonstrate mastery of the skill of “Educating the Public about Mental Health.” To that end, each student has to prepare three 1,000ish word posts on a particular class of mental disorders, with one of those focusing on changes made from the DSM-IV to the DSM-5.
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Female Orgasmic Disorder: Contributing Factors & Treatments by Ann O. Nonymous
Female Orgasmic Disorder is the continuous or frequent inability of a woman to have an orgasm, climax or sexual release, after sufficient sexual arousal and sexual stimulation. The decrease in responsiveness can be primary, in which a woman has never experienced an orgasm, or secondary, in which the decrease in responsiveness is obtained after a trauma. The decrease in responsiveness can be either general or specific to certain situations. Physiological and psychological causes are both reasons for a woman’s inability to experience an orgasm.
In typical situations, an orgasm is achieved when a woman is sexually aroused and the blood vessels in the pelvic area increase in size, which allows for more blood to flow to the genitals. The increase in blood flow is followed by fluid leaking out of the blood vessels and into the vagina to supply lubrication before and during sex. Tension in the body and blood flow to the pelvic area continues to increase as a woman encounters more sexual stimulation. Sexual stimulation occurs when a woman receives direct pressure on the clitoris or pressure on the walls of the vagina and cervix. Tension increases as blood flow increases. As tension is released, pleasurable contractions of the uterus and vagina are experienced by the woman. The release of the tension is know as an “orgasm.”
In Female Orgasmic Disorder, the sexual arousal and lubrication occur, just as in the typical orgasm situation. But, even though body tension increases, a woman is not capable of or has a lot of trouble reaching climax and releasing the tension. The inability to orgasm can lead to frustration and unsatisfying sexual experiences for both partners. A woman can develop anger, frustration, and other relational problems when an orgasm is unable to be achieved. Many physiological and psychological causes are to be considered for Female Orgasm Disorder.
Many factors contribute to orgasmic dysfunctions. Physiological causes of Female Orgasm Disorder involve specific biological dysfunctions in a woman’s body. Physiological causes include the following: medication side effects, damage to the blood vessels of the pelvic region, spinal cord lesions, damage to the nerves in the pelvic area, and removal of the clitoris from cultural genital mutilation. Psychological causes have to do with the emotional and mental aspect of a woman. Psychological causes include the following: self-image issues, relational problems, stresses, guilt about sexual pleasure, religious or cultural beliefs, emotional abuse, past sexual abuse, fear of pregnancy, fear of rejection, and other mental health disorders, such as major depression. Female Orgasm Disorder is more likely to have psychological causes versus physical causes. Studies have shown that about 50% of all women experience some orgasmic difficulties, but not all difficulties are considered to be Female Orgasm Disorder. Studies suggest that at least 10% of women never experience an orgasm, while up to 50% of women can only experience an orgasm through direct clitoral stimulation. Female Orgasm Disorder can also be diagnosed along with other disorders. A differential diagnostic process must be in place in order to develop a treatment plan.
The diagnosis of Female Orgasm Disorder is accomplished through a medical and psychological history. A clinician must also asses the history of the condition for a woman in which the failure of orgasm occurs. The frequency and duration of the problem must be explored. In some cases, the comorbidity of Female Sexual Interest/Arousal Disorder and Female Orgasm Disorder are the diagnosis. The comorbidity of the two disorders makes the diagnosis more complex. According to the American Psychiatric Association (APA), Female Orgasm Disorder cannot be diagnosed if the inability to climax is due only to physiological factors. Also, if Female Orgasm Disorder is a symptom of another major psychological disorder, then Female Orgasm Disorder cannot be considered as a diagnosis. Once a diagnosis has been put in place, then a treatment plan can be established.
Treatment is determined by the cause of the Female Orgasm Disorder. If physical issues are the reasons for a woman’s inability to be achieve orgasm, then the root of the problem is treated. In other situations, different methods are considered as a combination to treat the problem. Education is provided to teach a woman and her partner about the disorder. Counseling provides a woman and her partner an opportunity to process information. Another method involves psychotherapy, which allows for therapeutic interaction and treatment between a woman, her partner, and a trained professional. Psychotherapy also helps resolve tension in relationships that develops because of Female Orgasm Disorder. A woman and her partner can also participate in sex therapy in which therapists have specific training to help a woman and her partner concentrate on dealing with and overcoming Female Orgasm Disorder. In couples therapy, a woman and her partner complete assignments that concentrate on relaxation techniques, sexual exploration, and sexual communication. With the mentioned treatments, the prognosis is positive.
With appropriate treatment, a woman can experience orgasms again. But, even with treatment and the ability to experience orgasms again, a woman may not experience orgasms every time or in every situation. A woman may also not be completely satisfied with the result of the orgasm, as the climax may not be to the strength or quality she is expecting of an orgasm. Working through relational issues can enhance treatment and increase the prognosis of overcoming Female Orgasm Disorder. The process takes time and requires both the woman and her partner to be committed to solving the problem.
Female Orgasm Disorder can be frustrating and stressful for both the woman and her partner. Success in overcoming the disorder takes patience, commitment, and dedication. Seeking the right treatment options and plan play a valuable part in overcoming the disorder. It is important for a woman and her partner to understand Female Orgasm Disorder so they can provide positive support and understanding for each other.
